Developing Scales to Evaluate Staff Perception of the Effects of the Physical Environment on Patient Comfort, Patient Safety, Patient Privacy, Family Integration With Patient Care, and Staff Working Conditions in Adult Intensive Care Units

Abstract

Studies suggest that the physical environment can be important for patient comfort, patient safety, patient privacy, family integration with patient care, and staff working condition in adult intensive care units (ICUs). In the absence of any measuring scales, however, evaluations of the physical environment of ICUs in terms of any of these dimensions have remained vague. For rigorous evaluations of ICU designs from the viewpoint of clinical staff, a self-report instrument with several multiple-item scales was created. These scales were tested in a pilot survey that was administered among a small group of nurse managers and ICU directors at several best practice example sites. Reliability analysis of the survey data showed some scales to be internally consistent. For the other scales, factor analysis revealed multiple components, which were then combined to create additional subscales. Using these scales and subscales, the underlying effects of design on staff perception were studied at the best practice example sites that participated in the pilot survey. The results, limitations, and the future directions of the study are discussed.