Lacy Mangum, CHID, LVN, has used her eight years of experience in nursing as a way to help give the design team insight into the operations and thought processes of the healthcare team. This includes staff, patients and their families. As a board-certified healthcare designer with eight years of experience, she can also educate clients on code regulations, material selections, space adjacencies and efficiencies. This greater understanding of both processes creates a better healing environment for patients and positively impacts the delivery of care.

Lacy wrote this article to be included in the Nursing Institute for Healthcare Design newsletter for June 2017. She discusses changes in the operations of medication rooms since she started her career in the medical field, how to make educated decisions currently, and what can improve the efficiency of medication rooms and care for patients in the future.


Past
We all know nursing has changed tremendously over the past 20 years. As I started my career in 1999, the medical field in my area of practice was just introducing automated medication systems. As these were introduced, we noticed that there was increased time in pulling medications and distributing to our patients in a timely manner. Not all areas of nursing have updated to the automated system, but many have placed value in the improvement of patient care through medication error reduction, the recapture of medication and supply costs, and tracking shortage
needs.

Present
For most, the idea of automated medication and supply units are commonplace. Let us investigate some pros and cons and how to work through them. When designing new spaces, it’s great to hear feedback from the staff on what
needs improvement as much as what is working. A common complaint I hear is the size of medication rooms. “They’re too small!” With floor renovations and existing conditions, you’re often faced with making a this or that decision. Are you going to have 35 beds or 2 large medication rooms? If this is the case, it often doesn’t come to nursing making the decision and can’t be helped. Here are some questions to consider.

For Consideration
Q: How many nurses are staffing the unit?
A: A unit for critical care might have a greater need for multiple stations, fully
stocked, throughout the unit as opposed to one centralized. When there are 5 nurses all giving medications at the same time (0900, 1200, etc.) you can have a traffic jam!
Q: Do you have flexibility in placement automated systems?
A: If you are allowed by your state to place these in a recessed corridor space,
this frees up the nurse to use the corridor for circulation. The downside is, we are
not in a cockpit environment, have we introduced external distractors that lead to
increased medication errors?
Q: What are the quantities and sizes of the automated systems?
A: If you are already using the systems, evaluate similar units and gain some insight going into the design discussion. IF you are new to it, see if you can tour facilities and see what works for them. Ask your design professional for feedback on previous installations.
Q: What other equipment or supplies will be stored in this space?
A: By the time we have all the equipment in the room, most of the wall space is captured by machines. Now, you have to go down the hall to get your IV tubing. Make sure you are looking at what else will be in the space-it’s easier to plan from the beginning.

Future
When we design, we are thinking always of the future. We want to learn from past experience and update our knowledge after and during every project. Every client and situation is different. If you’re experiencing headaches from your medication room, take some Tylenol and get a mockup. Explore different layouts by taping the room and equipment off on the floor. It works best if you can have the actual equipment. Have your nursing team walk the space and go through a morning routine.