影响数字护理技术实施与应用的因素：系统综合评价

Factors Influencing the Implementation and Adoption of Digital Nursing Technologies: Systematic Umbrella Review.

作者信息

Walzer Stefan, Armbruster Christoph, Mahler Sonja, Farin-Glattacker Erik, Kunze Christophe

机构信息

Care & Technology Lab, Furtwangen University, Furtwangen, Germany.

Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Medical Faculty and Medical Center - University of Freiburg, Freiburg, Germany.

出版信息

J Med Internet Res. 2025 Jul 31;27:e64616. doi: 10.2196/64616.

DOI:10.2196/64616

PMID:40743516

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12355146/

Abstract

BACKGROUND

Digital nursing technologies (DNTs) are a promising solution to address challenges in health care systems, such as demographic shifts, nursing shortages, or difficulties in retaining nurses. Despite their potential benefits, the integration of DNTs into care settings remains complex due to multiple factors influencing their implementation and adoption.

OBJECTIVE

We aimed to examine factors that influence the implementation and adoption of DNTs used in nursing care settings from the perspective of nurses.

METHODS

We used an umbrella review methodology to synthesize the evidence on DNTs and the complexities of their implementation. We searched for systematic reviews that focused on DNTs in formal care settings across 4 databases (PubMed, CINAHL, Cochrane Library, and Business Source Premier) and examined reference lists of the included reviews published in English until January 2025. Two researchers independently performed data extraction and quality assessment. Data analysis was structured by embedding the results in the NASSS (nonadoption, abandonment, scale-up, spread, and sustainability) framework, a model for explaining the adoption and abandonment of health and care technologies, as well as challenges to their scaling, diffusion, and sustainability. Reporting of this study adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist.

RESULTS

A total of 4803 reviews were identified, of which 65 (1.36%) met the inclusion criteria. We identified 52 influencing factors across 6 NASSS domains, with particular emphasis on adopter-related barriers and facilitators. Key barriers included insufficient training, increased workload, and low technological confidence, which impacted efficiency and the quality of care. In addition, concerns regarding professional role, autonomy, and privacy influenced nurses' acceptance of DNTs. Facilitators included leadership support, a positive corporate culture, and targeted training initiatives.

CONCLUSIONS

We synthesized key facilitators and barriers to implementation and adoption of DNTs in nursing care. Leadership support, adequate training, and alignment with care needs drive successful implementation, while resource constraints and workflow disruptions pose challenges. Addressing both technological requirements and nursing needs is critical. Future research should focus on long-term studies and practical tools to support stakeholders in effectively integrating DNTs into nursing practice.

TRIAL REGISTRATION

OSF Registries 10.17605/OSF.IO/BG8CY; https://osf.io/bg8cy.

摘要

背景

数字护理技术（DNTs）是应对医疗保健系统挑战的一个有前景的解决方案，如人口结构变化、护理人员短缺或留住护士的困难。尽管它们有潜在的好处，但由于多种因素影响其实施和采用，将DNTs整合到护理环境中仍然很复杂。

目的

我们旨在从护士的角度研究影响护理环境中使用的DNTs实施和采用的因素。

方法

我们采用了一种伞状综述方法来综合关于DNTs及其实施复杂性的证据。我们在4个数据库（PubMed、CINAHL、Cochrane图书馆和商业资源全文数据库）中搜索了关注正式护理环境中DNTs的系统综述，并查阅了截至2025年1月以英文发表的纳入综述的参考文献列表。两名研究人员独立进行数据提取和质量评估。通过将结果嵌入NASSS（未采用、放弃、扩大规模、传播和可持续性）框架进行数据分析，该框架是一个用于解释健康和护理技术的采用和放弃以及其扩大规模、传播和可持续性挑战的模型。本研究的报告遵循PRISMA（系统综述和荟萃分析的首选报告项目）清单。

结果

共识别出4803篇综述，其中65篇（1.36%）符合纳入标准。我们在NASSS的6个领域中确定了52个影响因素，特别强调了与采用者相关的障碍和促进因素。关键障碍包括培训不足、工作量增加和技术信心低，这些影响了效率和护理质量。此外，对专业角色、自主性和隐私的担忧影响了护士对DNTs的接受度。促进因素包括领导支持、积极的企业文化和有针对性的培训举措。