Are ICU Bedspaces Based in Evidence, and Do They Support Patient Sleep? A Narrative Review

Objective: This narrative review summarizes some of the evidence guiding current intensive care unit (ICU) design, focussing on environmental factors impacting on sleep, and compares available evidence and recommendations to current ICU designs and builds. Background: The importance of sleep for recovery after illness is well known. However, hospitalized patients frequently experience poor and disrupted sleep. This is especially true for patients admitted to the ICU. There are many factors negatively impacting on ICU patients' ability to sleep. Some relate to their illness or pre-existing sleep problems; others relate to patient care activities. While the ICU bedspace may facilitate 24h care, there is growing awareness of the detrimental impact the bedspace environment (especially suboptimal lighting and excessive sound/noise) has on sleep quality, and important questions raised regarding how this may impact on recovery and health outcomes. Multiple guidelines and recommendations exist to guide ICU bedspace design. However, questions have been raised whether contemporary ICUs are evidence-based, and whether the available evidence is effectively translated into the built ICU. Methods: A comprehensive literature review was conducted, exploring the evidence supporting current ICU bedspace design and the impact of ICU design and environmental factors on patient sleep. Results and conclusion: This review summarizes the impact of the ICU bedspace environment on patient outcomes and describes features of the ICU bedspace design that may not adhere to best evidence and contribute to poor sleep. Suggestions on how ICU bedspaces can be improved to optimize sleep are provided.