(34) Healing Through the Screen: Virtual Nursing in Pediatric Hematology Oncology

Title: Healing Through the Screen: Virtual Nursing in Pediatric Hematology Oncology

Abstract : The complex needs of pediatric hematology oncology patients demand creativity designing care delivery models.

The virtual nurse project began as an organizational initiative in a pediatric healthcare system to develop a new model of care using a virtual nurse role to enhance patient care and complement bedside nursing responsibilities. After initial planning, including identifying physical workspaces, developing workflows, and installing bedside technology equipment, the inpatient pediatric hematology/oncology/transplant and cellular therapy (TCT) nursing team was charged with implementing this innovative model of care.

Nurse leaders within the pediatric hematology/oncology/TCT team began imagining the possibilities of utilizing the virtual nurse in clinical practice. Clinical nurses were invited to share their ideas and concerns in delegating traditional in-person nursing activities to the virtual nurse. The team identified several areas of nursing practice that the virtual nurse could prioritize, including completion of the inpatient admission database, patient education, care plan initiation, and discharge planning/education. Two-way camera technology was promoted to bring the virtual nurse into the patient/family space in a way that simulates and respects the importance of the nurse/patient relationship. An experienced bedside nurse was encouraged to pilot the role, with a plan to evaluate success through staff surveys, patient and family feedback, and chart review.

Although clinical nurses were initially hesitant to sacrifice a bedside nurse’s physical presence in staffing, the impact of the virtual nurse has been overwhelmingly positive. Qualitative feedback from bedside nurses indicated that 75% strongly agreed/agreed that the virtual nurse enhanced the bedside nurse’s role. The organization’s patient experience survey scores were significantly above baseline, indicating that patients and families experienced a higher level of comfort talking to nurses, nurses explaining things, and nurses listening carefully more often. The role of the virtual nurse improved timeliness of medication education, discharge throughput, and completion/documentation of patient education.