Oncology care setting design and planning part I: Concepts for the oncology nurse that improve patient safety.

摘要

This is the first article in a two-part series on designing healthcare settings to improve patient safety. Part I addresses concepts of error theory and evidence-based practice as they relate to planning safe care environments. Part II describes the design and planning of oncology care settings to prevent fungal infections and improve provider handwashing.The United States is facing one of the largest healthcare building booms in the country's history (Ulrich, Quan, Zimring, Joseph, & Choudhary, 2004). In the past five years, the hospital industry has spent almost dollar 100 billion in inflation-adjusted dollars on new facilities, an increase of 47% from the previous five years (USA Today, 2006).Reasons for the construction boom are many: the need to replace aging care centers built during the 1970s (Zigmond, 2006), new technologies (Ulrich et al., 2004), and remodeling of older buildings to be in compliance with new regulatory guidelines (Czarnecki & Havrilak, 2006). Other reasons for the building boom are bed shortages, capacity bottlenecks, and challenges by governmental and employer coalitions for health care to become safer, more productive, and more efficient (Berry et al., 2004). Given the projected increase in patients with cancer, oncology care centers also are experiencing a huge growth in new construction and remodeling of existing care centers.Because of the current and projected increase in healthcare construction, opportunity exists to improve the quality of new healthcare construction by applying error theory, the evolving science of evidence-based design, and involving oncology nurses working at the bedside. In an effort to help prepare oncology nurses to become part of this growth opportunity, this article describes concepts relating to error theory, highlighting the work of James Reason; and evidence-based design.