Virtual nursing has been a vital tool in our efforts to redesign the way we provide care. So far, the benefits have included:

• Improved patient safety and patient satisfaction
• More time for nurses to spend with their patients
• Better career longevity for tenured nurses
• Shorter discharge time for patients
• How We Started

The national nursing shortage has impacted North Mississippi Health Services like many others. Providing the best patient care requires supporting your bedside nursing staff. This project focused on creating tools that would give the staff more time and create a better patient experience.

During the COVID pandemic, we installed cameras on some units to help us provide better care to our patients. As we began looking into virtual nursing, we decided to use the resources we already had available to us. In April 2023, we launched a pilot program using the cameras and some of our most tenured, experienced nurses to assist in discharging patients.

We researched what other health systems were doing and quickly found that not many had implemented virtual nursing. We visited a hospital that was using virtual nursing for discharges, but we saw a much bigger vision for NMHS. The hospital we visited was impressive, but the nurses on the floor were still doing all the manual work while the virtual nurses were only reviewing discharge instructions.

We took what they were doing and built upon it. In our virtual nursing program, a physician enters an order for a discharge, which flags the virtual nurse. That nurse will make sure every component of discharge is ready – scheduling any follow-up appointments, arranging an ambulance if needed, confirming prescriptions, etc. Then, the nurse will talk with the patient over the in-room camera to review all instructions, provide education and answer any questions the patient has.

After we started our pilot, we quickly saw major improvements for our patients and our staff.

At first, everyone was a little nervous because it was a new concept. We did a lot of education and reassurance that this is a tool, not a replacement for staff. Now that they’ve been using it for over a year, we hear from nurses regularly how much virtual nursing has helped them and how much more one-on-one time they are able to spend with patients.

Virtual Nursing Results

An average in-person discharge takes about four hours. Nothing aggravates patients more than being told they are ready to go home and then waiting for four hours. After implementing virtual nursing, we were able to reduce our average discharge time to two hours. Our patients have expressed how much more they enjoy the process because of the uninterrupted time with a nurse. With an in-person discharge, the nurse might get called away to attend to a patient with a critical need, have to answer her companion phone or stop to talk to a physician. The virtual nurses are focused on one patient at a time, which gives patients a chance to ask all their questions and fully understand their instructions.

The cameras can zoom in close enough to read a prescription bottle so the nurse can see everything and answer any questions, which gives our patients a sense of security.

We have also seen improvements in patient safety. One of our units had a high fall rate –12 falls in one quarter. We implemented virtual nurse safety rounds, where the nurse educates patients to prevent falls. The next quarter, that unit’s fall rate went down to two. That’s an incredible improvement.

A Career Option for Tenured Nurses

Nursing can be a tough career, requiring a lot of time on your feet. Virtual nursing can be an option for nurses who want to stay in patient care but cannot spend 12-hour shifts on their feet. Our team of virtual nurses brings a wealth of expertise, with each member having a minimum of 10 years of experience. This extensive knowledge base allows us to leverage their skills to the fullest, ensuring exceptional care and support.

Protecting Patient Privacy

Patient privacy is an important component of our virtual nursing program. Each room contains a TV with a camera installed above it. The camera stays facing the wall. When it’s time for a virtual nursing visit, it makes a sound like a doorbell ring and the virtual nurse asks if it’s a good time. If the patient says yes, the camera will then turn to face the patient so they can see each other.

Plan for the Future

We started our pilot with 44 beds using a homegrown approach and resources we already had. To reach our bigger vision, we needed newer cameras. Today we have 144 beds with virtual nursing capability. By the end of FY 2025, we want to have virtual nursing capabilities for every hospital room.

Our staff have seen the benefits and are requesting it throughout our hospital, so we hope to expand into other departments in the future.