Abstract
BACKGROUND: The virtual nursing delivery model enables the provision of expert nursing care from a remote location, using technology such as audio and video communication, remote monitoring devices, and access to electronic health records. Virtual nurses spend an extensive amount of time on computers to provide care, and little is known about how this workflow may affect and contribute to cognitive fatigue. OBJECTIVE: This study aimed to use eye tracking technology and pupil size variation to determine instances of virtual nurse cognitive fatigue during their typical workflow. METHODS: This study examined the virtual nursing workflow by recording and analyzing virtual nurse encounters using eye tracking. This cross-sectional study was conducted during regular 12-hour shifts at a major Southeastern health center in the United States. RESULTS: The study found that 75% (22/29) of virtual nursing encounters demonstrated a first fatigue instance at 9.8 minutes during patient discharges and at 11.9 minutes during patient admissions. CONCLUSIONS: This study provides valuable insights into virtual nursing workflow design and how it may impact the cognitive fatigue levels of nurses providing inpatient virtual care.