Nurse stations to support caregivers

Nurse station planning and design can reduce staff stress and fatigue, improve patient safety, and improve the quality of healthcare delivery.

The nurse station is the center of activity on the inpatient hospital floor. Virtually every healthcare activity occurs at the nurse station, often concurrently, representing a wide range of staff roles. It is an environment that needs to enhance social interaction and work collaboration and simultaneously support focus work.

There are three schools of thought in nurse station design: centralized, decentralized, and hybrid. In centralized planning, nurses and staff work together in a central location. Quick access to colleagues supports smooth workflow and communication, social support, learning and mentoring, and efficient communication. Access to supplies and technology is centralized for space savings and efficient work.

However, centralized nurse stations offer less proximity and visibility to patients, and they increase congestion, noise, and distractions because they are a central hub of activity. This can lead to increased fatigue and work errors.

A decentralized nurse station has no central hub. Individual nurse stations are located throughout the unit, typically outside patient rooms. In this model, nurses are closer to patients, there tend to be fewer distractions and each nurse has their own workspace. The downside of this model is that nurses are separated from their colleagues, which reduces opportunities for staff mentoring, social support, and work interactions.

In some cases, there are opportunities for a hybrid configuration that offers individual workstations between rooms while also providing a centralized hub.

The sub-stations allow for focused work effort and support monitoring and interaction with patients and their families, while the central nurse station provides an interactive work environment that enhances social support, mentoring, and access to resources.

Regardless of the planning model used, there are several factors to consider when designing a nurse station:

• Ergonomics for control over work process.
  Features and furnishings should be adjustable and movable to reduce physical strain and to improve workflow, reducing cognitive load and stress.
   
• Functional support of a variety of work processes
  The spaces and their adjacencies need to support the activities of the users. The space should accommodate a variety of roles (doctors, nurses, radiologists) and different types of work activities (such as charting, group rounds, medication preparation and delivery).
   
• Optimize adjacencies of resources
  The spatial relationships between different activity areas should be planned to optimize adjacencies between them and to tangible resources, medications, food, supplies, and intangible resources, information, social support, advice, and mentoring.

• Work collaboration, mentoring and social support
The nurse station needs to support simultaneous collaboration, mentoring and focus work, as well as allow for different group sizes.

• Reduce distractions
Distractions can cause confusion, fatigue, work errors, and burnout. The nurse station needs to support many different types of information exchange but must do so while helping staff reduce distractions. Design the spaces and acoustical materials to minimize noise and visual distractions.