Barriers And Facilitators To Implementation Of Digital Nursing Technologies In Healthcare Settings: A Systematic Review
DOI:
https://doi.org/10.33751/jhss.v10i1.106Keywords:
Digital Nursing Technologies, Implementation, Barriers; Facilitators, Nursing Informatics, Electronic Health Records, Telehealth, Mhealth, Organizational ChangeAbstract
This systematic review aimed to synthesize evidence on barriers and facilitators to the implementation of digital nursing technologies (DNTs) in healthcare settings. A PRISMA‑guided search of Scopus and Web of Science identified 2,847 records; after screening and full‑text review, 45 empirical and review articles published between 2015 and 2025 were included. The review found that implementation success depends on interacting technical, organizational, individual, and system‑level factors, rather than technology characteristics alone. Technical and infrastructure barriers included inadequate connectivity, limited hardware, poor usability, and lack of interoperability, which were especially pronounced in low‑ and middle‑income and rural settings. Organizational barriers encompassed insufficient and one‑off training, weak leadership support, poor change management, unclear policies, high workload, and staffing constraints, while individual‑level barriers involved low digital literacy, technophobia, low motivation, and concerns about autonomy, safety, privacy, and data security. System‑level barriers related to limited government support, funding, regulatory clarity, and interoperability mandates. Key facilitators included strong leadership and clear vision, supportive organizational culture, continuous competency‑based training and just‑in‑time support, user‑friendly and reliable systems that integrate with workflows, high digital literacy, professional motivation, and enabling policy and funding environments. The review concludes that effective DNT implementation is a sociotechnical transformation requiring coordinated action across all levels, sustained organizational commitment, and context‑sensitive strategies that protect clinician well‑being and patient safety. These findings inform implementation planning and highlight priority gaps for future research, particularly in emerging technologies and under‑resourced settings.
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