Objective: To explore the implications of the single family room (SFR) care environment of neonatal intensive care units (NICU) compared to Open-bay, Combination and Double-occupancy configurations, focusing on family experience, neonate outcomes, staff perceptions, cost and environmental design. Study design: This study uses a multimethod design with 11 Level III NICUs. Space allocations, construction costs, staff preferences and perceptions, and occupant behaviors were evaluated. Results: SFR NICU design provides solutions for increasing parent privacy and presence, supporting Health Insurance Portability and Accountability Act compliance, minimizing the number of undesirable beds, increasing staff satisfaction and reducing staff stress. Conclusion: The analysis of this study suggests that there are benefits to SFR NICU. This study is an initial, comprehensive effort, the purpose of which is to spawn future, narrower, in-depth studies focused on SFR NICU design.

Aim: This study investigated the stability of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on 16 common environmental surface materials. Background: SARS-CoV-2 is the causative agent of severe coronavirus disease, a significant public health concern that quickly led to a pandemic. Contamination of environmental surface materials is of concern, with previous studies identifying long-term detection of infectious particles on surfaces. These contaminated surfaces create an increased risk for contact transmission. Methods: Surface materials were inoculated with 10,000 plaque forming units and samples were collected 4, 8, 12, 24, 30, 48, and 168 hours post infection (hpi). Viral titers were determined for each sample and time point using plaque assays. Nonparametric modeling utilized the Turnbull algorithm for interval-censored data. Maximum likelihood estimates for the survival curve were calculated. Parametric proportional hazards regression models for interval censored data were used to explore survival time across the surface materials. Results: There was a sharp decline in recoverable virus after 4 hpi for all tested surfaces. By 12 hpi, infectious SARS-CoV-2 was recoverable from only four surfaces; and by 30 hr, the virus was recoverable from only one surface. There were differences in survival curves based on the materials although some groups of materials are similar, both statistically and practically. Conclusions: While very low amounts of infectious SARS-CoV-2 are recoverable over time, there remains a risk of viral transmission by surface contamination in indoor environments. Individuals and institutions must follow appropriate procedures to decontaminate indoor environment and increase diligence for hand hygiene and personal protective equipment.

Objective: Three flooring materials, terrazzo, rubber, and carpet tile, in patient unit corridors were compared for absorption of sound, comfort, light reflectance, employee perceptions and preferences, and patient satisfaction. Background: Environmental stressors, such as noise and ergonomic factors, effect healthcare workers and patients, contributing to increased fatigue, anxiety and stress, decreased productivity, and patient safety and satisfaction. Methods: A longitudinal comparative cohort study comparing three types of flooring assessed sound levels, healthcare worker responses, and patient Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings over 42 weeks. A linear mixed model analysis was conducted to determine significant differences between the means for participant responses and objective sound meter data during all three phases of the study. Results: A significant difference was found for sound levels between flooring type for equivalent continuous sound levels. Carpet tile performed better for sound attenuation by absorption, reducing sound levels 3.14 dBA. Preferences for flooring materials changed over the course of the study. The HCAHPS ratings aligned with the sound meter data showing that patients perceived the noise levels to be lower with carpet tiles, improving patient satisfaction ratings. Conclusions: Perceptions for healthcare staff and patients were aligned with the sound meter data. Carpet tile provides sound absorption that affects sound levels and influences occupant’s perceptions of environmental factors that contribute to the quality of the indoor environment. Flooring that provides comfort underfoot, easy cleanability, and sound absorption influence healthcare worker job satisfaction and patient satisfaction with their patient experience.

OBJECTIVE: The objective of this study was to review, identify, and synthesize the literature on patient and healthcare worker safety related to flooring. The topic of flooring in the design of healthcare facilities is complex: healthcare associated infections, push/pull limitations, falls and fall injuries, and noise as a contributing factor to quality of care. BACKGROUND: Most hospitals have not been explicitly designed to enhance patient safety. Recommendations from the Agency for Healthcare Research and Quality (AHRQ) include preventing patient falls, reducing infections, and preventing medication errors as the areas of emphasis of evidence-based design to improve patient safety and quality of care. METHODS: A review of the literature was conducted through search engines using a predefined list of keywords to identify studies about flooring and the safety of patients and healthcare workers. Inclusion criteria included peer-reviewed theoretical and empirical studies published in English from 1982 to 2012. Final inclusion was obtained based on an analysis of research design. RESULTS: Of those 27 articles that met inclusion, 7 focused on healthcare associated infections; 9 focused on slips, trips and falls; 7 articles focused on noise; and 4 focused on fatigue. The studies are profiled in tables and organized by environmental variable. CONCLUSIONS: Though a limited number of studies met the criteria for this review, the evidence base is emerging to design for safety. Recommendations for future research and practical application of design are provided.

The type of flooring in hospitals has long been scrutinized in terms of its potential role in nosocomial (hospital-acquired) infections. This study was conducted for the purpose of detecting potential pathogens on tiled carpets, nontiled carpets, and vinyl flooring, all used in a Midwestern community hospital. A swab sampling protocol conducted over a 5-month period, coupled with denaturing gradient gel electrophoresis-16S rDNA molecular analysis, allowed for greater than 93% of the major components in the flooring samples to be identified at the genus and species level. This study evaluates the impact of floor finish materials as potential sources of microbial-related hospital-acquired infections.

SUMMARY: Upholstered furniture remains a consumer fire hazard. Flame retardant technologies are necessary but may present a health risk from chemical exposure. This study developed methodologies for measuring exposure to flame retardants and flammability performance, comparing the effectiveness of differing flammability reduction strategies on upholstered chairs with and without added flame retardants and the use of a barrier material. The chemical analysis focused on volatile organic compounds (VOCs) and flame retardants. Open flame tests were conducted on chair assemblies, and smolder resistance tests were conducted on chair materials. Results showed that VOC inhalation exposure during consumer use was low for all chair types. However, VOCs were significantly elevated during the chair burns. The organophosphorus flame retardant used in this study was found in air, settled dust and dermal transfer samples. The chairs with a barrier material demonstrated significantly lower flammability hazards when compared to the other chair types. All assembled chairs did not meet the criteria for smolder testing, suggesting a lack of correlation with open‐flame performance. This study demonstrated that combined human health and flammability advantages may be achieved for upholstered chairs constructed with an effective fire barrier material without any added flame retardants.