Date of Award

2024

Document Type

Project

College/School

College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Bonnie Bowie

Readers

Renee Rassilyer- Bomers

Abstract

Background: The COVID-19 pandemic increased the utilization of virtual care delivery. Virtual care modalities create accessible communication chains, promote team collaboration, and access to evidence-based resources. The virtual care model can also enhance care delivery and patient outcomes and reduce hospital-acquired conditions. The purpose of this study was to compare patient outcomes for care as usual (RN/CNA model) with a care model where virtual nurses are added to the care team on an acute care unit.

Methods: This quality improvement project utilized pre- and post-intervention analysis of inpatient falls and expected and observed length of hospital stay data collected from Press Ganey. The proposed intervention revises the current nursing care model to a team-based and virtual nursing model that includes bedside nurses, virtual nurses, nursing assistants, and nurse technicians. The existing model uses a ratio of 1 registered nurse to 4 patients and one nursing assistant per 12 patients. The proposed care mode pairs one nurse and one nursing assistant with six patients. In addition, two virtual nurses are assigned to 12 to 15 patients during the day and up to 30 patients at night. The virtual nurses work 12 hours to promote team collaboration with the 12-hour shift hospital-based staff.

Results: An independent t-test indicated that there is no statistically significant difference between observed and expected length of stay between care as usual and the addition of a virtual nurse to the team-based model. A run chart was conducted to determine whether patient fall rates changed during pre- and post-intervention. The analysis indicated that there is no difference in patient fall rates.

Conclusion: The integration of technology plays an essential role in improving care outcomes and organizational performance. This study shows that there was no significant difference in inpatient falls observed and expected length of stay. Since virtual nursing is a new care model, longitudinal studies are needed to follow up on the results and nurse satisfaction.

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