9. Room for one? (matter for discussion)
Emergency Care Association
That this meeting of RCN congress discuss whether single rooms in hospitals are an aspiration too far.
On this page:
- Watch the debate
- Read the progress report
- Read the debate report
- Read the background information
9. Room for one? (R)Progress report
Council Committee: NPPC
Committee decision: Covered by existing work
Council member/other member/stakeholder involvement: Ann Marie O Neill, Maura Buchanan, Ann Griffiths
Staff contact: alan.dobson@rcn.org.uk , linda.watterson@rcn.org.uk
Following the discussion at Congress it was recognised that the Department of Health mixed sex accommodation initiative and ongoing work regarding quality indicators and patient safety (with full RCN engagement), would ensure that patient dignity and privacy remained a key priority.
Debate report
There was a lively matter for discussion in the debating hall on the benefits of single rooms for patients.
The subject was proposed by Claire Picton, representing the RCN Emergency Care Association. She said while it might be a long term solution in some hospitals, it benefits infection control. She added: “Privacy and dignity issues are also important. Walls and doors tend to be better than curtains if you are trying to have a private conversation. “Nurses have a prime opportunity to be pro-active on this.”
John Hill from the Scunthorpe branch wondered if single rooms are always the most appropriate way of delivering care as he felt interaction with people is “a significant part of the healing process”.
Andrea Spyropoulos, Council member for the North West region, said there were many benefits for patients. She said: “You will not have to move patients, you will not have to disturb them, and they will be able to involve their relatives in their care. It gives an ideal opportunity to give privacy, dignity, confidentiality and keep patients safe.”
RCN President Maura Buchanan said she has been working with single rooms for 15 years, and it meant no infections like MRSA or C difficile had spread to other patients.
Student Elizabeth Osinibi, who works in London, said she could see the benefits of single rooms to prevent infections spreading. However, she felt some patients might think their nurses have forgotten about them; and she had also seen doctors leave the door of the rooms open, meaning patients did not have any more privacy.
Background
Patient and political demand for single rooms in hospital is growing. As the NHS struggles to do away with mixed-sex accommodation, a new challenge is already on the horizon. In line with the government’s dignity agenda and the NHS Next Stage Review focus on improving patient experience, the next step is a move towards single-room accommodation.
Department of Health current guidance on this issue states that all newly built NHS acute trusts should aim to have at least 50 per cent of new inpatient beds in single rooms.
At present, single-occupancy rooms currently account for just under one-third of NHS beds in England and the latest Department of Health figures show that 30.7 per cent of hospital inpatient beds are now housed in single rooms – up from 22.6 per cent in 2002–03. The Scottish, Welsh and Northern Irish devolved governments have pledged that all new-builds should have only single-room accommodation, except in certain situations.
Vice Chair of the Patients Association Michael Summers said: “Privacy can be very important when you feel ill or low.” He described NHS Nightingale wards as being ‘from a bygone age’, and while he accepted that there could be advantages, such as better patient visibility, from a nursing point of view of larger wards, stated that NHS hospitals needed to be ‘brought into the 21st century’.
There is little published UK evidence on the use of single-occupancy rooms. A recent review on single-occupancy rooms by the National Nursing Research Unit at King’s College London revealed that little is known about likely impacts on staff and patients.
The report highlighted a range of potential advantages and disadvantages for patients, which included:
- increased privacy, dignity and comfort and less disruption from other patients
- improved control over their environment
- enhanced sleep and contact with families
- increased patient satisfaction
- reduced infection rates, faster patient recovery rates
- reduced social interaction – and thus patient isolation
- less surveillance by staff
- increased failure to rescue and increased rates of slips, trips and falls.
The report also indicated the perceived advantages and disadvantages for staff, which included:
- more personalised patient contact
- fewer potential interruptions
- decreased chance of prescribing errors (with medical storage in rooms)
- an increase in staff travel distances
- the potential need for an increase in staffing levels as a result of more single room occupancy, and/or adjustments to staff skill mix.
References and further reading
Clews G (2009) A room of their own, Nursing Times, 18 August 2009, 105 pp.8-10
Department of Health (2006) The NHS in England: operating framework for 2007-08, London: DH. www.dh.gov.uk/en/Publicationsandstatistics/
The Scottish Government (2008) Provision of single room accommodation and bed spacing, Edinburgh: Scottish Government (Chief Nursing Office Directorate circular CEL 48 (2008), 11 November 2008).
www.sehd.scot.nhs.uk/mels/CEL2008_48.pdf