The role of physical design and informal communication

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teamwork, she cites studies by Weiland et al. (1996), McHugh et al. (1996), and Langhorne, Williams, Gilchrist, and Howie (1993) that found that interdisciplinary teams correlate with decreased length of hospital stay, better coordination of patient care, and decreased mortality one year after discharge, respectively. A study by Baggs et al. (1999) revealed that teamwork between intensive care unit (ICU) physicians and nurses resulted in a reduced risk of readmission to the ICU and decreased mortality. They also found a perfect rank order correlation between unit collaboration and patient outcomes, that is, the higher the unit collaboration, the better the patient outcomes. 1.6.2 Impact of Teamwork on Nurse Job Satisfaction Not only does teamwork among healthcare professionals benefit the patient, it also improves job satisfaction in staff. In a study of nurses’ job satisfaction and organizational characteristics, nurses' views of cohesion with their ward nursing team and collaboration with medical staff were found to be the best predictors of job satisfaction (Adams & Bond, 2001). Not only did Rafferty et al. (2001) find a positive relationship between teamwork and job satisfaction, they also found that nurses with higher teamwork scores planned to stay in their jobs and had lower burnout scores. In the same study, it is also interesting to note that nurses with higher teamwork scores also exhibited higher levels of autonomy, which suggests the presence of synergy rather than conflict. Dutta (2008) cited a study by Borill et al (2001) that found that healthcare staff working in well-functioning teams reported much lower levels of stress and were less likely to leave their organization or profession. The mounting evidence that establishes the link between teamwork and nurse job satisfaction challenges hospital administrators and nurse managers to rethink organizational priorities in an effort to retain their nursing workforce. 11
1.6.3 Graduate Nurses’ Sense of Belonging to a Team Winter-Collins and McDaniel (2000) cite Marlene Kramer (1974) who asserts that a supportive environment is one that allows for new graduates to develop a sense of belonging which can help them overcome the stress of a first job. In a study identifying the six stages that graduate nurses experience in adapting to the real world of hospital nursing, identification, or lack thereof, with the team was found to be a critical aspect throughout the process (Brighid, 2002). One of the two major sources of stress during the first stage of vulnerability was concern over their ability to meet the expectation of the team to which they did not yet feel they were a member. The final stage of developing a new professional self-concept was accomplished by identifying strongly with and being respected by the team. Brighid concluded that the new graduates’ professional identities seemed to have been socially constructed through interaction with the team. The previously mentioned study by Winter-Collins and McDaniel (2000) found that a strong sense of belonging was associated with the new graduates’ satisfaction with his or her job. This finding confirms the need for managers to increase new graduates’ sense of belonging to the team which may be a factor in the organization’s ability to retain them in the future. 1.6.4 Importance of Communication for Effective Healthcare Teams Because there is a wealth of evidence demonstrating the benefits of successful teamwork in healthcare, many researchers have sought to determine the factors that contribute to effective teams. A study by Mickan and Rodger (2005) identified six key characteristics of effective teamwork including mutual respect, goals, leadership, communication, cohesion, and purpose. A review of the literature revealed that one of these characteristics, communication, was consistently cited as a contributor to successful teamwork (Grubach & Bodenheimer, 2004; Lemieux-Charles & McGuire, 12
Page 1 and 2: THE ROLE OF PHYSICAL DESIGN AND INF
Page 3 and 4: ABSTRACT Graduate nurses experience
Page 5 and 6: Dedicated to my parents, John and L
Page 7 and 8: TABLE OF CONTENTS Biographical Sket
Page 9 and 10: LIST OF FIGURES Figure 1. 6N floor
Page 11 and 12: LIST OF TABLES Table 1. Overall per
Page 13 and 14: extraordinary opportunity to apply
Page 15 and 16: into the topic of nature as a thera
Page 17 and 18: tiles with sound-absorbing ceiling
Page 19 and 20: infections, pneumonia, cardiac arre
Page 21: try to gain a better understanding
Page 25 and 26: formal face-to-face communication n
Page 27 and 28: interactive and interpersonal learn
Page 29 and 30: • Evidence-based design has the p
Page 31 and 32: concluded that high visibility work
Page 33 and 34: Joseph (2006) cites anecdotal evide
Page 35 and 36: informal learning and communication
Page 37 and 38: 2.3 Site Description Crouse Hospita
Page 39 and 40: primarily composed of the nursing s
Page 41 and 42: o Nursing Students The following no
Page 43 and 44: Meetings were held over a three mon
Page 45 and 46: Figure 2 6N floor plan showing colo
Page 47 and 48: equirements, organizational require
Page 49 and 50: study by Vrijkotte, van Doornen, an
Page 51 and 52: graduate nurse’s strengths and ac
Page 53 and 54: 2.8 Data Analysis Focused interview
Page 55 and 56: CHAPTER 3 RESULTS 3.1 Organizationa
Page 57 and 58: ecause as a visitor entered the uni
Page 59 and 60: Figure 3 6N Floor Plan 48
Page 61 and 62: Figure 6 View of island work surfac
Page 63 and 64: Kitchen Locker Room Desk B1 at nurs
Page 65 and 66: Figure 13 Existing layout prior to
Page 67 and 68: Figure 15 Wall-mounted chart organi
Page 69 and 70: 3.1.2 Information Management and Te
Page 71 and 72: nurses and pharmacists and dispense
Page 73 and 74:
Because patients on 6N have a parti
Page 75 and 76:
There is encouragement to learn new
Page 77 and 78:
There is encouragement to learn new
Page 79 and 80:
“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
Page 99 and 100:
Frequency (%) 45.0 40.0 35.0 30.0 2
Page 101 and 102:
Table 14 Frequency of person by loc
Page 103 and 104:
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
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found that a major stressor for nur
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opportunities for informal learning
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unit suggests that designers and ho
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usually leads to expensive renovati
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including off the nursing unit or a
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APPENDIX A Memo Describing Study 12
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APPENDIX B Graduate Nurse Consent F
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• Members of the Cornell research
Page 137 and 138:
_____________________________ _____
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Informed Consent Form for Staff Cro
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Committee on Human Subjects (UCHS)
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Modified Categories for the Clinica
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134
Page 147 and 148:
136
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APPENDIX F Survey Items Pertaining
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APPENDIX G Survey Items Pertaining
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APPENDIX H Survey Items Pertaining
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APPENDIX I Blood Pressure Recording
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APPENDIX J Competency Evaluation Fo
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APPENDIX K Competency Category Defi
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o Expert - interprets labs; consult
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14. Care Plan delegate (using the r
Page 165 and 166:
APPENDIX L Interview Guides 154
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3. Does the current patient:nurse r
Page 169 and 170:
Interview Guide - Orientor Learning
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c. Did staffing levels affect the a
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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
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Buchanan, J., & Considine, G. (2002
Page 181 and 182:
Godinez, G., Schweiger, J., Gruver,
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Lumsdon, K. (1993). Baby boomers gr
Page 185 and 186:
Stolte, K., & Myers, S. t. (1995).
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