The findings contribute to the general body of knowledge on the impact of ED physical design on attributes that potentially improve staff satisfaction and work performance.

No abstract

This literature review provides an overview of the research organized into design-focused topic areas to support decision-making by architects and designers. This article highlights gaps in the research and identifies areas where best practice and design assumptions need to be evaluated using rigorous design research.

This study was conducted with the purpose of determining the frequency of medication errors (MEs) occurring in tertiary care emergency department (ED) of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5%) MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2%) and antimicrobial (23.6%) medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6%) and wrong time error (4.4%) were the most frequent administration errors. The less-experienced nurses (P=0.04), higher patient-to-nurse ratio (P=0.017), and the morning shifts (P=0.035) were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction of MEs in EDs.

A number of studies have identified childcare environments as significant resources for children’s development, learning through play, and contact with nature. However, there is a lack of knowledge about how, from a child’s perspective, specific outdoor physical environments in preschools stimulate children’s cognitive play. Emphasizing on the value of listening to children, this study reports the perspectives of 22, 4- to 5-year-olds. The study context was an outdoor preschool with natural, mixed, and manufactured settings. A combination of photo preferences and semi-structured interviews was used to investigate children’s perception of preferred settings and cognitive plays. The results identified that children mainly enjoyed functional and dramatic play. They mostly preferred mixed behavior settings that incorporated ranges of natural and manufactured elements. Compared to other settings, children found mixed settings provided the most opportunities for functional, constructive, dramatic, and game with rules play. The outcomes of this study have implications for the design of outdoor preschools, suggesting a balanced integration of nature with manufactured play features to enhance cognitive play experiences.