Single-room usage patterns and allocation decision-making in an Australian public hospital: a sequential exploratory study.
OBJECTIVE
The aims are to (1) measure occupancy rates of single and shared rooms; (2) compare single room usage patterns and (3) explore the practice, rationale and decision-making processes associated with single rooms; across one Australian public health service.


BACKGROUND
There is a tendency in Australia and internationally to increase the proportion of single patient rooms in hospitals. To date there have been no Australian studies that investigate the use of single rooms in clinical practice.


METHODS
This study used a sequential exploratory design with data collected in 2014.


METHODS
A descriptive survey was used to measure the use of single rooms across a two-week time frame. Semi-structured interviews were undertaken with occupancy decision-makers to explore the practices, rationale decision-making process associated with single-room allocation.


RESULTS
Total bed occupancy did not fall below 99·4% during the period of data collection. Infection control was the primary reason for patients to be allocated to a single room, however, the patterns varied according to ward type and single-room availability. For occupancy decision-makers, decisions about patient allocation was a complex and challenging process, influenced and complicated by numerous factors including occupancy rates, the infection status of the patient/s, funding and patient/family preference. Bed moves were common resulting from frequent re-evaluation of need.


CONCLUSIONS
Apart from infection control mandates, there was little tangible evidence to guide decision-making about single-room allocation. Further work is necessary to assist nurses in their decision-making.


CONCLUSIONS
There is a trend towards increasing the proportion of single rooms in new hospital builds. Coupled with the competing clinical demands for single room care, this study highlights the complexity of nursing decision-making about patient allocation to single rooms, an issue urgently requiring further attention.
School of Nursing and Midwifery, Deakin University and Centre for Quality and Patient Safety Research, Deakin University, Geelong, Victoria, Australia.
Melissa J
MJ
Bloomer
Palliative Care Research Team, School of Nursing and Midwifery, Monash University, Frankston, Victoria, Australia.
Susan F
SF
Lee
CLOVeR Clinical Systems Support, Peninsula Health, Frankston, Victoria, Australia.
David P
DP
Lewis
School of Nursing and Midwifery, Monash University, Frankston, Victoria, Australia.
Mary Anne
MA
Biro
School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia.
Cheryle
C
Moss
D001315:Australia; D003657:Decision Making; D006779:Hospitals, Public; D006801:Humans; D009726:Nurses; D057240:Patient Preference; D010362:Patients' Rooms; D011795:Surveys and Questionnaires
clinical judgement; decision-making; hospital care; nursing; research; ward design