Topic Area
In recent years, the argument in favour of single-occupancy rooms has gained currency not only in Saudi Arabia but also in Europe and the United States. In the context of nursing unit configuration, researchers and practitioners agree that single patient room wards provide privacy, dignity and comfort to patients (Hendrich, 2004), and guarantee reduced infection rates, fewer medical errors, and faster patient recovery rates (Maben, 2009).
However, many health institutions across the globe still retain the retrospective multi-bedroom wards, in large part due to real or imagined fears of staffing constraints associated with single patient room wards (Flynn & Mckeown, 2009). The proposed study, titled Impact of Nursing Unit Configuration on Staffing Demand: A Comparison Study between Single Patient Room Wards and Multi-Bed Room Wards, seeks to look into the managerial sphere of nursing unit configuration (single patient room versus multi-bedroom wards) and how the selected configuration impacts nurses’ staffing requirements.
Motivation of Interest
Consecutive studies have been carried out in the US and the UK on the challenges facing nursing managers in ensuring appropriate staffing across all ward levels (Ellis & Chapman, 2006). Seminal studies have also been undertaken on the benefits and drawbacks of single patient room wards versus multi-bedroom wards, and targets were drawn for practice (Chaudhury et al., 2004). In 2001, upon analysing the benefits of single-occupancy rooms, the UK’s Department of Health (DH) produced policy guidance stating that “…the proportion of single rooms in new hospital developments should aim to be 50 percent and must be higher than the facilities they are replacing” (Maben, 2009 p. 18).
Consistent with this recommendation, the Canadian Standards Association (CSA) acknowledges that the switch towards single-patient rooms is not only essential but desirable, as nosocomial infections and other hospital-acquired illnesses are becoming a deadly concern for care providers and patients (Stall, 2012). In one landmark study, researchers found that the physical environment of the healthcare workplace, along with other critical variables such as culture, technology and work-related processes, impacts the productivity, staffing requirements, health and safety of care providers (Joseph, 2006).
However, in Saudi Arabia, no comprehensive and conclusive studies appear to have been done specifically to compare staffing requirements between single patient room wards and multi-bedroom wards and to evaluate if the single patient room configuration provides the benefits indicated in other seminal studies (Adams & Bond, 2003; Bowblis, 2011). Deriving from these observations, it is only practical that a study investigating the impact of nursing unit configuration (single versus multiple room wards) on staffing demand be commenced within the Saudi Arabian context not only to inform future health policy and practice guidelines but also to address inherent staffing challenges that may distract health institutions from moving toward the preferred industry standard of single patient room wards (Bowblis, 2011).
Key Research Questions
The research questions intended to guide the proposed project include:
- Does nursing unit configuration (single versus multiple occupancy patient rooms) affect the nurse-patient ratio?
- Does a single patient room configuration put constraints on nursing time and resources in practice settings?
- What are some of the advantages and disadvantages involved in switching to a single patient room configuration within the Saudi context?
- What alternatives can be given to ensure the preferred configuration of single-occupancy rooms does not affect the delivery of care services to patients due to staffing constraints?
Aims of the Project
The specific aims of the proposed project are three-fold. First, the project aims to provide nursing managers with evidence-based guidelines on the suitability of single occupancy room wards as opposed to the more traditional multiple-bed room wards within the Saudi context.
Second, the project aims to come up with evidence-based guidance on how nursing unit configuration affects staffing demand in practice settings, and if the nurse-patient ratio within healthcare institutions is a predictor or consequence of nursing unit configuration. Lastly, by addressing the benefits and drawbacks of the two nursing unit configurations under investigation, the researcher aims to develop practical recommendations and alternatives that could be used by nursing managers to minimize staffing constraints within the preferred single occupancy configuration.
Work & Materials Involved
Apart from selecting the participants for the study, a standardised questionnaire schedule will be prepared for collecting data. Piloting will also be done to validate the questionnaire before the actual data collection process commences. Various scales will be used in the questionnaire to measure time consumed by caregivers’ in common nursing procedures across the two units (single room medical ward and multi-bedroom medical ward) at Prince Sultan Medical Military City in Riyadh, Saudi Arabia.
Methodology & Research Techniques
The researcher plans to conduct qualitative research to critically investigate the impact of nursing unit configuration on staffing demand. Extant research shows that a significant number of quantitative research studies are implicitly concerned with investigating the correlation between phenomena of interest, and are either descriptive or experimental (Hopkins, 2000).
The upcoming project will employ a descriptive research design because participants will only be measured once (Jirojwong et al., 2011), to investigate the relationship between nursing unit configuration (independent variable) and staffing demand (dependent variable). A self-administered survey will be used to collect qualitative data among the sampled participants. Emerging research has found that a survey approach in the form of a self-administered questionnaire is essentially effective when researchers are interested in the descriptive exploration of variables of interest, as is the case in the proposed project (Welford et al., 2012).
As far as population and sampling are concerned, it is important to note that potential participants for the proposed project will comprise nursing staff working in the two ward settings (single patient room medical ward and multi-bedroom medical ward) at Prince Sultan Medical Military City in Riyadh. A convenience sample of 50 nursing staff will be selected; in particular, 25 professionals will be chosen from each ward. Although convenience sampling is fraught with many methodical and generalization issues (Jirojwong et al., 2011), it is effective in this context because nurses are normally very busy and, as such, it is only plausible that selection is done based on convenient accessibility to the researcher (Phillips & Starwaski, 2008).
The questionnaire will be used to investigate the effect of nursing unit configuration on the work experiences of nurses and their efficiency. This research technique will be used to determine whether these professionals have enough time to complete their work before the end of their shift. Finally, the respondents should tell whether they get enough break times. The questionnaire will prompt nurses to express their opinions about the impact of unit configuration on their work, especially their ability to meet the needs of the patient. As suggested by Philips and Starwaski (2008), questionnaires are easy to apply in study settings; moreover, they are adaptable and cost-effective. Finally, this research technique can learn more about the opinions of people who are affected by a particular organizational change.
Proposed Outcomes of the Research
The researcher hopes to find a negative correlation between staffing constraints and the adoption of the single patient ward approach. The single-occupancy configuration is expected to demonstrate many advantages over the multiple-bed configuration. Lastly, the researcher expects to find minimal nurse-patient ratio disruptions depending on the nursing unit configuration.
References
Adams, A., & Bond, S. (2003). Staffing in acute hospital wards: Part 1. The relationship between number of nurses and ward organizational environment. Journal of Nursing Management, 11(5), 287-297.
Bowblis, J.R. (2011). Staffing ratios and quality: An analysis of minimum, direct care staffing requirements for nursing homes. Health Services Research, 46(5), 1495-1516.
Chaudhury, H., Mahmood, A., & Valentee, M. (2004). The use of single patient rooms versus multiple occupancy rooms in acute care environments. Coalition for Health Environments Research. Web.
Creamer, G.L., Dahl, A., Perumal, D., Tan, G., & Koea, J.B. (2010). Anatomy of the ward round: The time spent in different activities. ANZ Journal of Surgery, 80(2), 930-932.
Ellis, J., & Chapman, S. (2006). Nursing staffing requirements. Nursing Management, 13(4), 30-33.
Flynn, M., & Mckeown, M. (2009). Nurse staffing levels revisited: A consideration of key issues in nurse staffing levels and skill mix research. Journal of Nursing Management, 17(6), 759-766.
Hendrich, A.L., Fay, J., & Sarrells, A.K. (2004). Effects of acuity-adaptable rooms on flow of patients and delivery of care. American Journal of Critical Care, 13(1), 35-45.
Hopkins, W.G. (2000). Quantitative research design. Web.
Jirojwong, S., Johnson, M., & Welch, A.J. (2011). Research methods in nursing and midwifery: Pathways to evidence-based practice. Oxford: Oxford University Press.
Joseph, A. (2006). The role of the physical and social environment in promoting health, safety, and effectiveness in healthcare workplace. The Centre for Health Design. Web.
Maben, J. (2009). Splendid isolation? The pros and cons of single rooms for NHS. Nursing Management, 16(2), 18-19.
Phillips, P.P., & Starwaski, C.A. (2008). Data collection: Planning for and collecting all types of Data. London: John Wiley & Sons.
Stall, N. (2012). Private rooms: A choice between infection and profit. Canadian Medical Association Journal, 184(1), 24-25.
Welford, C., Murphy, C., & Casey, D. (2012). Demystifying nursing research terminology: Part 2. Nursing Researcher, 19(2), 29-35.