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Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e
Chapter 16 – Evidence-Based Practice Questions
This activity contains 4 questions.
Evidence for Effective Leadership and Management
Citation: Institute for Healthcare Improvement. (2009). Using evidence-based
environmental design to enhance safety and quality. Retrieved from
http://www.ihi.org/resources/Pages/IHIWhitePapers/UsingEvidenceBasedEnvironmental
DesignWhitePaper.aspx
Jha, A., Orav, J., Zheng, J., & Epstein, A. (2008). Patients’ perception of hospital care in
the United States. New England Journal of Medicine, 359, 1928.
Joint Commission. (2008). Guiding principles for the development of the hospital of the
future. Retrieved from http://www.jointcommission.org/assets/1/18/Hosptal_Future.pdf
Overview: There is a connection between physical design and quality care (Institute for
Healthcare Improvement, 2008). This connection needs to be understood by nurse
managers. Nurse leaders in HCOs should be involved in environmental design decisions
from new building, renovation, and day-to-day needs of the physical environment. The
Application: In 2008 the Joint Commission recognized the need for more consideration
of decision making in HCO environmental design in its report Guiding Principles for the
Development of the Hospital of the Future. To be cost effective and meet needs of the
changes in healthcare delivery, it is important to use evidence, when possible, to make
these critical decisions. It is noted that there is no perfect formula of interventions needed
to develop the best physical environment, and there should be a comprehensive review of
needs and a plan. Some examples of interventions identified by the Institute for
Healthcare Improvement that emphasize multiple patient needs in the healthcare
environment include the following:
• Install alcohol-based gel dispensers at each patient bedside and at all points of
care.
• Install noise mitigation materials.
• Use music and art as positive distractions.
• Include clear directions throughout the facility.
• Improve task lighting in pharmacy, medicine rooms, and procedure areas.
• Build private rooms.
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e
• Provide adequate space for families to stay overnight in patient rooms.
• Design space to support patient transfer from bed to stretcher, to wheelchair, and
so on.
• Assess and build patient bathrooms to accommodate patient care needs.
• Provide access to natural light.
• Install ceiling-mounted lifts in many patient rooms.
• Design decentralized nursing stations.
• Provide choices for patients to control lighting, privacy, music, and visual images.
• Other general examples are furnishing that is calming in color, useful in design,
and easy to clean. Floor surfaces should be safe, easy to clean, and coordinate
with colors.
Questions:
1.
How does the information from the Institute for Healthcare Improvement and the Joint
Commission compare to one another?
2.
Have you heard patients and families make comments about the environment in an HCO?
What were the comments? If they had complaints, were they identifying problems that
could be resolved easily or with more effort and how?
3.
Take an experiential trip and enter an HCO only for the purpose of describing its
environment. What do you see, hear, and smell?
4.
Describe examples of how a nurse manager might improve the environment in the
manager’s unit.
1.
Answers will vary according to student perspective.
2.
Answers will vary according to student perspective.
3.
Answers will vary according to student perspective.
4.
Answers will vary according to student perspective.
