The unintended consequences of decentralized nursing stations

The trend of decentralizing nursing stations — borne from an effort to lessen walking distance for nurses and allow for more time at the bedside — could have some unintended consequences, according to a study out of the University of Kansas.

A research team from KU's Institute for Health + Wellness in Lawrence reviewed the 2014 renovation of Jefferson, Mo.-based SSM St. Mary's Hospital's orthopedic unit to inform the planned expansion of SSM St. Joseph Hospital West in Lake St. Louis, Mo.

The team used an evidence-based design checklist and evaluated how the renovation affected patient satisfaction sores.

According to Hui Cai, PhD, assistant professor of the health and wellness program at KU's School of Architecture Design and Planning, scores improved on most patient care-related questions after the renovation, except for one — nurses' response to patient calls.

"Our hypothesis is that this is because of decentralized nurses' stations," she said. She believes decentralized stations put more physical distance between nurses and their peers and also create a visual disconnection, meaning nurses have to move further to talk to other nurses — resulting in less communication and greater delays in response to patients.

"This design trend needs to be further investigated before it is accepted as standard for every hospital. We have to see how to modify the design to achieve balance between shorter walking distance, better patient surveillance and better staff communication and collaboration."

Dr. Cai is conducting a second study on the effects of decentralized nursing stations. Those findings could be published later this year.

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