Implications for practice and research

• Actively including nurses in developing and implementing generative artificial intelligence-based technologies and emerging digital platforms can enhance their work motivation, engagement, satisfaction and patient care and safety.

• Receptive and embracing technology implementation in healthcare settings requires addressing challenges and enhancing opportunities for nurse-patient interaction.

Context

New technology, such as interactive electronic medical record systems, is widely embedded in healthcare settings and impacts nurses’ day-to-day functioning. Adapting to emerging technologies requires a degree of readiness, preparedness and comfort. Nurses must be deeply engaged expert users to employ new technologies in healthcare systems successfully. However, we do not know in what contexts a successful implementation of new technologies is employed, how it influences nurses’ workflow, and what works (or not) for nurses’ engagement, motivation, and satisfaction, which Jedwab et al 1 theorised using the current realist review.

Findings

Ten studies were conducted in hospitals, community and residential facilities in the USA, Canada, Finland, Taiwan and the Netherlands. Seven studies included nurses’ pre-technology and post-technology implementation assessment of their work-related motivation, engagement and satisfaction, while the rest only included post-technology implementation assessment data. Nurses had greater work-related motivation, engagement and satisfaction when they had more autonomy with the shared decision-making of the implementation of new technologies, provided sufficient resources and support to implement, and the implementation resulted in a positive experience for nurses and their patient care and safety. Nurse-engaged implementation of technology that did not consume nurses’ time and resources, such as double-charting, away from nurse–patient interaction, was more satisfactory for nurses.

Commentary

Developing, implementing and updating technology are central to healthcare systems. Jedwab et al synthesised nine theories to explain how emerging technology influences nurses’ personal and professional well-being and their workflow. The authors conducted a realist review to comprehensively explore the contexts and mechanisms of implementing technology in healthcare systems and what outcomes it renders for nurses’ work-related motivation, engagement, satisfaction and well-being.

Jedwab et al highlighted two contexts conducive to a receptive implementation of technology in healthcare systems: ‘pre-implementation’ and ‘use of new technology’. In the ‘pre-implementation’ context, providing relevance of new technology to practise and helping nurses understand the necessary rationale and build knowledge and skills to use technology enabled nurses with positive attitudes to intrinsically engage and build a set of competencies to employ new technology. In the context of the ‘use of new technology’, the authors emphasised that the implementation of technology may pose a risk of reduced patient–nurse interaction related to inefficiencies such as lack of hardware or software support, increased workload of hybrid workflow management or a need of double-charting of nursing communication. To provide safe and competent care, it is essential to implement and update the emerging technology while understanding and addressing the possible negative impacts of new technology in healthcare settings.

New developments, such as generative artificial intelligence-based digital platforms and their adaptation in healthcare settings, likely integrate deeply across healthcare contexts.4 Nurses, as frontline healthcare knowledge workers, may encounter unique challenges and opportunities to adapt to generative technologies and use them to improve patient and self-care while meeting the emerging challenges it may pose. Providing technology and digital platforms training is vital for nurses to engage in the evolving technology. Moreover, nurses have valuable patient care insights and can meaningfully contribute to developing and embracing receptive and relevant technology for healthcare settings.5 More research is needed to explore how nurses perceive, adapt and use emerging technologies at work and how that impacts their professional and personal well-being.