An Ethnographic Observational Study of Nurse Station Design Impact on Care Delivery and Health-Care Providers'...

BackgroundClinical spaces impact patient-provider interactions, health-care professionals' teamwork, and overall patient health-care outcomes. There is a strong connection between the physical environment, health-care organizational culture, patient care outcomes, and nurses' job satisfaction. The nurse station is a significant traditional spatial hub of activity in hospitals where nurses gather to work, socialize, collaborate, and coordinate care. Yet, less is known about the influence of nurse station design and institutional texts and ruling relations on care delivery and clinical interactions in Ghana.AimThis paper explores the role of nurse station design and institutional texts (the documentary materials such as print, photographs, media that influence what and how work is done) in patient care and nurses' interpersonal and professional interactions in Ghana.MethodsData for the study was obtained through 5 months of ethnographic participant observations and interviews with 11 nurses, 11 family caregivers, and 21 patients. All interviews were audio-recorded and transcribed. Field notes were handwritten and later typed. All data were manually coded inductively and analysed thematically and through institutional ethnography, yielding four interrelated themes: physical design and layout of nurses' stations, nurse station design and patient care coordination, nurses' interpersonal relationships, and collaborative care and information dissemination.ResultsThe study found that nurse station design influenced patient security and safety, quick response to patient needs, and close interaction between nurses and patients/family caregivers, thereby likely reducing nurses' travel distance to engage with patients/family caregivers. Furthermore, it encouraged peer education, shared learning, strong interpersonal and professional relationships, and collective dialogue among nurses within the same patient unit. However, these interactional patterns and ruling relations were not solely due to the nurse station design architecture but were text-coordinated.ConclusionThere is an imperative for further research to understand how nurse station designs and institutional texts mediate nurses' collegiality, nursing leadership, and nurse-student nurse clinical interactions in both teaching and research hospitals.