Nurses working in critical care units are more likely to take breaks during their shifts when they perceive strong teamwork with colleagues, according to research from The Center for Health Design. The study, published in the American Journal of Critical Care (AJCC), looked at how unit layout and design affect nursing culture and break-taking behavior.
Researchers surveyed 96 critical care nurses using an online questionnaire. Participants selected one of 13 unit layouts that most closely matched their work environment, which were categorized into racetracks with closed or open centers and pod variations. They also answered questions on teamwork, demographics, and their ability to observe patients from different locations within the unit.
The study found that units designed to foster connection and collaboration may promote more frequent restorative breaks among nurses. "The layout of critical care units has evolved significantly, and many newly designed units have decentralized workstations with individual alcoves between patient rooms," said Yolanda Keys, PhD, DHA, RN, NEA-BC, EDAC, research associate at The Center for Health Design. "The potential unintended consequences of these unit layouts include increased feelings of isolation and fewer opportunities for collaboration. We will continue to study how the built environment contributes to unit culture and patient outcomes."
Despite evidence that taking breaks can reduce burnout among nurses, less than half (43%) of survey respondents reported being very likely or extremely likely to take a 30-minute meal break during a 12-hour shift. Half indicated they were not likely at all to take any nonmeal breaks.
Open-ended responses revealed that about 80% of participants cited physical barriers—such as walls, columns, doors, curtains, long hallways, or equipment—that made it difficult to see co-workers or patients. Prior studies have highlighted the importance of leadership support, adequate staffing levels, and well-designed break areas in encouraging nurses to take needed rest periods and maintain resilience.
The research was supported by an Impact Research Grant from the American Association of Critical-Care Nurses (AACN).
