Physical environment is an important component in the acute care setting that can affect nursing and medication accuracies, as any inadequacy in physical environment would contribute to staff fatigue, stress, and burnout and result in errors. The article discusses a study conducted involving an extensive review and analysis of the literature on this topic and focus groups with various categories of staff members at three hospitals. The review demonstrates that the following environmental variables can contribute to errors in acute care settings: noise levels, ergonomics/furniture/equipment, lighting, and design/layout. Focus groups address the role of the physical environment on medication ordering, storage, delivery, dispensation, preparation, administration, and possible design responses to reduce errors. Integrating the major issues identified and the key findings from the focus groups, four design-related principles are recommended: balance between patient accessibility and reduction of disruptions, automation, minimize staff fatigue, and promoting a culture of safety.
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