Hospital admissions can be an extremely overwhelming experience, no matter the reason or duration of the stay. A significant contributing factor to this is the experience of sensory triggers, often at heightened levels and unique to the hospital setting. This overstimulation of the senses is further compounded by the person’s difficulty in modulating the environmental input to suit their individual sensory needs due to illness or injuring, having cognitive or mental health issues, and simply not having the ability to control the environment they are inhabiting.
Examples of sensory triggers unique to hospital settings include:
· Noises – beeping of machines, trolleys, moaning of patients
· Sights – hospital equipment, unfamiliar people, bright lights, unwell patients
· Smells – disinfectant, hospital food, bodily fluids
· Touch - transfers, assistance with self-care, injections, pain
Experiencing sensory triggers can result in increased stress and anxiety levels, feeling unsafe, emotional outbursts and aggressive incidents, which as well as extremely distressing for all involved, impact negatively on health outcomes.
However, research conducted across healthcare settings demonstrates that even small sensory changes to the hospital environment can have a positive impacting on patient stress levels and behaviour, thus creating a safer, more trauma informed and recovery informed environment. These positive outcomes have been shown to benefit both patients and staff.
Yakov et al (2017) found that the practice of dimming lights and reducing noise after 4pm in an acute mental health facility was extremely effective in reducing incidents of aggression and the use of restraint.
Ulrich et al (2018) cites numerous research articles supporting the positive impact of exposure to light reflecting natural rhythms, access to nature (like gardens), views of nature and artwork depicting nature has on stress and aggression levels in hospital settings.
The National Safety and Quality Health Service (NSQHS) Standards (2019) state that sensory modulation helps people manage distressing feelings and regain control without the need for restrictive interventions. Sensory modulation is changing how you feel through using your senses (Fitzgibbon & O’Sullivan, 2018). The standards recommend the following sensory informed environmental strategies to reduce the risk of aggression in a healthcare setting:
Allowing people to move around, preferably with access to outside areas
Reducing stimulus such as bright lights or loud noises
Providing privacy using curtains or side lounges.
In a hospital setting, using a Sensory Triggers Screen that was designed for Acute Medical Environment is a valuable method to:
· Identify a person’s sensory triggers and early signs of distress when in hospital
· Gather information regarding a person’s unique sensory needs
· Recommend and implement simple, practical, sensory informed strategies to better meet these sensory needs and where possible alleviate unnecessary stress to improve their hospital stay and recovery
Information to inform the Sensory Triggers Screen -( Acute Medical Environment) can be gathered from a variety of sources, including the patient, carers/significant others and care specialists who know the patient.
Resources:
Copy of infographic: Sensory Modulation Brisbane infographic:
Copy of Screen: Sensory Triggers Screen - Acute Medical Environment
Book: Sensory Modulation Resource Manual
Online Course: Using Sensory Modulation
References:
Australian Care Standards Quality Health Commission (2019). The National Safety and Quality Health Service (NSQHS) Standards, Minimising Patient Harm, Action 5.33, found in https://www.safetyandquality.gov.au/standards/nsqhs-standards/comprehensive-care-standard/minimising-patient-harm/action-533
O’Sullivan J and Fitzgibbon C (2018) Sensory Modulation: Resource Manual. Amazon Digital Services.
Ulrich, R. et al (2018) Psychiatric ward design can reduce aggressive behaviour, Journal of Environmental Psychology, 57:53-66 https://doi.org/10.1016/j.jenvp.2018.05.002
Yakov, S. et al (2017) Sensory Reduction on the General Milieu of a High-Acuity Inpatient Psychiatric Unit to Prevent Use of Physical Restraints: A Successful Open Quality Improvement Trial, Journal of the American Psychiatric Nurses Association DOI: 10.1177/1078390317736136