Rethinking Public Hospital Design in Low-Middle-Income Countries Through the Lens of Florence Nightingale's...

Area of Science:

• Nursing
• Healthcare Environmental Design
• Public Health

Background:

• Florence Nightingale's environmental theory remains relevant for understanding hospital design.
• Holistic nursing emphasizes the therapeutic environment as a core value.
• Low-resource settings present unique challenges for hospital environmental quality.

Purpose of the Study:

• To identify recurring environmental design problems in low-resource public hospitals.
• To assess the impact of these environmental issues on nursing care.
• To link these problems to infection risk, fall prevention, and therapeutic environments.

Main Methods:

• Clinical commentary based on composite field observations over two years.
• Observations guided by Nightingale's environmental theory and holistic nursing values.
• Synthesis of observations against evidence-based design and nursing literature.

Main Results:

• Identified four key patterns: poor ventilation/daylight, overcrowding, inaccessible washrooms, and increased nursing burden.
• These patterns correlate with increased infection risk and fall potential.
• Environmental deficiencies negatively impact nursing workflow and patient experience.

Conclusions:

• The hospital's physical environment is integral to whole-person care.
• Nightingale's theory offers a framework for low-cost environmental improvements in resource-limited settings.
• Nurses can advocate for environmental assessments and leadership to enhance care quality.