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Virtual Nursing for the Care of Hospitalized Patients
K Jane Muir1,2,3, Alexandra Maye1,2, Matthew D McHugh1,2
1Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia.
Importance:
It is unknown if virtual nursing (VN) enhances care quality or improves the workload of bedside nurses in hospitals.
Objective:
To describe what services VNs provide to patients and nurses in hospitals; to evaluate whether the presence of VNs improves nurse workload and patient care quality; and to examine bedside nurses' experiences with VNs.
Design, Setting, And Participants:
This cross-sectional study using mixed methods included results from the 2024 Nurses4All survey conducted between December 2023 and March 2024. Eligible respondents were hospital-employed registered nurses in 10 states.
Exposure:
Experience providing VN-assisted bedside care.
Main Outcomes And Measures:
Bedside nurses reported the services provided by VNs and answered questions about VNs' impact on workload and quality of care. Nurses also answered the open-text response, "Please share any positive or negative experiences you have had working with virtual nurses."
Results:
The registered nurse sample included 880 respondents with a mean (SD) age of 44.2 (12.3) years and 13.3 (11.3) years of experience (92 Asian [10.5%], 87 Black [9.9%], 514 White [58.4%]; 84 [9.5%] with Hispanic ethnicity). The top uses of VNs reported by nurses were patient observation (434 nurses [53%]), admission and discharge activities (381 nurses [45%]), and patient education (306 nurses [37%]). The majority of nurses (483 nurses [57%]) reported that VNs did not reduce their workload, and among these, 81 nurses (10%) said VNs increased their workload. Of the 366 nurses (43%) who said VNs reduced their workloads, only 70 (8%) reported that workloads were reduced "by a lot." Slightly over half of nurses (452 [53%]) said VNs improved quality of care, but only 96 (11%) reported that quality was improved "by a lot." VNs had no impact on care quality according to 391 nurses (47%), with 34 (4%) stating that VNs reduced care quality. Nurses described the strengths of VNs for monitoring and documentation, and limitations related to staffing, patient distrust, and workflow inefficiencies.
Conclusions And Relevance:
In this cross-sectional study, there were mixed findings on VNs, suggesting such models should be introduced cautiously.
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