Design of Australasian intensive care units: time for change or time for more research?

Recommendations exist to guide the design and construction of adult intensive care units, but current guidelines are hampered by the paucity of high-quality research. Much of the current literature on ICU design has focused on patient-centred outcomes, such as nosocomial infections, aspects of psychological and physiological wellbeing, and patient satisfaction, but the design of the ICU environment also affects health care workers. The literature seems to favour the use of single rooms rather than an open-plan ICU design, with the major benefits being to infection control, but this notion is controversial. For most aspects of ICU design, more research is required before definite conclusions can be drawn. This article discusses the application of evidence-based design to improve the ICU environment and reviews some of the controversial issues and concepts.