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Nursing unit design: same-handed rooms

The advantages and disadvantages of designing nursing units with same-handed versus mirrored patient rooms are reviewed in the (Pressler & Keil, 2011) point-counterpoint discussion.  Same-handed rooms, in which everything can be found in exactly the same location, are thought to enhance patient safety.  However, mirrored rooms may be less expensive in construction costs because of the ability to more efficiently design plumbing.  Same-handed rooms are not a brand new concept.  (Cahnman, 2006) provides a nice review of the developments in patient room design and discusses the factors that should be considered: acuity level, specialties, nursing care model, supply distribution model, how visible the patient is to be from the corridor, patient safety, and family amenities.  She presents examples of a hospital that opted for same-handed rooms with outboard toilet (St. Joseph’s Hospital, St. Paul, MN), and another that chose same-handed rooms with inboard toilet (The Miriam Hospital, Providence, RI).  The extra cost to build a same-handed room has been estimated to be $3,000 to $5,000 per room, due to increased plumbing costs (Maze, 2009).  Maze also quotes estimates from a large construction company about the popularity of different toilet room locations that the company was installing in new patient towers — 50% inboard toilet rooms, 38% outboard toilet rooms, and 12% nested toilet rooms.  CannonDesign also mentions the added construction cost of about $3500 per room more for same-handed than for mirror-image rooms, and identifies the major design challenge with the same-handed rooms to be the placement of nursing substations.  An example of a new 82-bed hospital built with standardized private rooms is St. Joseph’s Hospital (West Bend, WI), described in the items by Reiling.


Cahnman, S.F.  Key considerations in patient room design, part 1Healthcare Design, Apr. 2006; and, Key considerations in patient room design, part 2: the same-handed room.  Healthcare Design, May 2006.  http://www.sypultconstruction.com/images/Healthcare_Design_May_2006.pdf

CannonDesign.  Same-sided patient rooms on the rise, improve facility safety.  Healthcare Building Ideas, [no date].  http://cannondesign.com/FILES/original/2009/06/29/d37b346fb175436822ab15baa089a4693aea05a2.pdf 

Maze, C.  Inboard, outboard, or nested? Healthcare Design, Mar. 2009.

Pressler, G., and Keil, O.  Same-handed patient rooms: point-counterpointFacilityCare, [2011].

Reiling, J.G., and others.  Enhancing the traditional hospital design process: a focus on patient safety.  Joint Commission Journal on Quality and Safety;30(3):115-124, Mar. 2004.  http://www.premierinc.com/quality-safety/tools-services/safety/topics/construction/downloads/01-reiling.pdf

Reiling, J.G. Creating a Culture of Patient Safety Through Innovative Hospital Design, [2005].  http://www.ahrq.gov/downloads/pub/advances/vol2/Reiling.pdf

Reililng, J.G., Hughes, R.G., and Murphy, M.R.  The impact of facility design on patient safety, in: Hughes, R.G. (ed.) Patient Safety and Quality: An Evidence-Based Handbook for Nurses.  Rockville, MD: Agency for Healthcare Research and Quality, 2008, Chapt. 28.

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