Leveraging the trust of nurses to advance a digital agenda in Europe: a critical review of health policy literature

Abstract

This article is a critical and integrative review of health policy literature examining artificial intelligence (AI) and its implications for healthcare systems and the frontline nursing workforce. A key focus is on co-creation as essential for the deployment and adoption of AI. Our review hinges on the European Commission’s White Paper on Artificial Intelligence from 2020, which provides a useful roadmap. The value of health data spaces and electronic health records (EHRs) is considered; and the role of advanced nurse practitioners in harnessing the potential of AI tools in their practice is articulated. Finally, this paper examines “trust” as a precondition for the successful deployment and adoption of AI in Europe. AI applications in healthcare can enhance safety and quality, and mitigate against common risks and challenges, once the necessary level of trust is achieved among all stakeholders. Such an approach can enable effective preventative care across healthcare settings, particularly community and primary care. However, the acceptance of AI tools in healthcare is dependent on the robustness, validity and reliability of data collected and donated from EHRs. Nurse stakeholders have a key role to play in this regard, since trust can only be fostered through engaging frontline end-users in the co-design of EHRs and new AI tools. Nurses hold an intimate understanding of the direct benefits of such technology, such as releasing valuable nursing time for essential patient care, and empowering patients and their family members as recipients of nursing care. This article brings together insights from a unique group of stakeholders to explore the interaction between AI, the co-creation of data spaces and EHRs, and the role of the frontline nursing workforce. We identify the pre-conditions needed for successful deployment of AI and offer insights regarding the importance of co-creating the future European Health Data Space.

Nurses' Informatics Competency Assessment of Health Information System Usage

“…This study also found that the competencies of the important phases of the nursing process, nursing diagnoses, interventions, and outcomes were at a low level. Concerns must be raised, since structured and high-quality nursing data are a basis for utilizing big data in nursing and quality management, 13,21,28 affecting the reliability of results produced by artificial intelligence software, such as problem-solving software programs, to provide support to nurses and help them make more informed decisions in patient care 29 …”

“…Concerns must be raised, since structured and high-quality nursing data are a basis for utilizing big data in nursing and quality management, 13,21,28 affecting the reliability of results produced by artificial intelligence software, such as problem-solving software programs, to provide support to nurses and help them make more informed decisions in patient care. 29 Inadequate training, lacking connections with daily work processes, has been presented to associate with the lack of digital skills. 33 According to nurses, the best way to learn is learning by doing.…”

“…Because nursing documentation is one of the largest data sources in HIS data, it is essential that the data quality is excellent. This facilitates the secondary use of data with, for example, artificial intelligence software in digital environments 29 …”

“…This facilitates the secondary use of data with, for example, artificial intelligence software in digital environments. 29 Numerous factors have been proposed to affect nurses' informatics competencies. Kleib and Nagle 30 found that especially the quality of informatics training provided by the employer but also age, work setting, educational level, continuing edu-cation and training in informatics, previous informatics education, and the use of technology in patient care were associated with nurses' informatics competencies.…”

Electronic Health Records at People’s Hands Across Europe: The InteropEHRate Protocols

“…Specific rules are missing in the form of protocols as data sharing means, compliant with data governance and protection regulations, to provide the citizens the ability to receive a copy of their own data and control them. In this manuscript, the InteropEHRate [8] project and its main results are presented, for releasing locally siloed health data and providing citizens' control into managing their personal health data among multiple countries and healthcare providers, through mature data exchange protocols.…”