ABSTRACT Aim To synthesise international evidence on virtual wards (VWs) models and examine the pivotal role of clinical nursing leadership in the development, governance, and delivery of digitally enabled acute care. Background Virtual wards deliver hospital‐level care in patients' homes through telemedicine including remote monitoring, supporting admission avoidance and early supported discharge. While existing literature largely focuses on clinical outcomes and medical oversight, the contribution of nursing leadership to VW development and sustainability remains underexplored. Design and Methods An integrative review was conducted, synthesising evidence from empirical studies, service evaluations, and policy literature. Searches were undertaken between February and April 2025 across CINAHL, PubMed, EMBASE, and the Cochrane Library, alongside targeted grey literature searches. The review focused on acute, hospital‐integrated VW models implemented in Australia, Ireland, and the United Kingdom, enabling comparison of nursing leadership roles across three publicly funded healthcare systems. Results Twenty‐four sources met inclusion criteria, with six studies selected for in‐depth case analysis. Across all models, nurses, particularly those in senior and advanced practice roles, were central to VW implementation. Nursing leadership underpinned key enablers of successful VW delivery, including staff training, clinical governance frameworks, standardised protocols, interoperable electronic health records, and patient empowerment through technology. Nurses led remote assessment and monitoring, coordinated multidisciplinary teams, operationalised escalation pathways, and ensured continuity of care across acute and community settings. Conclusion This review demonstrates that clinical nursing leadership is foundational to the effectiveness, safety, and scalability of VWs. While medical leadership provides essential diagnostic oversight, nursing leadership delivers sustained operational coordination, patient‐centred design, and system integration. Empowering nurses to lead VW development is therefore critical to advancing integrated, high‐quality acute care beyond the hospital setting. Statement No patient or public contribution.
Lewis et al. (Sat,) studied this question.
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