Institutional members access full text with Ovid®

Share this article on:

Same-Handed and Mirrored Unit Configurations: Is There a Difference in Patient and Nurse Outcomes?

Watkins, Nicholas PhD; Kennedy, Mary RN, MS; Ducharme, Maria MS, RN, NE-BC; Padula, Cynthia PhD, RN

Journal of Nursing Administration: June 2011 - Volume 41 - Issue 6 - p 273-279
doi: 10.1097/NNA.0b013e31821c47b4

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.

Conclusion: 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.

Author Affiliations: Director of Research (Dr Watkins), HOK, New York City, New York; Chief Informatics Officer (Ms Kennedy), Chief Nursing Officer (Ms Ducharme), Research Specialist (Dr Padula), The Miriam Hospital, Providence, Rhode Island.

Correspondence: Dr Watkins, HOK, 1065 Avenue of the Americas, 6th Floor, New York City, NY 10018 (

Disclosure: Each author certifies that she or he has no commercial associations that might pose a conflict of interest in connection with this work.

This research was funded through in-kind matching donations and collaboration among the Miriam Hospital, HOK, and faculty from the Rhode Island School of Nursing.

© 2011 Lippincott Williams & Wilkins, Inc.