PDF(Pubmed)
Abstract：
BACKGROUND: Intensive care medicine continues to improve, with advances in technology and care provision leading to improved patient survival. However, this has not been matched by similar advances in ICU bedspace design. Environmental factors including excessive noise, suboptimal lighting, and lack of natural lights and views can adversely impact staff wellbeing and short- and long-term patient outcomes. The personal, social, and economic costs associated with this are potentially large. The ICU of the Future project was conceived to address these issues. This is a mixed-method project, aiming to improve the ICU bedspace environment and assess impact on patient outcomes. Two innovative and adaptive ICU bedspaces capable of being individualised to patients\' personal and changing needs were co-designed and implemented. The aim of this study is to evaluate the effect of an improved ICU bedspace environment on patient outcomes and operational impact.
METHODS: This is a prospective multi-component, mixed methods study including a randomised controlled trial. Over a 2-year study period, the two upgraded bedspaces will serve as intervention beds, while the remaining 25 bedspaces in the study ICU function as control beds. Study components encompass (1) an objective environmental assessment; (2) a qualitative investigation of the ICU environment and its impact from the perspective of patients, families, and staff; (3) sleep investigations; (4) circadian rhythm investigations; (5) delirium measurements; (6) assessment of medium-term patient outcomes; and (7) a health economic evaluation.
CONCLUSIONS: Despite growing evidence of the negative impact the ICU environment can have on patient recovery, this is an area of critical care medicine that is understudied and commonly not considered when ICUs are being designed. This study will provide new information on how an improved ICU environment impact holistic patient recovery and outcomes, potentially influencing ICU design worldwide.
BACKGROUND: ACTRN12623000541606. Registered on May 22, 2023. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385845&isReview=true .
METHODS: This is a prospective multi-component, mixed methods study including a randomised controlled trial. Over a 2-year study period, the two upgraded bedspaces will serve as intervention beds, while the remaining 25 bedspaces in the study ICU function as control beds. Study components encompass (1) an objective environmental assessment; (2) a qualitative investigation of the ICU environment and its impact from the perspective of patients, families, and staff; (3) sleep investigations; (4) circadian rhythm investigations; (5) delirium measurements; (6) assessment of medium-term patient outcomes; and (7) a health economic evaluation.
CONCLUSIONS: Despite growing evidence of the negative impact the ICU environment can have on patient recovery, this is an area of critical care medicine that is understudied and commonly not considered when ICUs are being designed. This study will provide new information on how an improved ICU environment impact holistic patient recovery and outcomes, potentially influencing ICU design worldwide.
BACKGROUND: ACTRN12623000541606. Registered on May 22, 2023. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385845&isReview=true .
摘要：
背景：重症监护医学不断改进，随着技术和护理提供的进步，提高了患者的生存率。然而,这与ICU床位设计的类似进步并不匹配。环境因素，包括过度噪音，次优照明，缺乏自然光和视野会对员工的福祉以及短期和长期患者的预后产生不利影响。个人，社会,与此相关的经济成本可能很大。未来ICU项目旨在解决这些问题。这是一个混合方法项目，旨在改善ICU床位环境并评估对患者预后的影响。共同设计和实施了两个创新和适应性的ICU床位，能够根据患者的个人和不断变化的需求个性化。这项研究的目的是评估改善ICU床位环境对患者预后和操作影响的影响。
方法：这是一个前瞻性的多组分，混合方法研究，包括一项随机对照试验。在2年的研究期间，两个升级的床位将用作干预床，而研究ICU中的其余25个床位用作对照床位。研究内容包括（1）客观的环境评估；（2）从患者的角度对ICU环境及其影响进行定性调查，家庭,和工作人员;(3)睡眠调查;(4)昼夜节律调查;(5)谵妄测量;(6)中期患者结果评估;和(7)健康经济学评估。
结论：尽管越来越多的证据表明ICU环境可能对患者康复产生负面影响，这是重症监护医学的一个研究不足的领域，通常在设计ICU时不考虑。这项研究将提供关于改善ICU环境如何影响患者整体康复和预后的新信息。可能影响全球ICU设计。
背景：ACTRN12623000541606。2023年5月22日注册。https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385845&isReview=true。
方法：这是一个前瞻性的多组分，混合方法研究，包括一项随机对照试验。在2年的研究期间，两个升级的床位将用作干预床，而研究ICU中的其余25个床位用作对照床位。研究内容包括（1）客观的环境评估；（2）从患者的角度对ICU环境及其影响进行定性调查，家庭,和工作人员;(3)睡眠调查;(4)昼夜节律调查;(5)谵妄测量;(6)中期患者结果评估;和(7)健康经济学评估。
结论：尽管越来越多的证据表明ICU环境可能对患者康复产生负面影响，这是重症监护医学的一个研究不足的领域，通常在设计ICU时不考虑。这项研究将提供关于改善ICU环境如何影响患者整体康复和预后的新信息。可能影响全球ICU设计。
背景：ACTRN12623000541606。2023年5月22日注册。https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385845&isReview=true。
