JMIR Publications

ABSTRACT

Background:

Canadian nurses are at the forefront of patient care delivery. While the Canadian health care system is embracing digital health, nurses are bound to integrate virtual care into practice. In early 2020, more Canadian nurses delivered care virtually than three years before.

Objective:

This study sought to uncover the professional and care setting related characteristics of the nurses who delivered care virtually in 2020 and to investigate the factors driving the uptake of virtual care by nurses prior to the pandemic of COVID-19.

Methods:

We utilized data from the 2017 and 2020 National survey of Canadian nurses. This survey collected data on the use of digital health technologies in nursing practice. It concerned regulated nursing professionals working in different health care settings and from different domains of nursing practice. We combined Chi-square independence test and logistic regression analysis to uncover the main drivers of virtual care uptake by nurses in 2020.

Results:

In early 2020, prior to the pandemic of COVID-19, nurses who delivered care virtually were predominantly nurse practitioners (85%), more likely to work in a primary or community care setting (62%), or in an urban setting (62%). Factors like nursing designation (P < .01), perceived quality of care at the health facility where the nurses practiced (P < .01), and the type of patient record keeping system they had access to (P < .05) had a statistically significant effect on the probability for nurses to deliver care virtually in early 2020. Furthermore, nurses’ perception of the quality of care they delivered through virtual technologies was statistically associated with their perception of the skills (Chi-square=308.66, P < .01) and knowledge (Chi-square=283.39, P < .01) to use these technologies.

Conclusions:

The study revealed some disparities in the uptake of virtual care by nurses across geographic regions. From an allocation standpoint, this finding should help decision-makers to pinpoint gaps in digital health utilization. Similarly, discrepancies in the use of virtual health across nursing designation have some implications for leadership at the care settings and for nurse educators in terms of competences and training for nurses at all levels of practice. Moreover, care settings are strongly encouraged to modernize their patient record keeping system as access to EMRs tended to influence the adoption of virtual care, which could foster interoperability. Finally, policy-related factors should not be overlooked when it comes to virtual care technologies integration in nursing practice.