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Centralized to hybrid nurse station: Communication and teamwork among nursing staff

Originally Published:
2015
Key Point Summary
Key Point Summary Author(s):
Dickey, Andrew
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Key Concepts/Context

Nursing stations often act as the primary workspaces for various members of a healthcare team while patients aren’t being directly worked with. Centralized nursing stations can lead to higher rates of telephone and computer use and administrative tasks while decreasing time spent caring for patients. Conversely, decentralized nursing stations have been found to create feelings of isolation and poor communication among staff. To emphasize the positive aspects of both formats, the authors propose a hybrid nursing station design that features decentralized stations connected to centralized meeting spaces.

Objectives

To examine nurses’ experiences regarding teamwork and communication while using a newly designed hybrid nursing station.

Methods

Over the span of two years, 20 nurses from a 30-bed medical-surgical unit and a 30-bed intermediate care unit were interviewed as both units shifted from centralized stations to hybrid stations. Interviews took place in a private room one hour either before or after work shifts; interviews were recorded and transcribed. The researchers collected demographic information from all participants as well. During analysis, the data were sorted into a list of four common themes: communication, teamwork, pros and cons of the new station, and perceptions of transitioning to a hybrid station.

Design Implications
A nursing station that provides decentralized, independent workspaces closer to patients could improve overall service towards patients and teamwork among staff members. Mixing this design with a centralized station for support staff, shared resources, and private space could help create an effective hybrid between both forms of nursing station design.
Findings

Workers reported that the advanced technology featured in the hybrid station contributed to feelings of physical and social isolation, while the addition of some equipment, such as wireless phones, was very helpful and efficient. Participants noted that the design of the hybrid stations allowed for more communications that focused on patient care, and that while the notion of teamwork seemed to dissipate at the beginning of the transition, strategies were eventually developed that improved teamwork levels. This included creating “pod teams,” or small groups that would cooperate throughout a shift. Less nurse socialization seemed to reduce the overall noise level and distractions for nurses.

Limitations

The authors note that the perspectives provided by the nursing staff from one hospital may not be generalized to specific workspace transitions occurring in other hospitals. Additionally, no observational data were gathered to compare with the nurses’ perspectives, meaning all conclusions were drawn from qualitative data.

Design Category
Building location/site optimization|Room configuration and layout|Unit configuration and layout
Setting
Hospitals
Outcome Category
Patient / resident satisfaction and comfort|Staff productivity / efficiency|Staff satisfaction
Environmental Condition Category
Physical proximity/density
Key Point Summary Author(s):
Dickey, Andrew
Primary Author
Zhang, Y.