KIEAE Journal

Korea Institute of Ecological Architecture and Environment (한국생태환경건축학회)
권호 표지
DOI QR코드

DOI QR Code

Testing The Healing Environment Conditions for Nurses with two Independent Variables: Visibility Enhancement along with Shortening the Walking Distance of the Nurses to Patient - Focused on LogWare stop sequence and space syntax for U-Shape, L- Shape and I-Shape NS-

  • Received : 2015.02.02
  • Accepted : 2015.04.17
  • Published : 2015.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Maximizing human comfort in design of medical environments depends immensely on specialized architects particularly critical care design; the study proposes Evidence-Based Design as an apparent analog to Evidence-Based Medicine. Healthcare facility designs are substantially based on the findings of study in an effort to design environments that augment care by improving patient safety and being therapeutic. On SPSS (Statistical Package for Social Science) t-test is applied to simulate two independent variables of PDR (Pre Design-Research) and POE (Post- Occupancy Evaluation). PDR is conducted on relatively new hospital Hallym University Dongtan Sacred Heart Hospital to analyse visibility from researchers' point of view, here the ICU is arranged in I-Shape. POE is applied on Dongguk University Ilsan Hospital to simulate walking on LogWare where two NS are designed based on L- Shape and Seoul St. Mary's Hospital, The Catholic University of Korea where five NS are functional for ICU Intensive Care Unit, Surgical Intensive Care Unit (SICU), Medical Intensive Care Unit (MICU), Critical Care Unit (CCU), Korean Oriental Medical Care Unit which are mostly arranged in U-Shape, and walking pattern is recognized to be in a zigzag path. Method: T-Test is applied on two dependent communication variables: walkability and visibility, with confidence interval of 95%. This study systematically analyses the Nurse Station (NS) typo-morphology, and simulates nurse horizontal circulation, by computing round route visits to patient's bed, then estimating minimum round route on LogWare stop sequence software. The visual connectivity is measured on depth map graphs. Hence the aim is to reduce staff stress and fatigue for better patients care by minimizing staff horizontal travel time and to facilitate nurse walk path and support space distribution by increasing effectiveness in delivering care. Result: Applying visibility graph and isovist field on space syntax on I- Shape, L- Shape and U- Shape ICU (SICU, MICU and CCU) configuration, I-shape facilitated 20% more patients in linear view as they stir to rise from their beds from nurse station compared to U-shape. In conclusion, it was proved that U-Shape supply minimum walking and maximum visibility; and L shape provides just visibility as the nurse is at pivot. I shape provides panoramic view from the Nurse Station but very rigorous walking.

Keywords

References

  1. D. Kirk Hamilton, (2006). Evidence-based design supports evidence-based medicine in the ICU. ICU Management Journal (Belgium), 6(3), 31. https://healthmanagement.org/c/icu/issuearticle/evidence-based-design-supp orts-evidence-based-medicine-in-the-icu
  2. Christopher J. Smiley, (2015) 'Using Prevention and Measurement to Drive Quality Improvement', DDS, Vol. 89.Suppl. 1.February 2015 The Journal of Dental Hygiene http://jdh.adha.org/content/89/suppl_1/27.full.pdf+html
  3. Sackett, David L., William Rosenberg, J. A. Gray, R. Brian Haynes, and W. Scott Richardson. "Evidence based medicine: what it is and what it isn't." Bmj 312, no. 7023 (1996): 71-72. DOI: http://dx.doi.org/10.1136/bmj.312.7023.71 http://www.bmj.com/content/312/7023/71.full?ijkey=3862b257094b8ea8fa49aed29d07eaedb7f168c3&keytype2=tf_ipsecsha
  4. Berwick DJ, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Affairs. 2008:27(3):759-769. 3. CMS QUALITY IMPROVEMENT ROADMAP. Available at: http://www.cms.gov/Medicare/Coverage/CouncilonTechInnov/downloads/qualityroadmap.pdf (Accessed October 6,2014). https://doi.org/10.1377/hlthaff.27.3.759
  5. Dutta, Ranojoy. "Influence of nursing unit layout on staff communication and interaction patterns, 2008. (Doctoral dissertation, Cornell University). http://www.haciric.org/static/doc/events/Nursing_Unit_Design,_Communication_and_Teamwork_An_Ecological_Approach_to_Integrated_Healthscape_Strategies1.pdf(Accessed18th January2015)
  6. Stichler, J. F. (2008). Healing by design. Journal of Nursing Administration,38(12), 505-509. https://doi.org/10.1097/NNA.0b013e31818ebfa6
  7. Clark, Paul R. "Teamwork: building healthier workplaces and providing safer patient care." Critical care nursing quarterly 32, no. 3 (2009):221-231. DOI: 10.1097/CNQ.0b013e3181ab923f http://journals.lww.com/ccnq/Abstract/2009/07000/Teamwork__Building_Healthier_Workplaces_and.6.aspx
  8. Choi, Yun Jeong, Ji Young Lim, Young Whee Lee, and Hwa Soon Kim. "Development of nursing key performance indicators for an intensive care unit by using a balanced scorecard." Journal of Korean Academy of Nursing 38, no. 5 (2008): 656-666. https://doi.org/10.4040/jkan.2008.38.5.656
  9. Haq, Saif. "Measuring the 'PLAN': Possibilities of Space Syntax in Healthcare Environments Research." Development of Tools for Healthcare Environments Research and Practice (2013). http://www.edra.org/sites/default/files/publications/EDRA_HealthcareTools_2013.pdf#page=18
  10. Guenther, Robin, and Anna Gilmore Hall. "Healthy buildings: Impact on nurses and nursing practice." OJIN: The Online Journal of Issues in Nursing 12.2 (2007) 10.3912/OJIN.Vol12No02Man02 http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No2May07/HealthyBuildings.aspx (accessed on 15thJanuary2015)
  11. J.S. Park, W.B. Park, J.H. Yoo, S.B. Hahn, "A study on Design Determinants from sustainable ICU for Healing Environment Based on EBD, Focus on Korea cases" The symposium on healthcare architecture in Asia (2013).
  12. Reiling, John. "Safe design of healthcare facilities." Quality and Safety in Health Care 15, Frontiers of Health Services Management Fall 2004, Vol. 21 Issue 1, p41-46. 6p. http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=bfa32ae5-d283-4b55-8737-d4e31f2c8db0%40sessionmgr112&vid=1&hid=105 Author affiliation: St. Joseph's Community Hospital of West Bend, Wisconsin, ISSN: 0748-8157
  13. Cohen, Gary. "First, do no harm." Designing the 21 st Century Hospital (2006): 1. http://synapse.koreamed.org/search.php?where=aview&id=10.4040/jkan.2008.38.5.656&code=0006JKAN&vmode=FULL http://noharm-asia.org/sites/default/files/documents-files/39/Designing_21st_Cent_Hosp.pdf#page=5
  14. Greener, Ian, Barbara Harrington, David J. Hunter, Russell Mannion, and Martin Powell. Reforming Healthcare: What's the Evidence?. Policy Press, 2014.
  15. Brannen, L. (2006). Preventative Medicine for the Environment: Developing and Implementing Environmental Programs that Work. Designing the 21 st Century Hospital, 83.
  16. Heo, Yeonsook, Ruchi Choudhary, Sonit Bafna, Ann Hendrich, and Marylyn P. Chow. "A modeling approach for estimating the impact of spatial configuration on nurses' movement." In Proceedings of the 7th International Space Syntax Symposium, p. 041. 2009. http://www.sss7.org/Proceedings/04%20Building%20Morphology%20and%20Emergent%20Performativity/041_Heo_Choudhary_Bafna_Hendrich_Chow.pdf
  17. Calvelo, Daniel, M-C. Chambrin, Denis Pomorski, and Pierre Ravaux. "Towards symbolization using data-driven extraction of local trends for ICU monitoring."Artificial intelligence in medicine 19, no. 3 (2000): 203-223. DOI:10.1016/S0933-3657(00)00046-4 http://www.sciencedirect.com/science/article/pii/S0933365700000464 (Accessed 18th January 2015)
  18. Carpman, Janet R.; Grant, Myron A. 'Wayfinding: A broad view'. Bechtel, Robert B. (Ed); Churchman, Arza (Ed), (2002). Handbook of environmental psychology., (pp. 427-442). Hoboken, NJ, US: John Wiley & Sons Inc, xiii, 722 pp.
  19. Gadbois, C., P. Bourgeois, M. M. Goeh-Akue-Gad, J. Guillaume, and M. A. Urbain. "Hospital design and the temporal and spatial organization of nursing activity." Work & Stress 6, no. 3 (1992): 277-291. 10.1080/02678379208259958 http://www.tandfonline.com/doi/abs/10.1080/02678379208259958#.VLtFbUeUcqI
  20. Zimmerman, Jack E., Stephen M. Shortell, Denise M. Rousseau, Joanne Duffy, Robin R. Gillies, William A. Knaus, Kelly Devers, Douglas P. Wagner, and Elizabeth A. Draper. "Improving intensive care: observations based on organizational case studies in nine intensive care units: a prospective, multicenter study." Critical care medicine 21, no. 10 (1993): 1443-1451. http://journals.lww.com/ccmjournal/Abstract/1993/10000/Improving_intensive_care__Observations_based_on.10.aspx https://doi.org/10.1097/00003246-199310000-00010
  21. Clark, Paul R. "Teamwork: building healthier workplaces and providing safer patient care." Critical care nursing quarterly 32, no. 3 (2009): 221-231. DOI: 10.1097/CNQ.0b013e3181ab923f http://journals.lww.com/ccnq/Abstract/2009/07000/Teamwork__Building_Healthier_Workplaces_and.6.aspx
  22. Vreeland, Ruth, and Geraldine L. Ellis. "Stresses on the nurse in an intensive-care unit." AORN Journal 10, no. 3 (1969): 54-56. DOI:10.1016/S0001-2092(08)70644-6 http://www.sciencedirect.com/science/article/pii/S0001209208706446
  23. Mahbub Rashid, "A Decade of Adult Intensive Care Unit Design: A Study of the Physical Design Features of the Best‐Practice Examples," Critical Care Nursing Quarterly, no. 4. p. 282, 2006. http://journals.lww.com/ccnq/Abstract/2006/10000/A_Decade_of_Adult_Intensive_Care_Unit_Design_A.3.aspx
  24. Wonbae Park "A new addition of Seoul National University Bungand Hospital, Korea", 21st Congress of International Federation of Hospital Engineering (2010) (IFHE) Japan
  25. Sundaramoorthi, Durai, Victoria CP Chen, Jay M. Rosenberger, Seoung Bum Kim, and Deborah F. Buckley-Behan. "A data-integrated simulation model to evaluate nurse-patient assignments." Health care management science 12, no. 3 (2009): 252-268. Health Care Manage Sci (2009) 12:252-268, DOI 10.1007/s10729-008-9090-7
  26. Nightingale, Florence. Notes on hospitals. Longman, Green, Longman, Roberts, and Green, 1863.
  27. Wickersheimer, Michael. Healing by Design: How Sustainable Design Strategies that Pertain to the Built Environment Can be Found in the Frameworks and Principles of Complementary & Alternative Medicine. Diss. Fashion Institute of Technology, 2013 http://www.fitnyc.edu/files/pdfs/Wickersheimer_Healing_by_design.pdf (Accessed on 15th January2015)
  28. Pronovost, Peter, Sean Berenholtz, Todd Dorman, Pam A. Lipsett, Terri Simmonds, and Carol Haraden. "Improving communication in the ICU using daily goals." Journal of critical care 18, no. 2 (2003): 71-75 DOI:10.1053/jcrc.2003.50008 http://www.sciencedirect.com/science/article/pii/S088394410370001X
  29. Reason, James. Human error. Cambridge university press, 1990.
  30. Orr, David W. The nature of design: ecology, culture, and human intention. Oxford University Press, 2002.
  31. Tucker, Anita L., and Amy C. Edmondson. "Managing routine exceptions: A model of nurse problem solving behavior." Advances in health care management 3 (2002): 87-113. https://doi.org/10.1016/S1474-8231(02)03007-0
  32. Hardy, Jeff. "No hidden patient: a safety design model." Trustee: the journal for hospital governing boards 60, no. 2 (2007): 32-33. http://psqh.com/sepoct06/facility-design.html
  33. Cai, Hui, and Craig Zimring. "Out of Sight, Out of Reach: Correlating spatial metrics of nurse station typology with nurses' communication and co‐awareness in an intensive care unit." In 2012. Proceedings: Eighth International Space Syntax Symposium, Santiago de Chile: PUC, p. 8145. 2012. http://www.sss8.cl/media/upload/paginas/seccion/Formato_-_8039_-_PDF.pdf(Accessed on 15th January2015)
  34. Dordevic, L., & Antic, S. Software Logware application in education of logistics managers. Info M, 11(41), (2012). 26-32.