Virtual nursing is gaining significant momentum as an effective way to redesign and redistribute nursing workloads. Virtual models ease the burden on nurses providing direct bedside care and motivate nurses who want to continue their practice but are unable to practice at the bedside by expanding their nursing careers .
PROBLEM
“Flexibility and different areas of practice and models of care can attract nurses considering leaving the profession and those who are considering leaving the profession,” said Sylvain Trepanier, RN, director of nursing at Providence health system. who cannot work in a traditional environment”. “Virtual nurses will become a new area of professional practice. It is hoped that this will help nurses stay engaged with the profession, enhance their careers and improve retention.”
SUGGESTION
Since 2004, Providence has used a variety of telemedicine technologies and virtual care models, including Teladoc Health, to support safe, high-quality care throughout the organization.
“Levering our extensive experience in telemedicine, it makes sense to adopt two-way audio/video technology to assist our nursing colleagues in solving a number of problems,” says Trepanier. problem that we hope to alleviate as we pilot a new model of nursing care.”
He continued: “The pilot development involved close collaboration between nursing and telehealth leadership as well as representatives from ancillary services. “We have carefully considered all aspects of bedside care and have had important discussions to determine what can be completed online and what needs to be taken care of in person. by the bedside.”
In discussions with the bedside staff, they identified too many duties for which they were responsible that prevented them from directly providing care to the patient, which caused dissatisfaction.
“The primary nursing model is no longer sustainable given the ongoing challenges of healthcare staffing and the aging of the population.”
Sylvain Trepanier, RN, Providence
“During staff feedback sessions, direct care nurses provided many examples of the different duties they are responsible for in patient management and how they strive to accomplish all of these duties. In this service, there are many opportunities to improve patient experience, improve operational productivity, Trepanier explains: “Reducing disruption and improving workload for our bedside nurses I”.
MARKET
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MEET CHALLENGES ONLY
At Providence, virtual care is being used to supplement or enhance care for patients. While bedside nurses still provide direct care to patients, virtual nurses can also join and appear in a patient’s ward in real time on their TV, ready patient support.
“Two-way audio and video technology was installed and configured for each patient room and communicated with the electronic health record to allow the nurse to seamlessly video conferencing with the patient,” explains Trepanier. .
He continued: “The team has developed specific roles and responsibilities for the bedside nurse, virtual nurse, and ancillary staff. “Communication tools such as secure chat and wearable two-way communication are also leveraged to enhance face-to-face correspondence between the virtual team and the bedside team.”
Processes are designed to share with the virtual group the attending supplier contact information. Paperless downtime documentation processes have been created to support virtual nurse EHR workflows.
Thereafter, training modules were created in the organization’s learning management system that were customized for different roles (bedside nurse, virtual nurse, all other caregivers and advanced users). All employees were required to complete modules and training was supplemented with online and virtual skills.
Additionally, as part of the virtual nurse referral process, the nurse virtually monitors the nurse at the bedside to observe the admission, discharge, and education processes.
RESULT
Trepanier notes: “The immediate results are extremely promising. “In the first week, virtual nursing and bedside nursing teams collaborated on new use cases for the model. Virtual nurses have also proven to be incredible advocates for our patients. them, creating an improved care experience.We have received extremely positive feedback from patients.
“Pilots are also providing views and data to help us answer additional questions,” he continued. “We are using data from this program to assess whether virtual nursing is helping to reduce the average length of hospital stay. In addition, we are monitoring whether these changes in the skill mix have may affect the caregiver experience, patient experience, cost of care and other quality index nursing sensitivities.”
Initial pilot successes have led to continuation and expansion plans.
TIPS FOR OTHER PEOPLE
“In addition to the technology that enables two-way communication, we have also optimized our EHR so that we can better coordinate care between our virtual and bedside care teams,” said Trepanier. “We’ve also enabled and improved the use of live sync communication tools – for example, live devices and chat apps.”
But technology is only part of the job. He said the following are even more important to the success of the virtual nurse program:
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Change management. Work with frontline carers to listen to their concerns and ideas, so that they buy the project before it starts. Leverage those initial conversations to inform and educate about the job. Determine the champion.
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Outline the scope and vision. Be very clear about the outcome and what changes will be made. Share with employees what to change and how before implementing workflow changes. This will allow employees to be ready to operate different workflows and ensure their reach is maximized, while everyone is working to the fullest extent of their license. This also allows enough time to train employees and ensure competence with any new skills.
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Executive patronage/leader. An engaged, present leader is required to articulate the vision and emphasize commitment to the program, staff, and patient safety. They need to be in the unit and present to their staff. They need to respond to concerns, defend the program, and voice their intentions why the organization is undergoing change.
“The primary nursing model is no longer sustainable given the ongoing challenges of healthcare staffing and an aging population,” said Trepanier. “We have to do something to address the nursing shortage, and we’re choosing to do it by innovating and redesigning the way we deliver care.”
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