Date of Graduation

Spring 2017

Document Type

Honors Research Project

Degree Name

Bachelor of Science in Nursing



Research Sponsor

Lisa Hart

First Reader

Diane Christensen

Second Reader

Connie Chronister


Over four million patients are admitted to the intensive care unit (ICU) every year. The ICU, along with many health care settings, is generally regarded as a stress inducing environment, which may contribute to negative patient outcomes. Yet, there has been little progress in developing environments that are optimal to patient healing and using evidence-based design for ICUs. Aspects of environment studied that can be manipulated to increase positive patient outcomes are aroma, light, noise, private rooms, windows, and layout of the room. The purpose of this systematic review is to answer the PICO question, in hospitalized critically ill adults, how does an environmental stressor or design, compared with standardized care, affect patient outcomes. We aimed to identify, review, and critically appraise the evidence about environmental stressors, design, and patient outcomes in the ICU setting. The unbiased search for electronic sources was conducted using healthcare-related databases, mainly MedLine and CINAHL. This systematic review found that interventions that manipulate light, sound, aroma, and room design can have positive effects on patient outcomes. However, these studies have confounding variables and other factors that affect validity and reliability. Therefore, there is a need for further research studying environmental effects on patients in the ICU setting. Furthermore, nurses should be involved in design of ICU patient rooms.