Hospitals see the potential in virtual nursing, but are still learning how to use it

PHILADELPHIA -- Philadelphia-area hospitals are rolling carts outfitted with video screens and virtual cameras into patient rooms with the hope that remote nurses can reduce patients’ risk of falling, pulling out tubes, or hurting themselves another way.

One remote nurse can do the work of up to a dozen in-person staffers by watching a bank of cameras stationed in patient rooms, and sometimes interacting with patients via video. Research has found these so-called virtual sitters can help reduce patient falls, because the nurses on the other end of the camera are not moving from room to room, but solely dedicated to watching patients’ every move.

But virtual sitters can also introduce their own safety risks: Jefferson Abington Hospital was cited by state inspectors in March for using virtual monitors in behavioral health patient rooms, which hospitals are required to keep free of anything that patients could use to hurt themselves, such as shade pulls, extra bedding, and power cables. Inspectors said that patients could have used the virtual monitors’ 8-foot-long power cords to strangle themselves.

Jefferson hospitals follow national guidelines that deem virtual sitters acceptable in behavioral health units, a spokesperson for the 18-hospital system said. Still, Abington administrators removed the carts and assigned staffers to watch the patients, making the incident a teaching moment.

Elsewhere in the region, health systems are also learning through experience how to best use virtual sitters and nurses — technology that rose in popularity during the COVID-19 pandemic, when hospitals needed to limit interaction and staff were stretched thin.

Penn Medicine nurses have found the effort required to maneuver the bulky equipment sometimes offsets the time that virtual nurses would save for on-the-floor staff. And in South Jersey, Virtua Health is testing whether its virtual nurses can take on more of the duties typically assigned to in-person nurses.

“Everyone is trying to figure out how to use the technology to improve patient care and safety, and we’re all learning as we go,” said Bill Hanson, Penn’s chief medical information officer.

Penn: Hype meets reality

Penn initially hoped mobile virtual sitters would reduce the need to assign staff to one-on-one observation duties, said Ann Huffenberger, a nurse and the director of the Penn Center for Connected Care. Penn has six hospitals, from its flagships in Philadelphia to medical centers in Lancaster and Princeton, and each has 12 virtual sitters.

“Everyone is thinking the technology is going to create such efficiency. We bought into the hype,” she said. “It didn’t really work out for us in that manner.”

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