Shifting Landscapes: The Impact of Centralized and Decentralized Nursing Station Models on the Efficiency of Care

Fay, Lindsey; Carll-White, Allison; Schadler, Aric; Isaacs, Kathy; Real, Kevin

doi:10.1177/1937586717698812

Cited by 30 publications

(63 citation statements)

References 21 publications

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“…The results in this study support those from other studies ( Fay et al, 2017 ; Real, Barduch, & Barduch, 2017 ). It appears that nursing unit design and size (particularly if medium or large units) may affect fall rates because some unit design shapes allow less close visual or aural monitoring than others, which is crucial for preventing falls.…”

Section: Discussionsupporting

confidence: 93%

“…This result may reflect lower visibility or access to other staff because of the longer straight corridors associated with the cross-shaped units in this study. This finding is similar to those reported by Fay, Carll-White, Schadler, Isaacs, and Real (2017) ; Real et al (2017) ; and Kalisch and Begeny (2005) , who found that visibility of other staff affected communication with each other, and decentralized workstations resulted in less access and less communication. This finding was also similar to that of Hua, Becker, Wurmser, Bliss-Holtz, and Hedges (2012) , who found that a move from a decentralized design to a hybrid design resulted in nurses feeling more isolated with fewer social interactions (i.e., communication).…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Nursing Unit Design, Nursing Staff Communication Networks, and Patient Falls: Are They Related?

Brewer

Carley

Benham‐Hutchins

et al. 2018

HERD

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Purpose:The purpose of this research is to (1) investigate the impact of nursing unit design on nursing staff communication patterns and, ultimately, on patient falls in acute care nursing units; and (2) evaluate whether differences in fall rates, if found, were associated with the nursing unit physical structure (shape) or size.Background:Nursing staff communication and nursing unit design are frequently linked to patient safety outcomes, yet little is known about the impact of specific nursing unit designs on nursing communication patterns that might affect patient falls.Method:An exploratory longitudinal correlational design was used to measure nursing unit communication structures using social network analysis techniques. Data were collected 4 times over a 7-month period. Floor plans were used to determine nursing unit design. Fall rates were provided by hospital coordinators.Results:An analysis of covariance controlling for hospitals resulted in a statistically significant interaction of unit shape and size (number of beds). The interaction occurred when medium- and large-sized racetrack-shaped units intersected with medium- and large-sized cross-shaped units.Conclusion:The results suggest that nursing unit design shape impacts nursing communication patterns, and the interaction of shape and size may impact patient falls. How those communication patterns affect patient falls should be considered when planning hospital construction of nursing care units.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Nursing Unit Design, Nursing Staff Communication Networks, and Patient Falls: Are They Related?

Brewer

Carley

Benham‐Hutchins

et al. 2018

HERD

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“…The close proximity of the medication room to the NS could improve the frequency of communication and efficiency. Previous studies conducted in Western hospitals also found that enclosed spatial layouts were beneficial to improving privacy (Calleja & Forrest, 2011;Zamani, 2019), and when nurses work in close proximity, the likelihood of communication could be increased (Cai & Zimring, 2011;Fay et al, 2017;Zborowsky et al, 2010).…”

Section: Discussionmentioning

confidence: 98%

Impacts of Nursing Unit Design on Visibility and Proximity and Its Influences on Communication, Privacy, and Efficiency

Xuan

Chen

2019

HERD

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Objectives: This study examines the role of visibility and proximity on nurse communication patterns, perception of privacy, and efficiency in double-corridor nursing units. Background: Nurses are extremely important for the quality of healthcare. The literature suggests that visibility and proximity have a substantial impact on the delivery of care and staff experience. However, few studies have empirically examined nursing units in China. Method: Questionnaire surveys, observations, and simulations of medication administration tasks were employed. Results: Visibility and proximity influenced communication patterns, perceptions of privacy, and efficiency. The type of wall in the medication room could impact nurses’ perception of privacy and efficiency. A partial glass wall in the medication room could achieve balance between privacy and visibility. A medication room that is adjacent to and is easily accessed from the nurse station (NS) could provide efficient communication and efficient work. The partition type between the NS and the doctor’s office and the layout of the medication room could impact communication patterns. The relative position of the NS, medication room, and disposal room could influence the flow of medication administration tasks, and a geographically contiguous spatial layout could enhance work efficiency. Conclusions: The findings contribute to the body of knowledge on the impact of visibility and proximity on nurses’ communication patterns, perception of privacy, and efficiency. Recommendations to improve the design of double-corridor nursing units are also provided.

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“…Work information includes work experience (as a nurse or other patient care work), work space design (any particular work space design that could impact the physical factors, such as patient bed, lifting aids (Pheasant and Ergs 1987), flooring (Cham and Redfern 2001), nursing unit layout (Cohen et al 2004;Fay et al 2017)), as well as work organisation factors (Koehoorn et al 2006). Shift work, particularly shifts that occur outside of a traditional 8-h daytime schedule, can have adverse health effects on nursing personnel, both physically and psychologically (He 2013;Samaha et al 2007).…”

Section: Work Informationmentioning

confidence: 99%

A framework for studying risk factors for lower extremity musculoskeletal discomfort in nurses

Sommerich

Chipps

et al. 2020

Ergonomics

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Lower extremity musculoskeletal discomfort (MSD) is prevalent, but understudied, in nurses. A comprehensive, theoretical, aetiological model of lower extremity work-related MSD in hospital in-patient staff nurses was developed through a review of the literature to provide a framework for aetiological and intervention research. The framework informed the design of a survey of 502 hospital staff nurses. Symptom prevalence ranged from 32% in hip/thigh to 59% in ankle/ foot regions. Logistic regression modelling using survey data showed that different work and personal factors were associated with discomfort in different regions of the lower extremity. Individual factors (e.g. older age, higher BMI or having any foot condition), physical factors (e.g. higher frequency of patient handling), psychosocial factors (e.g. lower job satisfaction) were associated with discomfort in one or more parts of the lower extremity. Future research should target these factors for intervention, to attempt to reduce occurrence of lower extremity discomfort in nurses.

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Shifting Landscapes: The Impact of Centralized and Decentralized Nursing Station Models on the Efficiency of Care

Cited by 30 publications

References 21 publications

Nursing Unit Design, Nursing Staff Communication Networks, and Patient Falls: Are They Related?

Nursing Unit Design, Nursing Staff Communication Networks, and Patient Falls: Are They Related?

Impacts of Nursing Unit Design on Visibility and Proximity and Its Influences on Communication, Privacy, and Efficiency

A framework for studying risk factors for lower extremity musculoskeletal discomfort in nurses

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