Hospital Lighting Design Guide PDF

6. LIGHTING FOR HOSPITALS 6.0 INTRODUCTION Lighting requirements in hospitals vary in the different areas of the hospital and depend also on a wide range of visual conditions needed by the various users; patients, doctors, nurses and cleaners. In some cases, the requirements of the m...

6. LIGHTING FOR HOSPITALS 6.0 INTRODUCTION Lighting requirements in hospitals vary in the different areas of the hospital and depend also on a wide range of visual conditions needed by the various users; patients, doctors, nurses and cleaners. In some cases, the requirements of the medical staff predominate, in others, comfortable lighting for the patients is of greater importance. Colour, both that produced by the light sources and that reflected by the surroundings, is particularly important. Firstly, it can help ensure the best conditions are created for treatment and examination purposes - for instance, where the diagnosis of a patient's condition may be related to the colour, or change in colour, of the patients skin. Secondly, it is a factor of psychological significance in reducing the clinical appearance of the hospital and suggesting a more friendly atmosphere, which will contribute towards the recovery of the patient. Interference free lighting should be provided in those areas where the use of radiation -sensitive electronic equipment is anticipated. Emergency lighting should be installed in all internal traffic areas and exits and all other areas where life and safety would be endangered by the absence of lighting. 6.1 HOSPITAL WARDS In ward areas the visual needs of the patients themselves and the medical and cleaning staff have all to be considered. Patients should be able to read and do handiwork in or next to their beds, to rest or sleep without being disturbed by any discomfort glare, and to safely move around the room by night as well as by day Where fluorescent lamps are concerned, the colour of the light should be selected with care. In those areas where a homely atmosphere is wanted, and where medical examination is not critical, perfect colour rendering is not needed and a lamp colour appropriate to the climate can be chosen: warm-white colour 83 for hospitals in colder climates and cool-white colour 84 for hospitals in the tropics. In those wards where medical examinations are performed and better colour rendering is needed, colours 93 and 94 respectively are to be preferred. The ward lighting should be installed in such a way as not to cause any discomfort glare to the patients-especially those whose field of view may include only the ceiling and the direction of the medical staff 6.1.1 General lighting in wards The general lighting in the ward should be sufficient to allow routine medical and domestic duties to be properly performed. The indirect lighting is preferred for this purpose, which is often incorporated in the bed-head luminaires should provide an illuminance of between 100 and 200 lux. There should be a light switch located at the door-way. 6.1.2 Local lighting over the beds This should be sufficient to provide good illumination for reading, handiwork etc. Illuminance at the bed-head should be between 100 and 300 lux over the full width of the bed. The luminance of the luminaires as seen by both patients and medical staff should not exceed 350 cd/m2, and heat radiated by the source should be as low as possible. There should be a light switch located within easy reach of the patient. 36 6.1.3 Examination lighting If examination or treatment of the patient cannot be carried out in an appropriate room, supplementary luminaires may be used in the ward. The lamps, which should be so screened that only the bed is illuminated, should give a minimum illuminance of 1000 lux. The light source should also have the desired colour rendering properties. 6.1.4 Night lighting Night lighting should be sufficient to provide the minimum amount of light necessary for nurses and patients to find their way about during the hours of darkness. This corresponds to an illuminance of 1.0 lux at floor level. It requires that the lamp be adequately screened. 6.1.5 Night observation lighting Night lighting intended for the observation.of patients should cause the minimum disturbance to other patients in the ward. An illuminance of 5 to 20 lux, restricted to the bed- head, is recommended. The light switch, located at the bed, should not be within reach of the patient. 6.2 CORRIDORS The lighting in corridors should be related to the lighting in adjacent rooms so that there is no difference in illuminance when passing from one to the other. This often means that provision must be made for reducing the illuminance in the corridor at night-time. In those cases where the corridor does not receive sufficient natural light during the day time, the artificial lighting in the corridor should facilitate visual adaptation by providing a rather high luminance on the wall opposite the door of a room that is illuminated by day light. An asymmetrical lay-out of luminaires along corridors is less disturbing to patients who are being wheeled along the corridors on trolleys The day time illuminance should be 200-300 lux. This can be reduced during night time to 5-10 lux in corridors open to bed-bays and 10-50 lux in all other corridors. 6.3 EXAMINATION ROOMS Examination lighting should be planned to accommodate a wide variety of possible visual tasks. This is normally achieved using a combined system of general and local lighting. The general lighting and the local lighting should be matched, as closely as possible, for colour temperature. The illuminance of the former type of lighting should be between 500 and 1000 lux. 6.4 THEATRE - SUITE LIGHTING The lighting of the operating theatre calls for a delicate balance between the very special lighting used to light the centrally placed operating table and that providing the illumination in the remainder of the theatre. The operating luminaire is designed to give shadow-free lighting of very high illuminance on the table variable in intensity between certain prescribed limits. The illuminance provided by the general lighting should be in the order of 1000 lux in order to always keep luminance differences within the theatre to an acceptable maximum. 37  The colour of the general illumination in an operating theatre should also be compatible with the illumination from the operating light, that is to say the colour temperature of the two sources should match as closely as possible. The preferred source for the general theatre lighting is the tubular fluorescent lamp having a colour temperature of around 4000 K and the best possible colour rendering. Luminaires should be of the multi- lamp recessed type, equipped with mirror reflectors to give maximum light output and low source luminance. The illuminance level given by the general lighting in the other rooms comprising the theatre suite, viz. surgeons1 and nurses' changing rooms, scrub room, sterilising room and necessary room, should be at least 50% of that given by the general lighting in the theatre itself in order to facilitate visual adaption when passing from one to the other. Colour rendering should be the same throughout the suite. 6.5 INTENSIVE-CARE ROOMS The illumination here must be suitable for a wide variety of visual tasks. Furthermore, the lighting system should include provision for changing the illuminance level quickly in order to satisfy emergency conditions. General illuminance should be variable from 300 lux down to almost zero. The preference is for (TL' colour 84 or 94. Supplementary luminaires are needed to provide the localised lighting used for examination and treatment purposes portable surgical luminaires (operating lights) should also be available. Curtains are needed to protect adjacent patients from illuminances that are disturbingly high. For psychological reasons, the lighting in the intensive care unit should be as similar as possible to that in the ward. 6.6 X-RAY ROOMS Rooms where x-ray examinations have to be carried out must be lighted according to the examination method adapted. For normal x-ray photography, no special demands are placed on the lighting, but where image intensifiers or television systems are in use it should be possible to reduce the general lighting to between 10 and 30 lux. Where direct observation of the screen is involved, orientation lighting giving no more than about 10 lux should be provided. For the positioning of patients and for the purposes of room cleaning, a dimmer- controlled general lighting installation that gives an illuminance of 100 lux will suffice. Other tasks e.g. the giving of injections, will require localised lighting. A pleasant, restful environment can be created by adding some decorative lighting for example a wall luminaire giving a low, comfortable level of lighting. 6.7 OTHER ROOMS A hospital will usually have many other rooms in addition to those mentioned above. There will probably be laboratories, offices, lecture theatres, reception areas, therapy rooms, children's wards, incubation rooms, kitchens and a variety of service and communication areas. The lighting for these rooms and areas is, however, the same as that for similar areas in other buildings. -------------------------------------- 38