Study finds mixed reviews of virtual nursing programs among bedside nurses

Hospitals struggling to attract and retain enough registered nurses at the bedside are implementing alternative strategies to ensure patients get needed nursing care. This includes virtual nursing programs, a model of care in which nurses use video and messaging technologies to assess, monitor, educate, and coordinate care for hospitalized patients from an off-site location.

A new study from the Penn Nursing's Center for Health Outcomes and Policy Research (CHOPR)-published in JAMA Network Open today-surveyed 880 in-hospital nurses about their experiences working alongside virtual nurses to care for hospitalized patients.

In one of the largest studies to-date on virtual nursing care, Penn Nursing researchers found the implementation of virtual nursing programs in hospital care has been received with mixed reviews.

More than half (57%) of in-hospital nurses say virtual nursing programs do not reduce their workload, and 10% say it has worsened their workload. The majority (53%) of in-hospital nurses report that working with virtual nurses improves patient care quality, but among them a fraction (11%) say the improvement in quality is substantial.

Virtual nursing programs have been heralded as an innovative silver bullet to hospitals' nurse staffing challenges, but our findings show that most bedside nurses are not experiencing major benefits. Hospitals should be cautious about implementing virtual nursing programs. There is no evidence that virtual nurses are a safe substitute for in-person nursing."

K. Jane Muir, PhD, MSHP, RN, FNP-BC, Lead Author, Assistant Professor of Nursing, Department of Family and Community Health, and CHOPR faculty

The study authors emphasize that while virtual nursing programs may hold promise for specific tasks, such as patient monitoring or documentation, the success of the programs likely depend on having sufficient in-person nurse staffing and well-defined implementation standards.

"The data is mixed as to whether virtual nursing programs offer relief to in-hospital nurses and enhance the quality of patient care, which suggests hospitals should proceed cautiously in the absence of strong evidence about whether and under which conditions virtual nursing programs are safe and effective," said co-author Karen B. Lasater, PhD, RN, FAAN, the Jessie M. Scott Term Chair in Nursing and Health Policy, Associate Professor in the Department of Biobehavioral Health Sciences, and CHOPR Associate Director

"While there is mixed evidence about the value of virtual nursing programs, there is strong evidence that staffing more nurses at the bedside is linked to better outcomes for patients and nurses alike."

The study was led by researchers at the Center for Health Outcomes and Policy Research. Funding for the study was from the National Council of State Boards of Nursing, the National Institute of Nursing Research/NIH, and the Agency for Healthcare Research and Quality.