by Matt Batcheldor

Vanderbilt University Medical Center has started its first virtual nurse program, in which a team of dedicated nurses complete certain tasks such as documentation remotely via a teleconference in the patient’s room, giving nurses at the bedside more time to care for patients in person. The goal of the program is to improve patient-and-staff satisfaction.

The program, which went live at Vanderbilt University Hospital on July 17, is being piloted first on the 36-bed Ventricular Assist Device and Transplant Unit on the seventh floor of Medical Center East, a stepdown unit that includes heart patients.

Up to three virtual nurses at a time are working on the unit 24 hours a day, initially focusing on admitting and discharge documentation duties, said Wendy Kiepek, RN, MSHI, executive director of HealthIT Operational Services, who is managing the project. They are also virtually rounding — that is, checking on patients and completing chart reviews.

“The energy from the virtual nurses is palpable,” Kiepek said. “It’s exciting to see their level of enthusiasm.”

Patients are asked for permission before they participate in the program. When the virtual nurse is ready to visit the patient, the nurse will virtually “knock,” asking if it’s OK to appear on camera. Only then will the high-resolution camera mounted on the ceiling turn on; otherwise, it is pointed up and cannot see the patient.

The virtual nurse appears on the patient room’s television/entertainment system, and the patient appears on the nurse’s monitor, part of an integrated technology system from vendor care.ai. Right now, the virtual nurses are physically located in a conference room on the seventh floor, along with other nursing informatics and technology representatives who are monitoring the new program in real time.

“The use of technology to support frontline nurses and staff is critical in today’s health care environment,” said Cindy Phipps, MSN, RN-BC, Vanderbilt Nursing Informatics Services’ lead on the virtual nurse project. “It demonstrates VUMC’s commitment, not only to our patients, but also to staff through the ongoing investment of time and resources in projects such as virtual nursing.”

Jim Sawyers, a heart patient from Goodlettsville, Tennessee, who was recently hospitalized on the unit, said he was happy to participate in the program.

“I think the virtual nursing will speed up service,” he said. “I think that Vanderbilt has raised its hand to say … we have the initiative to make things great. And I think this is one of the things that will. Kudos to them.”

Sawyers has become at ease with the virtual format. He has enjoyed his conversations with his virtual nurse, Katy Byers, RN, which extended beyond his own health to “Mexico and  prime rib.”

Meanwhile, Byers and the virtual nurse team have a constant line of communication with the unit’s nurses physically at the bedside. “The team on the floor has been tremendously helpful and gracious with us letting them know about a patient’s need, and they have responded very quickly,” she said. “I think it’s helping save call light fatigue from the bedside.”

The virtual nurse program is one way Vanderbilt is studying innovative nursing care models to respond to a national nursing shortage, said Jennifer Glenn, MSN, RN, NE-BC, senior associate for Nursing in the Heart/Neuro/Procedural areas, who represents nursing in the virtual nurse project. Vanderbilt nurses began exploring virtual nursing two years ago and have completed site visits to other organizations using the technology, she said.

The 11 nurses who have been trained to work virtually are all experienced nurses on the unit, she noted.

“We’ve had great success so far,” Glenn said. “The patients love it. Nurses see the value because it’s work taken off their plate, and it helps them better manage their patient assignments.”

As a part of the virtual nurse pilot project, Glenn said VUMC is closely monitoring a trove of data, including patient satisfaction, nurse workload and quality data. That will guide the potential future rollout of the program to other areas.

“Once again, Vanderbilt nurses are creating a new, innovative care model that engages a multidisciplinary team, with the shared goal of improving patient and family care and nurse satisfaction,” said Executive Chief Nursing Officer Marilyn Dubree, MSN, RN, NE-BC. “Congratulations to the entire team that is making the next generation of nursing care possible.”