Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 2 appraisals
Computers, informatics, nursing : CIN
Bridging the Gap Between Potential and Practice: An Integrative Review of Generative Artificial Intelligence in Nursing
BACKGROUND: Generative artificial intelligence (GAI) has emerged as a transformative tool in health care, particularly with the integration of large language models (LLMs) into electronic health record (EHR) systems. These tools have the potential to enhance clinical decision-making, increase efficiencies, and decrease time in the EHR. However, despite expanding availability, adoption in nursing practice remains limited. This integrative review aimed to synthesize the literature and explore barriers related to the integration of GAI tools into nursing practice. METHODS: We conducted an integrative search of peer-reviewed literature published between November 2022 and July 2025 to examine the current evidence while assessing for methodological quality. The retrieved articles were screened for title, abstract, and full text eligibility. We synthesized themes related to GAI adoption by nurses, focusing on ethical, educational, and workflow-related factors that influence use. RESULTS: A total of 10 studies met criteria including 7 qualitative descriptive design, 2 case reports, and 1 experimental clinical trial. Four key barriers emerged: educational gaps, ethical concerns, data transparency issues, and workflow misalignment contributing to nurses' hesitancy to engage with GAI tools. Recommendations include involvement of nurses in the design, implementation, and evaluation of GAI tools and mandatory AI curricula in nursing education. CONCLUSIONS: Overcoming barriers requires nurse involvement in GAI design efforts, targeted education, and governance models that foster trust and usability. Nurse-centered integration of GAI tools has the potential to advance workforce efficiencies while preserving patient safety.
4 July 2026
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Facilitators of and barriers to teamwork between operating room nurses and other practitioners: a meta-synthesis of qualitative studies
OBJECTIVES: Seamless collaboration in the operating room is the critical foundation for patient safety and successful outcomes. This synergy enhances efficiency, minimises errors and is a key determinant of the final surgical quality. The objective of this study is to synthesise qualitative studies on facilitators of and barriers to teamwork between operating room nurses (ORNs) and other practitioners. DESIGN: Systematic review and meta-synthesis of qualitative studies. DATA SOURCES: A systematic search was conducted across nine electronic databases: PubMed, Embase, Scopus, Web of Science (Core Collection), CINAHL, PsycINFO, CNKI, WanFang and Vip. The search covered the period from 1 January 2014 to 30 September 2025. The search strategy used both medical subject headings and free-text terms, supplemented by the snowball method and grey literature. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Qualitative studies exploring teamwork involving ORNs were included. Of 4839 initially retrieved records, 29 studies finally met the inclusion criteria. DATA EXTRACTION AND SYNTHESIS: Two researchers independently extracted data, including the author, year of publication, country, study design, study objective, interview location, number of participants, age, methods of data collection and analysis and duration of interviews. The key findings were synthesised into two overarching themes: facilitators (eg, professional skills, role awareness, team familiarity, patient-centred culture, effective leadership) of and barriers (eg, individualistic behaviour, hierarchical culture, insufficient resources, punitive management, environmental constraints) to teamwork between ORNs and other practitioners. A meta-synthesis was conducted to synthesise study results from different groups and countries. NVivo 15 was used for data management. RESULTS: A total of 29 qualitative studies (published between 2014 and 2025) were included in this study. Key facilitators of teamwork included professional skills, role awareness, team familiarity, patient-centred culture and effective leadership. Major barriers encompassed individualistic behaviours, punitive management, hierarchical culture, environmental constraints and insufficient resources. These factors worked across individual, interpersonal and systemic levels to shape OR teamwork. CONCLUSION: Optimising OR teamwork requires a multifaceted approach simultaneously addressing these facilitators and barriers. Interventions should simultaneously cultivate individual competencies (eg, skills, role awareness), foster positive team dynamics (eg, familiarity, psychological safety, inclusive leadership), and rectify systemic issues (eg, hierarchical culture, resource constraints, punitive management). In this way, teamwork between ORNs and other practitioners can be enhanced, thereby contributing to improved perioperative safety and outcomes. PROSPERO REGISTRATION NUMBER: CRD42024506414.
9 Apr 2026
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