‘Owning the space’—person-centred practice in a 100% single-room acute-care environment: an ethnographic study

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Abstract

Aims and Objectives: Exploring the influence of the 100% single-room environment on staff and patient experience of person-centred practice in an acute-care setting.
Background: Current building guidance for the NHS advocates increasing the single-room inpatient environment. There is little evidence of the impact of this design in adult acute care settings on the experience and delivery of person-centred care.
Design: Ethnography, underpinned by McCormack and McCance’s Person-centred Practice Framework.
Methods: Data collection took place between March and June 2018. Staff and patients in a National Health Service hospital in the United Kingdom took part in observations of practice (n=108 hours); face to face inpatient interviews (n=9); and participatory reflective staff groups (n=3). A reflexive journal was kept by the researcher throughout the study. Reporting adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
Results: Themes relating to care delivery and interactions were identified. Staff and patients’ views converged around visibility and isolation. Patients appreciated the privacy afforded by the single-rooms, while staff experienced a psychological shift, being viewed (and viewing themselves) as “visitors.” There was space for more sympathetic presencing, encouraging patients to speak more openly, to facilitate knowing and authentic engagement. However, time remained an issue resulting in more task focused care.
Conclusion: Changes to the physical environment have an impact on the delivery and experience of person-centred practice. While the facilities enhance patient experience, the interweaving of engagement, emotional support and the development of therapeutic relationships remain challenging.
Original languageEnglish
Pages (from-to)2921-2934
Number of pages14
JournalJournal of Clinical Nursing
Volume31
Issue number19-20
Early online date10 Nov 2021
DOIs
Publication statusPublished online - 10 Nov 2021

Bibliographical note

Research Funding
Department for the Economy, Northern Ireland

Publisher Copyright:
© 2021 John Wiley & Sons Ltd

Keywords

  • Adult Nursing
  • Attitudes
  • Communication
  • Ethnography
  • Experiences
  • nurse-patient relationships
  • Ward design
  • General Nursing
  • General Medicine
  • ward design
  • attitudes
  • experiences
  • adult nursing
  • nurse–patient relationships
  • communication
  • ethnography

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