The healthcare construction boom requires evidence for effective design of nurse stations, including evidence supporting workflow processes, computerization, integration of technology, communication of caregivers, and optimal patient outcomes. This article describes the examination of a traditional centralized nursing station using a total patient care delivery model and minimal computerization and a highly computerized, decentralized nursing station using a team nursing model. Results specific to communication activities, time with patients, number of patient visits per registered nurse, and patient satisfaction with response time are reported.Key WordsPatient care unit design, ergonomics, healthcare workflow, medical-surgical unit, registered nurse work activities.
Practice errors by nurses can cause harm to patients, families, practitioners, systems, and the profession. Because the nursing errors reported to the State Boards of Nursing are typically serious, analyzing their data has great potential for developing new strategies to reduce dangerous errors. With the guiding rationale being identification of categories central to the nurse's role and function in healthcare delivery errors, 21 case studies of nursing errors from 9 State Boards of Nursing files were analyzed to develop a taxonomy of nursing errors. Eight categories of nursing errors representing a broad range of possible errors and contributive or causative factors were identified: lack of attentiveness; lack of agency/fiduciary concern; inappropriate judgment; lack of intervention on the patient's behalf; medication errors; lack of prevention; missed or mistaken MD/healthcare provider's orders; and documentation errors. Causes for the error, at the system and practice responsibility levels, were identified in each case. The categories, an assessment of causes of errors, and an examination of the remediation actions taken were the first steps in devising a taxonomy of nursing error, designed with prevention in mind. The authors discuss their work and present the taxonomy.
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