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The Nurses’ Station Can Benefit from Digital Transformation
Centralized vs. Decentralized Nurse Stations
Hospitals are quickly adopting digital transformation technology for planning and monitoring patient care. As they do, the question of centralized versus decentralized Nurse stations becomes more important. Why? Because the location of Nurses’ stations can impact care quality. As new construction and capital projects increase, the question of where to locate Nurses’ Stations takes center stage. Since design impacts staff and resource planning, it’s important to choose the right layout model. Learn how digital tools and a fully integrated platform can help, no matter which model of Nurse Station layout your buildings have.
The Decentralized Model
Decentralized Nurses’ stations are typically placed as alcoves of smaller desks areas throughout patient wings, so you can think of them as satellite stations. In one study of decentralized versus centralized Nurse stations, researchers noted that caregivers could spend more time with patients in a decentralized model.1 It’s clear that personalized care and patient satisfaction is vital2, so reducing the amount of time it takes to walk to a patient room to respond to a Nurse Call increases opportunities for a positive experience. However, one study noted that “Consultations with medical staff and social interactions were significantly less frequent in decentralized nursing stations.”3
At the same time, Nurses may need even more time to locate information not stored in their decentralized area. A recent study noted that, “Advances in information technology have enabled Nurses to move away from traditional centralized paper-charting stations to smaller, decentralized work stations and charting sub-stations located closer to or inside patient rooms. Coupled with a mandate for private rooms in new hospital construction, these changes create longer patient care units and therefore longer distances for Nurses to walk.”1
The Centralized Model
Conversely, many hospitals typically have a standard centralized model for placement of Nurse stations relative to patient rooms. This “Hub and Spoke” model has a number of advantages for Nursing and clinical staff. With a centralized location, there is more opportunity for social interaction and collaboration. One study examining this issue indicated that their findings “illustrate how Nurses in centralized units characterized communication as proximity, teamwork and relationships.”4 For interdisciplinary teams, this closer and more frequent connection may improve efficiency and help relieve alarm fatigue.
At the same time, handoffs are smoother since some non-digital patient information is centrally located. Additionally, trained, centrally-located staff operating advanced patient monitoring equipment can assist Nurses in interpreting and reporting on results faster.
How can digital transformation help at the Nurses’ station?
In either model, typical dry erase marker boards used for scheduling or rounds need constant updating. That leads to latent information, misinterpretation and other errors. Conversely, integrated digital whiteboards take real-time data from numerous existing systems and display it clearly and accurately. Edits made to patient information in one of those systems automatically updates the digital displays and are reflected on connected devices. Your digital whiteboard vendor can recommend a variety of layouts and apps to streamline what you need to show and how input responses are managed. Ask your vendor for information on:
Video patient monitoring
First, with video monitoring Nurses can monitor patients from the Nurses’ station, whether centrally located or in a satellite station. This allows them to respond to nonclinical Nurse calls, or dispatch personnel to the patient room. Second, video monitoring allows caregivers to view and speak to patients without losing a personal touch in establishing trust. Using video, they can respond to a patient’s requests on the in-room digital whiteboard or bedside tablet, and push reminders and messages.
Telehealth and video
With video monitoring, Telemedicine and consultation videoconferencing on a digital Unit Whiteboard can speed scheduling and follow-up, with less inconvenience to patients. Information on digital devices can be updated more quickly since video provides immediate feedback.
Dynamic risk protocols
Using a digital Unit Whiteboard, caregivers can observe safety hazards to provide meaningful response. With timely recognition of deterioration or changes in a patient’s condition, they can observe patients engaging in risky behaviors, like attempting to remove tubes and cannulas, or tampering with equipment. Then, digital protocol and visitation flags on a Nurse station whiteboard can be dynamically edited and sync’d as needed without a trip to the patient room.
Restriction flags and updates
What’s more, risk flags appear automatically on a Unit Whiteboard in the Nurses’ station for other caregivers to view. Any changes to protocols made by a Nurse on the touchscreen of a digital patient whiteboard (like a change in pain level or updates to medications) display automatically.
Sync’d patient data
In the meantime, information on in-room digital whiteboards display sync’d data on the Unit Whiteboard. Patient Whiteboards can be tailored for specialties, units or departments. They typically display daily achievements, goals and schedules for transfer or discharge, which contributes to positive attitudes toward recovery.
In addition, dynamically updated medications show exactly what medications patients are taking, with dosing, description and image information. From a digital Unit Whiteboard, caregivers can push specific patient education videos to Bedside Tablets or whiteboards, send reminders about viewing, and monitor what content has been watched. This data is sync’d across the patient’s EHR.
Digital patient monitoring technology makes it easier to reduce wasted time and effort and increase staff satisfaction. Whether your facility uses a centralized or decentralized model, patient satisfaction increases when care information is precise and consistent. Moreover, using a digital, integrated solution will help break down patient data silos. Regardless of the Nurse station type, integration and digital tools ensure all caregivers have access to the real-time patient information they need to plan, deliver and analyze quality care.
 Zborowsky T, Bunker-Hellmich L, Morelli A, O’Neill M. Centralized vs. decentralized nursing stations: effects on nurses’ functional use of space and work environment. HERD. 2010 Summer;3(4):19-42. doi: 10.1177/193758671000300404. PMID: 21165850.
 Bayramzadeh S, Alkazemi MF. Centralized vs. Decentralized Nursing Stations: An Evaluation of the Implications of Communication Technologies in Healthcare. HERD. 2014 Summer;7(4):62-80. doi: 10.1177/193758671400700406. PMID: 25303427.
 Kevin Real, Joshua Santiago, Lindsey Fay, Kathy Isaacs & Allison Carll-White (2019) The Social Logic of Nursing Communication and Team Processes in Centralized and Decentralized Work Spaces, Health Communication, 34:14, 1751-1763, DOI: 10.1080/10410236.2018.1536940