What Is Cluster Care in Nursing? Overview and Benefits

It’s the start of your shift with a patient, and you need to assess them, collect a finger stick blood sugar, pass medications, and adjust the bed’s positioning. Doing all these tasks in separate room visits could take 20 minutes or more — and then there’s all the documentation you’ll need to do afterward. But if you plan ahead and use a cluster care approach, your patients will thank you and your shift will run more efficiently.

Cluster care is a time management method that aims to reduce the amount of visits a nurse makes to a patient’s room. Rather than spreading out their tasks, a nurse clustering care would gather supplies and attempt to complete them all in one room visit with a patient. Sounds simple, but new graduate nurses might struggle with clustering because it requires anticipating patient needs, and that comes with experience.

Ready to boost your efficiency? Let’s review the evidence for clustering care and some practical strategies for making your next shift run more smoothly.

Cluster Care: Evidence-Based Practice Across Specialties

There are many research-backed benefits of cluster care in nursing, and it’s proven to measurably make your life easier as a nurse. Nurses who use clustering strategies are likely to report lower fatigue levels than those who don’t. Also, you may be less likely to contract certain infections, like COVID-19.

Clustering also improves patient experiences and outcomes across specialty areas. For example, cluster care in NICU nursing impacts brain development and has both short- and longer-term impacts on outcomes. Clustering helps preterm infants sleep longer and limits their energy consumption. Pain scores and stress are lower in neonates when their care is clustered. Even months after discharge, infants whose care was clustered during their stay have higher body mass, height, and head circumference.

Clustering care is also important in adult critical care areas, where it’s associated with lower rates of complications related to intubation. Maintaining a calm, quiet environment is essential in helping patients heal from acute illnesses. Clustering care helps nurses complete their shift tasks more efficiently, prioritizing patient rest and allowing for longer periods of uninterrupted quiet time. Better clustering is also linked to lower rates of depression and anxiety in adult ICU patients.

Strategies for Clustering Care in Your Next Shift

Task efficiency is a core issue for new grad nurses, who tend to struggle with organizing their work and managing time. It’s normal to feel frazzled in your first few years of work as a nurse. But with practice, clustering tasks becomes second nature, and you’ll find that your shifts run more smoothly as a result. Here are practical strategies for clustering care across different nursing units:

Medical-Surgical Unit

• Gather all your supplies at once. When going into a patient’s room, carry everything you’ll need (medications, fresh water, new linens, wound care supplies, etc.) to avoid multiple trips. Take a second before you enter the room to be sure you have everything you need for each task.
• Combine assessments with care. Perform your head-to-toe assessment while administering morning medications and checking IV sites.
• Ask about comfort needs. Before leaving the room, ask if they need to use the restroom, reposition, or have any other requests.

ICU/Critical Care

• Batch tasks by timing. Coordinate assessments, turning, oral care, suctioning, and checking drip settings together to reduce patient stimulation. If you can, coordinate with a nursing assistant or another nurse to assist with these tasks before you go into the room.
• Sync medication administration. Give medications that are due around the same time together when appropriate.
• Plan for family updates. If family is present, offer updates while you’re in the room rather than making separate calls later.

Labor and Delivery/Postpartum

• Cluster assessments and education. Perform fundal checks, pain assessments, and newborn checks during the same visit that you’re educating the patient.
• Coordinate baby and mom care. If possible, check on the mother right before or after assisting with newborn feeding.
• Consolidate comfort care. Offer perineal care supplies, extra blankets, and snacks when administering pain meds.

Emergency Department

• Group diagnostics and treatments. When drawing blood for labs, start an IV at the same time (if it’s ordered).
• Prep for expected orders. Anticipate what a provider might need (e.g., ECG, fluids, or meds) based on the patient’s chief complaint.
• Educate during procedures. Explain discharge instructions while finishing IV fluids or monitoring for medication effects.

Long-Term Care and Rehabilitation

• Schedule care around routine. Combine morning hygiene, medication administration, and repositioning to minimize disturbances.
• Engage in conversation. While providing care, use the time to assess mood, cognition, and functional abilities, and ask how the patient is doing.
• Coordinate with therapy teams. If a patient has PT/OT scheduled, try to time pain meds and toileting assistance accordingly.

For new grads, the key to clustering care is thinking ahead — before entering and leaving a patient’s room, take a quick pause and ask, What else might they need? Don’t get discouraged if you feel like you’re running around more than you need to each shift. Clustering skills come with time.

Cluster Care Examples

What does it look like to use cluster care? Nursing examples include:

Example 1: NICU

Nurse Marcus is working in the NICU. To minimize stimulation and promote rest, he clusters care around scheduled assessments and feedings:

1. Before opening the isolette, Marcus gathers all his supplies, including feeding materials, clean linens, and diaper supplies. Marcus begins by introducing himself to the parents, and he narrates his tasks to educate them while he works.
2. Marcus gathers a full set of vital signs while ensuring the infant remains warm and comfortable.
3. Next, he performs a gentle diaper change, using the opportunity to check for skin breakdown and assess the infant’s temperature.
4. Feeding is scheduled, so Marcus proceeds with oral or gavage feeding, monitoring for cues of intolerance or distress. While feeding, he assesses and documents the infant’s suck-swallow-breathe coordination and provides developmentally supportive care like swaddling.
5. After finishing care, Marcus updates the parents on their baby’s progress and encourages participation in care when appropriate.

Example 2: ED

Bianca, an ED nurse, is caring for a patient with chest pain who was just placed in a room. Here’s how she clusters care to make the best use of her time and minimize stress for the patient:

1. Before entering the room, Bianca gathers all necessary supplies, including an ECG machine, IV start kit, blood collection tubes, and medication administration supplies.
2. As soon as she steps in, she quickly assesses the patient’s ABCs (airway, breathing, and circulation) and places them on a cardiac monitor, pulse oximeter, and oxygen if needed. While performing a focused cardiac assessment, she attaches leads and prepares to obtain a 12-lead ECG.
3. As soon as the ECG is complete, she draws blood for lab work while starting an IV.
4. While waiting for more provider orders, she asks about the patient’s pain level, gathers medication history, and begins patient education about what to expect next.
5. Before leaving the room, Bianca makes sure the patient has a call light, water, and a warm blanket for comfort.

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