Should Psychiatric Nursing Stations Be Opened or Closed?
Psychiatric nurses who work at inpatient mental health facilities interact with many different types of clients. Some may be relatively subdued and withdrawn while others may be more outgoing. Facilities designed to address the needs of the severely mentally incapacitated treat individuals with extreme cognitive and behavioral problems, and constant supervision and precaution are necessary to ensure the safety of both the clinicians and the clients. Nursing stations within these facilities are designed to provide maximum accessibility and supervision while also providing safety and security to the staff members. Some stations are designed with glass barriers and locked doors and others are built with no walls or windows, allowing both the staff members and clients open access.
Kelly Southard, the Quality Outcomes Coordinator at the Cone Behavioral Health Hospital in Greensboro, North Carolina, recently conducted a study to determine how each type of nursing station design affected therapeutic outcomes. For her study, Southard assessed 25 nurses and 81 clients in an acute psychiatric unit of a hospital before the nursing station was renovated and after. Prior to renovation, the nursing station was closed and had window and door barriers. The nursing station was only modestly renovated with new paint and countertops and removal of the window and door.
Southard found no significant differences in the perceptions of the ward environment after the renovation compared to before the renovation. The staff members and the clients did not report an increase in therapeutic ambiance as a result of having an open nursing station. However, many clients did comment that they felt that that the nurses were more accessible in the open station. Another interesting finding and one that is of concern to staff members charged with the care of high-risk clients was that the open station did not increase the level of aggression or violence on the ward. In contrast, the staff members discovered that the clients actually exhibited less aggression and anger after the renovations. Southard added, “Although more research is needed, these desired trends could be related to nursing staff being more readily available to better meet patients’ needs.”
Reference:
Southard, K., Jarrell, A., Shattell, M. M., McCoy, T. P., Bartlett, R. (2012). Enclosed versus open nursing stations in adult acute care psychiatric settings: Does the design affect the therapeutic milieu? Journal of Psychosocial Nursing & Mental Health Services, 50.5, 28-34.