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bio_man bio_man
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5 years ago
Citation: Catrambone, C., Johnson, M., Mion, L., & Minnick, A. (2009). The design of adult acute care units in U.S. hospitals. Journal of Nursing Scholarship, 41(1), 79–86.
Institute of Medicine. (2004). Keeping patients safe: Transforming the work environment of nurses. Washington, DC: National Academies Press.

Overview: This descriptive study examined the current state of hospital unit design characteristics recommended by the Agency for Healthcare Research and Quality (AHRQ) in 81 adult medical-surgical units and 56 intensive care units in six metropolitan areas. The AHRQ recommends that the following unit design characteristics positively impact patient outcomes: single rooms, work areas for staff that are not a long distance from the bedside, frequent staff hand hygiene stations, certain types of unit configuration, percentage of private rooms, and presence or absence of carpeting. The purpose of this study is to provide a benchmark and to assess nursing environments. Data were collected by observation, measurement, and interviews. The researchers conclude that few of the hospital units met the AHRQ recommendations. Further research is required to expand understanding of these design elements, their interaction, and impact on outcomes.

Application: Healthcare organizations are much more than a description of the organization. They are also physical buildings. Several recommendations in the Institute of Medicine (IOM) report Keeping Patients Safe: Transforming the Work Environment of Nurses (2004) pertain to design of work and workspace to prevent and mitigate errors. This study on unit design elements relates to the IOM work, which is referenced in the study. There are many factors and elements that impact the quality of care, and design is one of them. Historically nurses typically have had limited input into design of units, but more hospitals are including nursing management and staff nurses in the decision-making process when facilities are renovated or new buildings are built. For a long time, nurses just had to work within the space they had even if the design did not consider nursing staff needs; however, more is known today about the impact of space and design on work processes and staff.

1.
Based on your clinical experience, why is unit structure important to the staff and to patient outcomes? Present three examples to support your opinion.


2.
Why do you think it would be important to have standards related to unit structure and environment?


3.
If you were a patient, what type of unit would you want to be on? Describe it, and explain why this is the type of unit you would prefer.


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