title: The impact of daylight and views on ICU patients and staff.
abstract: OBJECTIVE
  Using a pre-test/post-test quasi-experimental study in two New Hampshire ICUs, the impact of daylight and window views on patient pain levels, length of stay, staff errors, absenteeism, and vacancy rates were examined. One ICU was operational until 2007, the second opened in 2007. ICU patients were randomly selected from cardiac surgery, pneumonia, and chronic obstructive pulmonary disease admissions of one or more days, 58 from the old ICU, and 52 from the new. Regular medical staff members assigned to the unit between October 2006 and September 2007 (old unit) and March 2008 and February 2009 (new unit) were included.
  
  
  RESULTS
  Variables other than unit design had a more significant impact on relative pain levels in each unit. Comparing light levels independent of ICU assignment supported the hypothesis that increased light levels reduce pain perception and length of stay, but the relationship was not statistically significant. One trend, not statistically significant, suggested that view was associated with reduced pain perception. A decrease in incident filings supported the hypothesis that improved natural light and views reduced errors, but results were not statistically significant. Some subcategories demonstrated significance. Mean absenteeism per person decreased from 38 to 23 hours from the old unit to the new (p = 0.05). Average vacancy rates decreased by 25% (from 10.12% to 7.49% staff openings per year) in the old and new units (p = 0.04).
  
  
  CONCLUSIONS
  High levels of natural light and window views may positively affect staff absenteeism and staff vacancy. Factors such as medical errors, patient pain, and length of stay require additional research.
authors.affiliation: Corresponding Author: Mardelle Shepley, College of Architecture, Texas A&M University, College Station, TX 77843-3137 (mardelle@archone.tamu.edu).
authors.forename: Mardelle McCuskey
authors.initials: MM
authors.lastname: Shepley
authors.forename: Raymond Peter
authors.initials: RP
authors.lastname: Gerbi
authors.forename: Angela E
authors.initials: AE
authors.lastname: Watson
authors.forename: Stephen
authors.initials: S
authors.lastname: Imgrund
authors.forename: Rana
authors.initials: R
authors.lastname: Sagha-Zadeh
mesh_terms: D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D019300:Medical Errors