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

backgroundDigital 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.

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

methodsWe 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.

resultsA 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.

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