how modern technology impacts critical thinking and nursing profession

How Technology Has Changed the Role of Nursing

As healthcare technology evolves, nurses serve on the front lines of applying the latest advancements to serve their patients with increasing efficiency and effectiveness. In fact, by 2017, more than 95% of all hospitals in the U.S. had adopted certified electronic medical record (EMR) systems.

Technology continues to shift the nursing field in many ways, with the pace of change expected to increase with time. Read on to find information on how this will take shape, whether nurses can expect to be replaced by technology, and recent advancements and trends in healthcare .

How Does Technology Affect Nursing?

Portable monitors give nurses the freedom to check on patients quickly, even when occupied with other tasks. The devices provide data on vitals, such as respiratory rates, electrocardiography, and oxygen levels. Nurses receive an alert if a patient needs urgent attention, which significantly reduces response times.

Medications

Nurses in most healthcare settings no longer need to “make rounds” to monitor patients’ IVs, as smart pumps allow for the more accurate and efficient administration of medication and fluids. Nurses use this technology to set how much each patient should receive, while alerts notify them of low levels, poor patient reactions, or issues with tubing.

Health Records

Through the use of EMRs, nurses and other medical professionals can quickly access critical patient information and reduce or eliminate the need for paperwork. EMRs give nurses current data that notifies them as a patient’s condition changes and whether a patient has allergies to certain medications.

Smart beds allow nurses to monitor patients weight, movement, and vitals, which can help prevent bedsores, injuries, and misdiagnoses. Technology-enhanced beds also reduce the amount of time nurses spend on adjusting equipment and supplies for safety reasons. In addition to hospitals, increasing numbers of nursing homes use smart beds.

Reduced Errors

Technology considerably reduces the likelihood of error in logging patient information like allergies to medications, medical history, and health conditions and illnesses. Apps make the administration of medication much less confusing or prone to human error. This, in turn, improves health outcomes and reduces hospital readmission rates.

Communication

Today’s nurses use team collaboration tools, instant messaging, and headsets that allow them to communicate with their colleagues in real time. These tools make coordinating care much easier, as they reduce the time required to access test results, along with identifying and diagnosing illnesses. Improved communication also provides for more efficient patient handover between departments.

Patients can increasingly access medical professionals, including nurses, from the comfort of their homes, thanks to mobile apps. Nurses advise patients on many health concerns, while patients update their own data to the apps so that medical professionals can best monitor their conditions and overall health on a regular basis.

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Can Nurses Be Replaced By Technology?

While technology poses no real risk of replacing nurses any time soon, nurses and all medical professionals will continue to incorporate ever-evolving technology into their daily routines. Nurses already commonly use EMR systems, wearable devices, and telemedicine to address their patients’ health needs.

Experts do not always agree on what the future of healthcare looks like, but nurses will continue to use machinery and artificial intelligence technology in ways that allow them to see more patients each day, administer medications more efficiently, and monitor conditions with complete confidence.

Recent Trends and Advancements in Nursing Careers

Technology continues to influence the nursing field and healthcare in some exciting ways.

For example, increasing numbers of hospitals have integrated what used to be multiple forms of communication into one streamlined system. Nurses wear headsets or badges that allow them to communicate with their colleagues in real time. These systems provide alerts in emergency situations and upload patient health data to EMR systems automatically.

Wearable technology allows nurses to scan barcodes on each patient’s bed to provide real-time data on vitals, medical history, medications, allergies, and test results. This allows for greater efficiency than the old method of filing, emailing, and charting patient information.

Hospitals also can now incorporate sensors and chips into mattresses, bedding, and blankets so that nurses and physicians can monitor patients’ movement, weight, blood pressure, and other key data. With time, this information can paint a fuller picture of a patient’s condition and progress.

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How Technology Is Changing the Nursing Industry

3 min read • February, 09 2024

From time-saving software to life-saving equipment, technology in nursing is essential to improving patient care and outcomes, encouraging nursing innovation, and promoting safety. Today's tech lets nurses streamline efficiencies, better manage workloads, and increase team communication. Best of all, nursing technology allows caregivers more quality time to interact with their patients and involve them in their care and treatment.

The Top New Technologies in Nursing

Nursing technology keeps getting better, with seemingly infinite application opportunities. Explore these technologies that are transforming the nursing industry to create higher-quality patient care and outcomes.

Electronic Health Records (EHRs)

With EHR systems universally replacing paper charts and records, nurses can access patient information in real time. This efficient data management tool reduces errors, streamlines documentation, and enhances communication among the health care team. One fast-growing field that utilizes EHR systems is nursing informatics, which uses technology and data to enhance patient care.

Portable Diagnostic Devices

From handheld vital sign monitors to portable EKG and ultrasound devices, nurses can conveniently and efficiently deliver on-the-spot care in various health care settings. These devices also empower patients to be more active in their treatment and health management from their homes. Self-monitoring lets patients strengthen communication and collaboration with their health care team.

Robotic Assistance

Robotic "colleagues" help ease nurses’ workloads , saving precious time, energy, and physical and mental strain. Cobots, or collaborative robots, perform repetitive tasks so nurses can focus on more pressing matters. They also assist with physically strenuous duties to reduce workplace injuries. Robotic carts can take over routine duties like transporting lab specimens, disposable equipment, and medications. There’s even artificial intelligence (AI) to draw blood.

Another new technology in nursing is eldercare robots. These bots assist older patients with various aspects of their daily care, such as mobility, monitoring, safety, and cognitive stimulation.

Electronic Medication Management Systems (EMMS)

EMMS is critical in streamlining medication management, reducing errors, and improving patient safety. The system includes functions for prescribing, administering, dispensing, reviewing, and disposing of medication. EMMS also decreases the risk of errors caused by illegible handwriting, incorrect orders, or dosing instructions.

Telehealth That Expands Possibilities for Care

The COVID-19 crisis accelerated the use of telehealth technology , and it continues to be instrumental in helping nurses reach patients outside the clinical setting. Those in remote areas or with limited mobility can receive medical consultations and follow-up care from home. Telehealth also lets caregivers remotely monitor patients with chronic conditions.

Improving Patient Care Through Technology

New nursing technology provides cost-effective solutions, enhances safety, improves patient outcomes , and offers a better work-life balance for nurses.

Let’s look at several ways technology impacts nursing practice.

• Technology streamlines communication. From HIPAA-compliant text messaging apps to standardized tools that correct miscommunications in patient handoffs, new communications tech helps nursing teams reduce fragmented care and make processes function more cohesively.
• Patients have better access to medical records . Patients have the right under federal law to access their medical records when requested. Having secure and current EHR software that’s simple and intuitive makes the delivery process seamless. It also empowers patients by giving them greater control over decisions regarding their health.
• Fewer barriers lead to greater health equity. According to the Centers for Disease Control and Prevention (CDC), individuals in remote areas of the U.S. are more likely to die prematurely from heart disease, cancer, and stroke. Telehealth can provide access to elderly and immunocompromised patients, and those with limited mobility or who live in remote regions.
• Less work demands decrease nurse burnout. Nurses spend up to one-third of their shift performing routine tasks like collecting supplies and picking up medications. Technologies like smart wearable sensors that collect patient data and electronic medication management systems that streamline processes can alleviate time-consuming responsibilities. These efficiencies let nurses focus on more critical tasks and quality patient time while reducing the risk of nurse burnout .

By embracing new technology in nursing as it emerges, caregivers can work more effectively to deliver the best patient care. It also plays a crucial role in easing the challenges nurses face regularly, reducing nurse fatigue and increasing overall quality of care.

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• Dec 29, 2023

The Future of Nursing Technology: Innovations Transforming Patient Care in 2024

As we step into 2024, the healthcare landscape is rapidly evolving, driven by remarkable technological advancements. These innovations are not just changing the way nurses work; they are transforming patient care, making it more efficient, personalized, and accessible. This article explores the cutting-edge technologies shaping the future of nursing and their impact on patient care.

The Rise of Telehealth

One of the most significant changes in recent years has been the widespread adoption of telehealth. The COVID-19 pandemic accelerated this trend, but its convenience and effectiveness have ensured its continued growth. Telehealth allows nurses to provide care remotely, using digital platforms to consult with patients, conduct assessments, and offer follow-up care. This technology has proven particularly beneficial in rural areas, where access to healthcare providers is limited. It also reduces the need for patients to travel, which is especially advantageous for those with mobility issues or chronic illnesses.

Artificial Intelligence (AI) in Nursing

AI is rapidly entering various aspects of healthcare, including nursing. AI-powered tools can analyze large datasets to help diagnose diseases, predict patient outcomes, and even identify patients at risk of certain conditions. AI is also used in robotic process automation to handle repetitive tasks, freeing nurses to focus more on patient care. Furthermore, AI-driven chatbots and virtual health assistants are becoming increasingly sophisticated, offering patients 24/7 support and guidance.

Wearable Health Technology

Wearable devices are not new, but their use in healthcare is reaching new heights. These devices can monitor a patient’s vital signs in real time, providing nurses with valuable data without requiring continuous, direct patient observation. This technology is instrumental in managing chronic conditions such as diabetes or heart disease, where constant monitoring can significantly improve patient outcomes.

Advanced Electronic Health Records (EHRs)

EHRs have evolved from simple digital versions of patient charts to comprehensive, interactive platforms. Modern EHRs can integrate data from various sources, including wearable devices, to provide a holistic view of the patient's health. They also use predictive analytics to alert nurses to potential issues, aiding in preventative care. Additionally, EHRs improve coordination among healthcare providers, ensuring that all team members are up-to-date with the patient’s status and care plan.

Virtual Reality (VR) and Augmented Reality (AR) in Training

VR and AR are changing the way nurses are trained, offering immersive and interactive experiences that traditional methods cannot match. These technologies can simulate real-life scenarios, allowing nurses to practice skills in a safe environment. This hands-on experience is invaluable, especially for high-risk or infrequently performed procedures.

The Internet of Medical Things (IoMT)

The IoMT refers to the interconnected system of medical devices and applications that communicate with healthcare IT systems. This includes everything from smart beds that can adjust themselves to optimize patient comfort to connected inhalers for asthma patients. IoMT devices provide nurses with real-time data, improving patient monitoring and enabling quicker responses to patient needs.

Blockchain in Healthcare

Blockchain technology, known for its use in cryptocurrencies, is also making its way into healthcare. It offers a secure way to store and share medical records, ensuring data integrity and patient privacy. Blockchain can streamline the sharing of medical records across providers, reducing errors and improving care coordination.

Personalized Medicine

Advancements in technology have made personalized medicine more feasible than ever. By analyzing a patient’s genetic makeup, lifestyle, and environmental factors, healthcare providers can tailor treatments specifically to the individual. This approach can be more effective and reduce the risk of adverse reactions, leading to better patient outcomes.

Challenges and Considerations

While these technologies offer incredible potential, there are challenges to consider. One of the main concerns is data privacy and security, especially with the increasing amount of sensitive patient information being stored and shared digitally. There is also the issue of accessibility, as not all patients may have the means or skills to use digital health tools. Additionally, there is a need for adequate training for nurses to use these new technologies effectively.

Preparing for the Future

Nursing education and training programs must evolve to leverage these technologies effectively. Nurses need to be equipped with clinical skills and a solid understanding of these technologies and how they can be applied in patient care. Continuous education and training will prepare nurses for this rapidly changing technological landscape.

The future of nursing technology looks promising, with innovations poised to revolutionize patient care. From telehealth to AI, wearable devices, and beyond, these advancements will enable nurses to provide more efficient, personalized, and effective care. However, to fully realize the benefits of these technologies, nurses must be prepared to adapt and continuously learn. As we embrace these changes, the potential to improve patient outcomes and transform healthcare is immense.

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Balancing care with technology

Garcia-Dia, Mary Joy DNP, RN, FAAN

Program Director, Nursing Informatics Information Technology Department, NewYork-Presbyterian, New York, N.Y.

Q How do we get back to the caring environment amidst the proliferation of technology within and outside of our healthcare delivery system?

The Future of Nursing report suggested that nurses will be called upon to fill expanding roles and master technologic tools and information systems. Nursing is an information-based profession, and technology helps bring information to the point of care to support nurses' decision-making processes. 1 A goal of informatics is to use technology to increase efficiency, make healthcare safer and more effective, and improve quality and outcomes. 2 As part of nursing practice, clinical decision support tools have been designed to improve regulatory compliance, such as incorporation of automated measurement tools, point-of-care alerts, links to evidence-based standards of care and clinical guidelines available within the electronic health record, and graphs depicting trending critical parameters.

Amidst these technologies, nurses can use the “head, hand, and heart” approach, which incorporates practical know-how with empathic understanding and technical knowledge to provide humane and sensitive care. 3 Practicing respect, actively listening, committing to taking the time to sit with patients, and establishing trust and transparency will balance the ubiquitous presence of technology while promoting safe, quality care. The theory of technologic competency as caring in nursing illuminates the coexistence of technology and caring with three key nursing processes: technology knowing (the competent use of technology in treating and caring for the patient as a coparticipant), mutual designing (the nurse and patient codesign a care plan), and participative engagement (shared activities in implementing the care plan and evaluating the patient's response and outcomes). 4

Nurse leaders have a dual role in promoting a vision that ensures the clinical perspective is front and center. As experts on the care environment, we can advocate on behalf of our nurses in guiding technology decisions that affect their workflow and patients. This entails being at the table and driving conversations with key stakeholders to understand how technologic tools impact communication, patient interactions, and workflow efficiencies. By engaging staff members through council meetings and listening to how nurses are adopting and using the right tools to reduce patient frustration and improve the care experience, we can provide important feedback for our technology partners. And by defining compassionate and caring behaviors in our education and training, we can mentor staff members in delivering high-tech, evidence-based care and foster a reflective practice that prepares nurses to competently cope with the inevitable change that technology brings.

This year we celebrate the Year of the Nurse and Midwife along with the 200th anniversary of Florence Nightingale's birth, whose use of patient data through observations and analysis to guide care paved the way for nursing informatics. Remember the reason why you became a nurse and share your caring stories on social media using #yearofthenurse.

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The Future of Nursing Informatics in a Digitally-Enabled World

• First Online: 05 January 2021

Cite this chapter

• Richard Booth 3 ,
• Gillian Strudwick 4 , 5 ,
• Josephine McMurray 6 ,
• Ryan Chan 3 ,
• Kendra Cotton 3 &
• Samantha Cooke 3  

Part of the book series: Health Informatics ((HI))

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11 Citations

The nursing profession has a history of embracing novel technologies that support the delivery of compassionate, person-centred care. The emergence and rapid adoption of ‘intelligent’ technologies that have the ability to act autonomously, but that are often embedded and ‘invisible’ to users, is challenging the nursing profession to reconsider their role in the health system of the future. Using a socio-technical lens the authors examine artificial intelligence and process automation technologies because of their significant potential to become much further embedded into nursing work and disrupt the healthcare system as we know it. Opportunities for nurses to transform their role in the healthcare value chain, will arise from the profession’s proactive reconceptualization of the nursing role in an era where technology is moving from discrete transaction processing and monitoring applications to pervasive computing. But the nurse’s traditional patient and family advocacy role will remain important, as policy, regulatory and ethical challenges arise from the development and use of these emergent digital technologies. The rapidly changing healthcare ecosystem demands nursing involvement in the research, design, adoption and use of emergent digital technologies. The subtle normalization of these technologies into the nursing role will require new nursing knowledge and skills, and different relationships between nurses (i.e., practice, education, research, leadership) and other actors (i.e. patients, physicians, technologies) in the healthcare ecosystem of the future.

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Technology that has the ability to perform actions or tasks (e.g., decision-making) which would normally require some degree of human intelligence

A term used to describe the extensive volume of both structured and unstructured data generated in the healthcare system

Robotics process automation that work in close collaboration with humans to complete shared tasks

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Factors impacting change and adaptation that the organization can try to influence but not control

Resistance to change

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An individual that provokes or supports transformative change within an organization

The phases of a specific process from beginning to conclusion, commonly reflecting software development or project management

An approach to options analysis by calculating the incremental impacts of change on cost and revenues

Graphical representation of the connection between concepts and ideas

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A security authentication with a high degree of confidence

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Non-repudiation of Origin, which documents evidence of origin of the message, and prevents denial of the message by the originating party

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Specific criteria that are measured at specific points in time to evaluate performance and/or change

Automation that reengineers processes to minimize human effort and increase both efficiency and productivity

Nightingale’s visualization depicting mortality causes

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Booth, R., Strudwick, G., McMurray, J., Chan, R., Cotton, K., Cooke, S. (2021). The Future of Nursing Informatics in a Digitally-Enabled World. In: Hussey, P., Kennedy, M.A. (eds) Introduction to Nursing Informatics. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-030-58740-6_16

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The Professional Nurse: Four Decades of Immense Change

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• 1 Author Affiliation : Director, Magnet Recognition Program®.
• PMID: 34910703
• DOI: 10.1097/NNA.0000000000001094

As one of the world's oldest occupations, nursing has seen, inspired, and innovated a host of changes. The evolution has been especially evident for the last 39 years. Since the 1980s, a growing focus on autonomy, research, and evidence-based practice has transformed nursing from a job to a profession. Concepts such as shared governance, interprofessional collaboration, and frontline engagement have transformed nurses from doctors' assistants to empowered and independent clinicians directly impacting patient outcomes and the healthcare environment. As the 30th anniversary of the American Nurses Credentialing Center comes to an end and the original Magnet® research celebrates a 39th birthday, we take a closer look at how the Magnet framework reflects these changes and how Magnet-designated organizations continue to advance nursing practice with innovation, knowledge, and leadership.

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How the nursing profession should adapt for a digital future

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• Richard G Booth , associate professor 1 ,
• Gillian Strudwick , scientist 2 ,
• Susan McBride , professor 3 ,
• Siobhán O’Connor , lecturer 4 ,
• Ana Laura Solano López , researcher 5
• 1 Arthur Labatt Family School of Nursing, Western University, London, Canada
• 2 Centre for Addiction and Mental Health, Toronto, Canada
• 3 School of Nursing, Texas Tech University Health Sciences Center, Lubbock, USA
• 4 School of Health in Social Science, University of Edinburgh, Edinburgh, UK
• 5 University of Costa Rica, San José, Costa Rica
• Correspondence to: R Booth rbooth6{at}uwo.ca

Transformation into a digitally enabled profession will maximize the benefits to patient care, write Richard Booth and colleagues

Digital technologies increasingly affect nursing globally. Examples include the growing presence of artificial intelligence (AI) and robotic systems; society’s reliance on mobile, internet, and social media; and increasing dependence on telehealth and other virtual models of care, particularly in response to the covid-19 pandemic.

Despite substantial advances to date, challenges in nursing’s use of digital technology persist. A perennial concern is that nurses have generally not kept pace with rapid changes in digital technologies and their impact on society. This limits the potential benefits they bring to nursing practice and patient care. To respond to these challenges and prepare for the future, nursing must begin immediate transformation into a digitally enabled profession that can respond to the complex global challenges facing health systems and society.

Many exemplars show how digital technologies already bring benefit to nursing practice and education. 1 For instance, telehealth programs where nurses provide daily monitoring, coaching, and triage of patients with several chronic diseases have helped reduce emergency department admissions. 2 Mobile devices, in particular smartphones and health applications, are enabling nurses to offer remote advice on pain management to adolescent patients with cancer 3 4 and supplement aspects of nursing education by providing innovative pedagogical solutions for content delivery and remote learning opportunities. 5

The development and application to nursing of systems based on AI are still in their infancy. But preliminary evidence suggests virtual chatbots could play a part in streamlining communication with patients, and robots could increase the emotional and social support patients receive from nurses, while acknowledging inherent challenges such as data privacy, ethics, and cost effectiveness. 6

Challenges persist

Digital technologies may, however, be viewed as a distraction from, or an unwelcome intrusion into, the hands-on caring role and therapeutic relationships that nurses have with patients and families. 7 This purported incompatibility with traditional nursing ideals, such as compassionate care, may explain some nurses’ reluctance to adopt digital approaches to healthcare. 8 9 In addition, nursing’s history was as structurally subordinate to other healthcare disciplines, 10 and the profession is still cementing its relationship and leadership in health systems.

The specialty of nursing informatics has long advocated for the integration of technology to support the profession, but it has comparatively few practitioners globally. Nursing informaticians are predominantly based in the United States, where the discipline seems to have originated, but many other countries and regions are expanding their digital nursing workforce and involvement with informatics. 11 12

Slow progress in some areas has been due to a lack of leadership and investment that supports nurses to champion and lead digital health initiatives. Globally, uncertainty remains regarding the next steps the nursing profession should take to increase and optimize its use of digital technology. This challenge is exacerbated by the global diversity of the profession, including unequal access to resources such as technological infrastructure maturity and expertise. Huge differences exist among countries and regions of the world in terms of the digitalization of healthcare processes, access to internet connectivity, and transparency of health information processes.

Selected technologies: benefits and challenges

The nursing literature contains many analyses of digital technologies used to support or extend the profession, including practice (eg, hospital information systems, electronic health records, monitoring systems, decision support, telehealth); education (eg, e-Learning, virtual reality, serious games); and, rehabilitative and personalized healthcare approaches (eg, assistive devices sensors, ambient assisted living). 1 T able 1 summarizes the potential benefits, challenges, and implications of emerging innovations to practice.

Benefits, challenges, and implications of selected digital technologies in nursing

• View inline

The table is not exhaustive, but the diversity of topics researched shows the profession recognizes the value and challenges of digital technologies. Given the evidence, for the profession to make further progress we recommend five areas for focused and immediate action. These recommendations should be qualified in light of regional context and professional background owing to global heterogeneity in nursing and the inclusion of digital technologies into healthcare.

Reform nursing education

We must urgently create educational opportunities at undergraduate and graduate levels in informatics, digital health, co-design, implementation science, and data science. 39 These should include opportunities to work with and learn from computing, engineering, and other interdisciplinary colleagues. For instance, nursing will need a critical mass of practitioners who understand how to use data science to inform the creation of nursing knowledge to support practice. 40 These practitioners will also need savviness and courage to lead the development of new models of patient care enabled by digital technologies. 41 42

Determining how, where, and why technology like AI should be used to support practice is of immediate interest and a growing competency requirement in health sciences and informatics education. 43 Nursing education should evolve its competencies and curriculums proactively for the increasing use of digital technologies in all areas of practice 39 while incorporating novel pedagogical approaches—for example, immersive technologies such as virtual and augmented reality—to deliver aspects of simulation based education. 44 45

Recently, the American Association of Colleges of Nursing released core competencies for nursing education, explicitly identifying informatics, social media, and emergent technologies and their impact on decision making and quality as critical to professional practice. 46

Build nursing leadership in digital health

All levels of nursing leadership must advocate more actively for, and invest resources in, a profession that is both complemented and extended by digital technology. The profession needs to evolve its use of digital technology by continuing to champion and support nurses to become knowledgeable in, and generate new scientific knowledge on, data analytics, virtual models of care, and the co-design of digital solutions with patients, differences across contexts and regions permitting.

Advancement of leadership competencies in existing informatics technologies, such as clinical decision support systems, electronic health records, and mobile technologies, is also essential: these kinds of systems will undoubtedly come with increasing levels of AI functionality. Possessing a critical mass of nursing leaders who understand the intended and unintended consequences as well as opportunities of these kinds of technologies is vital to ensure the quality and safety of nursing.

The increasing presence and recognition of the importance of chief nursing informatics officers is a step in the right direction. 47 Further, providing opportunities for nurses of all specialties to contribute to the development and implementation of digital health policies, locally and nationally, could increase future use of digital technologies in nursing.

Investigate artificial intelligence in nursing practice

The influence of AI on human decision making and labor are areas in need of immediate inquiry to support nursing practice for the next decade and beyond. AI technologies could provide the profession with huge benefits in data analytics and advanced clinical decision support.

Although many of the purported potential benefits of AI (eg, improved patient outcomes, streamlined workflow, improved efficiency) have yet to be fully shown in nursing research, 6 it is inevitable that AI technologies will be used more regularly to support and extend nurses’ cognitive, decision making, and potentially labor functions. 15

These opportunities bring new and dynamic practice considerations for nursing and interprofessional expertise. One example relates to the potential automation of inequity and injustice within systems and decision support tools containing AI 48 49 : self-evolving algorithms in systems sometimes unintentionally reinforce systemic inequities found in society.

Increased use of AI also brings novel policy, regulatory, legal, and ethical implications to the fore. The nursing profession must examine its role, processes, and knowledge against emerging ethical frameworks that explore the opportunities and risks that AI and similar innovations bring, while advocating for patient involvement in AI development and application. Floridi and colleagues offer tenets regarding AI development and the ethical considerations in using such innovations in their call to develop AI technology that “secures people’s trust, serves the public interest, and strengthens shared social responsibility.” 50 They also advocate that as guiding principles, AI should be used to enhance human agency, increase societal capacities, cultivate societal cohesion, and enable human self-realization, with an emphasis on instilling and reinforcing human dignity. 50 Further research, funding, and thought leadership in this domain are needed to help support the development of new practice policy, regulatory frameworks, and ethical guidelines to guide nursing practice.

Re-envision nurse-patient relationships

The profession must reframe how nurses interact with and care for patients in a digital world. The sheer variety of “do-it-yourself” health and wellness applications (eg, personalized genetic testing services, virtual mental health support), mobile and social media applications (eg, mHealth, wearables, online communities of practice) and other virtual healthcare (eg, telemedicine, virtual consultations) options available to consumers is impressive.

All this may seem antithetical toward the traditionally espoused nursing role—therapeutic relationships in physical interactions—but patients are increasingly empowered, connected to the internet, and demanding personalized or self-management healthcare models that fit their busy and varied lifestyles.

To maximize its impact on patient care, the profession should continue to develop virtual care modalities that exploit internet and mobile technology, drawing on its experiences with telehealth and remote models of care. 51 These care models might also be extended through virtual or augmented reality technologies or integrated with assisted living or “smart home” systems, 52 and potentially other precision and personalized healthcare solutions that leverage genomic and other biometric data.

Care approaches, interpretations of privacy, and technological interoperability functionalities should be co-designed among the interprofessional healthcare team, patients, and carers 53 and available where patients want them, ideally in both physical and digital realms. Deeper discussions and scientific research regarding access, cost, electronic resource use or wastage, and equity implications of the increasing digitalization of nurse-patient relationships will also need to be thoroughly explored.

Embrace digital practice

The profession requires a cultural shift. Its membership and leadership must demand the evolution of digital systems better to meet contemporary and emerging needs.

Too often, technology to support nursing is poorly configured, resourced, or not upgraded to respond to practice and societal trends. Nurses still commonly use practice systems that are lacking basic usability (eg, contributing to alert fatigue, reinforcing disruptive workflow processes) or generate added documentation burdens because of poor configuration and optimization. 54

There is huge variation globally in access to, integration of, and sustainability of digital technology. 55 56 57 Solutions vary and are context specific. Renewed awareness of digital technology’s use brought about by the covid-19 pandemic offers an impetus for change that nurses should embrace.

Tasks undertaken by nurses that do not add enough value to patient care present opportunities for partial or full divestment, 58 and may be better integrated into future technology enabled processes or delivered by other care providers.

The profession should revisit cultural interpretations of how technology such as drones, robots, and other AI enabled systems can be considered complementary to nursing practice and process, rather than as competition or adversaries. Collaboration with technology developers, providers, and patients will be essential to ensure success.

Although some outdated nursing activities and processes made redundant or less relevant will likely be missed by some in the profession, digital technology provides opportunities to support new models of care and approaches to nursing practice. We must not allow cultural and historical interpretations of nursing to upend or impede progress.

How nursing can stay relevant

Nurses entering the profession today will undoubtedly witness substantive disruption and change from digital technology by the time they are mid-career. 59 Without immediate action, the nursing profession stands to miss a remarkable opportunity to generate new roles, knowledge, and relationships within future health systems and societies saturated by digital technologies.

Nursing will continue to offer value and importance to healthcare systems in the coming decades. However, the profession must consider its role, knowledge, and relationships with technologies and patients to remain relevant in digitally enabled societies and healthcare systems and continue to provide compassionate care in a digital world. Without proactive strategic self-reflection, planning, and action, nursing will fail to control its trajectory across the chasm separating the past, present, and future of practice.

Key recommendations

Nursing must accelerate the transformation to a digitally enabled profession by investing in informatics education, research, and practice

Nurses should upskill in data science and other digital health topics to ensure emerging technologies such as AI are developed appropriately and safe for nursing practice and patient care

Nursing must invest in and lead digital health developments and collaborate with others to develop and deliver digital tools that patients and the public need

Nurses should champion informatics across all areas of professional practice, create leadership opportunities in digital health, and inform health policy in this area

Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

Provenance and peer review: Commissioned; not externally peer reviewed.

This article is part of a series commissioned by The BMJ for the World Innovation Summit for Health (WISH). The BMJ peer reviewed, edited, and made the decision to publish. The series, including open access fees, is funded by WISH.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

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2020: Emerging Technology in Global Nursing Care

Today, the global healthcare ecosystem begs for new processes, models, systems, and products that achieve the Quadruple Aim–to better manage populations, lower costs, and improve the patient and clinician experience (Bodenheimer & Sinsky, 2014). The nursing profession is enabling the achievement of these objectives by harnessing emerging technologies. Meeting these imperatives will not occur without nurses, as nurses are the largest group of practicing clinicians worldwide (Haddad & Toney-Butler, 2020) making them the most significant users of health technologies (Zadvinskis, et al.,, 2018). for patient care delivery.

With the distinguished honor of the World Health Organization deeming 2020 the Year of the Nurse and Midwife across the globe, it is time to take the perspective of nurses' care delivery now and how that will change in the future. Largely steeped in transforming healthcare and the global nursing profession is the tactical application of emerging technologies (Huston, 2013), those that eclipse electronic health record documentation and ordering systems, telehealth, smart devices, and mobile health. Emerging technologies beyond these now standard advances are taking over global health. This celebratory year is a perfect time to present evidence of the precise applications of emerging technologies in tactical care delivery and operations in all types of healthcare settings.

Emerging Technologies Impacting Global Health

In 2020, novel, intelligent, immersive, and connected technological advances have made their way into nursing care delivery settings globally. Due, in part, to globalization (Bradbury-Jones & Clark, 2017). stark illustrations of nurses who develop, champion, adopt, and apply emerging technologies to make better decisions at the point of care and support operations using these technologies have become a reality. These applications are rapidly occurring now, will continue, and are fortunately happening at a time when the need to improve global health outcomes is imperative. To meet this need, nurses are improving safe, quality care through the use of new technological innovations.

A change to optimize global health relies on nursing to improve the wellness of individuals, families, and communities, and to build a culture of health with the use of emerging technologies. The digital recognition of global social determinants of health (SDoH) (World Health Organization, 2018), improving the provision of effective, efficient, equitable, and accessible care across the care continuum using emerging technologies is happening now (Carroll, 2020). Nurses are committing to developing and putting novel technologies into practice to meet essential global health goals. Along with their unique and valuable knowledge and abilities to tackle these challenging health care objectives, nurses serve as crucial change agents in the creation and application of technological functionality that bridge the delivery of health care and social needs in both urban and rural communities. This trend will only increase in the next decade and beyond.

Emerging Technologies: The What and Why

Making waves in modern healthcare to achieve the Quadruple Aim across the globe requires groundbreaking technologies full of possibilities for nursing practice. These inventions may delay investors, end-users, and patients due to their unknown qualities and functionality. To demystify these transformative technologies, they are, in short, characterized as reasonable and consistent among the composition of people, institutions, and their patterns of relations that use them (Rotolo et al., 2015). They persist over time and have the potential to make a considerable impact on the socio-economic domains. Revolutionary technologies used in healthcare, are those that have radical novelty, fast growth, noticeable effect, and are uncertain and ambiguous.

What makes these emerging technologies different is their ability to fully penetrate society, which breaks down siloes and moves them into healthcare settings. Due to globalization, the mounting economic and social interdependence between countries that shift the patterns of health and disease (Bradbury-Jones & Clark, 2017) impacts global health. Those being health issues uncontained geographically that single countries cannot address alone. With this phenomenon, emerging technologies are now used across the globe to help nurses improve care delivery and operations, whether in highly evolved or underserved regions. The best use of intelligent, immersive, and connected technologies in nursing starts with innovations that are adaptable worldwide to improve global health outcomes.

Emerging Technology Applications in Global Nursing Care Settings

Patients and healthcare workers in developed countries benefit from the accessibility, and robust use of these technologies, particularly in rural settings and poverty-stricken nations, which leads to inequity as these emerging technologies are expensive and highly resource-driven (Wahl et al., 2018). However, the tide is changing. Emerging technologies, including Artificial Intelligence, Virtual Reality, and the Internet of Things, are steadily becoming available globally to nurses to optimize care delivery and routine operations critical to patient care worldwide.

Artificial intelligence (AI)

Artificial intelligence (AI) is the aptitude exhibited by smart machines through perceiving, thinking, planning, learning, and the ability to manipulate objects (National Institution for Transforming India (NITI) Aayog, 2018). This technology enables computer systems to perform tasks that usually require human intelligence (Pan, 2016). Clinical intelligence is the product of its use in healthcare (Health Information and Management Systems Society, 2018) as it enables more precise and expedited decision making, particularly for nurses (Simpson, 2012). AI used in nursing practice improves efficiencies and decreases low-value administrative tasks allowing nurses more valuable time to spend with patients in care settings (Carroll, 2019).

Application of AI in a nursing care setting. At the Massachusetts Institute of Medicine (MIT), nurses are using AI-driven robotics on a labor and delivery unit to help with resource allocation decision making such as bed management and nurse staffing. MIT’s robots use machine learning computer vision techniques to read the current status of the hospital unit using speech recognition. The robot receives feedback from the resource nurse, making auditory suggestions enabling nurses to consider the robot’s recommendations and put them into practice based on critical thinking (Gombolay, et al, 2018).

Virtual Reality (VR)

Newly used in healthcare and nursing practice settings, Virtual Reality (VR) is a technology that immerses and transports a patient into a ‘virtual world.’ (Ficarra, 2020). VR is a multi-sensory experience enabling a user to perceive being present in a simulated environment (Chirico et al., 2018). VR is an entirely imaginary digital experience, providing a realistic recreation of a three–dimensional environment experienced and controlled by the movement of the body (Ficarra, 2020). VR excludes the external (real-world) environment, and it resembles real-life interactions (Chirico et al., 2018; Chan et al., 2018). The computer-simulated environment is accessed through a head-mounted display (HMD) (Li et al., 2011) allowing patients to have a fully immersed, non–clinical, more comforting experience.

Application of VR in a nursing care setting. Nurses in the United Kingdom are using VR in burn units to decrease the traumatizing instances in patient wound dressing changes with excellent results (Furness, 2019). This revolutionary technology brings a better experience for both the patient and the nurse, through the use of distraction, to create a more comforting atmosphere in a highly stressful clinical environment.

Internet of Things (IoT)

The universal architecture of the Internet of Things (IoT) consists of sensors and mechanisms called things located at the data perception level, such as people, objects, and smart devices (Alqahtani, 2018). Technology developers place things on IoT–gateways and data acquisition systems, followed by a data center (or remote server) and then into the cloud (Edoh & Degila, 2019). IoT–enabled systems are sophisticated, embedded technologies for sensing, connecting, and processing that bring advanced applications and services in real-time and across geographies, particularly in healthcare and nursing care settings (Mieronkoski, et al, 2017).

Application of IoT in a nursing care setting. An IoT–based system is being used in India to transmit critical warning signs to nurses for expectant mothers at high-risk for fetal and maternal distress symptoms in rural areas of the country. A wearable device alerts nurses via the electronic medical record at the closest hospitals, allowing nurses to provide medical assistance to mothers by bringing them to hospitals to receive timely and critical maternal care (Garage Staff, 2018).

These applications provide clear evidence that nurses are on the cutting-edge of delivering care using revolutionary technologies and will continue to be in the coming years. Collectively, these everyday use cases show that despite the care setting, nurses do promote health and healing using emerging technologies. And the adoption in practice environments is a catalyst for changing roles that will evolve how nurses use emerging technologies to impact patient care in the future. In the year 2020, nurses are transforming global health practice by harnessing emerging technologies and are furthering innovation into the next phase of tackling critical healthcare challenges worldwide.

Education and Research

At the beginning of this century, finding actual nursing use cases and applications for novel technologies worldwide in the literature are still tricky. Much discussion still abounds about if and when using emerging technologies in nursing care will happen. In truth, healthcare organizations and public health systems are using emerging technologies, and it is imperative to bring this to light. More research, education, and documented evidence about nurses employing emerging technologies are urgently needed to advance nursing care delivery and the profession. Nurses charge is to study and create a narrative to share their experiences and wisdom to highlight and teach what they do with emerging technologies to make a case for further adoption and applications to achieve the Quadruple Aim. The continual use of these emerging technologies in nursing globally to advance and improve care delivery–in both highly-developed and underserved countries–depends on the disseminating knowledge about using innovations that impact nursing care delivery and improve patient experience and outcomes. There is no better time than during 2020, the Year of the Nurse and Midwife, to do so.

The views and opinions expressed in this blog or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.

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T., Fehily, O., Lindley S. A., & Thompson, A. R. (2019). Pain during wound dressings in burn care using virtual reality: A study of perceived impact and usability with patients and nurses. Journal of Burn Care & Research , 40 (6), 878–885. https://doi.org/10.1093/jbcr/irz106 Garage Staff. (2018, November). Using technology to fight maternal mortality worldwide. https://garage.ext.hp.com/us/en/impact/hp–wonder–project–maternal–mortality.html Gombolay, M., Yang, X. J., Hayes B., Seo N., Liu Z., Wadhwania, S., Yu, T., Shah, N., Golen, T., Shah, J. (2018). Robotic assistance in the coordination of patient care. The International Journal of Robotics Research, 37 (10), 1300–1316. DOI: https://doi.org/10.1177/0278364918778344 Haddad L. M., & Toney-Butler T. J. (2020). Nursing shortage. [Slide set]. Treasure Island, FL: StatPearls Publishing .   https://www.ncbi.nlm.nih.gov/books/NBK493175/ Health Information and Management Systems Society. (2018, December). 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Technology usage for teaching and learning in nursing education: An integrative review

Gopolang gause.

1 School of Nursing, Faculty of Health Sciences, North-West University, Mmabatho, South Africa

Isaac O. Mokgaola

Mahlasela a. rakhudu, associated data.

Data sharing is not applicable to this article because the study used data that are already in the public domain.

The increasing availability of technology devices or portable digital assistant devices continues to change the teaching-learning landscape, including technology-supported learning. Portable digital assistants and technology usage have become an integral part of teaching and learning nowadays. Cloud computing, which includes YouTube, Google Apps, Dropbox and Twitter, has become the reality of today’s teaching and learning and has noticeably improved higher education, including nursing education.

The aim of this integrative literature review was to explore and describe technology usage for teaching and learning in nursing education.

A five-step integrative review framework by Whittemore and Knafl was used to attain the objective of this study. The authors searched for both empirical and non-empirical articles from EBSCOhost (health information source and health science), ScienceDirect and African Journals Online Library databases to establish what is already known about the keywords. Key terms included in literature search were coronavirus disease 2019 ( COVID-19 ), digital learning, online learning, nursing, teaching and learning, and technology use.

Nineteen articles were selected for analysis. The themes that emerged from this review were (1) technology use in nursing education, (2) the manner in which technology is used in nursing education, (3) antecedents for technology use in nursing education, (4) advantages of technology use in nursing education, (5) disadvantages of technology use in nursing education and (6) technology use in nursing education amidst COVID-19.

Technology in nursing education is used in both clinical and classroom teaching to complement learning. However, there is still a gap in its acceptance despite its upward trend.

Contribution

The findings of this study contribute to the body of knowledge on the phenomenon of technology use for teaching and learning in nursing education.

Introduction

Technology devices, such as smartphones, have become the first and the last thing that human beings interact with on a daily basis (Alsayed, Bano & Alnajjar 2020 :244). Consequently, the authors add that this has created a strong bond between human beings and their technology devices (Alsayed et al. 2020 :244). The increasing availability of technology devices or portable digital assistant (PDA) devices continues to change the teaching-learning landscape, including but not limited to technology-supported learning (Forehand, Miller & Carter 2017 :51). The use of technology makes learning fun and exciting, and it cuts across all disciplines including nursing education (Forehand et al. 2017 :51). Technology usage in teaching and learning has risen to its peak recently given the current coronavirus disease 2019 (COVID-19) pandemic and its social distancing protocols. Higher education institutions including nursing education institutions globally have resorted to online learning to continue teaching and learning amidst COVID-19 pandemic.

Technology usage plays a vital role in the facilitation of learning in higher education institutions (Al-Hariri & Al-Hattami 2017 :84). Portable digital assistants and technology usage have become an integral part of contemporary teaching and learning (Hashim 2018 :2). The authors add that cloud computing, which includes YouTube, Google Apps, Dropbox and Twitter, has become the reality of today’s teaching and learning and has noticeably improved higher education, including nursing education. Similar to the context of this review, technology seems to be the backbone of teaching and learning wherein information searching, teaching and learning, and assessment are all reliant on technology. Students mainly use technology and technology devices for web browsing and class preparation and to document and record class proceedings for referral (Alsayed et al. 2020 :243). Several studies have highlighted the benefits of technology usage in nursing education that is associated with its exponential growth (MacKay, Anderson & Harding 2017 :3; Márquez-Hernández et al. 2020 :5; Subedi et al. 2020 :73).

According to Subedi et al. ( 2020 :73), technology use in teaching and learning is flexible, minimises travelling and thus is cost-effective, and it allows family time as classes can be attended at the comfort of one’s home. However, some perceive the home environment as disruptive and less conducive for teaching and learning. The benefits of technology usage in teaching and learning are not only limited to classroom setting or theoretical aspect of nursing education. In a study conducted by Mackay Anderson and Harding ( 2017 :3) and Márquez-Hernández et al. ( 2020 :5), students reported that technology and PDAs allow them to have access to a range of websites that enables them to make on-the-spot and sound clinical decisions when placed at clinical facilities for work-integrated learning (WIL). Furthermore, integration of technology usage with clinical settings has proven to be the driver of innovative ideas in making sound clinical decisions (DiMattio & Hudacek 2020 :4). Despite the notable benefits of technology use for teaching and learning in nursing education, there are still challenges that face this fast-growing modality of teaching and learning.

There are still nurse managers and educators who feel that technology usage in nursing education is disruptive, especially when used at clinical settings (Alsayed et al. 2020 :244). Some nurse educators prefer traditional teaching and learning than technology usage in teaching and learning (Al-Hariri & Al-Hattami 2017 :84). In addition, hardware and software issues, connectivity, security and safety of personal information, and lack of face-to-face interaction are some other challenges facing optimum use of technology in teaching and learning (Dhir et al. 2017 :875). Furthermore, non-proficiency regarding the use of Information and Communication Technology (ICT) and PDAs is also a challenge for technology usage in nursing education and also a factor contributing to its counterproductivity (Forehand et al. 2017 :51). This is seen mainly in students with little or no exposure to the use of computer during their basic schooling.

Integrative review question

What evidence exists on technology usage for teaching and learning in nursing education?

Design and methods

This study followed an integrative literature review design to explore and describe the existing evidence on technology usage for teaching and learning in nursing education. Integrative literature review design is described as a review method that aims to summarise theoretical or empirical evidence to generate a new understanding of a specific phenomenon or a healthcare problem (Broome as quoted in Whittemore & Knafl 2005 :546). As Chalmers et al. ( 2014 :156) put it, integrative reviews are important in ensuring that new primary research is generated from the full knowledge of the existing literature. Similar to this present review, researchers intend to generate new knowledge from the existing literature on technology usage for teaching and learning in nursing education. A five-step integrative literature review framework by Whittemore and Knafl ( 2005 :549) was used to attain the aim of this review. The steps are presented in Figure 1 .

Integrative review framework.

Step 1: Problem identification

Given the above background it is clear that a substantial amount of literature exists on the phenomenon in question. However, many of the studies conducted in subjects related to the use of technology in nursing education were conducted prior to COVID-19 pandemic, which necessitated the need for technology use in higher education including nursing education. Given the current impact of COVID-19 pandemic on teaching and learning in undergraduate nursing education, integrative literature review is mandatory in order to help nurse educators and researchers keep up-to-date with a large and rapidly growing body of evidence on technology use for teaching and learning in nursing education.

The purpose of this review was to explore and describe the evidence that exists on literature regarding technology usage for teaching and learning in nursing education. The variables in this review are technology usage and teaching and learning, and the population comprised articles retrieved from the initial search using the literature search strategy that is explained below.

Step 2: Literature search

The authors searched for both empirical and non-empirical articles from EBSCOhost (health information source and health science), ScienceDirect and African journals. According to Whittemore and Knafl ( 2005 :549), online databases have proved to be effective and efficient when coming to literature search stage of integrative review. The authors purposely chose the aforementioned online databases because of their potential to answer the review question as they publish health science-related articles. In addition, literature search was conducted only on electronic databases given the current risk of COVID-19 infection from contact with objects and surfaces. A Boolean search method was used to search for literature in the aforementioned databases using the following keywords: technology use, digital learning, online learning, nursing, and teaching and learning . Connecting words such as ‘and’ and ‘or’ were used to search for literature. For example, literature search was conducted as ‘“Technology use” or “Digital learning” or “Online learning”’. In order to enhance the literature search, synonyms such as e-learning for online learning and remote learning for digital learning were used to broaden the search of literature. The time frame was between 2016 and 2021. The rationale for including literature from 2016 was the fact that technology use has long been in the shores of nursing education. However, the authors acknowledge that the review was conducted in the COVID-19 era where technology use was at its peak. Therefore, the authors intended to explore and describe the evidence that exists on technology use in nursing education, without narrowing it to COVID-19, although acknowledging its impact on teaching-learning landscape. Specificity of literature search was ensured by the use of keywords that made the search specific to the aim of this integrative review. The use of synonyms and time frame ensured a comprehensive literature search. For each database, the authors applied filters such as ‘English’ and ‘full texts’ only to the retrieved articles in order to ensure that articles with a potential to answer the review question are subjected to screening process. An adapted PRISMA flow diagram from Stovold et al. ( 2014 :3) was then used to further screen the studies for their relevance and potential inclusion in this present review ( Figure 2 ). To ensure rigour, this integrative review was conducted under the supervision of experienced researchers.

PRISMA flow diagram.

Furthermore, Whittemore and Knafl ( 2005 :549) emphasise that sampling decisions such as keywords and search terms and inclusion and exclusion criteria must be rationalised and documented. Therefore, the rationale for the inclusion and exclusion criteria is described in Figure 3 .

Inclusion and exclusion criteria.

Step 3: Data evaluation

Nineteen articles were finally selected for inclusion in this review. The authors adapted the quality appraisal criteria by Kangasniemi, Pakkanen and Korhonen ( 2015 :1748) to appraise the quality of studies. Studies were appraised on four quality domains, namely, aims and objectives, study design, research methods and limitations. Studies were further evaluated on a three-point scale and were classed as ‘yes’, ‘poor’ or ‘not reported’ presented as ‘Y’, ‘P’ or ‘NR’, respectively ( Table 1 ). The choice of this quality appraisal tool was based on its track record as it was used by Kangasniemi et al. ( 2015 :1748) and later adapted by Moagi et al. ( 2021 :4) in their study, thus making the tool valid and reliable. However, articles were not excluded based on data evaluation. Most articles that were included in this present review followed quantitative approach wherein the researchers used surveys and questionnaires for data collection. This was followed by qualitative approach with interviews as their main method of data collection. The remaining articles followed mixed methods approach.

Quality appraisal of articles.

Source : Adapted from Kangasniemi, M., Pakkanen, P. & Korhonen, A., 2015, ‘Professional ethics in nursing: An integrative review’, Journal of Advanced Nursing 71(8), 1744–1757. https://doi.org/10.1111/jan.12619

vSIM, virtual simulation; ODL, open distance learning; DUT, Durban University of Technology; OL, online learning.

Step 4: Data analysis

Articles were analysed independently by the authors following six steps of thematic analysis, namely, familiarisation, coding, generating themes, reviewing themes, defining and naming themes, and writing up. Firstly, the authors went through included articles before analysis. Secondly, the authors highlighted phrases of the texts which described the content of such texts. Thirdly, themes were then generated from the pattern of the codes which were identified in the literature. Fourthly, the authors checked the accuracy of the themes to ensure that they are a true representation of the included studies. Fifthly, the authors labelled each theme, and this was succeeded by the sixth step which is writing up. An inductive approach of thematic analysis was used. This implies that the authors allowed data to generate themes as explained earlier. As six themes emerged: (1) technology use in nursing education, (2) the manner in which technology is used in nursing education, (3) antecedents for technology use in nursing education, (4) advantages of technology use in nursing education, (5) disadvantages of technology use in nursing education and (6) technology use in nursing education amidst COVID-19.

Ethical considerations

Ethical clearance to conduct this study was obtained from the North-West University Health Research Ethics Committee (NWU-HREC) (number: NWU-02071-20-A1). Ethical standards for conducting the research were followed in this article, even though it was a review and not conducted with human, plant or animal participants. Studies that had ethical approval were included.

Step 5: Data presentation

In this section, the authors outline and discuss the results of this integrative review.

The key results of this integrative review are described in this section under the following themes: (1) technology use in nursing education, (2) the manner in which technology is used in nursing education, (3) antecedents for technology use in nursing education, (4) advantages of technology use in nursing education, (5) disadvantages of technology use in nursing education and (6) technology use in nursing education amidst COVID-19. The results of this study included surrogate terms for technology usage for teaching and learning, such as ‘online learning’, ‘technology use in teaching and learning’, ‘e-learning’ and ‘virtual learning’.

Theme 1: Technology use in nursing education

The first theme discusses the frequency of technology use for teaching and learning in both classroom and clinical nursing education.

Information and communication literacy, information systems management and citizen digital health literacy are amongst the individual descriptors of learning that students should achieve in each of the key areas (O’Connor & LaRue 2021 :3). This implies that digital literacy is amongst the critical cross-fields for every graduate. As a result, the increase in the number of people who use computerised devices such as smartphones is relatively proportional to the amount of time spent on these devices (Zarandona et al. 2019 :70). For the students belonging to the millennial generation, technology devices have become the important tool for interaction (Willemse et al. 2019 :72). This is no exception in nursing education wherein the use of technology devices both in the class and in clinical placements is an order of the day. The use of mobile applications (apps) in nursing education has been ranked top in comparison to peer learning and clinical placement coordinators (O’Connor & Andrews 2018 :174). The authors further highlighted that an upward trend in technology use for teaching and learning continues to be noticed, especially in clinical nursing education.

Theme 2: Manner in which technology is used in nursing education

This theme discusses the manner in which technology is used for teaching and learning both in clinical and classroom settings.

Manner in which technology is used in classroom nursing education

According to Harerimana and Mtshali ( 2019 :6), technology in nursing education is primarily used for communication of instructions to the students to enhance their creativity and critical thinking skills and also for building relationships with stakeholders in nursing education. The authors add that technology in nursing education is used to maintain student attention in the classroom and to corroborate theoretical learning through the use of audio virtual aids. Teaching and learning in classroom is achieved through the use of mediums such as Microsoft Teams, Skype and Zoom together with a range of available social media platforms. Using those mediums, teaching and learning is then facilitated either synchronously or asynchronously through the use of PowerPoint presentations, didactic lectures, video-based learning, case-based learning, prerecorded lectures, quizzes or online whiteboards (Singh et al. 2021 :4). Moreover, technology in classroom nursing education can also be used to manage academic dishonesty through the use of software such as Turnitin (Harerimana & Mtshali 2019 :9).

Manner in which technology is used in clinical nursing education

Technology use in clinical teaching can be split into two entities which are interlinked, namely, the clinical placement for WIL and simulation lab. Generally, there has been a notable increase in the use of technology applications for teaching and learning in clinical nursing education of late (O’Connor & Andrews 2018 :174). According to O’Connor and Andrews ( 2018 :174) and Zarandona et al. ( 2019 :69), the most common uses of technology at the clinical placement for WIL include the use of software to access applications such as calculators, drug reference guide, disease and disorder books, and medical dictionary. This allows students to get the comfort of accessing instant references in their pocket when they need to make clinical decisions. On the same breath, there is a fraction of students who have been reported to misuse technology at the clinical facilities. In their study, Zarandona et al. ( 2019 :69) found that about 23% of participants admitted to having used technology for their own personal gain whilst at the clinical services, whereas 98% admitted that they begin with accessing their social media prior to university resources. Consequently, some nurses at the clinical facilities for WIL perceive technology use by nursing students at the clinical services as unprofessional (Willemse et al. 2019 :72).

The above perception by nurses at WIL facilities is different from that of nurse educators at institutions of higher learning or simulation lab. There seems to be an increasing interest by nurse educators and students to adopt technology use in teaching and learning in simulation lab (Foronda et al. 2016 :131; Van Vuuren et al. 2018 :16). Virtual online learning platforms such as virtual reality have been incorporated into simulation lab to provide immersive learning experience for nursing students (Chang & Lai 2021 :5). A study by Van Vuuren et al. ( 2018 :15) demonstrated that the use of high-fidelity simulators contributes positively to the reduction of errors in nursing care, thus improving teaching and learning and prioritising patient safety. The use of technology in simulation lab was further reported to be user-friendly by students (Foronda et al. 2016 :131). However, successful implementation of technology use in nursing education heavily relies on cooperation by all stakeholders involved, such as institutional management, willingness by educators and willingness by students (Verkuyl & Mastrilli 2017 :45).

Theme 3: Antecedents for technology use in nursing education

For technology use in teaching and learning to be effective, there are several antecedents that need to be in place. In this theme, the antecedents or enablers of technology for teaching and learning are discussed.

Antecedents for technology use in classroom nursing education

As much as there are still challenges to adapt to technology use in nursing education, especially given the current COVID-19 pandemic, it remains a reality that nursing education is shifting to online rather than face-to-face platform. There are several enablers that need to be in place to achieve the goal of technology use in nursing education. Internet facilities, computer hardware and software, students and educator competence in computer and Internet usage are basic antecedents for the use of technology in teaching and learning (Singh et al. 2021 :2). On the same breath, senior management and ICT department support is equally an important antecedent for technology use in nursing education (Mackay et al. 2017 :03). This is supported by Coopasami et al. ( 2017 :304) who found that psychological readiness, technological readiness and equipment readiness play a critical role as enablers of technology use in nursing education. Therefore, it can be summed up that simply owning a smartphone or a computer with access to Internet does not imply that one is ready for technology use for teaching and learning; readiness goes beyond equipment readiness as it also includes psychological and technological readiness.

Theme 4: Advantages of technology use in nursing education

There are several studies that have reported the advantages of technology usage in nursing education (Barisone et al. 2019 :59; Mackay et al. 2017 :3; Toothaker 2018 :82). This theme explores the advantages of technology use in nursing education concurrently with its benefits.

Advantages of technology use in classroom nursing education

According to Coopasami et al. ( 2017 :305), the use of technology in nursing education is one of the facilitators of self-directed and life-long learning, which are amongst the critical cross-field outcomes. In addition, in a study conducted by Maboe ( 2017 :225), about 40% of the respondents agreed that online discussion forums allowed them to study with their peers, whereas 20% of the respondents reported receiving no support from facilitators when engaged in online learning. This can be substantiated by the fact that when using technology for teaching and learning, tasks are usually completed at their own time and pace and that facilitates learner independence. As Uprichard ( 2020 :272) and Coopasami et al. ( 2017 :305) suggest, the one clear benefit of technology usage in teaching and learning is its flexibility of the location and time when completing tasks. This implies that teaching and learning can happen at any time when either party is at the comfortable location because it is neither time nor space bound.

Advantages of technology use in clinical nursing education

In clinical nursing education, the use of technology has risen recently at an alarming rate (O’Connor & Andrews 2018 :174). The use of applications, such as virtual reality and virtual patients, is perceived to be convenient, speed up the skills learning process and create a stress-free learning environment (Chang & Lai 2021 :5). However, at times, nurse educators find it hard to get relevant audio virtual materials to support learning of such clinical skills (Barisone et al. 2019 :58). Thus, equipping nurses with technological skill through the use of technology in clinical nursing education can go a long way in improving the marketability of nursing. This is vital as many nursing education institutions and health establishments are slowly going green and require technological skills in their potential incumbents.

Theme 5: Disadvantages of technology usage in nursing education

This theme discusses the disadvantages of technology use in both clinical and classroom nursing education. The disadvantages are discussed concurrently with the challenges.

Disadvantages and challenges of technology use in classroom nursing education

The shift to virtual approach of teaching and learning from traditional teaching overnight amidst COVID-19 lockdown regulations came as a huge challenge for many educational institutions to adapt to such sudden change. Network-related issues which include audio virtual disparities, interruption of sessions because of unexpected logging out from network and continuous buffering are amongst the challenges experienced when using technology for teaching and learning (Sigh et al. 2021 :2). Moreover, poor connectivity and technological illiteracy are also the challenges related to the use of technology for teaching and learning in nursing education (Suliman et al. 2021 :3; Uprichard 2020 :273). In addition, participants reported lack of time management between family responsibilities and online learning amongst married couples, which was seen as a disadvantage of technology use in classroom nursing education (Suliman et al. 2021 :4).

Disadvantages and challenges of technology use in clinical nursing education

As much as the use of technology in nursing education should not lose the unique potentiality of nurse–person relationship, it seems to be lacking human interaction (Uprichard 2020 :273). This is seen as a disadvantage when using technology for clinical nursing education, in a sense that, in the nursing profession, nurse–patient interaction and relation is vital as it plays a role in facilitating the tridomains of competence, namely, psychomotor, affect and cognitive. As a result, some clinical staff perceive the use of technology devices negatively; it is seen more as a social than an educational tool (Mackay et al. 2017 :3).

Theme 6: Technology use in nursing education amidst COVID-19

It is almost impossible to divorce technology use in nursing education with COVID-19 pandemic, especially in this era. This pandemic has indeed changed the teaching–learning landscape by navigating it to an abrupt online modality of teaching and learning, thus making technology use in nursing education unpopular and unfamiliar to nursing students because of a lack of preparation for its introduction (Oducado & Soriano 2021 :8). Although the main purpose for the shift to fully use technology for teaching and learning amidst the COVID-19 pandemic was mainly to safe the academic year, several researchers reported mainly on the challenges that were brought about the implementation of this modality of teaching and learning (Mawere et al. 2021 :53; Oducado & Soriano 2021 :8; Singh et al. 2021 :6). Such challenges included (1) the lack of training for both students and educators on technology-supported teaching and learning, (2) the lack of infrastructure that enables technology-supported teaching and learning and (3) the lack of devices that are necessary for technology-supported teaching and learning. The challenges were mainly owing to its abrupt introduction and the disparities that exist between the ‘haves’ and the ‘have-nots’. As Singh et al. ( 2021 :6) and Mawere et al. ( 2021 :53) put it, infrastructure for technology use for teaching and learning, including lack of capacity to use technology devices, is a huge challenge facing rural education institutions and disadvantaged students. Nevertheless, the upward trend of technology use remains in the shores of nursing education.

This integrative review offered a contemporarily updated evidence on technology usage for teaching and learning in nursing education. The findings of this integrative review indicated that there is a general adoption of technology usage for teaching and learning in higher learning institutions, although some challenges with regard to full adoption are still noted. This is evidenced by the recent upward trend in technology use for teaching and learning, especially given the current COVID-19 social distancing regulations. A study conducted by O’Connor and Andrews ( 2018 :174) concurs with the results of this review wherein they found that there is a notable upward trend in technology use for teaching and learning. Of the same importance is that this current review summarised evidence of the uses of technology in teaching and learning and its advantages.

The findings of this study further highlight that technology use in nursing education is not limited to classroom boundaries, but goes as far as clinical nursing education as well. Although their uses are different in those two components of nursing education, their aim is to corroborate or to complement each other. However, the acceptance of its use especially by nurses at the clinical facilities for WIL seems to be an issue till date. According to Willemse et al. ( 2019 :72), technology use at clinical facilities is perceived to be unprofessional. Zarandona et al. ( 2019 :69) stated that some students have been reported to be using technology devices for personal issues at least once when at practicals. However, there is no evidence supporting the connection between the negative perception of technology use by nurses and the seldom incorrect use of technology by student nurses.

Like any other approach in teaching and learning, there are disadvantages of technology use in teaching and learning. In this review, the disadvantages are discussed together with the challenges. Poor connectivity and interrupted sessions are amongst the challenges of technology use highlighted by a number of researchers (Maboe 2017 :226; Suliman et al. 2021 :3; Uprichard 2020 :273). Similarly, connectivity which leads to interrupted sessions seems to be an issue in the geographical context of the authors of this current review. In addition, the findings of this integrative review highlighted that some institutions have no capacity to offer technology-based nursing education because of lack of resources, which led to course extension for students. However, the common factor in the articles included in this review is that they were all conducted in urban areas with university students and educators as the study population.

Limitations of the study

The researchers used ‘technology use’ and ‘nursing education’ as search terms in this study, and there are other surrogate terms to these two terms used to search for literature. As a result, there is a likelihood that if a similar study can be conducted using surrogate terms like ‘health science education for nursing education’ and ‘e-learning for technology use’, it might yield different results. Secondly, the time frame in this study was set to the recent years (2016–2021), which can be a limitation also, given the fact that technology use in general has long been a burning issue given the fast approaching of Fourth Industrial Revolution. Lastly, the researchers focused on a discipline of nursing education in which if the context could be changed, it might yield different results.

The results of this integrative review showed that despite the few challenges and disadvantages reported with regard to technology use, its use continues to grow in an exponential way. Furthermore, the results showed that technology in nursing education is used in both clinical and classroom teaching to complement learning. However, there is still a gap in its acceptance despite its upward trend. To meet the demands of the Fourth Industrial Revolution and the upward trend of technology use amidst COVID-19 pandemic and possibly beyond, the authors of this study recommend that further studies should explore the acceptance of technology use by educators and students in nursing education. Also, further research is recommended on students’ and educators’ attitude towards technology use for teaching and learning in nursing education.

Acknowledgements

The authors acknowledge all authors of the data sources that were used in compiling this integrative review. The authors of data sources used in this article are acknowledged both in-text and in the reference list.

Competing interests

The authors have declared that no competing interests exist.

Authors’ contributions

All authors contributed equally to this article, from the conceptualisation until the completion of the final manuscript.

Funding information

This study was funded by the North-West University postgraduate bursary.

Data availability

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of any affiliated agency of the authors.

How to cite this article: Gause, G., Mokgaola, I.O. & Rakhudu, M.A., 2022, ‘Technology usage for teaching and learning in nursing education: An integrative review’, Curationis 45(1), a2261. https://doi.org/10.4102/curationis.v45i1.2261

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Seven Nursing Technologies Transforming Patient Care

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From pizza ordering to financial security, new technology is changing the way we live our lives every day. And now more than ever before, new technology is finding ways to impact the healthcare industry.

A new survey of over 600 professional nurses found that 82% agree that new technology and equipment innovation will positively impact patient care.

How Do Nursing Technologies Help Patients?

As more of the population ages, as life expectancy increases, and as the nursing shortage continues, these new medical technologies are crucial for continued patient care and the healthcare system at large. New medical technologies can make life easier for medical professionals and patients alike. Certain technologies can make patient care easier and more efficient for the doctors and nurses who manage a large patient load. They can also assist patients in getting the care they need with more convenient and accessible options.

The nursing profession finds many of these new medical technologies help them with routine processes, as well as decrease human mistakes and errors that can come from too few nurses who are working long hours with too many patients.

While nurses agree that new healthcare technology and innovative medical devices can help them, they also agree that technology shouldn’t replace day-to-day human interactions. Working directly with patients is a huge element of healthcare, and nurses provide a crucial element of interaction that allows patients to feel at ease.

Working with families, explaining procedures, and helping to take a patient’s mind off their sickness are all part of nursing jobs. Many healthcare professionals worry that increased healthcare technology could try to remove that human element. Unlike in other sectors, healthcare’s human interaction is crucial for patient success. It’s critical to find the right balance between technology and the human nuances that make nursing and healthcare successful.

Professionals also largely agree there shouldn’t be an overreliance on healthcare software and technology, and that human eyes on both symptoms and needs should be as important as what healthcare technology is saying. While technological advancements aren’t a cure-all as healthcare solutions, new technology is changing the way nurses work in positive ways.

There are seven stand-out technologies transforming medical care. As nurses are educated about new medical technologies and practices, patients and providers benefit.

So, what nursing technologies are being used?

1. Automated IV Pumps

Automated IV pumps control the dosages and drips given to patients. Software and medical tech allows nurses to change the drip amounts and medication doses so patients aren’t waiting for changes. There are IV pumps for nutrition that give needed meals at the right times. Additionally, there are self-pumps that allow patients to increase a controlled amount of pain medication for themselves.

Automated IV pumps help speed up nursing processes and can be crucial if there is a need for immediate adjustment. Changing medication through an automated process also removes elements of human error that could present issues for clinical patients and hospitals.

Automated IV kits give nurses opportunities to focus on other areas of work, instead of having to measure and give medication or food. Hospitals all have different kinds of automated IV pumps, so training and education is often based on the specific hospital or clinic where nurses work.

Additionally, many nursing schools give training and information on new software and technology, including how automated IV pumps work and why they’re valuable.

2. Portable Monitors

Portable monitor equipment allows nursing professionals to check on patients, even if they’re on the move or busy helping someone else. Portable devices monitor vital signs like ECG, respiratory rates, and oxygen saturations while transmitting the information back to a central monitor. This means that nurses will get an alarm notification if there’s an emergency.

Most hospitals have nurses check levels hourly. Portable monitoring technology allows nurses to track and note stats at the right time, even if there are a lot of other things going on. This helps them constantly monitor patients from anywhere in the hospital. The alerts and alarms sent to nurses through the portable monitor can save lives.

Nurses learn at their specific hospital how to utilize portable monitors, and nursing schools help teach students the value and general use of many common pieces of equipment.

3. Smart Beds

Smart bed technology can help nurses track movement, weight, and even vitals. Smart beds also play a major role in keeping patients safe and comfortable during a long hospital stay. With the number of falls and patient injuries inside hospitals, smart beds are very important for patient safety.

Smart bed technology gives nurses a constant in-room monitor that provides them with regular updates and communications on a patient’s activities. It can also help them identify patterns, which can lead to a new diagnosis or a different understanding of a condition.

Nurses also spend less time coming in and adjusting supplies and medical equipment for comfort or safety because they can help control that with their smart bed. It allows providers to get back to other important work that only humans can do.

4. Wearable Devices

Wearable devices and mobile apps are transforming the healthcare industry. Devices that help track heart rates, exercise, sleep, respiration, and more are helping people take their health into their own hands.

With increased accessibility to iPhones, nurses also benefit from apps and devices that help them care for patients. For example, the Steth IO smartphone stethoscope is essentially a stethoscope app that allows nurses and doctors to simply use their smartphone to get breathing sounds and see heart rates. Using a phone can be less intimidating—especially for younger patients—and gives providers a full range of information and easy tracking of medical needs.

Wearable devices from health tracking to specific patient monitoring are often called the future of healthcare. With access to huge amounts of data, wearable devices can help the entire healthcare process, from diagnosis to recovery.

They also help remove elements of human error for nurses because the communication of data comes directly from the device itself. It allows for faster record keeping and helps patients and nurses maintain consistent monitoring of health.

Wearable devices from health tracking, to specific patient monitoring, are often called the future of healthcare. With access to huge amounts of data, wearable devices can help the entire healthcare process; from diagnosis to recovery.

Wearable devices help remove elements of human error for nurses, because the communication of data comes directly from the device itself. It allows for faster record keeping, and helps patients and nurses maintain consistent monitoring of health.

5. Electronic Health Records

Electronic Health Records (EHR) are replacing older paper filing methods. Electronic Health Records allow nursing experts to document care provided to patients and retrieve information that can help prioritize care. Additionally, information entered into computer systems can then be accessed by the care team, including doctors and even patients themselves when necessary.

While security continues to be a concern for Electronic Health Records, HIPAA laws ensure security and privacy of electronic records are maintained by healthcare organizations, and new technology like blockchain and cryptography are easing privacy concerns.

EHRs can tell registered nurses (RNs) whether there are further steps they need to take for a patient, monitor small condition changes, and give them information immediately as alerts or reminders.

Real-time health updates impact the speed and accuracy of medical care. RNs learn how to use software systems on the job, but their education and training will help them quickly understand what different indications on medical records mean and what their course of action should be to ensure improved patient outcomes.

6. Centralized Command Centers

One of the newest ideas for hospitals, centralized command centers promise improved patient experiences and better ways for RNs and doctors to manage supplies, clinical technology, and capacity. This is done through software applications such as dashboards that provide real-time updates.

With shorter or non-existent delays between transitions of care, nurses and doctors can actively be aware of room availability, OR schedules, and what individual patients still need before being discharged. This allows everyone to do their job more efficiently and help patients more effectively.

Specifically designed for capacity management, command centers are performing well around the country. Many hospitals report operating at higher capacity with overall improved patient experiences.

7. Telehealth and Apps

Telehealth is a valuable, newer element in healthcare. Hospitals and clinics allow patients to virtually video chat with a doctor or nurse to describe their symptoms or show doctors things like rashes or bumps. This helps patients with a quick diagnosis without leaving the comfort of their own home. They can find out if they need to come in for further testing or diagnosis, get a prescription for medicine, or get medical advice.

Telehealth saves both patients and doctors money and time. Similarly, it prevents sick patients from coming to public places and exposing other patients. This technology is changing the way clinics operate and how patients are cared for.

Similarly, medical apps and wearables help patients and doctors work to improve health. Doctors and nurses can monitor vital signs of patients without them being in the office. They can be utilized for overall health and wellness, or for specific medical concerns such as seizures or diabetes. Apps can also help patients understand when they should call a doctor and when a simple over-the-counter medication could help. This again conserves resources in clinics and helps patients save time and frustration.

Apps can also help address mental health issues. Mindfulness apps help individuals understand their mental health and energy and remind them to take time for these important aspects of wellness.

Increasing app and telehealth technology gives doctors, nurses, and patients themselves more control over their health.

Nursing Education

New clinical healthcare technology is exciting and transformative, with innovations launching every day that impact the industry. This can present a challenge to nurses who are tasked with learning about this new technology and implementing it into their work lives—not to mention, how this can impact their career advancement.

With the advancements of new technology in the healthcare industry, it’s crucial for nurses to keep abreast of these innovations and elevate their capabilities to match what both patients and the industry require for exceptional care. Education is key to navigating these new waters.

Whether you’re already an RN and looking to advance your career , or you’re transitioning into a nursing position and need the educational support to make your career leap, working with an online university such as WGU can help you get the training you need with flexible coursework that can fit in with your busy schedule. Not only can furthering your education help you become more comfortable in managing the technological needs of the advancing healthcare industry, but you can also learn to prepare yourself for future advancements and innovations that may impact your role as a nurse.

As the healthcare industry continues to change with the support of new technology, nurses can change right along with it—and elevate patient care in the process.

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