Virtual nursing: Using innovation to care for patients

Anyone who has been hospitalized — or has been with a loved one while they were receiving care in the hospital — knows it can sometimes be a waiting game when preparing to be discharged. The doctor needs to share instructions with the nurse, who, in turn, shares it with the patient; medications need to be ordered at the pharmacy; and sometimes, transportation arrangements need to be made to ensure the patient arrives safely at their next destination.

Enter an additional and innovative way to care for patients in Sharp’s acute care hospitals: the Sharp HealthCare Virtual Nursing Program. Through this added resource, Sharp nurses — who are remotely set up in Sharp’s main headquarters in the Kearny Mesa area — can assist clinical nurses stationed near patients’ bedsides.

Reduced burnout, improved experience

Sharp’s Virtual Nursing Program launched in April of this year and is currently being used on two units at Sharp Memorial Hospital for patients who meet specific criteria. During the early phase, an average of 20 patients per day have used the program. The goal is to expand the program to Sharp’s other acute-care hospitals by the fall and add additional full-time nurses to support them.

“We have reached a time in nursing where the administrative burdens placed on the bedside nurse is taking precious time away from our patients,” said Tracy Plume, MSN-L, RN, director of Centralized Patient Placement at Sharp. “The nursing workload is feeling more and more unmanageable, adding to feelings of burnout and turnover.”

Through Sharp’s Virtual Nursing Program, Plume shares that Sharp nurses can now offer telehealth visits with certain patients. This allows nurses at the bedside to focus on the immediate needs of their patients.

Additional support for both nurses and patients

Using a bedside tablet, Sharp virtual nurses meet with a patient to conduct virtual visits for admission and discharge. They answer specific questions about the patient’s care and counsel them on what to expect after leaving the hospital. They also instruct patients how to set up and monitor their health records by using the Sharp app; arrange for discharge supplies, such as gauze and bandages; and even help schedule transportation arrangements.

“This in no way replaces the nurse at the bedside,” said Kara Yetter, MSHI, BSN, supervisor of Virtual Nursing at Sharp HealthCare. “This is additional nursing support for nurses and the entire care team at the bedside. Together, the virtual nurse operates and rounds with the onsite nurse as a team, discusses areas where virtual support could be beneficial, and collaborates with the floor nurses.

This ensures, Yetter says, Sharp is providing the most streamlined care possible for the patient. “It has been so exciting to use technology in a way that adds a nurse patient connection and gives the patient a better understanding of their care plan,” she says.

Learning from successful programs

While Sharp HealthCare is the first health system in San Diego County to offer a virtual nursing program, the concept is not new. In fact, other large health care systems in the U.S., including Providence, Stanford Health Care and Dignity Health, have been using virtual nursing programs for years. They all report that patient satisfaction scores have improved since their programs were implemented.

Sharp’s Virtual Nursing design team — made up of two dozen nurse leaders from across the Sharp system — were provided education from these national health systems to get a better feel for the program’s capabilities. Additionally, Sharp conducted hands-on virtual discharge simulation testing at the Sharp Prebys Innovation and Education Center to determine how the program would work.

Through input from Sharp’s Patient and Family Advisory Council members and Epic — Sharp’s health system software — support team members, they performed simulated care through iPads before putting the virtual care into practice.

Virtual nursing in action

In May, Karen Woodard’s 91-year-old mother, Yaeko, was hospitalized at Sharp Memorial Hospital. After receiving treatment for 12 days for pneumonia, low oxygen levels and other health issues, Yaeko was ready to go home.

Karen says that she felt extreme gratitude for the care her mother received. She especially appreciated the Virtual Nursing Program, which provided Karen with excellent information and guidance from a Sharp nurse.

“I’m so appreciative that we had a nurse who could explain all of my mother’s care plan after discharge, including changes to her medications,” Karen says. “The virtual experience was absolutely excellent. I’ve never had more questions answered by a nurse than this, and I felt she dedicated her time to focus on us and my mother’s care.”

While the goal of the program is to offer a convenient way for patients to get timely care and to increase the quality of patient teaching and home instructions, thereby decreasing readmission rates, Plume says it’s also about caring for Sharp’s caregivers.

“We’re making sure they are engaged and satisfied with new technology available to them in the care setting, while also essentially giving back hours of time to the bedside nurse who can then focus on delivering the highest quality patient care,” she says. “It’s a win-win for everyone.”

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