Patients' Experiences of a Virtual Nursing Model in an Acute Care Setting: A Mixed-Methods Study

BACKGROUND: Virtual nursing--defined as patient care delivered by a remotely located experienced nurse using information and communication technologies--has expanded significantly in the aftermath of the COVID-19 pandemic. But few studies have explored patients' experiences with virtual nursing in the medical-surgical acute care setting. PURPOSE: This mixed-methods pilot study aimed to explore patients' experiences with a co-caring virtual nursing model as part of their care in a medical-surgical acute care unit. METHODS: Data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey were used to explore patients' perceptions of their experiences with virtual nursing. In-person, semistructured patient interviews were also conducted prior to discharge. Changes in pre-pilot versus during-pilot HCAHPS survey scores were analyzed using descriptive and inferential statistics. Interview data were analyzed using thematic analysis. RESULTS: Thematic analysis identified three key themes: patients appreciated the virtual nurse as a member of the care team; the technology was easy to use and facilitated bidirectional communication; and patients' concerns about privacy eased with use. Although HCAHPS survey score analysis revealed improvements in patients' perceptions of overall care and medication-related explanations, only changes in their perceptions of nurses' listening, doctors' listening, and doctors' explanations were statistically significant. CONCLUSIONS: The study findings offer confirmation that the expansion of virtual nursing models into medical-surgical acute care settings is associated with improved patient experiences. Many patients reported that they appreciated the virtual nurse and were comfortable with the technology. Some patients voiced concerns about privacy, which eased over time. Others worried that virtual nurses might replace bedside nurses. These findings indicate a need for improvement in how virtual nursing models are introduced to patients. As virtual nursing models expand into more clinical settings and become more widely used, further mixed-methods studies are warranted.