Program Evaluation of Virtual Rn (ViRN) Integration: Assessing Adoption, Quality Process, and Nurse Satisfaction in Inpatient Care

Abstract

Background: The increasing complexity of healthcare and persistent nursing shortages have driven the adoption of creative care models such as the Virtual Registered Nurse (ViRN). ViRN leverages telehealth technology to provide remote clinical assistance, patient monitoring, and education to support the bedside nurses in acute care settings. By offloading admission, discharge, and patient education tasks, ViRN aims to enhance workflow efficiency, improve patient and nurse satisfaction, and medication safety. Purpose: This project evaluated the ViRN program at an academic medical center health system hub site, focusing on four objectives: adoption of ViRN for admissions and discharges, impact on heparin medication safety, nurse satisfaction, and overall integration into inpatient workflows. The goal was to assess the effectiveness of ViRN in optimizing nursing processes and supporting evidence-based program refinement and expansion. Methods: A qualitative and quantitative evaluation with descriptive statistics was conducted across three medical-surgical units (72 beds total). Quantitative data included electronic health record (EHR) reports on ViRN-assisted admissions/discharges and safety event records for Heparin administration. Nurse satisfaction was measured via an anonymous survey (Likert scale and open-ended questions). Qualitative thematic analysis captured nurses’ experiences and suggestions. All data were de-identified, and Institutional Review Board (IRB) approval was obtained. Results: From May 2023 to May 2025, ViRN assisted with 62.7% of admissions and 23.1% of discharges, with unit-level variability. Heparin safety events decreased post-implementation, with ViRN providing critical “good catches” and protocol adherence. Surveyed nurses (59% response rate) reported high satisfaction with ViRN’s accessibility, workflow support, and time-saving benefits, though some cited challenges with technology and role clarity. Overall ViRN utilization reached 41.9%, indicating moderate integration. Conclusions: ViRN integration improved workflow efficiency, medication safety, and nursing satisfaction in inpatient care. While adoption for admissions was high, discharges and overall utilization varied by unit, highlighting opportunities for targeted improvement. Continued monitoring, staff engagement, and communication enhancements are recommended to maximize ViRN’s impact and scalability.