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Chapter 4 – Evidence-Based Practice Questions
This activity contains 3 questions.
Evidence for Effective Leadership and Management
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?
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e
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.
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e
Chapter 4 – ANSWER KEY Evidence-Based Practice Questions
1.
Answers will vary according to student opinion.
2.
Answers will vary according to student opinion.
3.
Answers will vary according to student opinion.
