title: Same-handed and mirrored unit configurations: is there a difference in patient and nurse outcomes?
abstract: OBJECTIVE
  Despite growing awareness that hospital design can impact meaningful outcomes, the same-handed medical-surgical inpatient unit configuration has not been empirically investigated. This study measured differences in patient and nurse outcomes between the same-handed and mirrored unit configurations.
  
  
  BACKGROUND
  It has been hypothesized that the same-handed unit configuration may contribute to operational efficiencies, fewer adverse events, and reduced noise levels.
  
  
  METHODS
  A natural experiment of 8 medical-surgical inpatient units used 2 questionnaires developed for the study. The first questionnaire was available to registered nurses. The second was available to the nurses' patients.
  
  
  RESULTS
  Compared with participants on the mirrored unit configuration, participants on the same-handed unit configuration reported lower noise levels, better sleep quality, more frequent approaches to patients' right side, and improved satisfaction with organization of the workspace at patients' bedsides. The increased right-side approach was related to fewer instances of patients catching themselves from falling.
  
  
  CONCLUSIONS
  The same-handed unit configuration benefits patient experience, patient safety, and operational outcomes. Before renovation or new construction of units, nurse executives should consider the advantages of a same-handed unit configuration.
authors: HOK, New York City, New York 10018, USA. nick.watkins@hok.com
authors: Nicholas
authors: N
authors: Watkins
authors: Mary
authors: M
authors: Kennedy
authors: Maria
authors: M
authors: Ducharme
authors: Cynthia
authors: C
authors: Padula