Unit Layout and Critical Care Nurses’ Perceptions of Visibility, Teamwork, and Taking Breaks

BACKGROUND: The compounding effects of providing care during the COVID-19 pandemic and subsequent post-pandemic staffing shortages have led many experienced nurses to leave the bedside, with novice nurses being hired to fill the gap. Less experienced nurses need access to team members for the consultation, collaboration, and support required for intensive care work. Decentralization of nursing work stations and large, private rooms have resulted in intensive care units with long corridors that separate coworkers and make activities such as coaching, mentoring, and finding assistance more challenging. OBJECTIVES: To examine relationships between critical care unit layouts and nurses' perceptions of teamwork, breaks, unit layout, and visibility. METHODS: A national sample of nurses participated via an online survey in which respondents selected their unit layout from a variety of newly developed unit graphics and subsequently answered survey questions. Researchers explored relationships between teamwork and break-taking behaviors, unit layout, and both patient and coworker visibility with the aim of guiding health care leaders, design professionals, and the nursing profession in critical care unit design and operations. RESULTS: A statistically significant relationship was found between nurses' perceptions of teamwork and the likelihood of taking both meal breaks and nonmeal breaks, but no correlation was identified between unit layout and teamwork. CONCLUSIONS: Although more research is needed to understand how unit layouts influence nursing outcomes, units that foster connection and collaboration between critical care team members may encourage break-taking behaviors.