A Systematic Literature Review of Empirical Studies on Decentralized Nursing Stations

Abstract

Objectives: The objective of this systematic review of literature was to critically evaluate peer-reviewed evidence regarding the effectiveness of decentralized nurse stations (DNSs). Background: The DNS has become an important topic in healthcare design research and practice over the past decade with aims of improving staff efficiency and patient experience. Research has shown to be inconclusive, with studies reporting an assortment of mixed findings. Method: A systematic review of literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses search process of electronic databases, citation tracking, and manual searches of references. All authors evaluated the studies independently. Studies included were empirical, peer-reviewed investigations of DNS in hospitals over the past 15 years. Each study was evaluated using an accepted healthcare design evaluation framework. Results: Over 200 studies were identified. After exclusions, 21 studies published since 2003 were available for full evaluation. Key findings from this review include (a) there is a positive trend toward patient experience in units with DNS, (b) nursing teamwork was perceived to decline in units with DNS, (c) methodological issues may be responsible for the mixed and inconsistent findings, and (d) there is no consistent categorization of nurse station typology or standard definition for DNS. Conclusions: Based on the evaluation framework, DNS are supportive of the patient experience yet have a negative impact on nursing teamwork. Higher quality studies are needed to classify specific typologies of DNS and account for elements such as patient care models, communication, visibility, and other patient care–related factors.