Electronic Health Reporter

By Cindy Koppen, senior vice president of clinical solutions and chief nursing officer, Banyan Medical Systems.

As healthcare systems become increasingly patient-centric, the nursing profession will no doubt evolve along a similar trajectory. That evolution will inevitably require a reconciliation between a consolidated model for care delivery and some existing functions within nursing that aren’t entirely aligned with the goal of delivering the highest-quality care.

To determine how nursing practices can more wholly align with the future of healthcare delivery methodologies, we must first look at the core function of nurses and chief nursing officers to see where technology can modernize nursing and unlock benefits where they’re needed most.

The primary goal of the CNO is to ensure staff needs are met while creating an engaging, open nursing culture that promotes improved quality outcomes for patients and financial outcomes for the healthcare provider. Hospital technology is a growing part of the CNO’s toolbox because it can support the improvement of clinical and financial performance, identify trends, issues, and developments as they relate to patient care. It can also evenly distribute the nursing workload, improving the work-life balance of nurses and increasing the time available to spend with patients.

Current and Future Nurse Cohort Challenges

Nurse cohorts and staffing concerns are already an issue for many healthcare organizations, but these obstacles will become more challenging as Baby Boomers grow older. A 2017 survey from AMN Healthcare found that 73% of nurses in the Baby Boomer generation were planning to retire in the next three years, and even middle-aged nurses can struggle with the physicality of the work. One 2008 study found that nurses needed to walk as many as five miles during a 10-hour shift, which also constrains time with patients and can make it difficult to deliver the highest-quality care.

In the face of mounting physical demands and less time with patients, it’s no surprise that the oldest and most experienced nurses frequently retire or move to less demanding private clinics, leaving a void that hospitals cannot fill due to the overall nursing shortage.

CNOs Can Support Nurses and Patients With Hospital Technology

Many hospitals are full of state-of-the-art technology, but few of these tools can have as profound an impact as virtual providers. CNOs can augment staff to handle the hands-off aspects of care, relieving some of the strain on on-site nurses by increasing their capacity and more evenly distributing their workloads, freeing up more of their time to focus on hands-on patient care and eliminating the need for end-of-shift overtime.

Virtual nurses are also an excellent source of collaboration and critical thinking skills — resources that directly impact patient outcomes and experiences for the better.

Where Virtual Nurses Can Provide the Most Support

It’s important to note that virtual nurses, though beneficial in many uses, won’t positively impact all areas of patient care. CNOs must take into account the type of work being done as well as the infrastructure supporting the technology to ensure it has the biggest positive impact on on-site staff and patients.

In procedural environments such as surgery or catheterization labs, for example, it’s harder to find opportunities to reliably use virtual nursing technology because most of the work needs to be hands-on and performed by nurses in person. Additionally, because the infrastructure in most procedural environments is old while this technology is very new, virtual nursing can only serve as a support mechanism and not as a replacement.

At this point, it’s difficult to create reliability in procedural environments so that the staff would feel comfortable turning it over to a virtual counterpart. If the infrastructure were to fail during a procedure — due to a power outage from a storm, for instance — and the virtual component were lost, it would create significant problems for the on-site team.

The technology that’s allowing virtualization is still in its infancy. As the technology and supporting infrastructure improves and the reliability grows to enable 99% uptime in procedural environments, even when there’s a hurricane or tornado or some natural disaster, it will become more feasible. This reality, however, is still years, if not decades, away from being viable.

When used in the right environments, however, virtual nurses can still provide crucial support now. CNOs can start evaluating the opportunity to augment current staff with virtual nurses in the following use cases:

1. Inpatient units

For in-person nurses, the volume of patient churn on med surg floors can often be overwhelming. The good news is that virtual nurses are a viable option for a host of necessary but hands-off tasks, including admissions, medication reconciliation, processing admits, education for patients being discharged, and coordination of the discharge process. With this arrangement, on-site nurses can focus their attention on hands-on patient care and deliver the highest possible quality of care.

2. Emergency departments

Emergency department nurses regularly have to break from their bedside work to cover hands-off tasks such as admissions, which interrupts the delivery of care to patients who need it most. But when virtual nurses cover admissions and data collection processes instead, nurses can be uninterrupted in their care delivery.

3. Disease-specific populations

Care for patients with diseases such as COPD, heart failure, and diabetes requires many frank conversations about topics such as diet, lifestyle, medications, insulin, and daily weight. These conversations take time and close attention, which might be more efficient for virtual nurses to provide.

On-site nurses are tasked with caring for many patients and must physically move among them, possibly limiting the time they have for such conversations. Virtual nurses, on the other hand, don’t need to spend time traveling between patient rooms. They can direct more of their attention to having focused conversations with patients, ensuring patients have a complete understanding of the intricacies of their diseases. For example, the teach-back method, in which nurses ask patients to verify understanding of the information being conveyed, is a valuable tool for educating patients, but it does take time. In addition, virtual nurses can easily return to deliver additional education to supporting family members whenever they arrive.

Even before the pandemic, hospitals were caught in the grip of a nursing shortage. As aging nurses retire or take their experience to private clinics, the strain will only get worse. Fortunately, innovations in healthcare technology can help improve efficiency and ensure that nurses can continue to deliver the highest-quality care.