A Systematic Literature Review of Empirical Studies on Decentralized Nursing Stations
Health Environments Research & Design Journal,
DOI.org/10.1177/1937586718805222
ARTICLE
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The objective of this systematic review of literature was to critically evaluate peer-reviewed evidence regarding the effectiveness of decentralized nurse stations (DNSs).
Background: The DNS has become an important topic in healthcare design research and practice over the past decade with aims of improving staff efficiency and patient experience. Research has shown to be inconclusive, with studies reporting an assortment of mixed findings.
Method: A systematic review of literature was conducted using the Preferred Reporting Items for systematic Reviews and Meta-Analyses search process of electronic databases, citation tracking, and manual searches of references. All authors evaluated the studies independently. Studies included were empirical, peer-reviewed investigations of DNS in hospitals over the past 15 years. Each study was evaluated using an accepted healthcare design evaluation framework.
Results: Over 200 studies were identified. After exclusions, 21 studies published since 2003 were available for full evaluation. Key findings from this review include (a) there is a positive trend toward patient experience in units with DNS, (b) nursing teamwork was perceived to decline in units with DNS, (c) methodological issues may be responsible for the mixed and inconsistent findings, and (d) there is no consistent categorization of nurse station typology or standard definition for DNS.
Conclusions: Based on the evaluation framework, DNS are supportive of the patient experience yet have a negative impact on nursing teamwork. Higher quality studies are needed to classify specific typologies of DNS and account for elements such as patient care models, communication, visibility, and other patient care–related factors.
Lindsey Fay, MSArch, Assistant Professor, College of Design, School of Interiors, University of Kentucky
Lindsey Fay is an Assistant Professor in the University of Kentucky’s College of Design in the School of Interiors. Her work is centered around health design research and examines the intersection of people, processes, and the built environment. Currently, her research utilizes post-occupancy evaluation to assess the design of healthcare spaces and their impact on care delivery. It further implements this methodology as a learning tool and immersive learning experience for interior design students. Fay has worked with healthcare professionals, designers, patients, and students on a number of funded research endeavors. She is a frequent presenter at national and international conferences and has been published in a number of peer-reviewed journals.
Hui Cai, Ph.D., Associate Professor, Institute of Health and Wellness Design Department of Architecture, The University of Kansas
Dr. Hui Cai is the Associate Professor of Health and Wellness Program at the School of Architecture Design, and Planning. Prior to joining the faculty, she taught at the University of Missouri, Columbia. She also served as the Health + Science research leader and designer at RTKL Associates in Dallas. Cai received her Ph.D. degree in evidence-based design from the Georgia Institute of Technology after several years of architectural education and practice in China and Singapore. Dr. Cai’s current research focus is using a performance-driven and evidence-based design approach to analyze the relationship between culture, human behavior, and the physical environment, especially in healthcare settings. Since 2012, she has developed a series of post-occupancy evaluations (POE) with the focus on evaluating the impacts of the decentralized nursing unit typology on patient, staff, and organizational performance.
Kevin Real, PhD, Associate Professor and the Douglas and Carole Boyd Professor of Communication, University of Kentucky
Kevin's research interests involve communication in healthcare organizations, implementation of quality improvement processes such as Appreciative Inquiry in organizations, and occupational safety and health. His research has been published in Journal of Applied Communication Research, Management Communication Quarterly, AI Practitioner, Communication Theory, Communication Research, and Human Communication Research. He has won numerous awards Top Paper Awards at national and international conferences. He has been recognized at the University of Kentucky with a Research Excellence Award and a Teaching Excellence Award from the College of Communication and Information.
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