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Knowledge Repository

Scheduled Medications and Falls in Dementia Patients Utilizing a Wander Garden

Author(s): Detweiler, M. B., Murphy, P. F., Kim, K. , Myers, L. , Ashai, A.
Among dementia residents, fall risk is often compounded by the side effects of the medications routinely used to treat comorbid medical issues, in addition to treating concurrent depression, agitation, psychosis, anxiety, and insomnia. Of all the types of medications involved in increased fall risk, psychotropic medications have been identified as having the highest risk. Studies suggest that dementia patients using a wander garden may have decreased indices of agitation and reduced use of as-needed (pro re nata [PRN]) medications. In addition, the wander garden has been reported to be a positive environmental intervention to reduce falls in residents with dementia. 
Key Point Summary

Inclusive Indoor Play: Children at play

Author(s): Endicott, S., Kar, G., Mullick, A.
Prior research has shown that children with disabilities exhibit a more limited play repertoire than children without disabilities, due to barriers within indoor play environments that do not allow for equitable play amongst all children. This study is one part of the Inclusive Indoor Play project. This research project seeks to develop universal guidelines for design within indoor play environments, and design models of play environments that are inclusive to all children. 
Key Point Summary

The Effect of Environmental Design on Reducing Nursing Errors and Increasing Efficiency in Acute Care Settings: A Review and Analysis of the Literature

Author(s): Chaudhury, H., Mahmood, A., Valente, M.
In acute care settings, the physical environment plays an important role in staff efficiency and patient safety. Some research suggests that poor environments can result in staff stress, anxiety, and distractions due to noise; artificial lighting; improper or inadequate ventilation; and disorienting layouts of nursing units. There is less research on how environmental factors affect nursing staff health, effectiveness, errors, and job satisfaction. 
Key Point Summary

Using a Task Analysis to Describe Nursing Work in Acute Care Patient Environments

Author(s): Battisto, D., Pak, R., Vander Wood, M. A., Pilcher, J. J.
A growing body of research demonstrates linkages between workplace design and processes in healthcare facilities with staff and patient safety, operational efficiency, staff satisfaction, and medical errors. There has been less emphasis on the role of the built environment in helping or hindering care delivery. Research is needed on the contextualized activities performed by nurses and how nurses spend their time to measure the effects of interventions aimed at redesigning care to improve safety or efficiency or to understand the implications of policy changes for nursing practice.
Key Point Summary

Falls and Patient Mobility in Critical Care: Keeping Patients and Staff Safe

Author(s): Flanders, S. A., Harrington, L., Fowler, R. J.
A main priority in hospitals in the U.S. is ensuring both patient and staff safety throughout a patient’s stay. Falls are a major concern in hospitals, particularly in critical care units (ICUs), where nurses care for increasingly older populations that are prone to falls and injuries from falls. Another issue that arises in intensive care units is the decision of when it is safe to mobilize patients, a relevant consideration in relation to incidence of falls and durations of hospital stay. 
Key Point Summary

Clinical review: The impact of noise on patients’ sleep and the effectiveness of noise reduction strategies in intensive care units

Author(s): Xie, H., Kang, J., Mills, G. H.
The World Health Organization recommends that noise levels in hospitals stay below 30 dBA at night to allow for better rest, yet excessive noise is prevalent in many healthcare settings, including intensive care units (ICUs). Research indicates that, since the 1960s, noise levels in hospitals increased by an average of 0.38 dBA (day) and 0.42 dBA (night) per year. Other research reports that the noise level in ICUs ranges from 50 to 75 dBA, with a night peak level soaring to 103 dBA. It’s easy to see why sleep disturbance is common among these vulnerable patients.
Key Point Summary

Threading Needles in the Dark: The Effect of the Physical Work Environment on Nursing Practice

Author(s): Simmons, D., Graves, K., Flynn, E. A.
People’s ability to perform reliably and safely relies on the physical work environment. Nowhere is this connection more critical than in healthcare environments, which can be noisy, dimly lit, and chaotic. The United States Pharmacopeia addresses this issue in its draft general chapter of standards, “Physical Environments that Promote Safe Medication Use,” which specifies work environment guidelines to support efficient and safe medication use.
Key Point Summary

The impact of health facilities on healthcare workers’ well-being and performance

Author(s): Rechel, B., Buchan, J., McKee, M.
There is extensive research on the effect of healthcare environments on patients. But much less is known about health facilities’ impact the staff, even while there is growing recognition of the need for healthy working environments. Poor healthcare working environments can relate to the nature of the work—long and antisocial hours, little administrative support, physical labor, and, sometimes, violence. 
Key Point Summary

Access and care issues in urban urgent care clinic patients

Author(s): Scott, D. , Batal, H. , Majeres, S, Adams, J. , Dale, R. , Mehler, P.
Patients generally seek care in urgent care settings because doing so is more convenient than alternative care options, and the care provided is timelier.
Key Point Summary

Effects of two hospital bed design features on physical demands and usability during brake engagement and patient transportation: A repeated measures experimental study

Author(s): Kim, S., Barker, L. M., Jia, B., Agnew, M. J., Nussbaum, M. A.
Healthcare work is physically demanding and often results in work-related musculoskeletal disorders (WMSDs). Most research in this area has focused on patient-handling techniques during activities that require direct patient contact, such as patient transfer. But healthcare providers perform other patient-handling tasks as well, such as engaging bed brakes and transporting patients in beds. These activities could also contribute to WMSDs.
Key Point Summary