Comparing centralized vs. decentralized nursing unit design as a determinant of stress and job satisfaction

Historically, the nursing workforce has managed high turnover rates, increased acuity levels, and evolving staffing patterns reflective of managed care initiatives. However, the current shortage of qualified nurses is a critical concern to health care administrators within the United States and beyond. An aging nursing workforce is estimated to bring turnover rates to approximately 20% yearly [1]. The nurse population is expected to grow six percent between the years 2000-2020, while the demand for nurses in the US is expected to grow by 40% during the same time period [2]. This unrelenting nursing shortage combined with the aging nurse population creates a challenging situation to be addressed by nurse leaders and health care administrators within the next ten years [3]. A creative approach that is reflective of technological advancements in point of care and responsive to the generational makeup of the nursing workforce is fundamental to a unit design that is both functional and efficient, yet promotes a positive environment and cohesion among staff [4]. One such
approach involves assessing the designed layout of nurse units as supportive of technological advancement and stress mitigation. Various nurse unit designs can affect the efficiency of patient care through ready accessibility to patient rooms, information from other staff and medical information. Unit design can also contribute to noise levels with centralized nurse units typically having the higher level of noise since they are a central gathering area for all nurse staff [5]. Common environmental stressors in the work environment can be stressful to staff and influence job satisfaction and, ultimately, intention to change jobs. Mitigating or eliminating these environmental factors has the potential to improve staff satisfaction and retention. Stress influences nursing job satisfaction and, ultimately, intention to change jobs.

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