Kerrie Cardon, RN, AIA, ACHAWriter
Kerrie’s passion for creating safe, efficient, and healing healthcare environments stems from her years working as a registered nurse. As an architect, she has been a strong advocate—and has devoted her design career—to effecting change in healthcare environments.
August 25, 2010
Respite areas within healthcare environments for patients and families are becoming popular features. But what about creating respite areas for nurses?
Healthcare environments can be very stressful and exhausting environments. And, because of the nursing shortage, there is a tremendous incentive to recruit and retain valuable staff. Creating healing environments for nurses is a powerful tool to aid that effort.
Places of healing and respite might be as simple as including discrete areas within the nursing unit to sit and take a deep breath. Sometimes, however, nurses just need a place to get away.
Creating a single occupancy respite room would allow staff to recharge the spirit, rejuvenate the body, and replenish the soul. No televisions or phones. Possible soothing features would include a lounge chair, aromatherapy, a water feature, dimmable lighting, and soft music.
These respite spaces must be thoughtfully and adequately programmed so that staff has room to breathe. And just like we provide access to natural light for our patients and families, we must also give our nurses this same caring treatment. Some staff spaces are being designed with access to outdoor space adjacent to the staff lounge. Having space to be outdoors where nurses can get a breath of fresh air can be very curative.
As designers of healthcare environments, we have a fabulous opportunity to be the change agents—and create healing environments that will help recruit and retain nurses.
August 18, 2010
Medication errors are a major problem for healthcare providers. This is the result of several factors, many of which stem from nurses working harder than ever for longer hours and with sicker patients. Plus, their environments are often stressful and inefficient.
My recent job shadow of a nurse brought this situation home to me. There are several ways to make healing environments more safe and efficient. When it comes to medications, the best approach is to decentralize them to the patient room.
Nurses face frequent interruptions when they’re working. According to a recent study, those interruptions lead to medication errors. I observed this first-hand when my nurse encountered several interruptions during his shift. Securely storing medications near the patient would help to eliminate interruptions—especially those that occur between the med room and the patient room.
This move also would reduce nurse travel distances. Nurses typically walk long distances to the med room—my nurse accessed the med room 38 times in eight hours!
When nurses are retrieving medications from the med room, they have to wait to access the automated medication dispensing machine. Storing medications at the patient room would eliminate that wasted time spent waiting and would enable nurses to spend more time with their patients.
And then there’s waiting for the nurse to return from the med room. While nurses are waiting to access the automated medication dispensing machine, patients are waiting for them. This isn’t a good situation, particularly if the patient is in pain.
Storing medications in the patient room is part of creating flexible and adaptable environments for nurses. We architects must create spaces for nurses that help them deliver quality care.
August 11, 2010
In last week’s blog post, I recommended decentralizing supplies and equipment to the patient room based on my job shadow of a nurse. This week, the focus moves to cleaning equipment inside the patient room.
Unfortunately, patients acquire about 1.7 million infections in U.S. hospitals every year. As a result, there is an increasing need to apply strategies for infection prevention.
One strategy, for example, stems from the fact that sicker patients require more equipment. At the very least, an IV pole and pump should be standard equipment in every patient room—and cleaned there, too.
The traditional equipment cleaning process includes pushing it throughout the hospital to another department for cleaning. This means that a potentially contaminated item could be moving throughout the hospital. This isn’t a good idea.
Hospital staff already clean the patient’s bed, overbed table, bedside stand, and family furniture in the patient room. Adding equipment to the list would remove several steps from the equipment cleaning process. It also would improve operational savings and infection prevention rates.
Keeping and cleaning equipment in the patient room would significantly reduce staff travel distances, too, and eliminate hunting and gathering. And, it would allow nurses more time for their primary passion–taking care of their patients.
August 4, 2010
My recent job shadow of a med/surg nurse proved enlightening. It reinforced my belief that there should be a space available either directly inside or outside of every patient room to store supplies and equipment. Decentralizing important items to these areas would enable nurses to work more efficiently. And it would cut their travel time to supply areas and equipment rooms.
Storing supplies in or near patient rooms will require those spaces to be maintained, but this responsibility should not be shouldered by nurses. Their job is to care for patients, not to hunt and gather supplies.
There also should be a place in every patient room to store select pieces of equipment, such as IV poles and pumps. Patients now are sicker and the equipment storage needs for them has increased. The equipment might vary depending on the specialty of the unit, but this step would make it immediately accessible for use.
We architects already allocate and plan space for supplies and equipment in labor delivery recovery/postpartum rooms. If we use this same approach and reallocate the square footage that typically would go into an equipment room, that space could be used to provide storage in or near the patient room. This would eliminate wasted motion, give nurses what they need–where and when they need it–and allow them to focus on giving care.
July 28, 2010
During my recent job shadow of a nurse working on the med/surg floor at a nearby hospital, it felt like we walked for miles during his shift. I was probably right. According to a 2008 study, nurses walk between one and five miles per 10-hour daytime shift.
This amount of walking is caused mainly by central workstations and longer, inefficient circulation paths to single patient rooms. This was the case during my shadow experience. Not only was our travel route inefficient, it also resulted in greater activity at the workstation where concentration and limited interruptions are so important.
Single patient rooms are advantageous and preferable for a number of reasons, but the resultant unit configurations have created even longer travel distances for nurses. These rooms are larger and when located side by side, the distance increases from one patient to the next.
This activity could be remedied by decentralizing supplies, equipment, and medications to the patient room. Or, another strategy would be to design narrower support cores with more cross circulation. Designing more circulation paths through the support core would enable nurses to work cross corridor and reduce their travel distances.
Decentralizing supplies, equipment and medications, and designing narrower support cores with cross circulation are key to reducing travel distances and promoting safe and efficient nurse environments. Plus, the additional time they save could be spent with patients—a win-win situation for all.
Top photo via: Flickr.com
July 21, 2010
Editor’s note: This is the first post in a six-part series that will focus on improving caregiver work environments.
It’s been more than 20 years since I went from a career as a nurse to being an architect. So when I recently had the chance to shadow a nurse for eight hours, a number of things about his work environment surprised me.
I was sure that advances in technology and equipment would make work for nurses less demanding. That would give them more time with patients. I was wrong. Nurses are working harder than ever for longer hours and with sicker patients. And the number of patients they treat is increasing because of a nursing shortage.
Considerable attention has been given to patient-focused and family-centered environments. But only limited focus has been given to creating sustainable environments for nurses. Their environments remain stressful and inefficient, which unfortunately can lead to medical errors.
I wasn’t surprised when I saw a survey indicating that more than one-third of nurses would not recommend their profession to young people. The physical demands are great—six hours went by before we sat down for the first time—and the emotional stress can be exhausting.
As a nurse, I understand the demands faced by caregivers. As an architect, I believe my profession can respond to those demands by designing safe and efficient nurse environments that also provide respite and rejuvenation.
In part two of her series, Cardon will focus on decentralizing the nursing unit.
Photo via: WorkingNurse.com