A scoping review of virtual nursing models in inpatient, noncritical care settings

Background

The success of virtual nursing models in intensive care units has prompted its expansion to other acute care settings.

Purpose

The aim was to summarize peer-reviewed literature that described or evaluated virtual nursing models in noncritical care settings and describe policy and practice implications and future research needed to create actionable evidence.

Methods

Using the Arksey and O'Malley methodological framework, the PubMed, CINAHL, and Embase databases were searched for relevant published literature. The research team screened titles and abstracts; agreement from at least two members was required for article inclusion and data extraction.

Results

Of the 588 articles retrieved, 35 were included. Most virtual nursing care models had a specific, focused role for virtual nurses (e.g., admissions and discharges) rather than a co-caring model in which the virtual nurse had a more expanded role. Patient and nurse satisfaction were the most common outcome measures, followed by hospital throughput and efficiency measures. Factors associated with successful implementation included incorporating bedside nurse input during model development, in-person team building, and ongoing bi-directional communication between bedside and virtual nurses.

Conclusion

Model variability substantiates the need for more specific operational guidelines that define scopes and standards of practice with detailed role descriptions. Long-term implications of dividing nursing responsibilities remain unclear but may include the need to maintain competencies among bedside nurses and the development of virtual care competencies. Future research needs a unifying framework and should utilize longitudinal and multisite studies that test models in different environments.