Saif Khairat awarded $3.3 million NINR grant to study virtual nursing and nurse burnout

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Saif Khairat, PhD, MPH, has been awarded a $3.3 million R01 grant from the National Institute of Nursing Research (NINR) for his project, “Evaluating Nurse Demands and Resources with Virtual Nursing to Mitigate Burnout.” The planned project period is Feb. 2, 2026, through Nov. 30, 2030.

This study examines the relationship between virtual nursing and bedside nurses’ job demands, as well as other multilevel outcomes. It also explores the organizational resources required to support virtual nursing and proposes solutions to mitigate burnout.

“While telehealth has accelerated the growth of virtual nursing as a response to nursing workforce shortages, we still lack rigorous evidence on how these models affect patient, nurse, and health system outcomes,” said Khairat. “By integrating electronic health record (EHR) data, physiologic measures, and design thinking, our team will generate actionable evidence and identify scalable solutions that support a sustainable nursing workforce and strengthen patient care.”

Healthcare settings are struggling to provide enough nurses to meet patients’ needs. About 40% of nurses reported high rates of burnout and leaving their positions prematurely. Burnout is driven by high job demands and limited organizational resources. Virtual nursing, an organizational strategy developed during the pandemic to deliver patient care, is used by 43% of U.S. hospitals. In these models, remote nurses engage in team-based care using telehealth. Virtual nursing is expected to reduce job demands for bedside nurses, but little is known about its impact on job demands and resources.

To address this gap, the research team will conduct a multi-site, natural experiment across nine diverse hospitals. The study will generate real-world, data-driven evidence on the job demands and resources associated with virtual nursing.

The project includes three specific aims:

Determine the association between the use of virtual nursing and workplace job demands among bedside nurses using EHR and survey data.
Determine the association between the use of virtual nursing and individual job demands among bedside nurses using eye-tracking technology and wearable devices.
Determine the job resources required to support virtual nursing and identify organizational solutions to mitigate nurse burnout using Design Thinking workshops.

Guided by the Job Demands-Resources framework and using a mixed-methods sequential design, the study will examine the relationship between virtual nursing and the job demands and resources that drive nurse burnout. The team will use quantitative data, including EHR and physiologic measures, to evaluate job demands such as time pressure and mental demand. The study will also apply design thinking to identify organizational resources and develop solutions that address systemic contributors to burnout.

Expected outcomes include understanding the association between virtual nursing and workplace job demands, evaluating individual job demands using physiologic data, and identifying organizational resources needed to support bedside nurses using virtual nursing.

A key strength of this project is its embedded partnership with UNC Health, including clinical collaborators with hands on experience implementing virtual nursing in the health system. Prior work with UNC Health partners has already helped characterize the structure, workflows, and operational needs of virtual nursing, grounding the study in real virtual nursing workflows and accelerating translation of findings into practice.

Khairat’s research team includes Cheryl Jones, PhD, RN, FAAN, professor at the UNC-Chapel Hill School of Nursing; Jamie L. Crandell, PhD, associate professor at the UNC-Chapel Hill School of Nursing; Valerie Howard, EdD, MSN, RN, FAAN, dean and professor at the UNC-Chapel Hill School of Nursing; and Elizabeth Chen, PhD, associate professor in the Department of Health Behavior at the UNC-Chapel Hill Gillings School of Global Public Health. Linda Aiken, PhD, RN, FAAN, professor and founding director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania, serves as a consultant.