In 1854

In 1854, Florence Nightingale and her team volunteer nurses were assigned by Sidney Herbert, the Secretary of War, to care for the British soldiers fighting in the Crimean War. Nightingale and her thirty-eight nurses saw the alarming sanitary condition at the military hospital in Scutari. The soldiers were dying ten times because of the infectious disease than deaths from wounds during the war (NCBI 2011). Nightingale worked towards improvements in sanitation, nutrition, and activity for the patients of the hospitals. Death rates were reduced dramatically with the introduction of such measures.

The Environmental Theory of nursing started during the Crimean War where she found out the reason for mortality and implement an effective solution. In the hospital, she discovered that the soldiers were didn’t receive the enough care, lack of medicines and other resources, neglected on hygiene, and infection was uncontrolled (NCBI 2011). Furthermore, she was especially concerned with the impact of the physical environment on patient’s recovery, in particular the contribution of fresh air, clean water, effective drainage, cleanliness, natural light, warmth and quiet on patients and argued that a deficiency of any of these could diminish health and impede recovery (IJNS 2013). Florence Nightingale sees clearly that the hospital is lack of good sanitation so she focuses on the solution first by purchasing 200 Turkish towels, provided an enormous supply of clean shirts, plenty of soap, and such necessities as plates, knives, and forks, cups and glasses. Nightingale believed the main problems were diet, dirt, and drains—she brought food from England, cleaned up the kitchens, and set her nurses to cleaning up the hospital wards. A Sanitary Commission, sent by the British government, arrived to flush out the sewers and improve ventilation (NCBI 2011). She also believes that patients will achieve the optimal health by altering the environment, including minimizing the noise and having the individualized or specific diet. All of these areas can be manipulated to help the patient meet the goals and get healthy. This nursing Theory is a patient-care theory. It is the beginning of patient-centred approach that focuses on the care rather than nursing process. It is about having individualized care and providing care base on what the patient needs and not on general treatment because each patient has different situations and illnesses (Nursing Theory 2016). Florence Nightingale in her attempt to maintain a hygienically clean environment for patients and in hospitals. This effort eventually led to the introduction of a concept which came to be known as the sterile field, maintained during surgical procedures. Nightingale, beginning with her efforts during the Crimean War, was convinced of ‘the crucial importance of sanitary doctrines, and of the deadly consequences of overlooking or ignoring them (Science Direct 2018). In recent years, the effects of the physical environment on the healing process and well-being have proved to be increasingly relevant for patients and their families as well as for healthcare staff. The discussions focus on traditional and institutionally designed healthcare facilities relative to the actual well-being of patients as an indicator of their health and recovery. This review investigates and structures the scientific research on an evidence-based healthcare design for patients and their families and staff outcomes. Evidence-based design has become the theoretical concept for what are called healing environments. It is specified that the built environment can contribute to reducing errors, falls, and infections. The built environment can enhance the privacy, comfort, and control (Science Direct 2018). As hand washing is the single most effective way to prevent the spread of infection, the aseptic non-touch technique (ANTT) in the current year is undeniably consequential to prevent the contamination that can lead to infection. The ANTT is a framework for aseptic practice and the principles are intended for use in a range of settings from the operating theatre to the community (NHMRC 2010). The equipment sterilisation in the medical field is highly significant for prevention of cross-infection. The current time, it is essential for equipment and instrument to be dry, sterile, packaged instruments should be stored in a clean, dry environment and protected from sharp objects that may damage the packaging. Each equipment and instrument should be strictly and regularly examined for any breaks in the integrity that would impair either cleaning or disinfection/sterilization. Equipment that no longer functions as intended or cannot be properly cleaned and disinfected or sterilised should be repaired or discarded (NHMRC 2010).

The compassion and care of Florence Nightingale made a significant change in the healthcare system. It has been recognized as a profession, has regulation in education and practice, and is an area in which men and women can work to care for patients at many levels and be involved in getting people to their optimum health (Nursing Theory 2016). Healthy and clean environmental created a significant improvement to patients. Achieving optimal health starts from the cleanliness and maintenance of good environment.