Nurses’ perceptions and experiences of working in a new decentralised intensive care unit

Abstract

Introduction: Conforming to current best evidence, the ICU in a large tertiary teaching hospital in NSW Australia underwent redevelopment and moved into a new decentralised nursing station (DCN) design consisting of single-occupancy rooms clustered into four pods. The DCN design resulted in a new model of nursing care involving the addition of two new supportive nursing roles. Objectives/Aims: To explore nurses’ perceptions and experiences of the working environment and patient care 12 months following the introduction of the new model of nursing care in the DCN ICU. Methods: A prospective cross-sectional survey of nurses working in the new DCN ICU was undertaken. Years of ICU experience were collected, and perceptions and experiences of the working environment and patient care were measured using a 56-item questionnaire. Quantitative and qualitative data were analysed using SPSS v25 and a framework approach. One-way ANOVA was undertaken to investigate the differences in outcomes between nurses’ years of ICU experience. Results: One hundred and twenty-eight nurses completed the survey (response rate 60%). The mean number of years of ICU experience was 6.2 ± 5.3 years. The mean scores for: job satisfaction, continuity of patient care, quality of patient care, social cohesion, and team work were 3.02, 2.60, 3.48, 2.68, 2.78 respectively (maximum obtainable score 5). Seventy-two percent of respondents were satisfied with their job and 80% rated the workload as acceptable. Nurses with ≤1 year of ICU experience reported significantly higher continuity of care. Nurses with ≤3 years of experience reported higher overall quality of patient care. The two new supportive nursing roles were effective. Qualitative analysis supported the quantitative results with nurses reporting some elements that required improvement. Conclusion: Whilst nurses reported satisfaction with elements of the new model, the decentralised ICU negatively impacted teamwork and social cohesion which had implications for quality and continuity of patient care.