This is the question being explored in a new article by Kathrine M. Schledermann, a lighting designer and Industrial PhD student at Chromaviso. The article is part of the industrial PhD-study conducted in collaboration between Kathrine, Chromaviso, and Aalborg University. The study is partially funded by the Innovation Fund and investigates the implementation of circadian lighting in nursing homes and hospitals, with a focus on the work environment of the staff. This article uncovers the period leading up to the implementation of circadian lighting.
Research* conducted at Rigshospitalet has demonstrated that a Danish-developed circadian lighting system reduces depression, anxiety, circadian rhythm disorders, and fatigue in hospitalized patients. As a result, hospitals and nursing homes have now integrated circadian lighting into their care and treatment practices. This has sparked a need to examine and streamline the implementation of circadian lighting.
The new article delves into the perception of traditional lighting among nurses working in the Department of Anesthesia and Intensive Care 6021, Neurocenter, at Nordfløjen, which is part of Rigshospitalet, prior to the installation of the integrative lighting systems. It examines the advantages and disadvantages of the traditional lighting system in relation to their daily work and routines.
The utilization of traditional lighting and other key observations
The study conducted on the utilization of lighting systems in the daily work of nurses at the hospital has yielded a series of valuable observations:
- The nurses' use of lighting is greatly influenced by the needs and health of the patients. For example, evening and night shifts often work in near darkness to protect the patients and minimize disruptions to their circadian rhythm. This can be seen in the use of a pupil flashlight, which is often used when checking medication and other instruments connected to the patients at night.
- The nurses often find themselves in a dilemma between choosing lighting that suits the patients or lighting that provides good working conditions for themselves. The lighting system in multi-bed rooms can also cause disturbances as the nurses have to turn on the lights for the entire room when examining one patient, as the lights cannot be zoned.
- The nurses appreciate the ability to manually adjust the brightness of the overhead lights and determine the height and angle of a desk lamp. However, they have also found creative ways to use desk lamps, for example, to avoid turning on the overhead lights so they can still perform their work.
- Not everyone found the lighting system easy to operate and often had to experiment until they found a suitable setting. The nurses also raised critical questions about the purpose of the traditional lighting system and when it is best to use different lighting settings.
- The nurses often use bedside tables as workstations to store medication, medical equipment, gloves, and more. However, there is no lighting available for the bedside tables. Instead, the nurses use desk lamps, which they rotate 180 degrees away from the desk to illuminate the bedside table where possible. They generally appreciate the desk lamp as it has a warmer colour temperature and can be adjusted in height and rotation - some even noted the need for such a lamp near the patients.
- The nurses lack the ability to offer warm colour temperatures to create a cozy atmosphere for patients and their families, or for farewells with loved ones. They also miss the lighting changing throughout the day, as some of the nurses had experienced in their previous departments before moving to Nordfløjen. They have many light-sensitive patients and therefore also need warmer, dimmed light for this patient group, especially in the recovery room (PACU) where patients need to wake up after an operation.
Findings and conclusions
The study has uncovered several significant points when it comes to improving both patient well-being and supporting nursing tasks and routines. Overall, it is concluded that it is crucial to involve the staff in the design phase, as they can contribute knowledge about specific needs and the use of lighting that may not otherwise be considered in the design.
Additionally, it is concluded that even new buildings do not meet the requirements of activities and users in a complex environment such as an intensive care unit (Neurointensive) and recovery (PACU).
Based on the findings of the study, a series of recommendations have been formulated, highlighting the following aspects:
- Implement and educate the staff on the use of lighting and its various settings, as well as the impact it has on people's circadian rhythms.
- Design lighting and controls to meet the specific needs of each department.
- Zone the lighting in multi-bed rooms to prevent disturbance to other patients during nighttime examinations.
- Create flexible lighting solutions that can be adjusted as new needs arise.
- Install lighting for specific tasks and work areas within a room, such as medication handling and medical equipment.
- Design a dynamic lighting profile that supports the natural circadian rhythm of individuals, including nighttime lighting that allows work to be done without disturbing patients' and staff's sleep.
Find all results and recommendations from the study in the article here.
*Anders West – PhD: The effects of Naturalistic Lighting in stroke patients, Copenhagen University 2018.