The role of physical design and informal communication

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4. How long has this unit been using the Pyxis for medication? a. How effective is it? b. Is there a tech support service for the Pyxis? 157
Interview Guide - Orientor Learning: 3. We’re interested in how the design and layout of the unit affects on-the-job learning and communication with other RNs and doctors. By that I mean how the design affects how often and where you interact with others for certain types of communication and discuss certain things. I’m asking this because people often learn “on the job” from informally talking with others and asking questions. Space/Layout: a. Where was the best place to talk about X with 1) other RNs; 2) Drs; 3) AH i. specific procedures you were not sure about ii. verification of medications iii. patient care plan/patient status iv. socializing/emotionally venting v. teaching or providing advice b. Is there anything about the design of the unit – its size, layout, adjacencies of equipment and different rooms - that make it more or less likely to ask for or offer information, knowledge or experience? -offering advice, guidance, or correcting a GN? c. Were you ever uncomfortable discussing certain issues because there was no appropriate place to do so? d. Is there anything about the culture – formal or informal values/expectations - of the unit that would make it more or less likely to ask for or offer information, knowledge or experience? e. What do you think were the greatest aids for helping your GN gain competency and confidence? What was detrimental? 158
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THE ROLE OF PHYSICAL DESIGN AND INF
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ABSTRACT Graduate nurses experience
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Dedicated to my parents, John and L
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TABLE OF CONTENTS Biographical Sket
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LIST OF FIGURES Figure 1. 6N floor
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LIST OF TABLES Table 1. Overall per
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extraordinary opportunity to apply
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into the topic of nature as a thera
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tiles with sound-absorbing ceiling
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infections, pneumonia, cardiac arre
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try to gain a better understanding
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1.6.3 Graduate Nurses’ Sense of B
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formal face-to-face communication n
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interactive and interpersonal learn
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• Evidence-based design has the p
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concluded that high visibility work
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Joseph (2006) cites anecdotal evide
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informal learning and communication
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2.3 Site Description Crouse Hospita
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primarily composed of the nursing s
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o Nursing Students The following no
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Meetings were held over a three mon
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Figure 2 6N floor plan showing colo
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equirements, organizational require
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study by Vrijkotte, van Doornen, an
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graduate nurse’s strengths and ac
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2.8 Data Analysis Focused interview
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CHAPTER 3 RESULTS 3.1 Organizationa
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ecause as a visitor entered the uni
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Figure 3 6N Floor Plan 48
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Figure 6 View of island work surfac
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Kitchen Locker Room Desk B1 at nurs
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Figure 13 Existing layout prior to
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Figure 15 Wall-mounted chart organi
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3.1.2 Information Management and Te
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nurses and pharmacists and dispense
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Because patients on 6N have a parti
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There is encouragement to learn new
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There is encouragement to learn new
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“Validation,” at five times per
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Average Frequency/8hr 60 50 40 30 2
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3) shows that all interactions were
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Table 4 Overall percent & frequency
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Transit” - 2:59:48. However, the
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Time (hh:mm:ss) 0:02:53 0:02:36 0:0
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Patient Room 28% Nurses Station 25%
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3.3.4 Analysis of Task, Person and
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However, when asked if all of this
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Frequency (%) 50.0 45.0 40.0 35.0 3
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Frequency (%) 45.0 40.0 35.0 30.0 2
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Table 14 Frequency of person by loc
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occurred in equal amounts with the
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experienced by many GNs. Figure 33
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conditions in laymen’s terms. The
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• According to the GN, the greate
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Not enough staff to adequately cove
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Table 16 Change in GN stress rating
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Blood Pressure (mmHg) 121.0 119.0 1
Page 117 and 118: 3.6 Overall Summary of Findings •
Page 119 and 120: on validation, discussing patient c
Page 121 and 122: found that a major stressor for nur
Page 123 and 124: opportunities for informal learning
Page 125 and 126: unit suggests that designers and ho
Page 127 and 128: usually leads to expensive renovati
Page 129 and 130: including off the nursing unit or a
Page 131 and 132: APPENDIX A Memo Describing Study 12
Page 133 and 134: APPENDIX B Graduate Nurse Consent F
Page 135 and 136: • Members of the Cornell research
Page 137 and 138: _____________________________ _____
Page 139 and 140: Informed Consent Form for Staff Cro
Page 141 and 142: Committee on Human Subjects (UCHS)
Page 143 and 144: Modified Categories for the Clinica
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Page 147 and 148: 136
Page 149 and 150: APPENDIX F Survey Items Pertaining
Page 151 and 152: APPENDIX G Survey Items Pertaining
Page 153 and 154: APPENDIX H Survey Items Pertaining
Page 155 and 156: APPENDIX I Blood Pressure Recording
Page 157 and 158: APPENDIX J Competency Evaluation Fo
Page 159 and 160: APPENDIX K Competency Category Defi
Page 161 and 162: o Expert - interprets labs; consult
Page 163 and 164: 14. Care Plan delegate (using the r
Page 165 and 166: APPENDIX L Interview Guides 154
Page 167: 3. Does the current patient:nurse r
Page 171 and 172: c. Did staffing levels affect the a
Page 173 and 174: 5. What unique challenges do staff
Page 175 and 176: CWM Tool Task Category Definitions
Page 177 and 178: REFERENCES Adams, A., & Bond, S. (2
Page 179 and 180: Buchanan, J., & Considine, G. (2002
Page 181 and 182: Godinez, G., Schweiger, J., Gruver,
Page 183 and 184: Lumsdon, K. (1993). Baby boomers gr
Page 185 and 186: Stolte, K., & Myers, S. t. (1995).
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