The role of physical design and informal communication

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Interview Guide - Nurse Manager Staffing 1. When did you start working as the Nurse Manger for this unit? a. Did you have prior experience as a Nurse Manager? b. What are your primary roles and responsibilities as a Nurse Manager? c. What was most challenging about taking on this position? 2. Have there been any other changes in staffing in the past 6 months, such as different types of staff or staff turnover? 3. How far ahead is the schedule planned? a. Once the schedule is set, are there changes made? If so, to what degree? 4. How often are nurses floated from this unit, or onto this unit? 5. What general categories of AH are there, such as dietician, physical therapy? a. How are their schedules coordinated and integrated into the unit? b. Ease of contacting AH when not on unit? 6. What general categories of doctors are there, such as specialty, employer etc? a. How are their schedules coordinated and integrated into the unit? b. How frequently are they on the unit? c. Ease of contacting doctors when not on unit? 7. Among the nurses, what is the hierarchy of experience? a. Where does the Orientor fall? 8. How would you describe the relationship between the nursing staff and a. The AH b. The doctors c. Each other Patients 1. Are patient beds generally full? a. If yes, how often are there patients waiting to enter onto this unit? 2. What RN:patient ratio does this unit strive for? Is this usually met? 3. NP/PA:patient ratio? 4. Doctor:patient ratio? 161
5. What unique challenges do staff face on this unit, in dealing with med surge patients? Information 1. How are various patient records and recommendations from doctors, nurses and AH coordinated and shared? a. How effectively do these approaches work? 2. How are you, as the Nurse Manager, informed of hospital-wide events or changes? a. How effective are these approaches? 3. How are you, as the Nurse Manager, informed of challenges, changes, or suggestions pertaining to the unit? a. How effectively does this occur? 4. How are staff informed of events, activities or changes pertaining to both the unit and the hospital at large? a. How effective are these approaches? 5. Are there educational classes available to nursing staff at Crouse? a. If so, are nurses encouraged to participate in such classes? b. Would their participation be recognized by the unit? Technology 1. What are the computers used for by both nurses and doctors? 2. When there are problems with a computer, is there an IT support service? a. If so, how effective is it? 3. When was the Hill-Rom system implemented? a. Was there training for the system? b. How effective is it? 4. How long has this unit been using the Pyxis for medications? a. How effective is it? b. Is there a tech support service for the Pyxis? Final question: Did you feel adequately informed about our research? What could we have done differently to better inform? Make staff feel more comfortable? 162
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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
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3.6 Overall Summary of Findings •
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on validation, discussing patient c
Page 121 and 122: found that a major stressor for nur
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Page 125 and 126: unit suggests that designers and ho
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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 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 and 168: 3. Does the current patient:nurse r
Page 169 and 170: Interview Guide - Orientor Learning
Page 171: c. Did staffing levels affect the a
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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