HGA Architects and Engineers, Milwaukee, WI, USA.
Kent State University, Kent, MI, USA.
HERD. 2019 Oct;12(4):39-52. doi: 10.1177/1937586718822065. Epub 2019 Jan 17.
This postoccupancy study sought to understand whether a decentralized unit design supported a postpartum care delivery model by evaluating nurses' efficiency, staff perception, acoustical conditions, and patient satisfaction.
Today, standardization and decentralization design concepts are being applied to all types of inpatient unit. There have been many studies that investigated how these concepts influence care delivery on medical-surgical units, but no study has evaluated a postpartum unit.
This study utilized a mixed-method approach that involved unobtrusive shadowing (roughly 25 hr) and surveying ( = 19) of nursing staff, physical acoustic readings (eight, 24-hr readings), and comparison of patient satisfaction pre- and postmove.
On average, nurses spent roughly 36.90% of their time at charting stations. Nurses were observed mostly using the central charting station located at the entry of the unit and adjacent to the well-baby nursery rather than the five decentralized chart stations. This was due to nurses operating with old workflow habits, not fully integrating electronic medical records, and needing to be near the nursery and other nurses. Nurses were satisfied with their ability to interact and their proximity to supplies, patients, and team members while in the central charting station. Additionally, patient satisfaction significantly increased postmove, particularly with the overall hospital's quietness and cleanliness.
This study highlights the importance of aligning administrative operations of the unit with the design intent. Although standardization and decentralization design concepts aimed to improve nurses' workflow, misalignment with the operations may not deliver the most optimal outcomes.
本回顾性研究旨在通过评估护士的工作效率、员工感知、声学条件和患者满意度，了解分散式单元设计是否支持产后护理模式。
如今，标准化和分散化设计理念正应用于各种类型的住院病房。已经有许多研究调查了这些概念如何影响外科病房的护理服务，但尚无研究评估产后病房。
本研究采用了一种混合方法，包括对护理人员进行非干扰性的观察（约 25 小时）和调查（=19）、物理声学读数（8 个 24 小时读数），并比较移动前后患者的满意度。
平均而言，护士大约 36.90%的时间用于在图表工作站。观察到护士主要使用位于单元入口处并紧邻婴儿室的中央图表工作站，而不是五个分散的图表工作站。这是由于护士仍沿用旧的工作流程习惯，未完全整合电子病历，并且需要靠近婴儿室和其他护士。护士对在中央图表工作站时的互动能力和接近供应品、患者和团队成员的便利性感到满意。此外，患者满意度在移动后显著提高，特别是对医院整体的安静和清洁度。
本研究强调了使单元的行政操作与设计意图保持一致的重要性。尽管标准化和分散化设计理念旨在改善护士的工作流程，但与操作的不匹配可能无法实现最佳效果。
