Vanderbilt, Jefferson Health Systems Launch Virtual Nursing Programs

The health systems launched virtual nursing programs to enhance care operations and reduce the administrative load on a burned-out workforce.

Vanderbilt University Medical Center in Nashville, Tennessee, and Jefferson Health in Philadelphia have launched virtual nursing programs in an effort to improve care protocols and ease administrative burdens.

Vanderbilt University Medical Center's program is being piloted in its 36-bed Ventricular Assist Device and Transplant Unit. Eleven nurses have been trained to work virtually, but only three virtual nurses will support the unit at a time. Virtual nursing support will be available 24 hours a day. The nurses will initially focus on admission and discharge documentation duties.

The virtual nurse will "knock" first, asking the patient if they can appear on camera. Only when the patient says "yes" will the camera mounted to the ceiling turn on. The nurse then appears on the room's television/entertainment system, and the patient appears on the nurse's monitor. The virtual nurses are physically located in a separate room along with other nursing informatics and technology staff monitoring the new program.

"The use of technology to support frontline nurses and staff is critical in today’s health care environment," said Cindy Phipps, Vanderbilt Nursing Informatics Services' lead on the virtual nurse project, in the press release. "It demonstrates VUMC's commitment, not only to our patients, but also to staff through the ongoing investment of time and resources in projects such as virtual nursing."

Jefferson Health's virtual nursing program connects bedside nurses to remote nurses to support individualized care. The virtual nurses conduct patient check-ins and rounding and support other care tasks, including admission and discharge paperwork, patient and family education, and EHR documentation.

The virtual nurses communicate with patients using an audio-visual teleconferencing device in the hospital room.

"Virtual nurses are not a replacement for bedside nurses, instead they serve as an additional member of the hospital care team," Laura Gartner, DNP, RN, division director of clinical informatics at Jefferson Health, in the press release. "Bedside nurses and virtual nurses work together to ensure that patients continue to receive the safest and highest quality of care."

The press release also notes that the devices do not record conversations or the care provided.

Jefferson Health ran a pilot of the program from March to June. The pilot included nearly 400 patients, and virtual nurses participated in more than 100 patient interactions. A second expanded pilot is being planned. The new pilot will include tele-observation and e-consults between clinicians.

Vanderbilt University Medical Center and Jefferson Health are the latest healthcare provider organizations to implement virtual nursing.

In May, Fredericksburg, Virginia-based Mary Washington Healthcare implemented a virtual nursing program at Stafford Hospital to enable registered nurses (RNs) to work from a virtual operations command center and remotely care for patients. The bedside RNs are able to complete some care tasks remotely, giving them more time for patients requiring hands-on care, the press release noted.

Similarly, CHI Saint Joseph Health deployed a virtual nursing model using technology developed by CommonSpirit Health in April. But this model adds a virtual RN to in-home care teams to improve care quality and reduce staff challenges. Patients can connect with the virtual RN through a screen who helps with tasks related to charting, education, assessments, and discharges. 

One of the reasons healthcare providers are increasingly turning to virtual nursing is the projected nurse shortage in the United States.

Approximately 100,000 RNs left the workforce during the COVID-19 pandemic due to growing stress, burnout, and retirement, according to a 2023 study by the National Council of State Boards of Nursing (NCSBN). Another 610,388 RNs reported an intention to leave the workforce by 2027 due to the same factors.

"There is an urgent opportunity today for health care systems, policymakers, regulators and academic leaders to coalesce and enact solutions that will spur positive systemic evolution to address these challenges and maximize patient protection in care into the future," said Maryann Alexander, PhD, RN, NCSBN's chief officer of nursing regulation, in a press release.

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