Akron Children’s is using ‘virtual’ nurses. Here’s what that means for patients:

Akron Children's is using 'virtual' nurses. Here's what that means for patients:

For some patients staying at Akron Children’s Hospital and their families, an additional member of the care team is now available to provide updates and ask questions through their in-room monitors.

The hospital’s “virtual nurses,” registered staff nurses who do not replace nurses at the bedside, can also send video streams to parents and guardians when they’re offsite so they can check on their children.

Through Akron Children’s Hospital’s new inpatient virtual nursing program, select nurses split their time between bedside care and staffing a virtual workstation where they use video, audio and other technology to communicate with patients, families and health care providers. Nursing staff said virtual nursing benefits both patients and staff by providing regular patient monitoring and improving workflows.

The hospital has identified more than 250 safety risks through the virtual nursing program, where nurses watch over patient rooms via cameras and can beam in on TV screens that double as video-chat interfaces when needed, said Chief Nursing Officer Christine Young.

The hospital system aims to address the post-COVID-19 pandemic nursing shortage by allowing nurses to try new tasks to combat burnout and improve turnover and retention, Young said.

“I think it decreases the physical demand on on the nursing staff to be able to do one or two days in the virtual hub,” Young said. “But it’s also a bigger picture (of) nursing, I’ll call it. They oversee the whole floor, so they’re really looking at all the care delivery for all the patients on the floor.”

The virtual nurses also make rounds with the physicians, together reviewing patients’ health and care, Young said.

Virtual nursing has sped up patient admissions and discharges and communications with patients’ other providers, Young said.

Virtual nurses also help with education of patients and families, she said.

“You can do education at the bedside if you have to teach a hands-on skill to a family of how to do something, but the virtual nurse can teach some of the concepts as well,” Young said.

The hospital piloted the virtual nursing program in its 7 Medical unit from December 2023 to June. Since then, virtual nursing has fully launched in 7 Medical and has expanded to 7 Surgical, 6 Medical, 6 Surgical and inpatient hematology and oncology, Young said.

Virtual nurses are available in those units from 9 a.m. to 9 p.m., seven days a week, Young said.

How virtual nursing is incorporated in the 7 Medical unit

Akron Children’s nurse Stephanie Falk has been on the Akron Children’s nursing staff since 2007 and said she was the first nurse in the hospital to begin piloting virtual nursing tasks in December 2023.

Falk said the unit where she works, 7 Medical, is a general medical unit with a large focus on infant and toddler patient populations and respiratory illnesses and failure-to-thrive conditions.

“We can note if a parent left a side rail down too low, or things like that,” Falk said. “We can zoom in. I can see what an oxygen level’s set at because it has that capability. I can read a name band; I can zoom in that far. If I need to check IDs on parents, if they’re in the room, I can take that away from the nurse and I can worry about that. Little things like that. Tasks that can become time consuming — I can handle that as a virtual nurse.”

Falk estimated that she spends less than half of her work hours focusing on virtual duties, and when she’s serving as an on-duty virtual nurse, it’s for a whole shift.

She said she has said to familiar patients, “‘Hey, I saw you yesterday on the floor. I’m here virtual today.'”

Nurse Manager Christine Maimona, nurse manager for 7 medical, said Falk is an “additional resource” when she’s in the virtual nurse role.

“She’s not one of our staff nurses for the day. So if I need eight nurses, I still get eight nurses and then I get Stephanie on top,” Maimona said.

Akron Children’s explores expanding tech capabilities

In the virtual nursing program, Akron Children’s works with a vendor called care.ai to provide equipment and software, Young said. Through work with care.ai, hospital leaders are looking into incorporating more artificial intelligence, machine learning and ambient learning capabilities, which can detect risks such as down side rails, she said.

“We all work together, so we have a project manager from information technology who’s also a nurse,” Young said. “That was key to getting this off the ground, just making sure that all the Is were dotted, Ts were crossed, and making sure, from a technology standpoint, we were very stable.”

Video feeds and communications are not recorded or stored, according to Akron Children’s.

The cameras turn off from 9 p.m. to 9 a.m., Young said.

Families are able to opt out of receiving virtual care, and that has happened, she said — but she added that the response from families has been largely positive.

In January, the hospital also started piloting a virtual safety program, Young said. There are situations in which patients require monitoring throughout their entire stay, and the hospital is seeing how virtual nursing can fit that need, she said.

Virtual nursing includes mentoring, career development opportunities

Akron Children’s nurses are required to have three years of experience in the field before exchanging some bedside duties for virtual nurse responsibilities, Young said, adding that virtual nurses provide mentoring to newer nursing staff.

“So if the other nurses are busy providing care to their patients, they can call the virtual nurse and say, ‘Can you help me with this?’ ‘Can you look at this?’ and get that consult and that mentoring,” Young said.

Maimona said she hasn’t been hiring nurses from outside the hospital to take on virtual tasks for 7 Medical but that staff nurses with experience in the unit have made the transition into the “hybrid role.”

“A lot of my staff that are experienced find it to be a nice like next step in their career,” Maimona said.

For Falk’s part, she said she’s more focused on how virtual nursing can help her and her patients right now.

“Things like this just help support me in my nursing, period,” Falk said. “The fact that I have the insight I do impacts my what I do on the floor now, knowing, ‘Oh, I can just defer to the virtual for that.'”