Brewer Barbara B, Carley Kathleen M, Benham-Hutchins Marge, Effken Judith A, Reminga Jeffrey
1 The University of Arizona, Tucson, AZ, USA.
2 Carnegie Mellon University, Pittsburgh, PA, USA.
HERD. 2018 Oct;11(4):82-94. doi: 10.1177/1937586718779223. Epub 2018 Jun 19.
: The purpose of this research is to (1) investigate the impact of nursing unit design on nursing staff communication patterns and, ultimately, on patient falls in acute care nursing units; and (2) evaluate whether differences in fall rates, if found, were associated with the nursing unit physical structure (shape) or size.
: Nursing staff communication and nursing unit design are frequently linked to patient safety outcomes, yet little is known about the impact of specific nursing unit designs on nursing communication patterns that might affect patient falls.
: An exploratory longitudinal correlational design was used to measure nursing unit communication structures using social network analysis techniques. Data were collected 4 times over a 7-month period. Floor plans were used to determine nursing unit design. Fall rates were provided by hospital coordinators.
: An analysis of covariance controlling for hospitals resulted in a statistically significant interaction of unit shape and size (number of beds). The interaction occurred when medium- and large-sized racetrack-shaped units intersected with medium- and large-sized cross-shaped units.
: The results suggest that nursing unit design shape impacts nursing communication patterns, and the interaction of shape and size may impact patient falls. How those communication patterns affect patient falls should be considered when planning hospital construction of nursing care units.
本研究的目的是：（1）调查护理单元设计对护理人员沟通模式的影响，并最终对急症护理单元中的患者跌倒情况产生影响；（2）评估如果发现跌倒率存在差异，是否与护理单元的物理结构（形状）或规模有关。
护理人员沟通与护理单元设计常常与患者安全结果相关，但对于特定护理单元设计对可能影响患者跌倒的护理沟通模式的影响知之甚少。
采用探索性纵向相关设计，运用社会网络分析技术测量护理单元的沟通结构。在7个月的时间内收集了4次数据。使用楼层平面图来确定护理单元的设计。跌倒率由医院协调员提供。
对医院进行协方差控制分析后，发现单元形状和规模（床位数）之间存在统计学上显著的交互作用。当中型和大型赛道形单元与中型和大型十字形单元相交时，就会出现这种交互作用。
结果表明，护理单元设计形状会影响护理沟通模式，形状与规模的交互作用可能会影响患者跌倒情况。在规划医院护理单元建设时，应考虑这些沟通模式如何影响患者跌倒。
