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Windows in patient room doors?

October 19, 2012
by James M. Hunt, AIA
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Is it more important for staff to be able to see into a patient’s room from the corridor without opening the door or for patients to have privacy and the ability to shut out light from the corridor?

 This was the subject of a rather lengthy discussion recently among the Behavioral Healthcare Group on Linkedin.  I am not sure a consensus was reached.  The opposing points of view seem to be:

1. Staff members want to be able to observe the patient without entering the room

2. Patients want privacy while dressing and don’t want other patients to be able to look into their rooms when the door is shut.

 First of all, I am not sure that adequate nighttime observation of patients can be done through a closed door from a lighted corridor into a darkened room.  I know of several incidents where patients died by suicide in their beds and staff didn’t know it until hours later when staff tried to wake them up the next morning.  If the staff’s reason for wanting the window is to see where the patient is in the room before entering the room to avoid being attacked, that may be a valid reason.

 From the patient’s point of view, I can understand the desire for privacy.  They are in a strange place, surrounded by people they don’t know (some of whom are acting in a rather strange manner).  Anyone passing their door can see in through a window and infringe on their privacy.  This is probably why in many of the facilities I visit that have windows in the patient room to corridor doors the patients have covered the windows with paper or other materials from the inside.  This completely negates the intent of the windows and the cost of providing them.

 So what is the solution?  If the facility feels strongly about having these windows, I suggest that consideration be given to providing a window that has the capability of being visually opened and closed only by staff from the corridor side.  The window would have to meet several criteria to be acceptable in this application:

1. Comply with all applicable fire and building codes

2. Have appropriate break and shatter resistant glazing

3. Operable only from the corridor side

4. Operable only by staff

5. Operating mechanism that does not provide ligature attachment opportunities or present other hazards to patients

6. Tamper resistant from both corridor and patient room sides

 There are several products available that meet these criteria including those available from Vistamatic, LLC. and Unicel Architectural Corp.  Additional information on these products may be found in the NAPHS “Design Guide for the Built Environment of Behavioral Health Facilities” which is available for download free of charge at www.naphs.org.

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Jim Hunt

Behavioral Healthcare Design Consultant

Jim Hunt

www.bhfcllc.com

James M. Hunt, AIA, is a practicing architect and facility management professional with over 40...