Effect of Virtual Nursing Implementation on Emergency Department Efficiency and Quality of Care

Nursing shortages lead to longer emergency department (ED) wait times and incomplete documentation. US health systems are rapidly implementing virtual nursing, a new care delivery model, to improve care and alleviate nursing burden by providing nursing care and expertise via telehealth.

To evaluate the association of using virtual nursing for patients admitted via the ED with quality outcomes, namely, wait time, admission assessment duration, documentation completeness, and number of interruptions.

Non-randomized retrospective cohort study of adult patients over the age of 18 seen in the ED and subsequently admitted to one of six hospitals.

Patients who had in-person admission assessments median wait time was 525.5 min (IQR: 332.9-969.8), while the median wait time for patients using virtual nursing for admission assessments was 429.5 min (IQR: 292.6-954.5). In-person admissions had a median duration of 24.0 min (IQR: 15.0-36.0), while virtual nursing admissions median duration was 29.0 min (IQR: 18.0-42.0). The average number of uncompleted documentation fields for in-person admissions was 0.4 ± 1.5, while the average for virtual nursing admissions was 0.2 ± 0.5. Finally, the average number of interruptions during admission for in-person was 1.8 ± 1.5 interruptions, while virtual nursing admissions averaged 1.4 ± 1.3 interruptions.

Virtual nursing was associated with shorter wait times, more complete nursing documentation, and fewer interruptions during admission assessments for patients admitted via the ED.

Virtual nursing is a promising care delivery model that may lead to reduced nursing burnout and enhanced patient care coordination.