ARTICLE
Copeland, D., & Chambers, M. (2016). Effects of Unit Design on Acute Care Nurses’ Walking Distances, Energy Expenditure, and Job Satisfaction: A Pre–Post Relocation Study. HERD: Health Environments Research & Design Journal, 1937586716673831.
Abstract
Objectives: The purpose of this study was to determine what differences occurred in steps taken and energy expenditure among acute care nurses when their work environment moved from a hospital with centralized nurses’ stations to a hospital with decentralized nurses’ stations. Additional goals were to determine design features nurses perceived as contributing to or deterring from their work activities and what changes occurred in reported job satisfaction. Since design features can also affect patient outcomes, patient falls were monitored.
Method: A pre–post quasiexperimental design was used. RN participants completed an open-ended questionnaire and recorded pedometer data at the end of each shift, working for 3-month pre-relocation and for 3-month postrelocation. Nine months passed between the move and post-relocation data collection.
Results: There were significant reductions in nurses’ energy expenditure (p < .001) and steps taken (p ¼ .041) postrelocation. Overall, nurses’ job satisfaction was high and improved post-relocation, and patient falls decreased by 55%.
Conclusions: Post-relocation, a number of the dissatisfiers associated with the physical environment were eliminated, and nurses identified more satisfiers (in general and related to the physical environment). Patients are safer post-relocation as indicated by a decrease in falls. This decrease is even more noteworthy when considering that the numbers of patient beds on each unit is higher postrelocation.
Keywords: nursing unit design, acute care, inpatient hospitals, evidence-based design, medical/surgical unit, pre–post design, quasi-experimental, job satisfaction
Experts
Darcy Copeland is an assistant professor of nursing at the University of Northern Colorado and a nurse scientist at St Anthony Hospital in Lakewood, CO. Her clinical background is in mental health and forensic nursing. She has a master’s degree in forensic nursing from Fitchburg State College in Massachusetts and a PhD in nursing from UCLA. She is actively engaged in research and evidence based practice projects, facilitates an interdisciplinary EBP fellowship program at St Anthony Hospital, and has experience conducting both quantitative and qualitative research. Her most current research has looked at the relationships between healthcare provider perceptions of safety, exposure to violence and moral distress, burnout, and secondary traumatic stress.
Sam Burnette served as principal-in-charge of the design of St. Anthony Hospital, the project highlighted in this presentation. Sam has 34 years of experience at ESa in land planning, master plan design and design of new hospitals, hospital expansions and renovations, medical office buildings, outpatient surgery centers, cancer treatment and nursing/assisted living facilities across the country.
As an astute speaker, researcher and writer, he often tackles current pressing healthcare issues to help educate healthcare designers. Of these, he is a strong advocate of patient safety, and he sees Hospital-Acquired Infections (HAIs) as an on-going issue. He was invited to author “Infection Control: The Good Fight,” an In Focus article that was published in the October 2016 issue of Healthcare Design magazine. He was a guest speaker in 2016 at Texas A & M’s healthcare design lecture series for a presentation entitled “Safe Room 101: Elevating Your Patient Safety Vocabulary.” This spring, he presented “Evidence-Based Design: Design Factors Impacting Outcomes,” to the 2017 HCA Spring Training Conference in Nashville. He currently sits on the editorial advisory board of Healthcare Design magazine.