Background: New hospital design policies favour single rooms over traditional multi-bed wards for greater privacy, infection control and personalised care. However, concerns have been raised about higher risk of falls. Ysbyty Ystrad Fawr (new site) is the first local general hospital to be commissioned in UK to provide all single rooms with en suite facility which could have wider impact on patient outcome and this is not much studied.
Sampling methods: Patients who had documented falls, episodes of protection of vulnerable adults (PoVA) reported to Caerphilly County Council and new hospital acquired Clostridium difficile (C. difficile) in the new site over a period of 1-year were compared with 2-year retrospective standard audit data from old site (single room and multi-bed bays). All Wales fundamental of care audit data was also analysed for 1-year at each site. Patient satisfaction questionnaire (PSQ) on the single room facility was given to 15 randomly selected patients. Patient case-mix remained unchanged with move to the new site and individual patient characteristics were not studied.
Results: The incidence of falls, C. difficile and PoVA cases at the old and new site is shown as below
All Wales fundamentals of care audit showed 94.9% (old site) and 92.5% (new site) compliance with healthcare standards. PSQ (new site) showed 94% satisfaction, and all 15 patients agreed that they had received dignified care and privacy was maintained at all times.
Conclusion: Managing frail older people in single hospital rooms will be more challenging considering the observed significant increased incidence of falls. However, significant reduction of C. difficile and non-significant reduction of reported PoVA episodes without compromising fundamentals of care could support single room facility but, this need further research.