Hospital Environment Research Articles

Toward Restorative Hospital Environment: Nature and Art in Finnish Hospitals.

This study explores the integration of nature and art in recent hospital construction projects in Finland, focusing on public hospitals. Interviews with 15 stakeholders, including hospital executives, workers, designers, artists, and architects, reveal the value placed on nature and nature-themed art in hospital settings. The research question presented was: How nature and art are incorporated in Finnish hospitals in order to achieve a restorative hospital environment? Findings highlight themes that appeared in different hospitals: (1) the desired atmosphere, (2) nature and multisensory experiences, (3) social support, and (4) sense of connection and belonging. Bringing nature inside the hospital, whether through natural elements or artworks, emerges as a promising approach. Despite positive outcomes, challenges such as cost and maintenance persist, indicating the need for further research to optimize these initiatives. Overall, incorporating nature and art in hospitals has the potential to enhance healing and well-being for patients, families, and healthcare workers.

Fog-assisted healthcare framework for smart hospital environment

Fog-assisted healthcare framework for smart hospital environment

Hospital Wastes as Potential Sources for Multi-Drug-Resistant ESBL-Producing Bacteria at a Tertiary Hospital in Ethiopia.

The hospital environment is increasingly becoming an important reservoir for multi-drug-resistant (MDR) Gram-negative bacteria, posing serious challenges to efforts to combat antimicrobial resistance (AMR). This study aimed to investigate the role of hospital waste as a potential source of MDR ESBL-producing bacteria. Samples were collected from multiple sources within a hospital and its vicinity, including surface swabs, houseflies, and sewage samples. The samples were subsequently processed in a microbiology laboratory to identify potential pathogenic bacteria and confirmed using MALDI-TOF MS. Bacteria were isolated from 87% of samples, with the predominant isolates being E. coli (30.5%), Klebsiella spp. (12.4%), Providencia spp. (12.4%), and Proteus spp. (11.9%). According to the double disc synergy test (DDST) analysis, nearly half (49.2%) of the bacteria were identified as ESBL producers. However, despite exhibiting complete resistance to beta-lactam antibiotics, 11.8% of them did not test positive for ESBL production. The characterization of E. coli revealed that 30.6% and 5.6% of them carried blaCTX-M group 1 type-15 and blaNDM genes, respectively. This finding emphasizes the importance of proper hospital sanitation and waste management practices to mitigate the spread of AMR within the healthcare setting and safeguard the health of both patients and the wider community.

An Antimicrobial Copper-Plastic Composite Coating: Characterization and In Situ Study in a Hospital Environment.

A method has been proposed for creating an operationally durable copper coating with antimicrobial properties for the buttons of electrical switches based on the gas dynamic spray deposition of copper on acrylonitrile butadiene styrene (ABS) plastic. It is shown that during the coating process, a polymer film is formed on top of the copper layer. Comparative in situ studies of microbial contamination have shown that the copper-coated buttons have a significant antimicrobial effect compared to standard buttons. Analysis of swabs over a 22-week study in a hospital environment showed that the frequency of contamination for a copper-coated button with various microorganisms was 2.7 times lower than that of a control button. The presented results allow us to consider the developed copper coating for plastic switches an effective alternative method in the fight against healthcare-associated infections.

Decision discovery using clinical decision support system decision log data for supporting the nurse decision-making process.

Decision-making in healthcare is increasingly complex; notably in hospital environments where the information density is high, e.g., emergency departments, oncology departments, and psychiatry departments. This study aims to discover decisions from logged data to improve the decision-making process. The Design Science Research Methodology (DSRM) was chosen to design an artifact (algorithm) for the discovery and visualization of decisions. The DSRM's different activities are explained, from the definition of the problem to the evaluation of the artifact. During the design and development activities, the algorithm itself is created. During the demonstration and evaluation activities, the algorithm was tested with an authentic synthetic dataset. The results show the design and simulation of an algorithm for the discovery and visualization of decisions. A fuzzy classifier algorithm was adapted for (1) discovering decisions from a decision log and (2) visualizing the decisions using the Decision Model and Notation standard. In this paper, we show that decisions can be discovered from a decision log and visualized for the improvement of the decision-making process of healthcare professionals or to support the periodic evaluation of protocols and guidelines.

A Clinical Trial Evaluating the Efficacy of Deep Learning-Based Facial Recognition for Patient Identification in Diverse Hospital Settings.

Facial recognition systems utilizing deep learning techniques can improve the accuracy of facial recognition technology. However, it remains unclear whether these systems should be available for patient identification in a hospital setting. We evaluated a facial recognition system using deep learning and the built-in camera of an iPad to identify patients. We tested the system under different conditions to assess its authentication scores (AS) and determine its efficacy. Our evaluation included 100 patients in four postures: sitting, supine, and lateral positions, with and without masks, and under nighttime sleeping conditions. Our results show that the unmasked certification rate of 99.7% was significantly higher than the masked rate of 90.8% (p < 0.0001). In addition, we found that the authentication rate exceeded 99% even during nighttime sleeping. Furthermore, the facial recognition system was safe and acceptable for patient identification within a hospital environment. Even for patients wearing masks, we achieved a 100% success rate for authentication regardless of illumination if they were sitting with their eyes open. This is the first systematical study to evaluate facial recognition among hospitalized patients under different situations. The facial recognition system using deep learning for patient identification shows promising results, proving its safety and acceptability, especially in hospital settings where accurate patient identification is crucial.

The Influence of Noise Level on the Stress Response of Hospitalized Cats.

The study aimed to investigate the impact of noise levels in the hospital environment on the stress experienced by hospitalized cats undergoing elective ovariohysterectomy surgery. A total of 33 domestic female cats were included in the study, divided into four groups: a control group (CG) and three experimental groups based on ward noise levels: G1 (Quiet, <60 dB), G2 (Medium, between 60 and 85 dB), and G3 (Noisy, >85 dB). Behavioral assessments, respiratory rate (RR), and plasma cortisol levels ([Cort]p) were measured as indicators of stress. A composite measure of stress, termed the final stress value (FSV), was calculated by summing scores across various behavioral categories. Data collection occurred at three time points: immediately following surgery (T1), and at 2 h (T2) and 3 h (T3) post-surgery. FSV and RR were assessed at all three time points (T1, T2, and T3), while [Cort]p levels were measured at T1 and T3. The study observed that the median values of FSV, RR, and [Cort]p tended to increase with both higher noise levels and longer exposure durations to noise. Significant differences in RR were found between group pairs G1G2 at T1 (|D| = 0.63 < cut-off = 0.98), and G2G3 at T2 (|D| = 0.69 < cut-off = 0.97). Regarding [Cort]p, significant differences were noted between the CGG1 group pair at T0 (p < 0.01), and T3 (p = 0.03). Furthermore, an excellent Spearman correlation coefficient (rho = 0.91) was found between FSV and RR, indicating that RR can serve as an effective tool for assessing stress levels in cats. The findings of this study provide valuable insights into the welfare of cats in a hospital environment and support the scientific validity of existing recommendations aimed at improving their well-being. Specifically, the study underscores the importance of minimizing noise levels in hospitals as a means to reduce stress in cats. This conclusion aligns with existing guidelines and recommendations for enhancing the welfare of hospitalized cats.

Performance measurement of factors affecting consumer experience in healthcare services using fuzzy and grey techniques

PurposeThe importance of consumer experience in service industries, particularly healthcare, is widely acknowledged as it captures the intricacies of quality management. In tandem with the emerging research trends that evaluate service excellence through user experience, this study renders a performance analysis of the dimensions of consumer experience that individually or collectively shape healthcare consumers’ perceptions of service quality.Design/methodology/approachA cross-sectional study was conducted across 13 mid-tier corporate hospitals to collect data from 438 patients. The data was processed through factor analysis in SPSS to confirm sample adequacy and factor extractability. Further, two independent multi-criteria decision-making (MCDM) tools, Fuzzy Technique for Order Performance by Similarity to Ideal Solution (F-TOPSIS) and Grey Relational Analysis (GRA), were executed to render performance analysis of identified factors.FindingsUsing F-TOPSIS, factors such as “information” and “hospital environment” received higher performance ratings, while items related to “communication with doctors” and “humanistic care” received lower rankings. Minor yet anticipated deviations were observed while verifying performance scores using GRA. Nonetheless, both outcomes exhibited a strong correlation coefficient of 97.14%, confirming analytical consistency.Originality/valueHitherto, such usages of hybrid MCDM techniques have rarely been executed to convey a clear understanding of consumers’ experiences in healthcare services. Moreover, the findings provide a clear insight into consumers’ key response areas, which can further be translated to maximize consumer gratification, thus assisting healthcare managers in improving service performance and clinical decision-making.

Random Body Movement Removal Using Adaptive Motion Artifact Filtering in mmWave Radar-Based Neonatal Heartbeat Sensing

In response to the pressing requirement for prompt and precise heart rate acquisition during neonatal resuscitation, an adaptive motion artifact filter (AMF) is proposed in this study, which is based on the continuous wavelet transform (CWT) approach and takes advantage of the gradual, time-based changes in heart rate. This method is intended to alleviate the pronounced interference induced by random body movement (RBM) on radar detection in neonates. The AMF analyzes the frequency components at different time points in the CWT results. It extracts spectral peaks from each time slice of the frequency spectrum and correlates them with neighboring peaks to identify the existing components in the signal, thereby reducing the impact of RBM and ultimately extracting the heartbeat component. The results demonstrate a reliable estimation of heart rates. In practical clinical settings, we performed measurements on multiple neonatal patients within a hospital environment. The results demonstrate that even with limited data, its accuracy in estimating the resting heart rate of newborns surpasses 97%, and during infant movement, its accuracy exceeds 96%.

Exploring the dark side of informal mentoring: Experiences of nurses and midwives working in hospital settings in Uganda.

Mentoring literature explores the dark side of mentoring as factors such as gender and race and how they affect the overall mentoring experience. The sociocultural context of the nursing and midwifery professions presents unique characteristics warranting a qualitative exploration of negative mentoring experiences. We aimed to characterise the dark side of mentoring based on informal mentoring relationships occurring among nurses and midwives working in hospitals. Utilising semistructured interviews in a qualitative descriptive design and reflexive thematic analysis, we examined the perceptions of 35 nurses and midwives from three public hospitals located in the Western, Northern and North-western regions of Uganda. Findings emerged in four overarching themes mentoring process deficits, mentoring relational problems, organisational challenges in mentoring and implications of negative mentoring experiences. Our study findings underscore that, while mentoring is frequently beneficial, it can also be interspersed with negative experiences arising from relational dynamics, particular mentoring processes and the overarching hospital environment. Notably, nurses and midwives actively transformed these challenges into opportunities for growth and self-improvement, while introspectively examining their roles in contributing to these negative experiences. Such a proactive approach highlights their resilience and steadfast commitment to professional development, even in the face of adversity.

Designing Socially Assistive Robots

Socially assistive robots (SARs) are becoming more prevalent in everyday life, emphasizing the need to make them socially acceptable and aligned with users' expectations. Robots' appearance impacts users' behaviors and attitudes towards them. Therefore, product designers choose visual qualities to give the robot a character and to imply its functionality and personality. In this work, we sought to investigate the effect of cultural differences on Israeli and German designers' perceptions of SARs' roles and appearance in four different contexts: a service robot for an assisted living/retirement residence facility, a medical assistant robot for a hospital environment, a COVID-19 officer robot, and a personal assistant robot for domestic use. The key insight is that although Israeli and German designers share similar perceptions of visual qualities for most of the robotics roles, we found differences in the perception of the COVID-19 officer robot's role and, by that, its most suitable visual design. This work indicates that context and culture play a role in users' perceptions and expectations; therefore, they should be taken into account when designing new SARs for diverse contexts.

Genomic Epidemiology ofMycobacterium abscessusat an Adult Cystic Fibrosis Program Reveals Low Potential for Healthcare-Associated Transmission

RationaleNontuberculous mycobacteria (NTM) has been reported to be transmitted between people with cystic fibrosis (pwCF) attending Cystic Fibrosis (CF) Centers. A suspectedMycobacterium abscessusoutbreak was investigated at the University of Texas Southwestern (UTSW) Adult CF Program using a combination of pathogen genomic sequencing and epidemiologic methods.ObjectivesApply the Healthcare-associated Links in Transmission of NTM (HALT NTM) study to investigate the occurrence of potential healthcare-associated transmission and/or acquisition of NTM among pwCF infected with genetically similar NTM isolates.MethodsWhole genome sequencing (WGS) of respiratoryM. abscessusisolates from 50 pwCF receiving care at UTSW was performed to identify genetically similar isolates. Epidemiological investigation, comparison of respiratory and environmental isolates, and home residence watershed mapping were studied.Measurements and Main ResultsWGS analysis demonstrated seven clusters of genetically similarM. abscessus(four ssp. abscessusand three ssp.massiliense). Epidemiologic investigation revealed potential opportunities for healthcare-associated transmission within three of these clusters. Healthcare environmental sampling did not recoverM. abscessus, but did recover four human disease-causing species of NTM. No subjects having clustered infections lived in the same home residence watershed. Some subjects were infected with more than oneM. abscessusgenotype, both within and outside of the dominant circulating clones.ConclusionsHealthcare-associated patient-to-patient transmission ofM. abscessusappears rare at this Center. However, polyclonal infections ofM. abscessusspecies and subspecies, not originating from the endemic hospital environment, suggests multiple shared modes of acquisition outside the healthcare setting.

Enhancing Patient Safety Through Effective Interprofessional Communication: A Focus on Medication Error Prevention.

Medication errors significantly impact patient safety and healthcare costs. This study investigates the influence of interprofessional communication on medication error rates, with a focus on identifying actionable strategies to improve communication efficacy among healthcare professionals. Utilizing a quantitative approach, this research distributed a detailed online questionnaire to a broad cohort of healthcare workers in various settings within Saudi Arabia. The survey encompassed sections on demographics, the frequency and quality of interprofessional communication, perceived barriers and facilitators to effective communication, and personal experiences with medication errors. Statistical analysis was performed using SPSS to derive descriptive and inferential statistics, alongside thematic analysis for qualitative responses. The survey attracted 1165 respondents, predominantly aged 20-30 (68.58%) and female (65.49%). Pharmacists constituted the largest professional group (40.34%). We identified a notable positive correlation (r = 0.16) between high-quality interprofessional communication and employment in hospital environments or having 5-20 years of experience. In contrast, negative correlations were observed with employment in non-traditional healthcare settings (r = -0.19) and professionals with less than five years of experience (r = -0.13), indicating communication challenges. The analysis also highlighted a concerning frequency of prescription and dispensing errors, with 52.70% of participants reporting prescription errors as the most common issue encountered. Effective interprofessional communication is pivotal in mitigating medication errors within healthcare settings. The study illuminates specific areas for improvement, including the need for targeted communication training, particularly for less experienced professionals and those in non-traditional settings. Enhancing communication channels and fostering an environment conducive to open, interdisciplinary dialogue are essential steps towards advancing patient safety and reducing medication errors.

Monitoring of the hospital environment and costs attributable to Health Care-Associated Infections A Systematic Review

Monitoring of the hospital environment and costs attributable to Health Care-Associated Infections A Systematic Review

LITERATURE REVIEW OF THERMAL COMFORT FOR HOSPITAL DESIGN

Creating indoor environments in hospitals that meet the varied needs of patients and staff is essential, with thermal comfort being a critical factor affecting patient healing and the welfare of medical personnel. While numerous studies explore thermal comfort and related contexts, there is a shortage of review articles on this vital subject. This paper aims to address this gap by conducting a thorough and evaluative review of existing research, analyzing 160 articles to identify key themes and provide insights into future research directions. Additionally, it is observed that achieving satisfactory thermal comfort is influenced by various factors, including the patient's health status and the nature and intensity of staff activities, underscoring the context-specific nature of this phenomenon. The review also explores measures aimed at reducing energy consumption in hospital settings. Important issues such as the limitations of predicted mean vote (PMV) and the influence of demographic factors such as gender and age on thermal comfort are addressed. Ultimately, this review provides valuable insights into designing and evaluating thermal environments in hospitals, highlighting the need for tailored approaches to ensure optimal conditions for both patients and staff. Key Words: Thermal comfort; Hospital buildings; Improvement measures; Energy efficiency.

Microbiological status of donor human milk – A single center study from Poland

Human milk is considered the most suitable source of nutrition for infants. Donor human milk from human milk banks (HMB) is recommended as the best alternative for infants whose mothers' own milk is unavailable. Microbiological screening of milk donated to HMB is important to ensure the quality and safety of the pasteurised human milk. This article describes the microbiological status of human milk donated to the Regional Human Milk Bank in Toruń, Poland. Statistical data regarding the microbiological analysis of milk from 292 donors were collected in the years 2013–2021. Total of 538 milk samples were tested. Only in 6% of human milk samples the bacteria level was above the required standard and/or the milk had potentially pathogenic bacteria. The main core of donors’ breastmilk bacteria represents the skin microbiota, and the composition of the microbiota is strictly related to the surrounding environment. The most abundant genera detected in milk samples were the Staphylococcus group. Prolonged hospitalisation of infants' mothers and/or offsprings is associated with potentially pathogenic bacteria colonization in milk. The use of the modern identification method MALDI-TOF resulted in more accurate results compared to the biochemical methods. Our analysis indicates that most of the tested milk samples (94%), both expressing at home and in hospital environments, meet the criteria for admission to the human milk bank.Effective techniques for identifying microorganisms ensure that donor milk from human milk banks meets the guidelines set for these units.

Vulnerability to risky sexual behavior among patients with severe mental illness in Uganda

BackgroundThe relationship between severe mental illness and risky sexual behaviors, defined as acts associated with a higher risk level is notably significant in sub-Saharan Africa. In Uganda, mental disorders have been substantially correlated with unsafe sexual practices, contributing to the global burden of risky sexual behaviors. The consequential outcomes, such as sexually transmitted diseases, has resulted into a significant challenge in managing severe mental illness and potentially increased risky sexual behaviour. There is an urgent need to identify and understand factors specific to Uganda that amplify the vulnerability of severe mental illness patients to risky sexual behaviors. This study aimed to understand the vulnerability factors to risky sexual behaviour in severe mental illness in central and south-western Uganda, seeking to inform the development of tailored and effective intervention strategies to address this critical issue.MethodsThis was a qualitative descriptive study that was carried out at Butabika and Masaka hospitals in Uganda, involving a varied group of 32 individuals, comprising 12 persons with diagnosed Severe Mental Illness (Schizophrenia, Bipolar Affective Disorder, or Recurrent Major Depressive Disorder) and to risky sexual behaviors, 8 caregivers (who had patients with severe mental illness and to risky sexual behaviors) and 12 mental health specialists, (who had treated these participants). Purposive sampling was done by intentionally selecting participants based on specific attributes relevant to the research question and the objective of the study which was to explore the factors contributing vulnerability to risky sexual behaviour in severe mental illness in central and south-western Uganda. The interviews were conducted, centered on personal experiences and influences on risky sexual behaviors for the persons with severe mental illness, targeting insights into the nuanced interplay of severe mental illness and sexual behavior. For caregivers and mental health specialists, the interviews were conducted to gain a comprehensive understanding of the unique challenges, perspectives, and experiences they encounter in providing support and treatment respectively. The interviews were tape-recorded and transcribed verbatim. Framework analysis of transcribed interviews, using NVivo11 software that helped to systematically organize and code data within the predetermined and emergent thematic framework, we were able to identify patterns and themes to address the research question and objective.ResultsThe study findings underscored a pervasive pattern of engaging in risky sexual behavior among individuals coping with severe mental illness, a growing concern traditionally associated with sexually transmitted infections like HIV and AIDS, unwanted pregnancies, and sexual encounters with strangers. This problem was largely attributed to factors such as compromised judgment due to underlying morbidity, abnormally high libido, poverty, desperation, and inadequate social support. Additionally, sexual deprivation, often a result of stigma, discrimination, and prolonged periods of hospitalization, was found to contribute to irresponsible and risky sexual acts. Respondents also highlighted certain practices and structural weaknesses within hospital environments, such as stripping patients naked when going to seclusion rooms and inadequate patient monitoring.ConclusionsThe findings underscore the need for targeted interventions addressing both individual and structural factors to alleviate the risks associated with sexual behavior among individuals with severe mental illness.

NURSING'S ROLE IN RISK SCREENING AND CLASSIFICATION IN EMERGENCY SERVICES IN BRAZIL: AN INTEGRATIVE REVIEW

Nurses are health professionals who work on the front line of triage and risk classification in urgency and emergency sectors. Unfortunately, in some cases, other specialties from other hospital sectors try to go against the nurses' choices. Furthermore, there are some reports of verbal and physical violence against these professionals. The nurse is essential for screening and risk classification in the hospital environment, he is the one who has the first contact with both the patient and the companion, the humanized vision of these professionals makes all the difference in the entire patient process, be it screening care and clinical internship.

A meta-analytic comparison of scent effect between retailing and hospitality

PurposeThis meta-analysis aims to examine and compare the pleasant ambient scent effects on consumers’ affective, cognitive and behavioural responses in the retail and hospitality sectors.Design/methodology/approach55 articles, including 102 effect sizes, are collected from electronic databases and search engines. The effect of pleasant ambient scents on consumer responses is examined using meta-regression analysis.FindingsThe results show a positive effect of pleasant ambient scent on all responses in both sectors, while the effects on cognitive and behavioural responses are stronger in hospitality than retailing. Moreover, the scent effects in hospitality research vary with method aspects, including sampling frame, research design, setting and location.Research limitations/implicationsThe findings provide theoretical insights on the sensory tangibilization of experience and methodological insights on designing scent research.Originality/valueThe stronger effect of pleasant ambient scents on cognitive and behavioural responses in a hospitality environment signals that contextual differences should not be neglected. Moreover, hospitality researchers need to stay vigilant to the methodological influence on the findings about scent effects. These findings enrich the sensory marketing literature, in which contextual comparison is scarce.

Highly effective decontamination in a hospital environment: An easy-to-operate, low-cost prototype.

Healthcare-associated infections (HAI) are illnesses acquired during healthcare and are often the most important adverse event during healthcare. With the aim of increasing the effectiveness of disinfection/decontamination processes in the health service with safe and not promote microbial resistance, we propose the development of portable equipment associated with type C ultraviolet light (UVC). The efficiency of the irradiance emitted by the equipment (at dosages 3.5, 5.0, and 60 mJ/cm2) was determined by the action exerted after exposure against four different bacterial (Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus) and three different fungi (Candida albicans, C. parapsilosis, and Aspergillus section Fumigati). It was possible to observe that all treatments were capable of inactivating the bacterial species evaluated (p < 0.05), causing the irreversible death of these microorganisms. The most effective elimination of fungal agents was at a dose of 60 mJ/cm2 of UVC radiation, with a decrease in the fungal inoculum varying between 94% and 100% in relation to the control without exposure. Thus, our study showed that the application of the portable prototype with UVC light (254 nm) at a distance of 48 mm, allowed an average irradiance of 3.5 mW/cm2, with doses of 3.5 ≈ 60 mJ/cm2 (from 1 to 60 s of exposure), which can promote the total reduction of the bacteria evaluated and significantly reduce fungal growth. Therefore, this prototype could be used safely and effectively in the hospital environment, considerably reducing contamination and contributing to the reduction of healthcare-associated infection risk.