The role of physical design and informal communication

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Table 2 Frequency of tasks for each week of data collection Frequency (%) per Week Task 2 3 4 5 6 7 8 9 Patient 14.1% 10.1% 14.0% 10.6% 20.1% 16.0% 17.2% 13.4% Patient Interactive 4.2% 17.6% 11.0% 5.6% 13.4% 13.2% 11.2% 18.3% Non-Interactive 27.5% 31.8% 29.9% 33.1% 30.2% 32.0% 28.4% 24.6% Social 16.2% 13.5% 12.8% 16.2% 9.4% 9.1% 10.4% 7.7% Administrative 3.5% 0.7% 0.6% 1.4% 3.4% 4.6% 3.0% 0.7% Being Taught 3.5% 1.2% 1.4% 1.5% Seeking Assistance 7.0% 2.0% 3.7% 1.4% 3.4% 3.7% 3.0% 2.8% Seeking Advice 2.8% 5.4% 4.3% 5.6% 1.3% 1.8% 3.0% 2.1% Discussing Patient Care 11.3% 10.8% 11.6% 12.7% 10.1% 10.0% 14.9% 25.4% Providing Assistance 2.1% 3.4% 6.1% 6.3% 2.0% 0.5% 3.7% 0.7% Providing Advice 7.7% 4.7% 4.3% 4.2% 4.0% 5.9% 2.2% 3.5% Validation 0.7% 0.7% 1.4% Other 0.6% 0.7% 2.0% 1.8% 1.5% 0.7% Total (%) 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Frequency 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 2 3 4 5 6 7 8 9 Week Social Discussing Patient Care Patient Interactive Figure 21 Frequency of communication tasks that show a pattern of change over time b) Time The percentage of total time (over 25 hours of data collection) spent on each task shows a very similar, though not identical, distribution as the frequency analysis. The highest percentage of time was spent in non-interactive tasks (25.9%) followed by “Patient” (24.6%), “In Transit” (12.1%), “Discussing Patient Care” (7.8%), and “Social” (6.5%) (See Table 3). Analysis by average time of a single interaction (Table 71
3) shows that all interactions were brief, with the longest of those taking place in the patient room, but lasting less than two minutes in duration. Of the communication tasks, “Being Taught” had the longest average time (1m 35s) followed by “Discussing Patient Care” and “Providing Assistance” (43s each), “Seeking Advice” and “Social” (39s each), and “Validation” (30s) (See Figure 22). Table 3 shows that, on average, over three hours are spent in the patient room in an 8-hour shift, and over two hours are spent in non-interactive tasks. Walking on the unit (the most frequently occurring task) accounted for nearly an hour of an 8-hour shift, yet each “In Transit” event averaged only 20s. Table 3 Total time (over 25 hours of data collection), percentage of total time, average time per task, and average time per task per 8-hour shift Task Total Time Percent Avg. Time Avg. Time/8hr Patient 6:07:00 24.6% 2:02 1:58:12 Patient-Interactive 3:37:24 14.6% 1:28 1:10:01 Non-Interactive 6:25:35 25.9% 1:02 2:04:11 In Transit 2:59:48 12.1% 0:20 0:57:54 Social 1:37:01 6.5% 0:39 0:31:15 Administrative 0:11:43 0.8% 0:24 0:03:46 Being Taught 0:17:26 1.2% 1:35 0:05:37 Seeking Assistance 0:18:09 1.2% 0:25 0:05:51 Seeking Advice 0:26:03 1.7% 0:39 0:08:22 Discussing Patient Care 1:56:24 7.8% 0:43 0:37:29 Providing Assistance 0:26:59 1.8% 0:43 0:08:41 Providing Advice 0:19:31 1.3% 0:20 0:06:17 Validation 0:02:31 0.2% 0:30 0:00:49 Other 0:05:03 0.3% 0:25 0:01:38 Total 24:50:23 100.0% 72
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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
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
Page 81: Average Frequency/8hr 60 50 40 30 2
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
Page 109 and 110: • According to the GN, the greate
Page 111 and 112: Not enough staff to adequately cove
Page 113 and 114: Table 16 Change in GN stress rating
Page 115 and 116: 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
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APPENDIX B Graduate Nurse Consent F
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• Members of the Cornell research
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_____________________________ _____
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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
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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
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APPENDIX L Interview Guides 154
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3. Does the current patient:nurse r
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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
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CWM Tool Task Category Definitions
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REFERENCES Adams, A., & Bond, S. (2
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Buchanan, J., & Considine, G. (2002
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Godinez, G., Schweiger, J., Gruver,
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Lumsdon, K. (1993). Baby boomers gr
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Stolte, K., & Myers, S. t. (1995).
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