| 1. |
- Andersson, Morgan, et al.
(author)
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Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology dense environments : Is it possible to feel at home in a patient room in an intensive care unit?
- 2019
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In: Nursing Inquiry. - London : Wiley-Blackwell Publishing Inc.. - 1320-7881 .- 1440-1800.
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Journal article (peer-reviewed)abstract
- This paper focuses on the patient’s perspective and the philosophical underpinnings that support what might be considered optimal for the future design of the Intensive Care Unit (ICU) patient room. It also addresses the question of whether the aspects that support at-homeness are applicable to ICU patient rooms. The concept of ‘at-homeness’ in ICUs is strongly related to privacy and control of space and territory. This study investigates whether the sense of at-homeness can be created in an ICU, when one or more patients share a room. From an interdisciplinary perspective, we critically reflect on various aspects associated with conflicts surrounding the use of ICU patient rooms. Thus, from an architectural and a caring perspective, the significance of space and personal territory in ICU patient rooms is emphasized. Recommendations for further research are suggested. In conclusion, privacy and control are deemed to be essential factors in the stimulation of recovery processes and the promotion of wellbeing in situations involving severe illness or life-threatening conditions.
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| 2. |
- Andersson, Morgan, 1965, et al.
(author)
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Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology-dense environments
- 2019
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In: Nursing Inquiry. - : Wiley. - 1440-1800 .- 1320-7881. ; 26:4
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Journal article (peer-reviewed)abstract
- This paper focuses on the patient's perspective and the philosophical underpinnings that support what might be considered optimal for the future design of the intensive care unit (ICU) patient room. It also addresses the question of whether the aspects that support at-homeness are applicable to ICU patient rooms. The concept of “at-homeness” in ICUs is strongly related to privacy and control of space and territory. This study investigates whether the sense of at-homeness can be created in an ICU, when one or more patients share a room. From an interdisciplinary perspective, we critically reflect on various aspects associated with conflicts surrounding the use of ICU patient rooms. Thus, from an architectural and a caring perspective, the significance of space and personal territory in ICU patient rooms is emphasized. Recommendations for further research are suggested. In conclusion, privacy and control are deemed to be essential factors in the stimulation of recovery processes and the promotion of well-being in situations involving severe illness or life-threatening conditions.
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| 3. |
- Bazzi, May, 1979, et al.
(author)
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Collaboration in the Hybrid Operating Room: A Focus Group Study From the Perspective of the Nursing Staff
- 2021
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In: Journal of Radiology Nursing. - : Elsevier BV. - 1546-0843 .- 1555-9912. ; 40:3, s. 259-267
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Journal article (peer-reviewed)abstract
- Technical advancements in the operating room setting continue, and the concept of the hybrid operating room is promoted and accepted worldwide. The hybrid setting means inclusion of radiology in the already complex environment of a traditional operating room. Collaboration in this type of environment becomes essential and investigating how the nursing staff experiences this collaboration in the hybrid operating room is needed. The aim of the study was to investigate how the nursing staff from the specialties of surgery, anesthesiology, and radiology experienced collaborating in a hybrid operating room. Explorative qualitative design was used. Five focus groups consisting of operating room nurses, operating room assistant nurses, nurse anesthetists, assistant nurse anesthetists, and radiographers were included in the study. Interviews using semistructured questions were conducted. Directive content analysis was used for the data analysis. The following categories revealed: (1) different patient safety perspectives; (2) responsibilities being shared and divided; (3) collaboration becoming better over time; (4) uneven division of labor in a strained work situation and different terms of employment; (5) lack of education and joint meetings; and (6) environmental constraints for satisfying collaboration. The nursing staff in the hybrid operating room highlighted they worked toward a common goal but prioritized their own specific tasks rather than the procedure as a whole. This, together with the uneven task distribution and unclear responsibilities, could create tension between the different staff categories, impacting procedures negatively. The results revealed the importance of proper preparation of the staff to work in the hybrid operating room. Having team building activities, common meetings, relevant training to meet educational needs, and adjusting the team composition could improve hybrid operating room collaboration and improve patient safety and outcomes. © 2021 Association for Radiologic & Imaging Nursing
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| 4. |
- Bazzi, May, 1979, et al.
(author)
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Patients' lived experiences of waiting for and undergoing endovascular aortic repair in a hybrid operating room: A qualitative study
- 2020
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 29:5-6, s. 810-820
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Journal article (peer-reviewed)abstract
- Aims and objectives The overall aim of the study was to illuminate the patients' lived experiences of waiting for and undergoing an endovascular aortic repair (EVAR) in a hybrid operating room (OR). Background The hybrid OR is an example of the technological advancements within hospitals. The environmental impact on humans is well recognised but is rarely taken into account when hospitals are designed or rebuilt. The patient's experience of a hybrid OR is not earlier described. Design A qualitative design based on hermeneutic phenomenology was implemented. Methods Interviews were conducted with 18 patients. A thematic interpretation based on van Manen's approach was then used to analyse the findings. The consolidated criteria for reporting qualitative studies (COREQ) were used (Data S1). Results The following three themes emerged from the interviews: (a) being scheduled for surgery induced both anxiety and hopefulness; (b) feeling watched over and surrendering to others in the technology intense environment and (c) feeling relief but unexpected exhaustion after surgery. In the discussion, the results were additionally reflected upon out from the four lifeworld existentials: lived body, lived space, lived time and lived others. Conclusions The hybrid OR technology did not frighten the patients, but it was also not an environment that promoted or was conductive to having a dialogue with the staff. The disease and surgery brought feelings of anxiety, which was largely associated with the uncertainty of the situation. We suggest that continuity in contact with staff and patient-centred information could be solutions to further calm the patients. Relevance to clinical practice The hybrid OR environment itself did not seem to frighten the patient, but the way the high-tech environment increased the distance between the patient and the multiple staff members needs further investigation.
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| 5. |
- Bazzi, May, 1979, et al.
(author)
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Team composition and staff roles in a hybrid operating room: A prospective study using video observations
- 2019
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In: Nursing Open. - : Wiley. - 2054-1058. ; 6:3, s. 1245-1253
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Journal article (peer-reviewed)abstract
- Aim The aim of the study was to evaluate team composition and staff roles in a hybrid operating room during endovascular aortic repairs. Design Quantitative descriptive design. Methods Nine endovascular aortic repairs procedures were video-recorded between December 2014 and September 2015. The data analysis involved examining the work process, number of people in the room and categories of staff and their involvement in the procedure. Results The procedures were divided into four phases. The hybrid operating room was most crowded in phase 3 when the skin wound was open. Some staff categories were in the room for the entire procedure even if they were not actively involved. The largest number of people simultaneously in the room was 14.
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| 6. |
- Bazzi, May, 1979, et al.
(author)
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The drama in the hybrid OR: Video observations of work processes and staff collaboration during endovascular aortic repair
- 2019
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In: Journal of Multidisciplinary Healthcare. - 1178-2390. ; 12, s. 453-464
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Journal article (peer-reviewed)abstract
- Introduction: A hybrid operating room (OR) is a surgical OR with integrated imaging equipment and the possibility to serve both open surgery and image-guided interventions. Aim: This study aimed to investigate the work processes and types of collaboration in a hybrid OR during endovascular aortic repair (EVAR). Methods: Data consisted of video recordings from nine procedures, with a total recording time of 48 hrs 39 mins. The procedures were divided into four episodes (Acts). A qualitative cross-case analysis was conducted, resulting in a typical case. The type of collaboration during specific tasks was discussed and determined based on Thylefors' team typology. Results: An extensive amount of safety activities occurred in the preparation phase (Acts 1 and 2), involving a number of staff categories. After the skin incision (Act 3), the main activities were performed by fewer staff categories, while some persons had a standby position and there were persons who were not at all involved in the procedure. Discussion: The different specialist staff in the hybrid OR worked through different types of collaboration: multi-, inter-and transprofessional. The level of needed collaboration depended on the activity performed, but it was largely multiprofessional and took place largely in separate groups of specialties: anesthesiology, surgery and radiology. Waiting time and overlapping tasks indicate that the procedures could be more efficient and safe for the patient. Conclusion: This study highlights that the three expertise specialties were required for safe treatment in the hybrid OR, but the extent of interprofessional activities was limited. Our results provide a basis for the development of more effective procedures with closer and more efficient interprofessional collaboration and reduction of overlapping roles. Considerable waiting times, traffic flow and presence of people who were not involved in the patient care are areas of further investigation. © 2019 Bazzi et al.
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| 7. |
- Björk, Kristofer, 1985-, et al.
(author)
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Family members’ experiences of waiting in intensive care: a concept analysis
- 2019
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In: Scandinavian Journal of Caring Sciences. - London : Wiley. - 0283-9318 .- 1471-6712. ; , s. 1-18
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Journal article (peer-reviewed)abstract
- AIM:The aim of this study was to explore the meaning of family members' experience of waiting in an intensive care context using Rodgers' evolutionary method of concept analysis.METHOD:Systematic searches in CINAHL and PubMed retrieved 38 articles which illustrated the waiting experienced by family members in an intensive care context. Rodgers' evolutionary method of concept analysis was applied to the data.FINDINGS:In total, five elements of the concept were identified in the analysis. These were as follows: living in limbo; feeling helpless and powerless; hoping; enduring; and fearing the worst. Family members' vigilance regarding their relative proved to be a related concept, but vigilance does not share the same set of attributes. The consequences of waiting were often negative for the relatives and caused them suffering. The references show that the concept was manifested in different situations and in intensive care units (ICUs) with various types of specialties.CONCLUSIONS:The application of concept analysis has brought a deeper understanding and meaning to the experience of waiting among family members in an intensive care context. This may provide professionals with an awareness of how to take care of family members in this situation. The waiting is inevitable, but improved communication between the ICU staff and family members is necessary to reduce stress and alleviate the suffering of family members. It is important to acknowledge that waiting cannot be eliminated but family-centred care, including a friendly and welcoming hospital environment, can ease the burden of family members with a loved one in an ICU.
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| 8. |
- Engwall, Marie, et al.
(author)
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Let there be light and darkness : findings from a prestudy concerning cycled light in the intensive care unit environment.
- 2014
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In: Critical Care Nursing Quarterly. - : Wolters Kluwer Health Lippincott Williams & Wilkins. - 0887-9303 .- 1550-5111. ; 37:3, s. 273-298
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Journal article (peer-reviewed)abstract
- The present study reports findings concerning light in an intensive care unit setting presented from 3 aspects, giving a wide view. The first part is a systematic review of intervention studies concerning cycled light compared with dim light/noncycled light. The findings showed that cycled light may be beneficial to preterm infant health. Second, a lighting intervention in the intensive care unit is presented, comparing and assessing experience of this lighting environment with that of an ordinary room. Significant differences were shown in hedonic tone, favoring the intervention environment. In the third part, measured illuminance, luminance, and irradiance values achieved in the lighting intervention room and ordinary room lighting are reported.
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| 9. |
- Engwall, Marie, et al.
(author)
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Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit
- 2015
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In: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 31:6, s. 325-335
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Journal article (peer-reviewed)abstract
- Patients in an intensive care unit (ICU) may risk disruption of their circadian rhythm. In an intervention research project a cycled lighting system was set up in an ICU room to support patients' circadian rhythm. Part I aimed to compare experiences of the lighting environment in two rooms with different lighting environments by lighting experiences questionnaire. The results indicated differences in advantage for the patients in the intervention room (n=48), in perception of daytime brightness (p =0.004). In nighttime, greater lighting variation (p =0.005) was found in the ordinary room (n = 52). Part II aimed to describe experiences of lighting in the room equipped with the cycled lighting environment. Patients (n=19) were interviewed and the results were presented in categories: "A dynamic lighting environment", "Impact of lighting on patients' steep", The impact of lighting/lights on circadian rhythm" and The Lighting calms". Most had experiences from sleep disorders and half had nightmares/sights and circadian rhythm disruption. Nearly all were pleased with the cycled lighting environment, which together with daylight supported their circadian rhythm. In night's actual lighting levels helped patients and staff to connect which engendered feelings of calm. (C) 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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| 10. |
- Engwall, Marie, et al.
(author)
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Patients' Self-Reported Recovery After an Environmental Intervention Aimed to Support Patient's Circadian Rhythm in Intensive Care
- 2021
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In: Herd-Health Environments Research & Design Journal. - : SAGE Publications. - 1937-5867 .- 2167-5112. ; 14:4, s. 194-210
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Journal article (peer-reviewed)abstract
- Background: Patients in intensive care units (ICUs) are among the most vulnerable, and they require support to start their recovery. The design of the patient area in the ICU can play a prominent role in both the quality of care and patients' recovery. The lighting environment has the opportunity to restore and strengthen the natural human circadian rhythm and health. Aim: To evaluate patients' self-reported recovery after being cared for in an ICU room rebuilt according to evidence-based design principles that promote recovery. Method: An intervention was set up in a two-bed patient room including a cycled lighting system. Self-reported recovery was reported at 6 and 12 months after discharge. Data were analyzed using a 2(mechanically ventilated, nonmechanically ventilated) x 2(intervention room, ordinary room) analysis of covariance (ANCOVA) and 2(male, women) x 2(intervention room, ordinary room) ANCOVA. Results: Data from the different rooms showed no significant main effects for recovery after 6 months, p = .21; however, after 12 months, it become significant, p. < .05. This indicated that patient recovery was positively influenced for patients cared for in the intervention room (M = 8.88, SD = 4.07) compared to the ordinary room (M = 10.90, SD = 4.26). There were no interaction effects for gender or if the patients had been mechanically ventilated either at 6 or 12 months' postdischarge. Conclusions: A cycled lighting system may improve patient self-reported recovery after ICU care; however, more research on the topic is needed.
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