Using Evidence-Based Design Principles To Design: Imagine Yo ✓ Solved

Using evidence-based design principles to design: imagine yo

Using evidence-based design principles to design: imagine you are the health care administrator reviewing architect recommendations for toilet placement within the new wing of the hospital. The architect has provided four toilet placement options: outboard, inboard, same-handed, and nested. For each layout (outboard, inboard, same-handed, nested): 1) Describe in 45–90 words the evidence-based design principle that applies to the layout and cite at least one peer-reviewed or scholarly reference. 2) Describe in 45–90 words the impact on stakeholders (patients, clinical staff, hospital staff, family/visitors).

Paper For Above Instructions

Introduction

Toilet location in acute-care units influences infection control, privacy, workflow, wayfinding, accessibility, and patient experience. Applying evidence-based design (EBD) principles helps administrators balance clinical safety, operational efficiency, dignity, and family needs. This paper examines four toilet placement strategies — outboard, inboard, same-handed, and nested — describing the core EBD principle for each and the likely stakeholder impacts, citing relevant literature to inform an evidence-based recommendation.

Outboard Layout

Evidence-based design principle (45–90 words): An outboard layout places toilets along the exterior corridor wall or room perimeter to maximize daylight, ventilation, and direct corridor access. EBD supports locating sanitary facilities to enhance natural light, visual surveillance, and easy access while reducing trip distances to corridors, improving infection control through separable circulation paths (Ulrich et al., 2008; Passini et al., 2000).

Stakeholder impact (45–90 words): For patients, outboard toilets reduce travel distances and can increase feelings of safety through daylight and passive surveillance. Staff benefit from clear sightlines and shorter retrieval times. Family/visitors appreciate ease of access. However, corridor-adjacent toilets may increase noise or odors without proper ventilation; careful finishes and mechanical design mitigate these risks (Ulrich et al., 2008).

Inboard Layout

Evidence-based design principle (45–90 words): An inboard layout places toilets within the interior core or service zones, often adjacent to nurse stations or shared support spaces. EBD emphasizes clustering utility spaces to centralize plumbing, reduce infection transmission by limiting corridor exposure, and support controlled access and cleaning routines (CDC, 2003; Hamilton & Watkins, 2009). Centralization can simplify maintenance and reduce scope for contaminated traffic flows.

Stakeholder impact (45–90 words): Patients gain privacy and reduced exposure to corridor traffic, but some may face longer travel paths. Clinical staff benefit from proximity to cleaning supply zones and streamlined housekeeping; centralized placement can improve routine infection-control cleaning. Visitors may have less convenient access. Inboard toilets may constrain daylight and require robust ventilation and wayfinding to offset interior placement drawbacks (CDC, 2003).

Same-handed Layout

Evidence-based design principle (45–90 words): Same-handed layout means toilet rooms mirror or match room-handedness, placing the toilet consistently on the same side relative to bed orientation. EBD supports consistent spatial organization to reduce cognitive load, speed staff tasks, and standardize equipment placement, which improves safety and reduces errors during transfers and care activities (Hamilton & Watkins, 2009; Reiling et al., 2008).

Stakeholder impact (45–90 words): Patients experience predictable spatial cues that aid mobility and independence; staff benefit from standardized procedures for transfers, reducing ergonomic strain and time spent searching for fixtures. Housekeeping gains efficiency through uniform cleaning patterns. Families find orientation intuitive, aiding assistance. Same-handed design supports accessible transfers and decreases accidents when paired with appropriate grab bars and turning clearances (ADA, 2010).

Nested Layout

Evidence-based design principle (45–90 words): A nested layout situates toilet rooms within a semi-private alcove or antechamber directly adjacent to the patient room (often inside a bathroom cluster). EBD endorses nested arrangements to increase privacy, reduce corridor exposure, and buffer noise; they can create a transitional space supporting dignity while enabling staff to observe without intruding (Verderber & Fine, 2000; Joseph & Ulrich, 2007).

Stakeholder impact (45–90 words): Patients benefit from enhanced privacy and dignity, improving satisfaction and willingness to use in-room facilities. Families value reduced public exposure during personal care. Staff maintain modest observation and easier in-room assistance, but nested designs may slightly increase room footprint and housekeeping complexity. Proper sightline and alarm integration preserve safety while protecting privacy (Verderber & Fine, 2000).

Comparative Discussion and Operational Considerations

Tradeoffs among the four options revolve around accessibility, infection control, privacy, and workflow. Outboard layout optimizes access and daylight but must manage odors and noise; inboard supports centralized cleaning and reduced corridor contamination though may reduce daylight and wayfinding clarity (CDC, 2003; Passini et al., 2000). Same-handed solutions enhance standardization and ergonomics, reducing errors and staff strain (Hamilton & Watkins, 2009). Nested arrangements prioritize dignity and privacy, increasing patient satisfaction but requiring larger room footprints (Verderber & Fine, 2000).

Operationally, infection prevention and hand hygiene are critical regardless of layout; proximity to handwashing sinks, hands-free fixtures, and materials that withstand frequent disinfection should be specified (WHO, 2009; Pittet, 2001). Wayfinding cues (consistent signage and sightlines) help visitors and disoriented patients locate facilities quickly, which literature shows reduces stress and delays (Passini et al., 2000). Accessibility compliance per ADA standards must be integrated to support mobility-impaired patients and reduce falls (ADA, 2010).

Recommendation

Balance clinical safety and patient experience by prioritizing a hybrid approach: adopt same-handed and nested principles within patient rooms (to maximize standardization and privacy), with selective outboard access points for public and family use to reduce room footprint pressure and improve flow. Centralized inboard service zones should support housekeeping and plumbing strategies. This layered solution aligns with EBD research that recommends matching layout to operational needs while safeguarding privacy, accessibility, and infection control (Ulrich et al., 2008; Hamilton & Watkins, 2009; CDC, 2003).

Conclusion

Toilet placement decisions should be driven by evidence-based goals: reduce infection risk, support safe and efficient staff workflows, ensure accessibility, and preserve patient dignity. Each placement option offers strengths: outboard for access and daylight, inboard for service efficiency and containment, same-handed for standardization and safety, and nested for privacy. An informed hybrid strategy, supported by hand hygiene infrastructure and wayfinding, best serves stakeholders.

References

  • Ulrich RS, Zimring C, Zhu X, DuBose J, Seo HB, Choi YS, Quan X, Joseph A. (2008). A review of the research literature on evidence-based healthcare design. Health Environments Research & Design Journal.
  • Hamilton DK, Watkins D. (2009). Evidence-Based Design for Multiple Building Types. John Wiley & Sons.
  • Centers for Disease Control and Prevention (CDC). (2003). Guidelines for Environmental Infection Control in Health-Care Facilities. U.S. Department of Health and Human Services.
  • Pittet D. (2001). Improving adherence to hand hygiene practice. Lancet Infectious Diseases.
  • Passini R, Pigot H, Rainville C, Tétreault M.-H. (2000). Wayfinding in a hospital environment: A cognitive approach. Environment and Behavior.
  • ADA Standards for Accessible Design. (2010). U.S. Department of Justice.
  • Verderber S, Fine D. (2000). Healthcare Architecture in an Era of Radical Transformation. Van Nostrand Reinhold.
  • Joseph A, Ulrich R. (2007). Sound, lighting and other environmental factors in healthcare design. Journal of Environmental Psychology.
  • Reiling J, Murphy S, Kelliher J. (2008). Linking evidence-based design to health-care outcomes. Journal of Nursing Administration.
  • World Health Organization (WHO). (2009). WHO Guidelines on Hand Hygiene in Health Care.

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