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Modular Nursing – Optimizing RN Involvement in Patient Care and Management

Nursing models help define how care is delivered, how resources are allocated and deployed, and can provide the structure that defines both the organization of responsibilities as well as accountability.

While staffing and nursing care models tend to come, go and or evolve, healthcare delivery issues such as nursing shortages and crises such as pandemics force regular evaluations of these models to help nursing leadership identify the nursing model that is best suited to the current situation.

Defining Modular Nursing
The primary nursing care model may not be as appropriate for the current pandemic moment, whch has led some organization to consider a modular nursing model. Modular nursing is not new—it began its evolution in the 1950s—but is rather a modification of the team nursing model. Team nursing is still in practice today and calls for registered nurses and physicians to coordinate the work of the entire patient care team. In addition to the nurse and physician, the team might also include occupational and physical therapists as well as social workers and discharge planners. Eventually, the team nursing model was modified to include nursing assistants, licensed practical nurses, and some other unlicensed personnel.

Team nursing eventually evolved into modular nursing. In this model a patient care unit is divided into geographic modules with an RN as team leader. The same team of caregivers is regularly assigned to the modules. The team will include RNs and will also include LPNs and nursing assistants. Typically, each module will have access to the medications, supplies, and linens needed within the module. The goal of modular nursing is to make patient care less fragmented and is most frequently used in inpatient and outpatient care areas. 

Modular Nursing – Capitalizing on Strengths
The healthcare delivery system in the U.S. continues on its journey of value-based rather than volume-based care, and healthcare providers are evaluating nursing models that support value-based care.

The modular nursing model has the potential to provide advantages for both patients and nursing staff and may be a particularly good fit for value-based care.

  • Geographic proximity and a smaller team can make for more efficient communication between team members and between team members and patients and families—this might be especially noticeable on larger units.
  • The model allows for RNs to be more involved in the planning and coordination of patient care, which can result in better continuity of care and make transitions of care more seamless. Continuity of patient care is improved as the team of caregivers grows more familiar with their patients and their unit.
  • Modular nursing models also make it easier to assign teams based on patient acuity, and the skills and or experience of the providers can more easily be matched to patient care needs.
  • The smaller, more focused patient care teams can result in higher levels of accountability for individual team members—an important element of team member job satisfaction.

Modular Nursing – Managing Weaknesses
While advantages appear to outweigh disadvantages, there can be some challenges as well:

  • Modular nursing requires a high level of nursing leadership. Education, particularly around the specifics of the model and in nursing leadership and management skills, can help support nurses in this model.
  • Modular nursing can be difficult to execute with inconsistent team members. The model depends on assigning a consistent group of caregivers to a specific set of patients within a specific area of a nursing unit. High levels of staff turnover or a high percentage of travelers might make this difficult to implement. Fortunately, higher levels of staff satisfaction with the model may make it easier to attract and retain a consistent staff.
  • It may complicate staff assignments. Creating a team that has all of the competencies needed for patients on their module can be a challenge – particularly on units where acuity is high. The educational needs of team members may be easier to identify when using this model which may make it easier for nurse leaders to assign the most relevant and necessary education as it is needed.

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