Issues affecting nurses' capability to use digital technology at work: An integrative review

Abstract

Background. Digital capability, that is the ability to live, work, participate and thrive in a digital world, is imperative for nurses because increasingly nurses' work and patient outcomes are influenced by technology.Aim. To evaluate and synthesise the evidence regarding the development of digital capability in nurses and the strategies that support effective integration of digital skills into the workplace.Design. Whittemore and Knafl's methodology, following the preferred reporting items for systematic reviews (PRISMA) guidelines. Data sources. CINAHL, Embase, PsychINFO, Medline (Ovid) and Pubmed databases were searched for articles published in English from 2008-2019. Search terms included; digital capabil*, digital literacy, informatics, nursing informatics, health informatics, nurs*, knowledge, knowledge integration, competency, continuing education, nursing skills, workplace, work environment. Review methods. A total of 35 studies were retrieved for quality assessment by two reviewers using standardized critical appraisal instruments from the Joanna Briggs Institute (JBI-MAStARI and JBI-QARI). Minimum essential criteria and scores were agreed prior to appraisal.Results. The 17 studies included comprised quantitative (n=7), qualitative (n=8) and mixed methods (n=2). Integration of digital capability in nurses' workplaces is dependent on user proficiency and competence (theme 1). Nurses use technology to access data at the point of care, specifically accessing evidence to guide care (theme 2a) as well as accessing the medical records (theme 2b). Nurses have several concerns related to the use of technology at point of care (theme 3), some of which can be resolved through investment for implementation (theme 4).Conclusions. There are key attributes of digitally proficient nurses. Nurses with these attributes are more inclined to use digital technology in their work. Involvement of the nurses as end users in the development of digital systems to ensure they are fit for purpose, alongside investment in professional development opportunities for nurses to develop digital capability, should be prioritised.

Now more than ever, nurses need to be involved in technology design: lessons from the COVID‐19 pandemic

“…The perspective of nurses in technology development has traditionally been absent for a number of reasons: the prioritisation of cost over functionality, an ill‐conceived understanding that nurses are resistant to change, and a lack of encouragement from organisational leaders (Hamer & Cipriano, 2013). This has led to downstream effects, such as significant interruptions in provider workflow and the subsequent necessity for workarounds (Brown et al, 2020; Koppel et al, 2008). A relevant example of the impact of poor technological design on patient care is the use of barcode medication administration (BCMA), which purports to reduce medication errors and improve patient safety.…”

“…COVID‐19 is rapidly increasing our reliance on technology in health care (King, 2020; Morris, 2020; Weiss et al, 2020) and strong nursing leadership is needed to shift the organisational culture of healthcare institutions to ensure that nurses are provided opportunities to share their perspectives on the functionality and interoperability of all implemented technologies (Brown et al, 2020; Hamer & Cipriano, 2013; Kelly et al, 2016). Nursing leaders within institutions can create structured opportunities that allow for collaboration between technology developers and nursing staff through product development and user testing to increase the usability of healthcare technologies.…”

“…Nurses understand the demands that are being placed on healthcare staff on the frontlines of the COVID-19 pandemic, as well as the intricacies of patient populations, infection control practices, and the organisational structure of hospital units; all of which are important considerations that should inform the innovation process of technological systems from idea generation and mobilisation, to diffusion and implementation (Eley et al, 2009;Mariello, 2007). COVID-19 is rapidly increasing our reliance on technology in health care (King, 2020;Morris, 2020; and strong nursing leadership is needed to shift the organisational culture of healthcare institutions to ensure that nurses are provided opportunities to share their perspectives on the functionality and interoperability of all implemented technologies (Brown et al, 2020;Hamer & Cipriano, 2013;Kelly et al, 2016). Nursing leaders within institutions can create structured opportunities that allow for collaboration between technology developers and nursing staff through product development and user testing to increase the usability of healthcare technologies.…”

Polish Nurses’ Attitude to e-Health Solutions and Self-Assessment of Their IT Competence

“…In private life, the most frequently used electronic device is a smartphone (81.7%) and a computer (72.3%) at work. For many years, the health sector in many countries has been undergoing the process of digitization, and tele-medicine and tele-nursing successfully play a strategic role in many areas of patient care [ 24 , 25 ]. The nurses as a profession are more and more visible on the web, not only using electronic devices, providing services to their patients, but also participating in training, conferences, and internet fora.…”

How the nursing profession should adapt for a digital future

“…There is huge variation globally in access to, integration of, and sustainability of digital technology 555657. Solutions vary and are context specific.…”