Impact of Hospital Unit Design for Patient-Centered Care on Nurses’ Behavior

Abstract

In an effort to be more patient- and family-centered, many hospitals have recently provided nursing units that provide more space and amenities for family members. However, these units raise a concern that larger unit size might cause nurses to walk longer distance and spend more time for traveling in the hallway rather than time at bedside. Although it may be counterintuitive, a unit that is designed for patient-centered care, despite being larger with extra space for family members, may not necessarily increase nurses’ walking distance. Through observations, this exploratory study compares nurses’ trips to procure medications in a smaller intensive care unit (ICU) and those in a larger ICU designed for patient-centered care. The smaller unit observed has global visibility to most of patient rooms, and the larger unit has local visibility from distributed substations to patient rooms. The comparison showed that nurses did not walk longer and spend more time getting medication in the larger unit. They did interact less and made fewer extra stops than the smaller unit. Unlike some studies, nurses did not walk further in a larger unit. This study suggests that visibility, the presence of substations, and location of medications can reduce walking. This needs verification in further research.