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Best Practices for Implementing Hospital-Based Virtual Nursing: An Integrative Review.

Madeleine Whalen¹, Nadine Rosenblum, Alexandra A Johnson

¹Madeleine Whalen is the evidence-based practice program coordinator, and Nadine Rosenblum and Alexandra A. Johnson were, at the time of this writing, inquiry program coordinators, all at The Johns Hopkins Hospital in Baltimore, MD. Contact author: Madeleine Whalen, mwhalen8@jhmi.edu. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

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|November 20, 2025

Summary

This summary is machine-generated.

Virtual nursing offers a solution to nursing workforce challenges. However, best practices for implementing virtual nursing in non-ICU settings are still developing, requiring further research.

Keywords:

best practices implementation integrative review staffing models telenursing virtual nursing

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Area of Science:

Nursing
Healthcare Management
Health Informatics

Background:

Nursing workforce faces unprecedented threats like burnout and stress, impacting job satisfaction and retention.
Virtual nursing emerges as a potential solution, though its implementation in non-ICU settings lacks established best practices.
Current virtual nursing models are well-established in ICUs but are newer to other hospital areas.

Purpose of the Study:

To identify best practices for implementing virtual nursing in inpatient, non-Intensive Care Unit (ICU) settings.
To address the gap in knowledge regarding virtual nursing implementation outside the ICU.
To guide healthcare systems in adopting virtual nursing in general hospital units.

Main Methods:

An integrative review guided by the Johns Hopkins Evidence-Based Practice model was conducted.
Systematic searches of PubMed, CINAHL, Embase, and Cochrane databases were performed.
Evidence underwent independent screening and appraisal to synthesize findings and develop recommendations.

Main Results:

Limited evidence from one quasi-experimental study and five quality improvement projects was synthesized.
Guidance was identified for virtual nurse scope and skills (clinical and soft skills).
Needs of bedside nurses and patients, and operational concerns for leadership were highlighted.

Conclusions:

There is a significant lack of information on virtual nursing in non-ICU hospital settings.
Further research is needed on the impact of virtual nursing on bedside nurses, patients, and leadership.
Implementation science research is crucial to develop virtual nursing programs and inform best practices.