Virtual Nursing Programs in Acute Care Settings: A Scoping Review of Patient, Nurse, and System-Level Outcomes
Clinical Snapshot
PICO Framework
| P — Population | Adult patients and nursing staff in acute care hospital settings |
| I — Intervention | Virtual nursing (VN) programs — remote nurses supporting bedside staff via audiovisual technology |
| C — Comparator | Usual care / traditional bedside nursing (comparator not consistently defined across included studies) |
| O — Outcomes | Patient outcomes (satisfaction, safety indicators), nurse outcomes (satisfaction, administrative burden, turnover), and system-level outcomes (discharge efficiency, financial metrics) |
Bottom Line
This scoping review maps the emerging literature on virtual nursing programs in acute care, synthesising findings from just 11 predominantly cross-sectional pilot studies. The evidence suggests potential benefits for nurse and patient satisfaction, discharge efficiency, and administrative burden reduction — but these findings are based on weak study designs without control comparisons, and outcomes such as patient safety indicators and financial metrics are inconsistently reported. No pooled effect sizes are available, and formal risk of bias assessment was not conducted. The authors appropriately conclude that virtual nursing 'shows promise' but cannot substitute for adequate bedside staffing. For senior clinicians and health system leaders, this review serves as a useful evidence map rather than a practice-changing synthesis. Institutions considering virtual nursing implementation should treat it as an adjunct to — not a replacement for — workforce investment, and should embed prospective evaluation into any pilot program. The Australian context adds further complexity, given state-based nurse-to-patient ratio legislation and evolving digital health governance. Rigorous randomised or quasi-experimental studies with standardised outcome reporting are urgently needed before virtual nursing can be recommended as evidence-based practice.
Key Findings
P Value: Not reported at review level
Effect Size: Not quantified — no pooled effect sizes reported (scoping review design)
Primary Outcome: Narrative synthesis across 11 studies: strongest evidence for improved nurse satisfaction and patient satisfaction; reports of improved discharge efficiency and reduced administrative burden for bedside nurses
Nnt Or Sensitivity: Not calculable from available data — no comparative effectiveness data with control groups reported
Confidence Interval: Not reported — no meta-analytic synthesis performed
Clinical Application
Implementation feasibility depends on capital investment in audiovisual infrastructure, electronic health record integration, workflow redesign, and staff training. Sustainability requires ongoing technology maintenance and governance frameworks. The evidence base does not yet support a standardised implementation model. Australia faces comparable nursing workforce challenges, including documented shortages, high turnover, and burnout — particularly post-COVID-19. Several Australian states have mandated nurse-to-patient ratios (e.g., Victoria, Queensland, NSW), which may influence how VN roles are defined and regulated. The Australian Digital Health Agency's national telehealth frameworks and the TGA's oversight of software-as-a-medical-device may apply to certain VN platforms. RACGP and ACORN guidelines do not yet address VN in acute care. PBS implications are not directly relevant. Australian health services considering VN should note that the current evidence base is insufficient to justify large-scale investment without prospective evaluation. Pilot programs with embedded research designs are recommended, aligned with ACSQHC safety and quality frameworks. Acute care inpatient settings experiencing nursing workforce pressures, particularly those with high documentation burden, discharge coordination challenges, or difficulty retaining experienced nursing staff. Most applicable to tertiary and metropolitan hospitals with existing telehealth infrastructure.
Abstract
OBJECTIVE: To synthesize the literature on the influence of virtual nursing (VN) on patient, nurse, and system-level outcomes in acute care. BACKGROUND: Persistent nursing workforce challenges, including staff shortages and turnover, have been intensified by the COVID-19 pandemic, rising patient acuity, and increasing documentation demands. Many health systems have adopted VN programs, where remote nurses support bedside staff using audiovisual technology. Although these programs are rapidly expanding, evidence of their effectiveness remains limited. METHODS: These authors conducted a scoping review following PRISMA guidelines. Eleven studies reporting patient, nurse, or system-level outcomes were included. RESULTS: Most studies were cross-sectional pilots. Evidence was strongest for nurse and patient satisfaction, with reports of improved discharge efficiency, reduced administrative burden, and higher patient satisfaction. Findings for other outcomes, including safety indicators and financial metrics, were inconsistently reported. CONCLUSIONS: Virtual nursing shows promise for enhancing patient satisfaction and workflow efficiency, but cannot replace investments in sufficient bedside staff and resources.
References
- 1.Nikpour, J., Bouvier, M., Razmpour, O., Leslie, S. L., & Cimiotti, J. P. (2026). Virtual nursing programs in acute care settings: A scoping review of patient, nurse, and system-level outcomes. The Journal of Nursing Administration. Advance online publication. https://doi.org/10.1097/NNA.0000000000001753
This content is for educational purposes for healthcare professionals only and does not constitute clinical advice. Clinical decisions should be based on individual patient assessment, current guidelines, and appropriate specialist consultation. Editorial Standards · Privacy Policy · Terms of Service