Illumination and Lighting in Hospital

Every modern hospital consists of many components serving diverse functions. They may be non-medical areas, such as offices, kitchens, laundries and libraries and may be lighted in the same way as those found in industry or commerce. There are also many specialised interiors, such as operation theatres, clinics, treatment rooms and wards, where special lighting techniques and fittings will be required to achieve the desired standard of lighting, hygiene, electrical safety, reliability and ease of maintenance.

Complex structures of hospitals by the nature of their construction require special lighting and illumination requirements. Thus, different type of services in the hospital need to have specific illumination and lighting in different areas as per requirements of the services that are being rendered.

These guidelines for lighting and illumination requirement for hospitals are intended towards satisfactory lighting of those interior areas which are peculiar to hospital buildings.

Hospitals need to ensure that there is adequate lighting and illumination in the circulation area, indoor areas, and procedure rooms and in front of the facility and on the access road of the hospital. The hospital also needs to ensure that it uses energy efficient measures like use of natural light and energy efficient bulbs.

Lighting of the Patients Rooms or Wards

The  patients’ rooms in a hospital often account for more than half of the useful floor space. The lighting of patients’ rooms is of great importance and has to satisfy the needs of the patients as well as those of the medical and nursing staff. Moreover, the total lighting effect should be such as to contribute to the general decor and should be free of glare to the recumbent patient.

Lighting for Medical and Nursing Staff

This lighting should be adequate to enable them to carry out their routine tasks. Lighting should enable the staff to carry out such tasks as reading thermometer or making charts at the bedside or elsewhere.

It is recommended that the nursing stations are to be illuminated with at least 150-300 lux level of lighting.

Lighting for the Patients

For the patients in the wards, lighting should create a cosy and pleasant atmosphere. Lighting in the wards should be planned in such a way that meets the specific requirements of the patients in a ward, for example, some of the patients may like to sleep before the scheduled time of ‘lights out ’ so a high level of illumination will be a nuisance to those patients.

Considering all these requirements the level of illumination of 100 lux is acceptable for general lighting of wards which will also meet the needs of the nursing staff.

Apart from general lighting, individual patients can be provided with additional lights in the form of bed head lights which can be switched ‘on’ or ‘off’ by patients themselves. These lights also contribute to the general appearance of the wards by breaking the monotonous uniformity that will result from general lighting.

Examination Lighting

In certain emergencies it is required to examine the patient in the ward itself for which an examination light capable of providing 1000 lux will be required. For such situations a mobile examination lamp which can be attached to a wall socket by the bedside may be used as providing a separate examination lamp by the bed side may not be good idea as its use may not be that frequent.

Night Lighting

At night after ‘lights out’ the wards cannot be left in complete darkness. The nursing station should be able to take in the ward at a glance to make sure that everything is alright. Those patients who can move should also be able to make their way to the lavatory, etc. At night lighting system should give enough illumination (about 1 lux) for this purpose.

The lighting installation in a ward therefore is recommended as follows:

Lighting requirements in wards

Lighting Requirements of Corridors

Corridors in a hospital serve a more important function than in many other buildings because they act as transitional areas between wards and service rooms and between naturally lit and artificially lit rooms.

Doctors discuss their work with their colleagues and make notes. Thus the corridors, in a sense, act as a working area. Moreover, corridors also fall within the visual range of the patients in the wards and therefore require special attention. The artificial lighting to be provided in the corridors will depend on the architectural layout adopted for the building.

Single Corridor Layout

In the ‘single corridor’ layout the wards and the service rooms are on the two sides of the corridor. In such layout the corridor itself will have enough day lighting. In the evening the corridors needs to have an illumination of about 100 lux. But after ‘lights out’ the corridors needs to be provided with similar night lighting arrangement as for the wards, that is minimum of 1 lux lighting arrangement.

Double Corridor Layout

In the ‘double corridor’ or ‘race track’ plan the wards are placed around the outside of the building and are normally day lighted. In the centre of the building are the service rooms which will have no access to daylight and will require artificial lighting at all times. During the day the staff will move between the wards receiving daylight to the internal rooms which are artificially lit to a level. The corridor should bridge these two levels and an illumination of 150 lux is to be provided in the corridors during the daytime. In the evenings the corridors need to have 100 lux of illumination level as the ward illumination level is of 100 lux.

Lighting of Surgical Areas

Lighting of Operating Theatres and Labour Room

The general lighting of procedure rooms should be at least 300 lux. This level of illumination is adequate for the technical staff to operate the ancillary equipment in the operation theatres.

The visual requirement in the theatre is the detailed examination of tissue, organs and instruments at the site of the operation. The size of critical detail is very small with a very low contrast. It is recommended that the illumination level for lighting on the operating tables should be between 2000 and 10000 lux. Lower levels than this may be more comfortable for the surgeon where fine detail does not have to be discriminated like in labor rooms.

Light Sources

In general, the operating table light fittings employ tungsten lamps and produce a very high level of illumination, with very good colour rendering properties but it is not advisable to use filament lighting for general lighting of the theatre because of the additional heat output that would be produced by this form of lighting. It is more practical to use fluorescent light sources which inherently have low heat output and have added advantage of producing good colour of lighting which is needed for rendering medical purposes.

Anaesthetic Room

In view of the close association of this room with the theatre proper a general illumination of 300 lux is recommended with provision for a spotlight (which can be either fixed or portable).

Recovery Room and Intensive Care Units

General lighting may be installed as in a normal ward with a separate system to raise the illumination level up to 300 lux for each bed independently. The fitting designs should be such as to limit the spread of lighting onto the adjacent beds. Dimming of the individual bed lights should be provided for.

Recommended illumination values and Glare index

The levels of illumination and glare index recommended for different areas in a hospital are listed as follows:

Illumination in front and on access road

Hospital needs to ensure that the front of the hospital and access road to the hospital is well illuminated with use of street lamps. The lamps should be installed in a way that no dark areas are there on the access road. In addition to these, display boards used for the name of the hospital and emergency department should be well illuminated.

Energy Efficient Measures

Hospital needs to ensure that it follows energy efficient measures while planning for lighting requirements of the hospital. Energy efficiency measures that can be adopted by the hospital includes following measures:

1. Adequate use of natural lights/day light.
2. Use of energy efficient bulbs like CFL or LED.
3. Limited use of artificial lights.

• Switching off of lights when not needed.
• Defining and following “lights out” hours for hospital for different area.
• Labelling of switches to enable staff to select only those lights which are needed, etc.

Source: : Guidelines For Implementation Of "KAYAKALP" Initiative