The Impact of Window Views in ICU Patients and Staff

Mardelle Shepley
Art + Science / SBRA / Texas A&M University

Angela Watson
Shepley Bulfinch Richardson Abbott (SBRA) Boston, MA
(Click here to download full paper)

The purpose of this research is to evaluate the impact on patients and staff of a new intensive care unit (ICU) which was designed to incorporate large windows with views of nature. No studies have examined the role of windows and views in an ICU environment. Evidence exists, however, that 1) windows in ICUs can reduce patient delirium (Wilson, 1972; Keep, James & Inman, 1980), 2) views of nature can reduce postoperative stays, negative evaluative comments, and requests for analgesics in acute care units (Ulrich, 1984), and 3) sunlight can reduce the perception of pain and requests for medication (Walch, et al., 2005).

While it has been argued that ICU patients are not aware of the physical environment, several researchers have obtained useful data regarding patient memories of the ICU experience (Bohrer, et al., 2002; McKinney & Deeny, 2002; Rattray, Johnston, & Wildsmith, 2004; Swaiss & Badran, 2004). Regarding staff, windows have been found to improve job satisfaction and retention in offices (Farley and Veitch, 2001), although no studies were found that addressed the impact of windows on medical staff.

Methodology
The participants in this project include an academic researcher, a practicing healthcare architect, a hospital vice president of facilities, and an ICU physician. The hypothesis of this research is that improved light levels and window views in an ICU will positively impact patients and staff. To study this, old and new ICUs contained within the same hospital and staffed by the same personnel are being compared. Data are being gathered regarding window attributes (per Verderber,1987): proximity of head of bed to window, window to total wall area ratio, and sill height above floor.

Sunlight intensity (per Walch, et al., 2005) data (lux) have been gathered for December and March and readings will be taken in June and September 2008 as well. Three measurements are being taken: direct, reflective, and ambient.

Percentage of view of nature relative to total view was also measured. Regarding dependent variables, data are being gathered including: staff attrition, staff absenteeism, medical errors, patient satisfaction, patient length of stay, patient mortality, and pain scale measurements

Results
The new ICU has larger views of nature. Initial reports indicate improvements in some patient and staff outcomes in the new unit.

Conclusion
The researchers recommend that designers emphasise natural light and window views in intensive care units.