In the ongoing debate surrounding the funding and staffing of hospitals in New Zealand, an essential aspect often overlooked is the need for single rooms in all public hospitals. Commonly, patients are placed in shared rooms with multiple occupants, often with both genders sharing the same space, a practice fraught with ethical considerations and safety concerns. However, the fundamental shift to prioritise single rooms during new hospital construction and renovations should not be overlooked. This pivot not only addresses infection control and privacy but also counters the notion of cost by considering the economic implications of mitigating infections and bacterial resistance.
The latest research consolidates clinical and ethical arguments, advocating the need for single rooms as the core standard of care. Conventional wisdom may view shared rooms as a cost-saving measure. However, a persuasive argument for individual rooms hinges on the financial and health implications of infections and bacterial resistance. Single rooms significantly mitigate risks, minimizing exposure to communal infection sources like tactile surfaces, unfiltered air, toilets, and water systems. Furthermore, they eliminate the necessity for intra-hospital room transfers, which amplify the chances of infection transmission between patients.
Supporting this argument, robust evidence indicates a notable reduction in infections within intensive care units that utilize single-occupancy rooms. Further research also reveals a decreased hospital transmission rate of COVID-19 in single-occupancy environments. Currently, these rooms are prioritized for patients already diagnosed as infectious. This approach, however, does not account for the significant volume of transmissible infections unknown at the time of ward placement. A lack of capacity means even with known infections, hospitals often fail to meet basic guidelines due to a deficit of single rooms. For instance, only 30% of rooms in Wellington and Hutt hospitals are single occupancy. Thus, without the norm of single occupancy, hospitals can’t adequately manage infection control.
Additionally, single occupancy rooms become vital in the face of New Zealand’s ageing population and increasing hospitalization rates. A quarter of hospital patients are affected by delirium, which leads to longer stays, complications, and a heightened risk of death. Single occupancy rooms offer controlled environments conducive for delirium prevention and management. Also, the unique behavioral and psychological challenges associated with dementia patients, such as hallucinations, sleep disturbances, depression, and aggressiveness, can be more effectively managed with individual rooms. Considering that the prevalence of dementia is projected to more than double by 2050, New Zealand hospitals must prepare for this inevitable rise in demand.
Shared rooms unequivocally compromise clinical care and violate patient rights. The importance of patient dignity and privacy is highlighted by regulations under the Health Information Privacy Code and the Health and Disability patient Code of Rights. Based on these facets, it is evident that shared rooms, with their reliance on curtains for privacy, are grossly inadequate. Overwhelming patient surveys validate the preference for single occupancy due to privacy and confidentiality factors, countering arguments favoring multi-bed rooms for the sake of companionship.
While constructing single rooms may increase upfront costs due to a larger hospital footprint, no credible economic evidence supports the financial feasibility of multi-bed rooms. The potential savings during future pandemics, in terms of reduced mortality, patient transfers, and disease transmission, should not be underestimated. Furthermore, improved management of conditions such as delirium and dementia could decrease the length of stay and cost.
Therefore, there is an unequivocal collective argument on clinical, ethical, and legal grounds for single-occupancy hospital rooms. It is crucial for New Zealand to align with international best practices and adopt single patient rooms as the standard in new hospital builds and upgrades. Ignoring this renders the country’s code of patient rights impractical, overlooks key lessons from the COVID-19 pandemic, and neglects to address the needs of an ageing population.