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The Impact of the Built Environment on Patient Falls in Hospital Rooms: An Integrative Review.

Authors
  • Pati, Debajyoti1
  • Valipoor, Shabboo2
  • Lorusso, Lesa2
  • Mihandoust, Sahar1
  • Jamshidi, Saman1
  • Rane, Apoorva1
  • Kazem-Zadeh, Mahshad3
  • 1 From the Department of Design, College of Human Sciences, Texas Tech University, Lubbock, Texas.
  • 2 Department of Interior Design, College of Design, Construction and Planning, University of Florida.
  • 3 Rinker School of Construction Management, College of Design, Construction and Planning, University of Florida, Gainesville, Florida.
Type
Published Article
Journal
Journal of patient safety
Publication Date
Jun 01, 2021
Volume
17
Issue
4
Pages
273–281
Identifiers
DOI: 10.1097/PTS.0000000000000613
PMID: 31157738
Source
Medline
Language
English
License
Unknown

Abstract

The aims of this study were to identify and evaluate scientific evidence examining the impact of the built environment on patient falls in hospital rooms. An integrative review (IR) with a systematic literature search was performed using the patient, intervention, comparison, outcome framework. We searched CINAHL, PsychINFO, PubMED, and Web of Science databases. The search included peer-reviewed studies from 1990 to 2017 written in English. An additional hand search was also conducted. Selected articles were reviewed and rated based on a hierarchical categorization, comprising six evidence levels, developed by the American Association of Critical-Care Nurses and adapted for evidence-based design systematic literature reviews. After a multitiered process, 30 articles met the selection criteria. Thematic areas were created based on the examined elements of the physical environment including patient room configuration and available space, bathroom configuration, bathtub and shower, door, bed height and bed rail, flooring, floor mats, patient chair, lighting, toilet, handrail, grab bars, intravenous pole, sink, ceiling lift, and wheelchair and walking aids. Findings of studies on each element are discussed in detail. Some environmental elements have not been examined in past relational or causal studies, and the level of evidence for the examined attributes is not high enough to gain robust confidence in healthcare design decision-making. Because of the low level of evidence for several environmental elements, conclusions must be taken with caution. More studies using quantitative, relational, or causal designs are recommended to develop actionable interventions on patient falls in hospital rooms. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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