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Accepted for/Published in: JMIR Human Factors

Date Submitted: Oct 2, 2024
Date Accepted: Mar 6, 2025

The final, peer-reviewed published version of this preprint can be found here:

Association of Virtual Nurses’ Workflow and Cognitive Fatigue During Inpatient Encounters: Cross-Sectional Study

Khairat S, Morelli J, Liao WT, Aucoin J, Edson B, Jones CB

Association of Virtual Nurses’ Workflow and Cognitive Fatigue During Inpatient Encounters: Cross-Sectional Study

JMIR Hum Factors 2025;12:e67111

DOI: 10.2196/67111

PMID: 40262176

PMCID: 12040296

Association of Virtual Nurses’ Workflow and Cognitive Fatigue During Inpatient Encounters: A Cross-Sectional Study

  • Saif Khairat; 
  • Jennifer Morelli; 
  • Wan-Ting Liao; 
  • Julie Aucoin; 
  • Barbara Edson; 
  • Cheryl B. Jones

ABSTRACT

Background:

The virtual nursing (VN) delivery model enables the provision of expert nursing care from a remote location, using technology such as audio/video communication, remote monitoring devices, and access to the electronic health record (EHR). 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:

Utilize 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 US.

Results:

The study found that 75% of VN encounters demonstrated a first fatigue instance at 9.8 minutes during patient discharges and 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.


 Citation

Please cite as:

Khairat S, Morelli J, Liao WT, Aucoin J, Edson B, Jones CB

Association of Virtual Nurses’ Workflow and Cognitive Fatigue During Inpatient Encounters: Cross-Sectional Study

JMIR Hum Factors 2025;12:e67111

DOI: 10.2196/67111

PMID: 40262176

PMCID: 12040296

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