Becker's Clinical Quality & Infection Control

17 NURSING SPOTLIGHT No new staff, all new results: Why virtual nursing is thriving at ChristianaCare By Mariah Taylor In two years, Newark, Del.-based ChristianaCare has expanded virtual nursing to 41% of its beds without adding a single new staff member. e first bed with virtual nursing launched in September 2022. By June 2023, virtual nursing was live across 17 units representing 510 beds at ChristianaCare's Newark and Wilmington, Del., hospital campuses. By September 2024, the system plans to go live with approximately 400 more beds to the program on additional medical and surgical units as well as cardiac stepdowns, oncology, and women's health and pediatrics. "I think we'll have nuanced learning coming from the additional types of work that virtual nurses can do in those patient populations other than the typical admissions, discharges and care coordination," Michelle Collins, DNP, APRN, vice president of nursing professional excellence at ChristianaCare, told Becker's. ChristianaCare's strategy for virtual nurses allows it to leverage the staff it already has and reduce nurse burnout and stress, and potentially reducing call outs. Virtual nurses are selected by nurse managers using several criteria: the desire to be a change agent, the experience of being a preceptor and having years of clinical nursing experience. Targeting retiring nurses is not part of the health system's strategy. "We le it in the hands of the nurse managers to identify those clinical nurses optimized to transition into this role," Dr. Collins said. Once selected, virtual nurses are trained on the technology and asked to commit at least two shis per pay period to virtual nursing. ey work in the virtual nursing center across from the hospital's largest campus, which allows them to help each other as needed. e program has not added any new staff or technology, instead leveraging the technology it acquired amid the COVID-19 pandemic and partnered to further develop our interactive platform, Dr. Collins said. e effect Since the program launched, nearly 24,000 patients have received virtual care and more than 87,000 calls have been exchanged between patients and nurses; the calls averaged 8 minutes. Virtual nurses improve patient experience, have caught potential errors and contribute to decreased length of stay and readmission rates. Virtual nurses also relieve the burden on bedside nurses, act as coaches for new nurses and provide support to virtual and bedside colleagues. One nurse told Dr. Collins she never wanted to work without a virtual nurse again. Bedside nurses leverage their virtualized partners for as many tasks as possible. Dr. Collins added that she has heard nurses say they decided not to call out because they knew they would be working virtually. What's next? e system is considering putting virtual nursing in areas such as the emergency department. e expansions will come with a few changes, including more comprehensive training and orientation "We need to figure out how to work very differently and how to be nimbler in how we utilize our experienced registered nurses," Dr. Collins said. "But we also need to leverage virtual technology for other roles, other clinicians and providers as well for healthcare overall." Her advice for systems wanting to do something similar: "Make sure you know what you actually need, not the shiny dangling object that somebody wants to sell you and says it works in all these wonderful ways. Figure out some of your own workflows, determine what you have that you could leverage today. at is the spirit of innovation that we are looking to capture because it doesn't need to be perfect. Let's try it. Where did it go really well? Where did it go wrong? How could we make it better? What can we do? Leveraging the mindset of critical inquiry and creating this work as a standardized practice for virtual care is really important." n Texas nursing program shutters after 44 years By Paige Twenter H ouston Community College no longer offers its Associate Degree in Nursing program, according to the Texas Board of Nursing. The college voluntarily ended the program Dec. 31. The ADN program has operated under a conditional approval since April 2023, meaning it hasn't met state standards for three years, the Houston Chronicle reported Feb. 23. It has been operating since 1979. For Texas nursing programs to remain approved, the average passing rate among first-year test-takers of the National Council Licensure Examination-RN has to be 80%, according to the news outlet. Between 2018 and 2022, the ADN program's average passing rate fell from 94% to 49%. The state's nursing board handed the college a sanction in 2020 after a 77% pass rate. The figure then dropped to 57% then 49%, or 97 of 197 students passing. Officials told the Houston Chronicle the closure came after 57 students were not able to take a licensure exam because "there were no available testing sites in Houston and the surrounding areas." "HCC takes pride in the ADN program's legacy," the school said. "This challenging decision to close the program reflects our adherence to the highest nursing education standards. … In collaboration with the Texas Board of Nursing, this decision marks our proactive stance in adapting to healthcare education's evolving needs, with a commitment to innovative nursing education solutions." Houston Community College said it is focusing on graduating the 57 students and confirming them a testing location. n

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