Download Single Rooms vs. Double Rooms: Which is more

Running Head: Single Rooms vs. Double Rooms 1
Single Rooms vs. Double Rooms: Which is
more beneficial for patients?
Brie Schreiber
Youngstown State University
NURS 3749: Nursing Research
Dr. Patricia Hoyson
Summer 2011
Final Report
Single Rooms vs. Double Rooms 2
Single Rooms vs. Double Rooms:
A Review of the Literature
A patient’s hospital room is the central location for care and healing. Inside the hospital room,
the treatment, medication, cleaning, assessments, transfers, education, and visitations from family
occur. While these things are occurring for one patient, another patient is typically sharing the
experiences simply by being in the same room. Hospitals normally contain patient rooms that hold more
than one patient, but typically do not exceed four patients. When more than one person is occupying a
hospital room, complete privacy becomes almost impossible.
Patient preferences for types of rooms are unique to each individual and are determined at the
beginning of patient care at the hospital. Rooms and roommates are not a permanent situation and can
be considered for change upon request by a patient. Once a patient is in their assigned room, why
would they wish to change to a different room without a doctor or unit ordering this move? The desire
to move can be stimulated by a multitude of things: lack of privacy, lack of confidential assessments and
treatments, and lack of ability to rest/sleep, leading to a slower rate of recovery (Boardman & Forbes,
2007). When a patient has a roommate in a hospital, the roommate has potential to obtain full
knowledge about their roommate simply by listening within the room. The curtain that typically serves
as a divider does nothing to diminish sound or serve as an efficient barrier. Patients and nurses, after
managing through double room set-ups, have occasionally stated that private or single rooms provide a
better opportunity to improve health care and recovery when compared to the double rooms. Are
private (single occupancy) rooms more beneficial than multi-person (double occupancy) rooms for
providing direct patient care?
Determining which type of room setup provides the most beneficial patient care holds the
potential for improving patient health, satisfaction, and overall hospital efficiency. The patient is the
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number one priority for all hospitals, therefore, the available options for providing the best care must
always be analyzed. If single rooms are determined to be more beneficial for patients and their care,
hospitals need to find ways to make these arrangements available. Hospitals and units currently being
built can incorporate a multitude of private rooms into their floor plans before construction begins.
Many hospitals in the country are currently undergoing remodeling or expansion making now the
perfect time to research for definitive findings. If this research is funded and the findings indicate that
private rooms are more beneficial, the hospital will in turn, gain more profit because patients would pay
for an upgrade to a single patient room over the lower rate for a multi-person hospital room (Boardman
& Forbes, 2007).
The purpose of this research report is to review the current research literature and compare the
benefits that patients in standard hospitals receive in each type of room setup: private or multi-person.
The benefits for the patients will consist of items that provide direct patient care and improve overall
health status of the individual.
Review of Literature
Chaudhury, Mahmood, and Valente (2006) chose to study cost differences between private and
multi-person rooms. These researchers also set out to determine if infection control or patient care
were affected by the different types of patient rooms. (119). Chaudhury, Mahmood, and Valente (2006)
focused on nurses and administrative personnel in acute-care hospitals when handing out surveys
asking participants to rate patient care issues in the two types of patient rooms. Their study involved an
assessment of nineteen items: “layout, availability of space in room, arrangement of furniture, privacy,
walking distance from nursing station, visibility, degree of surveillance capability, storage space for clean
supplies, storage space for dirty supplies, location of storage area, sink, bathroom, door, and window
locations, space for family members, noise level/acoustics, lighting on space, heating and cooling,
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bathroom size, and wheelchair accessibility” (122). The researchers also analyzed direct patient care
items: room usage, interaction among patients, interaction with family, flexibility, quality of monitoring,
comfort level, recovery rate, probability of medication errors, falls incidences, and rates of pain or sleep
reducing medications taken (121-122). The study on nurses’ perception occurred in North-Western
United States where the surveys were given in allotted one hour time slots as to not interfere with the
nurses’ floor workload. The results shown from the surveys given by Chaudhury, Mahmood, and
Valente’s study indicate overwhelmingly that nurses preferred private rooms. The percentages figured
from the study show how much more beneficial single rooms are when compared to multiple occupancy
rooms (123). Overall, the study performed by Chaudhury, Mahmood, and Valente (2006) demonstrated
a high preference for single rooms for generalized patient care. A majority of the results favored single
rooms while some results still showed only moderate recognition of difference between the two types
of rooms. The researchers in this study, however, only studied staff preferences on room occupancy.
Studying nurse’s perceptions alone will not allow for an accurate measure of patient satisfaction with
room occupancy, thus requiring more research be done in this field.
Van de Glind, de Roode, and Goossensen (2007), instead of focusing on nurses, reviewed a
research study that set out to determine if patients benefitted from staying in single rooms while in the
hospitals (153). The researchers focused on whether or not patient’s benefits were higher in private
rooms by analyzing areas including stress, effective care, safety, nursing and hospital care, and health
quality. Van de Glind, de Roode, and Goossensen (2007) determined that the following measures were
to be considered for every single patient room designed, “privacy and dignity of patients, noise and
quality of sleep, patient satisfaction with care, hospital infection rates of MRSA, patient safety: fall
accidents, medication errors, patient recovery rates, and complications and length of stay” (155). The
review group looked at multiple studies such as randomized control trials, quasi-experimental studies,
and opinion articles. Under randomized control trials, patient satisfaction and infection rates were
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studied. Based on the evidence, the review group determined that patient satisfaction rates increased
significantly in most areas when moved from a multiple occupancy room into a single room. Their
results, however, did not indicate a decrease in the spread of nosocomial infections when only looking
at patients who have already been colonized with an infectious bacterium or virus (156). The quasiexperimental studies found looked at privacy, care, and noise levels or quality of sleep. Privacy, an
important factor for many patients and families, was highly increased in single rooms, therefore,
increasing overall patient satisfaction. The single rooms, however, were noticed to conflict with open
and direct patient monitoring in critical care situations. Van de Glind, de Roode, and Goossensen (2007)
concluded that in critical care scenarios, the room design needs to hold a proper balance between
adequate patient privacy and nursing monitoring needs (156-158). The quasi-experimental studies for
noise and quality of sleep needs to be further analyzed and more research needs to be done. The
research found by Van de Glind, de Roode, and Goossensen (2007) only looked at single patient rooms
instead of studying both single and multi-person rooms (158). Overall, the literature review conducted
by Van de Glind, de Roode, and Goossensen (2007) demonstrated a positive correlation between singleperson rooms and enhanced patient satisfaction with quality of direct care in the hospital setting.
Although some articles and studies lacked proper sample sizes or comparison groups, the reviewers did
not stumble across any negative effects of patients being placed in private rooms.
A third and final research study done by Florey, Flynn, and Isles (2009) also analyzed patient
preferences for single or multiple occupancy rooms. The researchers wanted to monitor the satisfaction
of patients who have stayed or were currently staying in multiple occupancy rooms compared to those
who switched to single rooms or had been admitted into a single patient hospital room upon entering
the hospital (5). Florey, Flynn, and Isles (2009) used a questionnaire that was given out equally between
patients currently in private rooms and patients in multi-person rooms. Over the course of the five day
study, the researchers asked patients if they would prefer single or shared patient rooms upon their
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next admission into the hospital after being asked a series of questions related to overall patient care
(5). Florey, Flynn, and Isles (2009) found that some patients preferred shared rooms, especially if they
were terminally ill and required longer hospital stays. A majority of acute-care patients, however,
wished to have single rooms upon their next admission into the hospital regardless of any feelings of
loneliness. The patients in single rooms noted lack of disturbance by noises and adequate privacy for
discussing personal issues and having family time (6). The research, however, showed an alarming
amount of patients who were pleased with their care in the multiple occupancy rooms and would like to
be placed in one again upon next admission into the hospital. Florey, Flynn, and Isles (2009) noted a
limitation to their study including their sample population of survey subjects. The researchers had the
questionnaire done in a hospital setting where the majority of patients were older and chronically ill,
therefore, they were staying in the hospital for longer periods of time as well as fearful of suffering from
social isolation (7). The results of this study done by Florey, Flynn, and Isles (2009) require more
research done but in a setting where more acute-care patients will be included as well as a lower mean
age for patients. In studying patient preferences for room occupancy, researchers were able to
recognize that patients can prefer multi-person rooms over single person rooms. These preferences
need to be addressed by designers and hospital administration upon building new hospitals or
remodeling current facilities.
Conclusion
Through the analyzed research, the question of whether private (single occupancy) rooms are
more beneficial than multi-person (double occupancy) rooms for providing direct patient care has not
been conclusively determined. The purpose of this report was to review the current research and
compare any benefits that patients in standard acute care hospitals received in all types of room
arrangements. After reviewing the three chosen articles, the mean average of patients, nurses, and
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hospital staff preferred patients to be placed in to a private room upon hospital admission for acute
illness situations. A chronically ill or older population of individuals, however, might prefer to be placed
in a room with other patients with similar ailments. Each research article housed limitations that may
have construed precise data collection; therefore, more research can be done in the near future using
different sample individuals to represent the normal population of individuals seen in the hospital
setting. Furthering research on this topic will allow for nursing professions to provide higher quality of
care based on patient environmental preferences. An article reviewed earlier noted that nurses respond
well to private rooms for patients over multiple occupancy rooms. The nurses felt that better patient
care could be given in a private setting and the patients in this study responded well to the
opportunities for better, individualized nursing care. Using the three research articles chosen, this report
was able to overall support ideas that private rooms are more beneficial to patients for providing care
than multiple occupancy room setups. These results may be able to aid in the designing and constructing
of future acute care and long term care facilities by allotting for a majority of single patient rooms while
still offering multi-person care environments.