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High turnover has become a critical concern throughout the field of health care. As evidence has demonstrated, there is a negative correlation between nursing turnover and patient outcomes (Hu, Wang, Lan, & Wu, 2022). The World Health Organization (WHO) reports that the global nursing shortage is expected to exceed 7.6 million by 2030. Approximately 34% of graduate nurses will leave the bedside within their first two years of practice and 60% leave within eight years of practice (WHO, 2016). The challenge of turnover has placed immense pressure on health care organizations to develop creative solutions to ensure safe patient care and improve patient outcomes.
Within a 500-bed hospital, a telehealth virtual registered nurse (VRN) monitoring system was developed to improve care coordination, while simultaneously providing nursing staff with continuous resource support. The VRN was an experienced registered nurse (RN) with a minimum of 2 years of bedside experience in the acute care setting. The VRN staff performed high-level tasks including patient admissions, patient discharges, patient education, and documentation of patient care interventions. They also functioned as a resource of knowledge and guidance for novice nurses at the bedside.
The VRN staff within the organization focused their monitoring efforts on two units, a medical-surgical/telemetry/neurology unit and a medical-surgical/telemetry/COVID/renal unit. Both units had the highest documented patient acuity and lowest nursing retention rates over the past year within the organization. In addition, these units had the highest rates of adverse patient safety events related to patient falls and deterioration in clinical condition as evidenced by the documented rate of rapid responses and transfers to critical care. On both units, the VRN acted as a collaborative resource to the primary bedside clinicians, leading to documented improvements in patient outcomes and staff engagement.
Currently, there is limited documented evidence in the United States and Europe that explores the effectiveness of the implementation of telehealth within acute care (Lisk et. al., 2020). Virtual nursing has provided insight into the benefit of capitalizing on technology and telehealth communication devices in the acute care setting. VRN utilization had numerous benefits, including a decrease in patient falls, improved compliance with Joint Commission standards of care, and significantly improved nursing satisfaction and engagement throughout the units. Further evidence revealed that patient falls on the neurology unit decreased by 25% when a VRN was present. To date, when a VRN was present on the unit, only one fall occurred within a five-month period, demonstrating a positive correlation of the safety benefits the VRN provides.
The advantages of the VRN reached all system spheres within the acute care organization, providing benefits at the patient, nursing, and organizational level. With the increasing shortage of bedside clinicians, the VRN takes advantage of innovative technology to promote quality nursing care, improve patient outcomes, and provide cost-saving benefits to health care organizations in the current volatile environment.
• Hu, H., Wang, C., Lan, Y., & Wu, X. (2022). Nurses’ turnover intention, hope and career identity: the mediating role of job satisfaction. BMC Nursing, 21(1), 1–11. https://doiorg.stjosephshealth.proxy.liblynxgateway.com/10.1186/s12912-022-00821-5
• WHO. Global strategy on human resources for health: Workforce 2030. 2016. https://www.who.int/hrh/resources/16059_Global_strategyWorkfor ce2030.pdf. Accessed 2 May 2022.
• Lisk, L., Buckley, J., Wilson, K., Martinez, V., Cadiz, V. R., Poropat, L., Scruth, E. A. (2020). Developing a Virtual Nursing Team to Support Predictive Analytics and Gaps in Patient Care. Clinical Nurse Specialist, 34, 17-22. https://doi.org/10.1097/NUR.0000000000000496
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