Virtual nursing implementation and workflow integration: A qualitative study of challenges and effective strategies

Area of Science:

• Nursing
• Health Services Research
• Telehealth

Background:

• US nursing shortages have worsened, impacting patient care and increasing nurse workloads.
• The COVID-19 pandemic accelerated the adoption of telehealth and virtual nursing (VN) as a solution.
• Limited research exists on the practical implementation and integration of VN into healthcare systems.

Purpose of the Study:

• To examine stakeholder-perceived challenges and effective strategies for implementing and integrating virtual nursing (VN).
• To provide insights for health systems planning to adopt or scale VN services.

Main Methods:

• Qualitative study involving 18 stakeholders (virtual nurses, bedside nurses, VN leadership) at a large urban hospital.
• Semi-structured interviews were conducted to gather experiences with VN program implementation.

Main Results:

• Four key themes emerged: need for formal/hands-on training, technology challenges (tablet function, tech support) alongside benefits (confidentiality), importance of secure communication systems for collaboration, and value of experienced nurses in VN roles for mentorship.
• Bedside nurses reported tablet issues and need for live technical support.
• Virtual nurses found ongoing group sharing beneficial.

Conclusions:

• Stakeholder perspectives offer actionable recommendations for effective VN implementation and integration.
• Findings can guide health systems in successfully adopting or expanding VN programs to address nursing workforce challenges.