Revolutionizing pediatric nursing care: Leadership, change management, and virtual nursing transformation

Pediatric inpatient nursing faces increasing workforce strain, care complexity, and change saturation. Although virtual nursing has emerged as a care model redesign to support direct care teams and enhance patient and family experiences, the existing literature primarily reflects adult or outpatient settings. Evidence describing implementation, role integration, and change management approaches specific to pediatric inpatient virtual nursing remains limited.

To describe the nurse-led implementation of a pediatric inpatient virtual nursing model and identify practical change management strategies to support successful integration.

A descriptive case study examined the phased implementation of an inpatient virtual nursing program at a freestanding academic children's hospital. Leadership strategies, staff engagement approaches, workflow integration efforts, and frontline feedback were analyzed using Plan-Do-Study-Act cycles.

Initial implementation was challenged by change saturation, role ambiguity, and limited frontline ownership. Reframing virtual nursing as a team-based care model, applying Kotter's change framework, and engaging interdisciplinary staff with codesign, improved acceptance, clarified role boundaries, and reduced resistance.

Successful pediatric inpatient virtual nursing integration requires intentional change management, nurse-led leadership, and phased implementation. Centering people before platforms and engaging frontline teams are essential for sustainable care model redesign.