Patient room lighting influences on sleep, appraisal and mood in hospitalized people

Background: Simulations based on models of healthcare worker (HCW) mobility and contact patterns with patients provide a key tool for understanding spread of healthcare-acquired infections (HAIs). However, simulations suffer from lack of accurate model parameters. This research uses Microsoft Kinect cameras placed in a patient room in the medical intensive care unit (MICU) at the University of Iowa Hospitals and Clinics (UIHC) to obtain reliable distributions of HCW visit length and time spent by HCWs near a patient. These data can inform modeling efforts for understanding HAI spread. Methods: Three Kinect cameras (left, right, and door cameras) were placed in a patient room to track the human body (ie, left/right hands and head) at 30 frames per second. The results reported here are based on 7 randomly selected days from a total of 308 observation days. Each tracked body may have multiple raw segments over the 2 camera regions, which we “stitch” up by matching features (eg, direction, velocity, etc), to obtain complete trajectories. Due to camera noise, in a substantial fraction of the frames bodies display unnatural characteristics including frequent and rapid directional and velocity change. We use unsupervised learning techniques to identify such “ghost” frames and we remove from our analysis bodies that have 20% or more “ghost” frames. Results: The heat map of hand positions (Fig. 1) shows that high-frequency locations are clustered around the bed and more to the patient’s right in accordance with the general medical practice of performing patient exams from their right. HCW visit frequency per hour (mean, 6.952; SD, 2.855) has 2 peaks, 1 during morning shift and 1 during the afternoon shift, with a distinct decrease after midnight. Figure 2 shows visit length (in minutes) distribution (mean, 1.570; SD, 2.679) being dominated by “check in visits” of <30 seconds. HCWs do not spend much time at touching distance from patients during short-length visits, and the fraction of time spent near the patient’s bed seems to increase with visit length up to a point. Conclusions: Using fine-grained data, this research extracts distributions of these critical parameters of HCW–patient interactions: (1) HCW visit length, (2) HCW visit frequency as a function of time of day, and (3) time spent by HCW within touching distance of patient as a function of visit length. To the best of our knowledge, we provide the first reliable estimates of these parameters.Funding: NoneDisclosures: None

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Implications for the Physical Design of the Postnatal Care Unit from a Targeted Analysis of Issues With Accessing the Bathroom at Night in the Acute Setting: A Secondary Analysis

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857921101223 ◽

2021 ◽

Vol 10 (1) ◽

pp. 309-312

Author(s):

Varshita Chirumamilla ◽

Joseph M. Gerard ◽

Alison E. Sweeney ◽

Kristin P. Tully ◽

Alison M. Stuebe ◽

...

Keyword(s):

Healthcare Providers ◽

Secondary Analysis ◽

Hospital Environment ◽

Patient Room ◽

Hospital Visit ◽

Acute Setting ◽

Targeted Analysis ◽

Standard Patient ◽

Clinical Environments ◽

Visual Privacy

Assessing hospital environment conditions is necessary for healthcare providers and patients to coordinate safe care. The aims of this research included: a) identifying patterns in hospital visit feedback transcripts regarding bathroom doors and lights in the hospital room and b) interpreting the results to make recommendations for more enabling clinical environments. The methods used by the research team included organizing transcript data, assigning codes, and conducting an interrater reliability test to assess codebook efficacy. Finally, working with maternal and infant mortality experts, recommendations for the hospital were developed. We identified four possible interventions to address barriers: a) implement low-height, dimmable lighting along the base of the patient room, b) provide personal lights, such as penlights, to staff for nighttime assessments, c) install and improve on existing grab bars in patient room bathrooms and d) replace the standard patient room bathroom door with a different kind of auditory/visual privacy barrier.

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Evaluation of a Continuous Decontamination Technology in an Intensive Care Unit

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1201 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s519-s519

Author(s):

Tami Inman BSN ◽

David Chansolme

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Urban Hospital ◽

Patient Room ◽

Colony Forming Units ◽

Prevention Interventions ◽

Continuous Application ◽

Low Levels ◽

Healthcare Associated ◽

Cleaning And Disinfection

Background: The scientific literature increasingly indicates the need for the development of continuous disinfection to address the persistent contamination and recontamination that occurs in the patient rooms despite routine cleaning and disinfection. Methods: To determine a baseline microbial burden level on patient room surfaces in the intensive care unit (ICU) of a large urban hospital, 50 locations were swabbed for total colony-forming units (CFU) and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA). Once the baseline in ICU patient rooms was established, 5 novel decontamination devices were installed in the HVAC ducts near these patient rooms. The devices provide a continuous low-level application of oxidizing molecules, predominately hydrogen peroxide. These molecules exit the duct and circulate in the patient room through normal convection, landing on all surfaces. After activation, environmental sampling was conducted every 4 weeks for 4 months. The effect from continuous low levels of oxidizing molecules on the intrinsic microbial burden and the prevalence of MRSA were analyzed. In addition to external laboratory reports, the facility tracked healthcare-associated infections (HAIs) in the unit. HAI data were averaged by month and were compared to the preactivation average in the same unit. Results: The preactivation average microbial burden found on the 50 locations were 179,000 CFU per 100 in2. The prevalence of MRSA was 71% with an average of 81 CFU per 100 in2. After activation of the devices, levels of microbial burden, prevalence of MRSA, and average monthly HAI rates were all significantly lower on average: 95% reduction in average microbial burden (8,206 CFU per 100 in2); 81% reduction in the prevalence of MRSA (13% vs 71%); 54% reduction in the average of healthcare-onset HAIs. All data were obtained from the averages of sampling data for 4 weeks during the 4-month trial period. Conclusions: The continuous application of low levels of oxidizing molecules throughout the patient rooms of an ICU demonstrated 3 outcomes: reduced overall surface microbial burden, lowered the incidence of MRSA, and significantly decreased the monthly average HAI rate. Please note, the ICU ran other infection prevention interventions at this time, including standard cleaning, as well as and their standard disinfecting techniques.Funding: This study was supported by the CASPR Group.Disclosures: None

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Creating a Safer Patient Room Environment: The Contribution of Patient Bed Height

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857921101163 ◽

2021 ◽

Vol 10 (1) ◽

pp. 180-184

Author(s):

Dorothy Taylor ◽

Janice Morse ◽

Andrew Merryweather

Keyword(s):

Elderly Patient ◽

Fall Risk ◽

The Elderly ◽

Lower Leg ◽

Patient Specific ◽

Leg Length ◽

Patient Room ◽

Patient Falls ◽

Sit To Stand ◽

Bed Height

Elderly patient falls are expensive and may cause serious harm. Studies have identified the sit-to-stand-and-walk (STSW) task as the task where the greatest number of elderly patient falls occur. There is a great need to identify the particular movement and environmental conditions that lead to these elderly patient falls. This study begins to address this gap by evaluating the elderly patient during self-selected hospital bed egress. Using an observed fall risk episode (FRE) as a fall proxy, statistically significant parameters were identified which include bed height, pausing prior to initiating gait, level of fall risk, and Stand phase. Low bed height was identified as the least safe bed height. Patient-specific bed height (PSBH) using the patient’s lower leg length (LLL) is recommended. In addition, suggested guidelines are presented for clinical application in setting PSBH without measuring the patient’s LLL.

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Harnessing COVID-Driven Technical Innovations for Improved Multi-Disciplinary Cancer Care in the Post-COVID Era: The Virtual Patient Room

Cancer Control ◽

10.1177/1073274820964800 ◽

2020 ◽

Vol 27 (1) ◽

pp. 107327482096480 ◽

Cited By ~ 1

Author(s):

Austin J. Sim ◽

Gage Redler ◽

Jeffrey Peacock ◽

Cristina Naso ◽

Stuart Wasserman ◽

...

Keyword(s):

New Technology ◽

Multidisciplinary Care ◽

Virtual Patient ◽

Paradigm Shifts ◽

Patient Room ◽

Patient Centered ◽

Team Members ◽

The Road ◽

Centered Care ◽

Virtual Visits

Emergence of the COVID-19 crisis has catalyzed rapid paradigm shifts throughout medicine. Even after the initial wave of the virus subsides, a wholesale return to the prior status quo is not prudent. As a specialty that values the proper application of new technology, radiation oncology should strive to be at the forefront of harnessing telehealth as an important tool to further optimize patient care. We remain cognizant that telehealth cannot and should not be a comprehensive replacement for in-person patient visits because it is not a one for one replacement, dependent on the intention of the visit and patient preference. However, we envision the opportunity for the virtual patient “room” where multidisciplinary care may take place from every specialty. How we adapt is not an inevitability, but instead, an opportunity to shape the ideal image of our new normal through the choices that we make. We have made great strides toward genuine multidisciplinary patient-centered care, but the continued use of telehealth and virtual visits can bring us closer to optimally arranging the spokes of the provider team members around the central hub of the patient as we progress down the road through treatment.

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The Effects of Dressing Room Lighting on Consumers' Perceptions of Self and Environment

Journal of Interior Design ◽

10.1111/j.1939-1668.2009.01037.x ◽

2010 ◽

Vol 35 (2) ◽

pp. 37-49 ◽

Cited By ~ 10

Author(s):

Anne Baumstarck ◽

Nam-Kyu Park

Keyword(s):

Dressing Room ◽

Room Lighting

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Photolysis of bilirubin in serum specimens exposed to room lighting

Clinica Chimica Acta ◽

10.1016/j.cca.2007.09.019 ◽

2008 ◽

Vol 387 (1-2) ◽

pp. 181-183 ◽

Cited By ~ 8

Author(s):

Nadja N. Rehak ◽

Stacey A. Cecco ◽

Glen L. Hortin

Keyword(s):

Room Lighting

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1222. Are Reduced Concentrations of Chlorine-Based Disinfectants Effective Against Candida auris?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1085 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S439-S439

Author(s):

Jessica Kumar ◽

Jennifer Cadnum ◽

Y Karen Ng Wong ◽

Thriveen Sankar Chittoor Mana ◽

Heba Alhmidi ◽

...

Keyword(s):

Sodium Hypochlorite ◽

Exposure Time ◽

Environmental Protection Agency ◽

Simulated Patient ◽

Patient Room ◽

Candida Auris ◽

Colony Forming Units ◽

Sodium Dichloroisocyanurate

Abstract Background Currently, sporicidal disinfectants such as bleach are recommended for daily and terminal disinfection of the rooms of patients with Candida auris colonization and/or infection. However, bleach and other chlorine-based disinfectants can have adverse effects on surfaces and personnel. Disinfectant solutions with reduced chlorine concentrations are commonly used for other pathogens, but it is not known if diluted or alternative products maintain efficacy against C. auris both in vitro and in vivo. Methods We tested the efficacy of different concentrations of a sodium dichloroisocyanurate (NaDCC) product and sodium hypochlorite using the method recommended by the Environmental Protection Agency (EPA) for evaluation of the efficacy of liquid disinfectants against C. auris (EPA MLB SOP MB-35-00) and in a simulated patient room. Carriers were exposed to each disinfectant for 1 and 2 minutes. Log reductions were calculated by subtracting viable organisms recovered after disinfectant exposure vs. deionized water controls. Results As shown in the figure, the NaDCC product at 4306 ppm tested with a 2 minute contact time reduced C. auris by ≥5 log10 colony-forming units (CFU) but had reduced efficacy with shorter exposure time or lower concentrations. Sodium hypochlorite was effective with 1 or 2 minute exposure times at a concentration of 6,500 ppm, and was effective at 4,000 ppm with an exposure time of 2 minutes. In the simulated patient room, NaDCC reduced C. auris contamination by ≥6 log10 CFUs on all surfaces. Conclusion A chlorine-based NaDCC product was effective at reducing C. auris. Both NaDCC and sodium hypochlorite products exhibited reduced efficacy at lower concentrations, particularly at concentrations below 4000 ppm. The NaDCC products were also effective in reducing contamination in the simulated patient room. UV-C treatment was an effective adjunct to manual cleaning. Disclosures All authors: No reported disclosures.

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