The role of physical design and informal communication

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2.4 Physical Layout The physical configuration of 6N is best described as a double-corridor, or “racetrack” design (Figure 1). A racetrack plan is created by pulling apart the room blocks along the two sides of the corridor and inserting in the center a core containing an array of support amenities (Verderber & Fine, 2000). The unit is also a reflective plan: the two sides of the floor are essentially mirror images. Figure 1 6N Floor Plan The 20 patient rooms, 16 double-bed and 4 single-bed, are arranged in a U- shaped pattern separated from the service core area by a continuous hallway. A main corridor divides the service core into 2 sections. The smaller section is composed of two utility rooms, the kitchen, and the staff locker room. The larger portion is 27
primarily composed of the nursing station with the medication room and offices and flanking both sides. The centralized nursing station includes four large desks, each equipped with computers and seating for two to three people. These desks feature two work surface heights: a lower surface for those who are seated and a raised surface convenient for those who are standing. In addition, a large raised work surface is located in the center of the nursing station. 2.5 Sample Size and Selection The original intent of the study was to compare the communication patterns, stress levels, and competencies of graduate nurses on two nursing units differing in physical layout. Based on previous staffing patterns, the nurse managers and administrators expected that each unit would hire three to four graduate nurses. However, their projections did not align with the available pool of incoming graduate nurses. Instead, only one graduate nurse was hired on 6N. Despite this turn of events, the study continued as an exploratory case study of the multiple social, physical, and technological factors impacting a graduate nurses’ orientation experience. This alternative approach was deemed worthwhile and capable of providing valuable insight into a relatively unexplored area of research because it focused on the nursing unit as an integrated workplace system with diverse care providers, not on a single graduate nurse. Since the study is an ecological analysis of the nursing unit as a system, the sample consisted of more than just the focus graduate nurse. In actuality, the sample also included a core group of personnel who worked on the unit between the hours of 7am and 3pm. The total number of each type of staff employed on the unit is shown below: 28
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 and 22: try to gain a better understanding
Page 23 and 24: 1.6.3 Graduate Nurses’ Sense of B
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: 2.3 Site Description Crouse Hospita
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
Page 81 and 82: Average Frequency/8hr 60 50 40 30 2
Page 83 and 84: 3) shows that all interactions were
Page 85 and 86: Table 4 Overall percent & frequency
Page 87 and 88: Transit” - 2:59:48. However, the
Page 89 and 90:
Time (hh:mm:ss) 0:02:53 0:02:36 0:0
Page 91 and 92:
Patient Room 28% Nurses Station 25%
Page 93 and 94:
3.3.4 Analysis of Task, Person and
Page 95 and 96:
However, when asked if all of this
Page 97 and 98:
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
Page 105 and 106:
experienced by many GNs. Figure 33
Page 107 and 108:
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
Page 113 and 114:
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
Page 145 and 146:
134
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 and 168:
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
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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