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The Effects of a Serene Break Area on











                                    Nurses’ Well-Being












                                    Zach Bosworth, Malea Hill, Cortney Ihnen, Zharayya Miller














                                                                                  BACKGROUND                                                                                                                                                                           EVIDENCE TABLE









                            Registered nurses encounter a variety of situations and                                                                                                                                                                       Study



                            circumstances that will impact their overall health. Nurses                                                                                                                                     Study                       Design/                         Sample #                                   Findings related to


                            experience work-related stress and anxiety that can alter their                                                                                                                             Author(s)                     Evidence                          & Setting                                  the PICO question



                            quality of work. Research was conducted to determine if a                                                                                                                                                                      Level


                            space for nurses to relax and have quiet time would improve                                                                                                                               1. Hoolahan,                Quasi-                          27 nurses on a 34-                   Nurses were taught to identify stress in
                                                                                                                                                                                                                                                  Experimental/
                                                                                                                                                                                                                                                                                  bed medical surgical  themselves and others. When nurses felt
                                                                                                                                                                                                                      S.E., et al.
                            well-being. The space may be considered a break room, calm                                                                                                                                (2012).                     Level 2                         unit at the University  stressed, they were encouraged to utilize
                                                                                                                                                                                                                                                                                  of Pittsburgh Medical  the restoration room. Staff viewed the
                            room, or be a space that incorporates nature to increase                                                                                                                                                                                              Center                               serenity room as a relaxing place to go



                            therapeutic effects.                                                                                                                                                                                                                                                                       when unplanned events happened during
                                                                                                                                                                                                                                                                                                                       their shift, resulting in stress reduction.




                                                                               PICO QUESTION                                                                                                                          2. Largo-                   Nonexperimental/                503 office staff at                  Nature contact can be fostered through
                                                                                                                                                                                                                                                                                  Southeastern
                                                                                                                                                                                                                                                  Level 3
                                                                                                                                                                                                                      Wight, E., et al.
                                                                                                                                                                                                                                                                                                                       environmental modifications to reduce
                                                                                                                                                                                                                      (2011).                                                     University in the                    employee stress. Nature contact is valued
                                                                                                                                                                                                                                                                                  United States                        as it had the strongest association with

                                                                                                                                                                                                                                                                                                                       stress reduction and health.
                            • Population: Nurses in the inpatient setting                                                                                                                                                                                                                                                                                                                                                                                       RECOMMENDATION



                            • Intervention: Serene break area                                                                                                                                                         3. Nejati A., et            Mixed Methods/                  10 nurses from                       The creation of better designed staff break


                            • Comparison: No serene break area                                                                                                                                                        al. (2016).                 Level 3                         healthcare-sector                    areas can be of significant benefit for staff                                                 Results consistently show that a serenity area decreases

                                                                                                                                                                                                                                                                                  architectural firms in  and patient outcomes. The study supports
                            • Outcome: Well-being                                                                                                                                                                                                                                 conjunction with 993  that these improved staff break areas


                            Question: In the inpatient setting, how does a serene break                                                                                                                                                                                           additional nurses                    improve nurses’ job satisfaction, retention,                                                  stress and increases a feeling of well-being and renewal. A
                                                                                                                                                                                                                                                                                  from the Academy of  and performance, while also decreasing
                                                                                                                                                                                                                                                                                                                                                                                                                     pilot project is necessary before a serenity area can be
                                   area compared to no serene break area affect nurses’                                                                                                                                                                                           Medical-Surgical                     job-related health concerns.                                                                  confidently implemented in all settings. Key stakeholders

                                                                                                                                                                                                                                                                                  Nurses
                                   reported well-being?



                                                                                                                                                                                                                      4. Nejati A., et            Mixed Methods/                  10 nurses from                       The restoration provided by improved                                                          would include unit managers, human resources, and

                                                                                                                                                                                                                      al. (2016).                 Level 3                         healthcare-sector                    design for nurses’ use is expected to                                                         healthcare architects to help facilitate change. More research

                                                         EVIDENCE SEARCH METHOD                                                                                                                                                                                                   architectural firms in  increase nurses’ well-being and allow them                                                                 is needed to identify how serenity spaces affect patient
                                                                                                                                                                                                                                                                                  conjunction with 993  to better provide care for their patients.

                                                                                                                                                                                                                                                                                  additional nurses                                                                                                                  outcomes.

                                                                                                                                                                                                                                                                                  from the Academy of


                            Search Databases:                                                                                                                                                                                                                                     Medical-Surgical
                                                                                                                                                                                                                                                                                  Nurses

                            1. EBSCO                                                                                                                                                                                  5. Salmela, L.,             Organizational                  69 ED nurses in an                   94% of staff thought that other departments


                            2. CINAHL                                                                                                                                                                                 et al. (2020).              Experience/                     upper midwest                        would benefit from a serenity room. Results                                                                                    PROPOSED EVALUATION



                            3. PubMed                                                                                                                                                                                                             Level 5                         trauma center                        demonstrated that using the serenity room
                                                                                                                                                                                                                                                                                                                       for a short period of time resulted in

                            4. PsycInfo                                                                                                                                                                                                                                                                                decreased stress and increased renewal for                                                                         Measure                                                    How will it be measured?
                                                                                                                                                                                                                                                                                                                       staff members.


                            Search Terms:                                                                                                                                                                                                                                                                                                                                                                            Stress                                                                Nursing Stress Scale (NSS),



                            1.Serenity rooms AND nurses AND stress                                                                                                                                                                                                                                                                                                                                                                                                                         Perceived Stress Questionnaire



                            2.Nurses AND staff break areas                                                                                                                                                                                                                               RESULTS                                                                                                                                                                                           (PSQ), surveys


                            3.Nursing AND work environment AND stress


                            4.Nurses and serenity rooms                                                                                                                                                                Evidence shows that nurses without proper high-level breaks                                                                                                                                   Well-being and renewal                                                Turnover rate, missed days of





                            Restrictions used to narrow the search: peer-reviewed, English                                                                                                                             are negatively affected by stress. Proper breaks begin with an                                                                                                                                                                                                      work, Behavioral Risk Factor
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Surveillance System (BRFSS),

                            language, within the past ten years                                                                                                                                                        appropriate designated break area. High-level break rooms                                                                                                                                                                                                           surveys

                                                                                                                                                                                                                       provide a serene atmosphere to optimize nurse restoration.



                                                                                                                                                                                                                       The evidence shows restoration within a designated break                                                                                                                                      Exposure to the                                                       Room usage diaries, Nature


                                                                                                                                                                                                                       area greatly improved nurse stress levels, job satisfaction,                                                                                                                                  intervention                                                          Contact Questionnaire (NCQ),



                                                                                                                                                                                                                       retention, and performance.                                                                                                                                                                                                                                         surveys
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