Tele health Nursing Models in Virtual Hospitals: Effects on Patient Outcomes, Safety, and Service Efficiency in Outpatient, Critical Care, Medical Consultation, and Mental Health Services; A Systematic Review

Authors

  • Bashayer Hijab Alanizi Outpatient Department, Staff nurse, Seha Virtual Hospital, Ministry of Health Author
  • Meshari Dhaifallah Albaqami Author
  • Sulaiman Ali Alshareef Nursing, King Saud University Medical City Author
  • Waleed Alhassan Siraj Staff nurse, Head of the Department of Psychiatry and Addiction, Seha Virtual Hospital, Ministry of Health Author
  • Noof Ali Ameri Programs and Committees Administration, Staff nurse, Seha Virtual Hospital Ministry of health Author
  • Faisal Khamis Alshammari Staff Nurse, General department of medical consultation, Seha Virtual Hospital, Ministry of Health Author
  • Ayidh Saud Alqahtani Staff Nurse, Clinical Resource Nurse, Al-Kharj Military Industry Corporation Hospital. Author
  • Suaad Mohammed Alrowaily Staff nurse, Department of Psychiatry and Addiction Medicine, Seha Virtual Hospital, Ministry of Health Author
  • Shahad Nahis Almutairi Staff nurse, ICU, Seha Virtual Hospital, Ministry of Health Author
  • Reema Abdullah Alfawzan Staff nurse, ICU, Seha Virtual Hospital, Ministry of Health Author
  • Mohammed Nasser Altaif Nursing, King Saud University Medical City Author

DOI:

https://doi.org/10.65759/ynw47674

Keywords:

Telehealth, Virtual hospital, Telenursing, Remote patient monitoring, Tele-ICU, Transitional care, Nurse-led interventions, Patient safety, Readmissions, Service efficiency

Abstract

Background: Telehealth enabled virtual hospitals are increasingly used to extend nursing care in outpatient follow-up, critical care, medical consultation, and mental health services. Studies found benefits for outcomes, safety, and efficiency, but effects differ by model and setting. Objective: To systematically review telehealth nursing models in virtual hospitals and evaluate the effects on patient outcomes, safety indicators, and service efficiency in major service lines. Methods: We conducted a systematic review of original studies according to PRISMA guidelines to evaluate nurse-involved telehealth models. Eligible designs included randomized trials and observational studies reporting at least one domain outcome (clinical outcomes, safety, or efficiency). Two reviewers independently screened records, extracted data, and assessed risk of bias using RoB 2 or ROBINS-I. Results were synthesized by service line and outcome domain. Results: Included studies covered nurse-led outpatient telemonitoring, transitional care, tele-ICU support, and telemental health care management. Telehealth nursing models were associated with reductions in readmissions and emergency visits in transitional care, improvements in symptom control and quality of life in chronic disease programs, and lower mortality or shorter ICU length of stay in tele-ICU contexts. Patient satisfaction and acceptability were positive. Conclusion: Telehealth nursing models in virtual hospitals improve outcomes and efficiency while supporting safe, continuous care. We need standardized reporting of safety indicators and implementation fidelity.

References

1. Kruse CS, Krowski N, Rodriguez B, Tran L, Vela J, Brooks M. Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open. 2017 Aug 3;7(8):e016242.

2. Wilcox ME, Adhikari NK. The effect of telemedicine in critically ill patients: systematic review and meta-analysis. Crit Care. 2012 Jul 18;16(4):R127.

3. Leppin AL, Gionfriddo MR, Kessler M, Brito JP, Mair FS, Gallacher K, et al. Preventing 30-Day Hospital Readmissions. JAMA Intern Med. 2014 Jul 1;174(7):1095.

4. Krzesiński P, Jankowska EA, Siebert J, Galas A, Piotrowicz K, Stańczyk A, et al. Effects of an outpatient intervention comprising nurse‐led non‐invasive assessments, telemedicine support and remote cardiologists’ decisions in patients with heart failure: a randomised controlled trial. Eur J Heart Fail. 2022 Mar 14;24(3):565–77.

5. Kwok C, Degen C, Moradi N, Stacey D. Nurse-led telehealth interventions for symptom management in patients with cancer receiving systemic or radiation therapy: a systematic review and meta-analysis. Support Care Cancer. 2022 Sep 14;30(9):7119–32.

6. Wong AKC, Zhou SY, Tao X, Tsui NY, Kwok VWY, Wang RM, et al. The Effectiveness of Nurse-Led Telecare Consultations Among Patients Who Have Experienced a Stroke: Systematic Review and Meta-Analysis. J Med Internet Res. 2025 Nov 27;27:e74149.

7. Hagi K, Kurokawa S, Takamiya A, Fujikawa M, Kinoshita S, Iizuka M, et al. Telepsychiatry versus face-to-face treatment: systematic review and meta-analysis of randomised controlled trials. Br J Psychiatry. 2023 Sep 1;223(3):407–14.

8. Mo Y, Chu M, Hu W, Wang H. Association between the nurse-led program with mental health status, quality of life, and heart failure rehospitalization in chronic heart failure patients. Medicine (Baltimore). 2021 Mar 12;100(10):e25052.

9. Dawson NL, Hull BP, Vijapura P, Dumitrascu AG, Ball CT, Thiemann KM, et al. Home Telemonitoring to Reduce Readmission of High-Risk Patients: a Modified Intention-to-Treat Randomized Clinical Trial. J Gen Intern Med. 2021 Nov 27;36(11):3395–401.

10. Howland C, Despins L, Sindt J, Wakefield B, Mehr DR. Primary Care Clinic Nurse Activities with a Telehealth Monitoring System. West J Nurs Res. 2021 Jan 22;43(1):5–12.

11. Goudarzian M, Fallahi-Khoshknab M, Dalvandi A, Delbari A, Biglarian A. Effect of telenursing on levels of depression and anxiety in caregivers of patients with stroke: A randomized clinical trial. Iran J Nurs Midwifery Res. 2018;23(4):248.

12. Fortney JC, Pyne JM, Edlund MJ, Williams DK, Robinson DE, Mittal D, et al. A Randomized Trial of Telemedicine-based Collaborative Care for Depression. J Gen Intern Med. 2007 Aug 10;22(8):1086–93.

13. Hoerster KD, Jakupcak M, Stephenson KR, Fickel JJ, Simons CE, Hedeen A, et al. A Pilot Trial of Telephone-Based Collaborative Care Management for PTSD Among Iraq, Afghanistan War Veterans. Telemed e-Health. 2015 Jan;21(1):42–7.

14. Becker CD, Fusaro M V., Al Aseri Z, Millerman K, Scurlock C. Effects of Telemedicine ICU Intervention on Care Standardization and Patient Outcomes: An Observational Study. Crit Care Explor. 2020 Jul;2(7):e0165.

15. Sadaka F, Palagiri A, Trottier S, Deibert W, Gudmestad D, Sommer SE, et al. Telemedicine Intervention Improves ICU Outcomes. Crit Care Res Pract. 2013;2013:1–5.

16. Watanabe T, Ohsugi K, Suminaga Y, Somei M, Kikuyama K, Mori M, et al. An evaluation of the impact of the implementation of the Tele-ICU: a retrospective observational study. J Intensive Care. 2023 Mar 7;11(1):9.

Downloads

Published

2025-12-09