Title : Best practices for implementing a hospital-based virtual nursing program
Abstract:
Healthcare must advance with new technologies to meet patient needs. Integration of Evidence Based Practice (EBP) Virtual Nursing (ViRN) will help modernize how we care for patients in the hospital setting. Nurses continuously search for innovative ways to improve patients’ health outcomes. ViRN can help bedside nurses manage patient care and patient education by alleviating some time-consuming tasks that nurses perform. These tasks can include pro-active surveillance, rounding, monitoring, consults, emergency response, decision support, documentation, patient admission, medication and discharge education, new nurse mentoring, expert advice, rounding, care coordination, and triage. Functions of the ViRN varies depending on needs of ICU, (audits vs rescue), to supplement and support bedside RN. ViRN can contribute to knowledge of safety and quality measures, and best practices as well as research for the care of patients. The introduction of ViRN in the hospital setting can be beneficial to bedside nursing teams in addressing these issues and making sure hospitalized patients are receiving the safest and most efficient care possible. An EBP team of bedside nurses focused on the feasibility and the resources needed to implement ViRN in the hospital setting. The EBP question we asked was: “What are best practices to implement virtual nursing in the ICU?” To address the question, the team performed a systematic integrative review to identify and appraise articles using the Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals Model & Guidelines. PubMed, Embase, CINAHL, and Cochrane databases were queried for relevant studies examining interventions to successfully launch virtual nursing in the intensive care setting. The initial search resulted in 327 articles. Title and abstract screening resulted in 31 articles. Two independent reviewers read and appraised full-text documents resulting in 16 articles in the final review. Of these, six were Level III A/B quality, four were Level IV A/B quality, and six were Level V A/B quality articles.
The resulting evidence provided several good and consistent best practice recommendations for translation. Nursing leadership's essential involvement and support is crucial for seamlessly integrating the interprofessional team. The development of the plan should incorporate Diversity/Equity/Inclusion (DEI) factors and Healthy Work Environment (HWE) concepts. Efficient placement of the ViRN is achieved through the use of "Hub and Spoke" models. Building trust and communication between the ViRN and bedside RN is pivotal, emphasizing clear role expectations for both, encompassing required skills in communication, collaboration, and critical thinking. Staffing levels must be determined based on various factors, including facility type and patient acuity. The ViRN role serves as a key support for hospital, patient, and nursing metrics, encompassing aspects such as length of stay, best practice adherence, ICU readmissions, costs, clinical outcomes, patient safety, time to intervention, burnout or compassion fatigue, satisfaction, and nurse retention. Hospital units can utilize these recommendations to provide state-of-the-art care for patients and find success in the implementation of a ViRN program.
Audience Take Away Notes
- Audiences will learn why ViRN is valuable for their setting
- The audience will learn that using these best practice recommendations for implementing ViRN in the hospital setting will help nurses in their job responsibilities by saving valuable time to perform hands-on patient care. These ViRN implementation strategies will help make the health care team more efficient in caring for patients.
- Few existing quantitative research articles were found in our literature search therefore, opportunities exist to strengthen the literature with additional research.
