Getting started

[Cynthia Russell, DNP, RN-BC]

We are considering starting with the use case of in-patient admission support for our pilot program of virtual nursing. We have limited nursing resources so would not be able to operate 24/7. We are thinking of staffing the program to support during peak admission periods. Has anyone attempted this approach as a proof of concept?

Topic

[Dr. Bonnie Clipper]

@krissycockman      I love that you are piloting 12hr shifts/7 days per week.

the top 5 overall use cases are:

Top Virtual Nursing Workflows 

1. Admission documentation with limited assessment 
2. Discharge documentation with medication reconciliation 
3. Transfer documentation 
4. 2 nurse verification of medications and blood products 
5. The intervention of clinical deterioration through expert nurses 

of course, there are many other uses as well.

[Cynthia Russell, DNP, RN-BC]

@KrissyCockman,

thank you for sharing your starting point. I have been thinking about the problem and whether we need to develop a job description and that led me to think about the competencies that would be needed by a virtual nurse. Then what type of training might virtual nurses need? The role clarity issue you raised I think is paramount, is that outlined in a policy or perhaps the job description?  It would be as important for the virtual nurse to know their limits as the clinical nurse. Are you using current employees? Have you experienced any external reviews and received feedback from any agency? Say magnet, the joint commission, a state agency.

To answer your question.  The CNO assigned this to one of her nursing directors. That person is thinking to pilot between 7 am to 5 pm Monday-Friday to support admission history collection as a starting point. I suggested that if you look at the admission arrival data that the time window would need to be reset to mirror that activity pattern. The IT department is attempting to repurpose iPAD devices and use our existing telehealth platform as a way to support the pilot.  I am not directly involved, but the nursing director is working with IT directly to see if the iPADs would work. I assume she will pull a team together if the technology testing works out.  So when I know more- I will reach out.

[Krissy Cockman, RN, MSN-BC]

Hi Cynthia,

We currently have two units participating in our Virtual Nurse proof of concept. The workflows that we are currently piloting include Admission History/Medication by History and Discharge Education. Neither of these proofs of concept run 24/7 as one unit operates 10 am-10 pm 7/days a week and the other unit operates 10am – 8pm M-F.  The key to success is clinical buy in and clear roles and responsibilities of the bedside clinical team and the virtual team. What inpatient support are you looking to pilot? Would love to talk more and provide more context!

[Dr. Bonnie Clipper]

Cynthia- I am not aware as to any programs that are doing this. I bet they are out there.

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