Increasing the number of single rooms in hospitals will lead to patients being harder to monitor and in some cases at greater risk of dying, nurses are warning.
Placing patients in single rooms instead of traditional wards has led to safety breaches, according to nearly half of nurses surveyed by Nursing Times.
Difficulties in observing patients being treated in single rooms have led to serious incidents including suicides, invasive lines being pulled out and assaults on nurses, the survey of more than 1,200 nurses has revealed.
Single rooms have come under close scrutiny in recent weeks after the Conservatives’ draft health manifesto stated single rooms should be expanded “as resources allow” – a watering down of an earlier pledge to double them. The government also wants to build more single rooms.
While the majority (64 per cent) of nurses surveyed supported the policy, many also had concerns.
More than two thirds said single rooms made it more difficult to observe patients (70 per cent) and healthcare support staff (67 per cent).
One said: “Patients inside rooms are forgotten about. They are isolated, lonely and are not observed as they should be in order to be kept safe.”
Many were aware of patients dying as a result of less frequent checks by nurses.
More than half (53 per cent) of nurses surveyed said certain groups of patients were better off in traditional wards, such as patients who were elderly, anxious, confused and depressed.
Patients who nurses felt benefited most from single rooms included those who had infections or weakened immune systems, were vulnerable, needed palliative care, had gynaecological or embarrassing conditions and those who posed a risk to others.
Nearly two thirds (64 per cent) of nurses said single rooms increased their workload and 70 per cent said they required extra staff or more support from managers.
However, nearly all (91 per cent) agreed single rooms improved levels of privacy and dignity for patients, while 69 per cent said they reduced healthcare associated infection rates.
Shadow health minister Anne Milton told Nursing Times that patient expectations and reducing HCAIs made the move to more single rooms a necessary.
She said: “Nurses may well not like single rooms and I understand why, but what matters is having a structure to hinder the impact of healthcare associated infections.
“Expectations have risen and patients don’t want to be on a ward with lots of other people, even four other people. We have to give the public what they want and be very mindful of the need to consult,” she said.
North Teesand Hartlepool NHS Trust deputy director of nursing Cath Fiddle said areas of her hospital consisting predominantly of single rooms had seen “significant reductions” in rates of MRSA and clostridium difficile.
She said all patients were risk assessed to see whether they were prone to falls, before they were placed in single rooms.
Hillingdon Hospital Trust director of nursing Marie Batey said: “We had some initial concerns about whether some of our confused vulnerable people would wander. But actually it would appear that when they’re in a single room they seem to be more settled.”
Early observations suggested this could be because they were feeling more comfortable and secure, she said.
Just over half of nurses responding to the survey said most adults attending hospital for elective care preferred to be accommodated in single rooms.
But King’s College London National Nursing Research Unit deputy director Jill Maben said there was little evidence to back this up. She said: “Often the idea of being in single rooms is much more appealing when we’re not ill.”
One respondent to the survey agreed, saying: “Many patients prefer the camaraderie of the bay which can boost morale and reduce the length of hospital stays.”
Another said: “Recent experience has show that the majority of patients in single rooms feel isolated, state that they do not see anyone for most of the day and feel more depressed.”
A Department of Health spokeswoman said: “The department’s guidance is that the proportion of single rooms in new hospital developments should aim to be 50 per cent, but should not fall below 20 per cent and must be higher than the facilities they are replacing.”
All mental health patients should be accommodated in single rooms, she said.
She added: “Each trust makes an informed choice regarding the appropriate percentage of single bed provision based on practical considerations such as site restrictions and affordability as well as clinical and operational restrictions.
“In some cases, providing single rooms for all patients may not be clinically appropriate.”