Title : Transforming nursing care model with virtual nursing
Abstract:
Ongoing workforce shortages, rising patient acuity, and increasing documentation demands at a pediatric hospital have placed added pressure on maintaining safe high-quality care while supporting nurse well-being. Virtual Nursing introduced an innovative solution, leveraging technology and experienced nurses to optimize current resources. This rotational hybrid care model between bedside staff and virtual nurses led to reduced burden and preserved patient-centered care excellence by instilling trust in care delivery interchangeably. Guided by this evidence, the purpose of this initiative was to integrate Virtual Nursing on 5 inpatient units to streamline workflows, improve documentation efficiency, increase time at the bedside, and strengthen patient and family education. A pilot unit informed expansion to four additional inpatient units. Upon expansion, technology advances occurred with integration of enhanced technology on televisions in rooms, behavioral health safe cameras, and navigating technology needs that wouldn’t interfere with EEG equipment. The platform advances also supported integrated translation services, enabling real time communication for families with limited English proficiency . Lastly it allowed parents and legal guardians who were unable to be at the bedside to see and speak with their hospitalized child and care team. Upon expansion the individual units also saw the opportunity for additional optimization and utilized it for documenting ventilator settings, diabetic education, family rounding, and medication double checks. Leadership rounds, feedback loops, and trended data ensured engagement, adaptability, and continuous improvement. Post-implementation outcomes continue to show measurable impact during the pilot and continued expansion. Patient satisfaction scores on “likelihood-to-recommend" metric increased from 83.9% to 85.2% on the pilot unit, reflecting improved communication, care coordination and enhanced alignment with patient-centered care models. Since initiation and expansion, virtual nurses continue to complete approximately 50% of admissions and 80% of discharges, saving bedside nurses over 6,000 hours since inception; time that was redirected to hands-on, patient-centered bedside care. Utilization of virtual nurses on the pilot unit also increased completion of learning needs assessment on admission from 81% to 97%, further supporting patient and family centered care education. This has also been accomplished within the expansion as well. In addition, all patients are monitored by virtual nurses in-between patient rounding and care calls, identifying more than 500 safety concerns and good catches, reinforcing a harm-free environment, safety-focused care environment. Virtual nurses are also able to collaborate between units to give additional support when an influx of tasks occur on an individual unit. These results demonstrate a scalable, innovative model to address workforce challenges, improve efficiency, and enhance patient and family centered care. The individual approach on units allowed for sustaining quality and safety through technology and collaboration which provided more time at the bedside, higher quality education provided to patients and families, and increased satisfaction scores. Showing that empowered nursing staff can make transformational changes in care delivery led to staff satisfaction as well. Future expansion of this initiative could show an increase in possibilities for virtual nursing impact on care delivery in other care settings like an emergency department or outpatient settings.
