Effects of Unit Design on Acute Care Nurses’ Walking Distances, Energy Expenditure, and Job Satisfaction: A Pre–Post Relocation Study

Objectives: The purpose of this study was to determine what differences occurred in steps taken and energy expenditure among acute care nurses when their work environment moved from a hospital with centralized nurses’ stations to a hospital with decentralized nurses’ stations. Additional goals were to determine design features nurses perceived as contributing to or deterring from their work activities and what changes occurred in reported job satisfaction. Since design features can also affect patient outcomes, patient falls were monitored. Background: The construction of a replacement facility for a 224-bed Level 1 trauma center provided the opportunity to compare the effects of centralized versus decentralized nurses’ stations on nurses’ experiences of their work environments. Method: A pre–post quasi-experimental design was used. RN participants completed an open-ended questionnaire and recorded pedometer data at the end of each shift, working for 3-month pre-relocation and for 3-month post-relocation. Nine months passed between the move and post-relocation data collection. Results: There were significant reductions in nurses’ energy expenditure ( p < .001) and steps taken ( p = .041) post-relocation. Overall, nurses’ job satisfaction was high and improved post-relocation, and patient falls decreased by 55%. Conclusions: Post-relocation, a number of the dissatisfiers associated with the physical environment were eliminated, and nurses identified more satisfiers (in general and related to the physical environment). Patients are safer post-relocation as indicated by a decrease in falls. This decrease is even more noteworthy when considering that the numbers of patient beds on each unit is higher post-relocation.