Racetrack wards have an edge over other ward designs. Wards' central-core configurations also influenced nursing efficiency and effectiveness. Quality scores were higher in Nightingale wards-nurses' greater observation capability was a significant factor. Racetrack wards were considerably less-well staffed and grade-mix dilute and consequently the cheapest. Time-out and down-time were not excessive in any ward type, and it is likely that ward leadership may be compensating for some variables' negative effects. Bay wards, owing to their greater occupancy peaks and troughs, had a propensity to generate heavier workloads. Racetrack ward nursing activity was also close to idyllic. Patient dependency did not stand out in any ward type but as the literature predicted, direct patient care was higher in Nightingale wards. Later, wards were classified in eight ways and differences between ward types examined. Patient dependency, nursing activity, workload, nursing quality and staffing data in the original database were obtained using mainly non-participation observation methods.

Of 390 wards approached, 375 generated usable data. To improve nursing efficiency and effectiveness by capitalizing on the best ward design features.Ī database consisting of 375 UK wards, constructed for other research and development purposes, was revisited and reconfigured for the present study. While studies provide helpful guidance, nursing efficiency and effectiveness implications are speculative. Whether ward designs influence nursing structures, processes and outcomes, therefore, has not been fully answered. There are important relationships between ward design, patient welfare and staff activity in the literature but studies seem not to have tested all the variables.

Rhys hearn dependency assessment tool