Needs Assessment of Virtual Nursing Implementation Using the Donabedian Framework

Nursing shortages are a significant problem that affects healthcare access, outcomes, and costs and challenges the delivery of care in hospitals. The virtual nursing delivery model enables the provision of expert nursing care from a remote location, using technology such as audio/video communication, remote monitoring devices, and access to the electronic health record. However, little is known about the structure and processes supporting the implementation of virtual nursing in healthcare systems. This study examined the requirements for implementing a virtual nursing care team by characterizing the structure and processes of virtual nursing, using the Donabedian framework. The study conducted an observational and qualitative evaluation of a virtual nursing care team at a major Southeastern health center in the United States. The study found that key aspects for implementing a virtual nursing program include the number of available virtual nurses per shift, the availability of appropriate virtual nursing equipment, the physical layout of the virtual nursing center, the training of virtual nursing nurses on best practices of virtual encounters, simultaneous use of electronic health record, creation, and training of nurses on policies and procedures such as escalation of technical issues, and available support resources for problem resolution. The study provides valuable insights into the structure and processes of virtual nursing care that can be used to improve healthcare delivery and address nursing shortages.