Digital technologies are rapidly transforming the healthcare landscape, profoundly impacting the nursing profession globally. From the increasing integration of artificial intelligence (AI) and robotic systems to the widespread use of mobile health (mHealth), internet, and social media, and the growing reliance on telehealth, particularly highlighted by the COVID-19 pandemic, nurses are navigating an increasingly digital world. This evolution demands a commitment to continuous learning and adaptation and emphasizes the critical role of information literacy for nurses to effectively leverage these technologies and maintain the highest standards of patient care.
While digital advancements offer significant opportunities within nursing practice and education, persistent challenges hinder their full integration. A primary concern revolves around the profession’s ability to keep pace with the relentless evolution of digital technologies and their societal impact. This lag limits the potential for nurses to fully harness these tools to enhance both their practice and patient outcomes. To overcome these obstacles and prepare for the future, a fundamental shift towards becoming a digitally enabled profession is essential. This transformation necessitates continuous learning and adaptation, ensuring nurses possess robust information literacy skills to navigate and contribute to this evolving digital environment.
Numerous examples illustrate the benefits digital technologies already bring to nursing. Telehealth programs, for instance, empower nurses to provide remote patient monitoring, coaching, and triage for chronic conditions, demonstrably reducing emergency department admissions. Mobile devices and health applications facilitate remote pain management advice for adolescent cancer patients and offer innovative pedagogical solutions for nursing education through remote learning.
The application of AI in nursing, though still in its early stages, shows promising potential. Virtual chatbots can streamline patient communication, and robots could augment emotional and social support for patients. However, these advancements also bring inherent challenges related to data privacy, ethical considerations, and cost-effectiveness, all of which require nurses with strong information literacy to critically assess and address.
Overcoming Challenges in Digital Integration
Despite the potential benefits, some perceive digital technologies as a distraction from the core of nursing: the hands-on caring role and the therapeutic relationships with patients and families. This perceived conflict with traditional nursing values, such as compassionate care, might contribute to some nurses’ reluctance to fully embrace digital healthcare approaches. Furthermore, nursing’s historical position within healthcare hierarchies and its ongoing efforts to solidify leadership roles within health systems add complexity to digital adoption.
Nursing informatics has long championed technology integration within the profession. However, the number of informatics specialists remains relatively small globally, with a concentration in the United States. While digital nursing workforces are expanding in other regions, progress is sometimes hampered by a lack of leadership and investment in initiatives that empower nurses to champion and lead digital health transformations. Global disparities in technological infrastructure, expertise, and digital healthcare maturity further complicate the situation. Significant variations exist across countries and regions in healthcare digitalization, internet access, and transparency of health information processes, highlighting the need for tailored approaches to continuous learning and adaptation in information literacy for nurses worldwide.
Digital Technologies in Nursing: Benefits, Challenges, and the Need for Information Literacy
The body of nursing literature extensively analyzes digital technologies supporting the profession across practice (e.g., hospital information systems, electronic health records (EHRs), monitoring systems, telehealth), education (e.g., e-learning, virtual reality), and personalized healthcare (e.g., assistive devices, smart homes). Table 1 (adapted from the original article) summarizes the benefits, challenges, and implications of key digital technologies in nursing, emphasizing the crucial role of information literacy in navigating these complexities.
Table 1. Benefits, Challenges, and Implications of Digital Technologies in Nursing
| Digital Technologies | Potential Benefits | Current Challenges | Future Implications & Information Literacy Needs |
|---|---|---|---|
| Artificial Intelligence (AI) & Big Data | Improved infection identification through decision support systems. Enhanced pandemic response via big data analytics for contact tracing and population health management. | Biases in datasets ingrained in AI algorithms. Complexity potentially reducing nurse involvement in system development. Ethical and accountability concerns regarding AI-driven decisions, including transparency and privacy. | Research needed for AI-based nursing in acute and primary care. Policies on professional accountability are crucial. Educational and leadership competencies in AI and data analytics are essential. Nurses require information literacy to understand AI biases, ethical implications, and contribute to responsible development. |
| Automation (Robotics, Drones) | Support for individuals with cognitive, sensory, and motor impairments. Assistance for the ill or injured. Support for caregivers and the clinical workforce. | Successful implementation requires collaboration among technologists, researchers, providers, and users. | AI and robotics innovations will significantly alter nursing practice and professional culture. Nurses must participate in co-design to ensure solutions complement practice. Cost-benefit analysis of complex technologies and resource use is needed. Information literacy is vital to assess the impact of automation on nursing roles, ethics, and patient care. |
| Assisted Living Technologies (“Smart Homes”) | Motion monitoring systems to personalize care for older adults with memory problems. | Privacy implications. Variety and rapid turnover of technologies make device selection difficult. Technical and financial barriers. | Nurses should be involved in the design, development, and implementation in collaboration with patients and carers. Information literacy is needed to guide patients and families in selecting and using appropriate technologies while addressing privacy concerns. |
| Clinical Decision Support Systems (CDSS) | Early detection of infectious diseases and automated trigger of appropriate actions. | Alert fatigue from over-alerting clinicians. Unclear effectiveness in some clinical settings (e.g., emergency departments) due to lack of research rigor. | Nurses must be involved in design, development, and implementation. Usability should be prioritized to enhance, not disrupt, decision-making and workflow. Information literacy is crucial to critically evaluate CDSS alerts, understand their limitations, and integrate them effectively into clinical judgment. |
| Electronic Health Records (EHRs) | Improved data completeness, structure, and legibility compared to paper records for nursing documentation. | Documentation quality and quantity issues due to time constraints, poor system design, or user interface. | Nurses require dedicated time, equipment, and a supportive digital work culture. AI-driven CDSS integrated into EHRs will be important but require careful consideration of intended and unintended consequences. Nursing leadership should redesign EHRs to reduce documentation burden. Information literacy is needed to efficiently utilize EHRs, ensure data quality, and advocate for system improvements. |
| Mobile Health (mHealth) | Patient coaching via applications can improve short-term outcomes. | Perceived lack of affordability and reliability of mHealth applications for clinical decision support. Concerns about nursing’s professional image when using mHealth, particularly in hospitals. | Policies and a professional culture supporting mobile device use in clinical practice are needed. Integration with EHRs and other technologies is important. Information literacy is necessary to evaluate mHealth apps, address patient privacy concerns, and integrate them professionally into practice. |
| Telehealth/Telemedicine | Beneficial in nursing homes during outbreaks (e.g., COVID-19) to reduce isolation and protect residents and staff. | Nurses’ technical skills and negative attitudes towards telemedicine can be barriers. Concerns regarding data privacy and confidentiality. | Nurses should support the co-design of telehealth systems and virtual care models with patients and carers. Information literacy is critical to develop telehealth skills, address privacy concerns, and effectively deliver virtual care. |
| Personalized/Precision Healthcare | Tailored treatment allows nurses to deliver more individualized care. | Rapid technological change and equity issues related to technology access may undermine precision health development. | Nurses should advocate for equitable patient access to genomic health data for personalized healthcare solutions. Information literacy is required to understand genomic data, advocate for equitable access, and deliver personalized care effectively. |
| Social Media & Online Information (Internet) | Diverse health information resources support nursing processes and patient/student education. | Variable quality and reliability of online health information, especially on social media, posing potential risks. | Nurses need education on appropriate social media and online health information use and should support patients’ use for self-management. Information literacy is paramount to critically evaluate online health information, guide patients to reliable sources, and use social media professionally. |
| Virtual & Augmented Reality (VR/AR) | VR training enhances knowledge in nursing education. VR/AR can be used as treatment tools or clinical interventions for pediatric and adult populations. | VR/AR can cause simulation sickness, including dizziness and visual disturbances. | Low-cost VR/AR devices and software should be developed by nurses and educators, integrated with existing digital technologies. Information literacy is needed to evaluate VR/AR applications, understand their limitations and benefits in education and patient care. |
This table, while not exhaustive, highlights the broad spectrum of digital technologies in nursing and underscores the profession’s recognition of both their value and associated challenges. To advance further, five key areas for focused action are recommended, keeping in mind regional contexts and professional diversity due to global variations in nursing and digital technology integration.
Five Key Actions for a Digitally Enabled Nursing Profession
To fully realize the potential of digital technologies and address the outlined challenges, nursing must prioritize continuous learning and adaptation through strategic actions focusing on education, leadership, research, and practice evolution. Information literacy serves as the bedrock for success across all these domains.
1. Reform Nursing Education for the Digital Age
Urgent action is needed to integrate informatics, digital health, co-design principles, implementation science, and data science into nursing curricula at both undergraduate and graduate levels. These educational reforms must include opportunities for interdisciplinary collaboration with computing, engineering, and other relevant fields. Developing a critical mass of nurses proficient in data science is essential to generate nursing knowledge that informs practice and to lead the development of innovative, technology-enabled patient care models. Furthermore, nursing education must proactively evolve competencies and curricula to address the increasing use of AI and other digital technologies in all practice areas. Incorporating novel pedagogical approaches, such as immersive VR/AR technologies for simulation-based education, is also crucial. The American Association of Colleges of Nursing’s inclusion of informatics, social media, and emergent technologies in core competencies for nursing education signals a positive step in this direction. This educational reform is fundamentally about fostering continuous learning and adaptation and building strong information literacy skills from the outset of a nurse’s career.
2. Cultivate Nursing Leadership in Digital Health
Nursing leadership at all levels must actively advocate for and invest resources in a profession that is both enhanced and expanded by digital technology. This requires championing and supporting nurses to become proficient in data analytics, virtual care models, and the co-design of digital solutions with patients, while acknowledging contextual and regional differences. Advancing leadership competencies in existing informatics technologies, such as CDSS, EHRs, and mHealth, is equally vital, especially as these systems increasingly incorporate AI functionalities. A critical mass of nursing leaders with a deep understanding of the opportunities and potential consequences of these technologies is paramount to ensure patient safety and care quality. The growing recognition of Chief Nursing Informatics Officers is a positive development. Furthermore, empowering nurses from all specialties to contribute to digital health policy development at local and national levels can drive greater digital technology adoption in nursing. Leadership development must emphasize continuous learning and adaptation and promote information literacy as core leadership competencies in the digital age.
3. Investigate Artificial Intelligence in Nursing Practice
The impact of AI on human decision-making and labor within nursing demands immediate and thorough investigation to guide practice in the coming decade and beyond. AI technologies hold immense potential for nursing in areas like data analytics and advanced CDSS. While the full benefits of AI in nursing (e.g., improved patient outcomes, workflow optimization) are still under investigation, its increasing integration into cognitive, decision-making, and potentially labor-related nursing functions is inevitable. These advancements present new practice considerations for nursing and interprofessional collaboration. For instance, the potential for AI systems to inadvertently perpetuate inequities and injustices within healthcare systems requires careful attention. The ethical, regulatory, legal, and policy implications of increased AI use are also crucial. Nursing must proactively examine its role, processes, and knowledge in light of emerging ethical frameworks for AI, advocating for patient involvement in AI development and application. The principles of AI development that prioritize public trust, public interest, and shared social responsibility, aiming to enhance human agency, societal capacities, and human dignity, as proposed by Floridi and colleagues, should guide the nursing profession’s approach to AI. Further research, funding, and thought leadership are needed to develop practice policies, regulatory frameworks, and ethical guidelines for AI in nursing practice. This necessitates nurses engaging in continuous learning and adaptation to understand AI, its ethical dimensions, and develop the information literacy to navigate its complexities.
4. Re-envision Nurse-Patient Relationships in a Digital World
Nursing must redefine how nurses interact with and care for patients in an increasingly digital environment. The proliferation of “do-it-yourself” health applications, mHealth, social media platforms, and virtual healthcare options empowers patients and reshapes their expectations. While seemingly at odds with traditional nurse-patient interactions, these digital modalities align with the growing demand for personalized, self-management healthcare models. To maximize its impact, nursing should continue to develop virtual care modalities leveraging internet and mobile technology, building upon telehealth experiences. These models can be further enhanced through VR/AR, smart home technologies, and personalized healthcare solutions utilizing genomic and biometric data. Care approaches, privacy considerations, and technological interoperability must be co-designed with interprofessional teams, patients, and carers, ensuring accessibility in both physical and digital realms. In-depth discussions and research are needed to address access, cost, resource utilization, and equity implications of digitalizing nurse-patient relationships. This evolution requires nurses to embrace continuous learning and adaptation to build new forms of therapeutic relationships in digital spaces and develop information literacy to guide patients in navigating the digital health landscape.
5. Embrace Digital Practice and Demand System Evolution
A cultural shift within nursing is essential. The profession, from individual members to leadership, must demand the evolution of digital systems to better meet contemporary and future needs. Too often, technology intended to support nursing is poorly designed, under-resourced, or not updated to reflect practice and societal trends. Nurses frequently encounter systems with poor usability, contributing to alert fatigue and inefficient workflows, or generating excessive documentation burdens due to inadequate configuration and optimization. Global disparities in access, integration, and sustainability of digital technology persist. Context-specific solutions are necessary. The heightened awareness of digital technology’s role during the COVID-19 pandemic provides a crucial impetus for change that nursing must seize. Tasks that do not significantly contribute to patient care should be re-evaluated, with potential for automation or delegation to other providers through technology-enabled processes. The profession should re-examine its perceptions of technologies like drones, robots, and AI systems, viewing them as complementary tools rather than competitors. Collaboration with technology developers, providers, and patients is vital for successful integration. While some outdated practices may be missed, digital technology offers opportunities to create innovative care models and evolve nursing practice. Cultural and historical interpretations of nursing should not hinder progress. Embracing digital practice necessitates a culture of continuous learning and adaptation, requiring nurses to develop information literacy to effectively utilize and advocate for better digital tools and systems.
Ensuring Nursing’s Continued Relevance
Nurses entering the profession today will undoubtedly witness significant digital disruption throughout their careers. Without proactive action, nursing risks missing a crucial opportunity to define new roles, generate new knowledge, and reshape relationships within future health systems and societies saturated with digital technologies. Nursing will remain invaluable to healthcare systems in the coming decades. However, to maintain relevance in digitally enabled societies and healthcare systems and continue to provide compassionate care in a digital world, the profession must strategically reflect on its role, knowledge base, and relationships with both technology and patients. Proactive self-reflection, planning, and action are essential for nursing to navigate the transformative journey from its past and present to a digitally driven future.
Key Recommendations for Digital Transformation in Nursing
- Accelerate the transformation to a digitally enabled nursing profession through investments in informatics education, research, and practice.
- Upskill nurses in data science and digital health to ensure emerging technologies like AI are developed responsibly and safely for nursing practice and patient care.
- Invest in and lead digital health developments, collaborating to create and deliver digital tools that patients and the public need.
- Champion informatics across all nursing practice areas, create leadership opportunities in digital health, and actively inform health policy in this domain.
By embracing continuous learning and adaptation and prioritizing information literacy, the nursing profession can confidently navigate the digital age, ensuring its continued relevance and leadership in providing compassionate and effective patient care in an increasingly technologically advanced healthcare landscape.
