Table 1.
Benefits, challenges, and implications of selected digital technologies in nursing
| Digital technologies | Examples of potential benefit | Examples of current challenges | Future implications |
|---|---|---|---|
| Artificial intelligence/big data | Use in decision support systems can improve the identification of infection13
Pandemic/outbreak response using big data analytics to help in contact tracing and population health response14 |
Biases in current datasets can become ingrained in artificial intelligence (AI) algorithms15
Techniques are complex and may unintentionally reduce nursing involvement in the development of these systems16 Ethics and accountability of decisions generated by these systems, including transparency and privacy concerns17 |
AI based nursing in acute and primary care needs research Policies needed on professional accountability Educational and leadership competencies and opportunities related to AI and data analytics |
| Automation technologies (eg, robotics, drones) | Robots can support people with cognitive, sensory, and motor impairments; help those who are ill or injured; support caregivers; and aid the clinical workforce18 | Technologists, researchers, providers, and users must collaborate to ensure success18 | Emerging innovations coupling AI and robotics will have intended and unintended changes to nursing practice and its professional culture Nursing must assist in co-designing and developing these solutions to be complementary to practice Cost-benefit analysis of developing complex health technologies that use planetary resources is needed |
| Assisted living technologies or “smart homes” technology | Motion monitoring system in homes can help tailor care decisions for older adults with memory problems19 | Privacy implications Variety and turnover of different technologies makes identifying suitable devices challenging20 Technical and expense barriers21 |
Nurses should be involved in the design, development, and implementation of systems in collaboration with patients and carers |
| Clinical decision support systems | Systems can detect infectious disease and trigger appropriate actions22 | Over alerting clinicians results in alert fatigue and workarounds23
Owing to lack of research rigor, the impact and effectiveness in some clinical environments (eg, emergency departments) is unclear24 |
Nurses should be involved in design, development, and implementation Consider usability when designing systems that improve rather than disrupt decision making and workflow |
| Electronic health records (EHRs) | Nursing documentation is superior to paper based records in aspects of data completeness and structure, including legibility25 | Weaknesses in documentation quality and quantity due to factors such as the time required or poor system or interface design25 | Nurses need dedicated time and equipment and a supportive digital work culture AI driven clinical decision support integrated into the EHRs to facilitate decision making will be important to look for intended and unintended consequences Nursing leadership should redesign EHRs to reduce burden of documentation |
| Mobile health | Coaching patients via applications can improve short term outcomes26 | Perceived lack of affordability and reliability of mobile applications for clinical decision support27
Concerns over the professional image of nursing when using mHealth, particularly in hospital settings28 |
Need to develop policies and a professional culture that supports use of mobile devices in clinical practice. Where relevant, these should be integrated with EHRs and other related technologies |
| Telehealth/ telemedicine | Beneficial in nursing homes during outbreaks of infectious disease—eg, during the covid-19 pandemic to reduce isolation and keep residents and nursing staff safe29 | Nurses’ technical skills and negative attitudes towards telemedicine can be a barrier, as can their concerns around data privacy and confidentiality30 | Nurses should support the co-design of telehealth systems and emerging virtual models of care with patients and carers |
| Personalized/ precision healthcare | Treatment tailored to individual patients enables nurses to deliver more personalized care31 | Pace of technological change and equity issues related to technology access could undermine precision health developments32 | Nurses should advocate for patients and families to have equitable access to their genomic health data for use in personalized and precision healthcare solutions |
| Social media and online information (internet) | Diverse pools of health information facilitate nursing processes and support patient and student education33 | Quality and reliability of online health information, particularly on social media, varies, and it can be risky or unsafe34 | Nurses should be educated about appropriate use of social media and online health information and support patients’ use of these technologies to improve their self-management |
| Virtual and augmented reality | Virtual reality training can improve knowledge in nursing education35 and be used in pediatric and adult populations as a treatment tool or clinical intervention36 37 | Can cause simulation sickness, including dizziness and visual disturbances38 | Low cost devices and software should be developed by nurses and educators that can integrate with existing mobile, internet, and other digital technologies |