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Nursing Reports
Special Issues
Nursing Digital Innovation: From Care Delivery to Professional Development
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Nursing Digital Innovation: From Care Delivery to Professional Development

A Special Issue of Nursing Reports (ISSN 2039-4403) belonging to the section "Artificial Intelligence and Digital Innovations in Nursing Care".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 4582

Editors

Dr. Carla Sílvia Fernandes

E-Mail Website
Guest Editor
1. School of Health, Polytechnic Institute of Viana do Castelo, 4900-314 Castelo, Portugal
2. Aditgames, Association for Innovation, Technologies and Games in Health, 4490-565 Porto, Portugal
3. Rise@Health Research Unit, 4200-319 Porto, Portugal
Interests: digital health; nursing informatics; rehabilitation technologies; gamification in healthcare; mobile health; serious games; patient self-management
Special Issues, Collections and Topics in MDPI journals
Dr. Bruno Magalhães

E-Mail Website
Guest Editor
1. School of Health, University of Trás‑os‑Montes and Alto Douro (UTAD), 5000‑801 Vila Real, Portugal
2. Oncology Nursing Research Unit IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), 4200-072 Porto, Portugal
3. RISE@UTAD-Health Research Network, University of Porto, 4200-319 Porto, Portugal
4. Clinical Academic Centre of Trás-os-Montes, Alto Douro (CACTMAD), 5000-801 Vila Real, Portugal
Interests: cancer; chemotherapy; mHealth; eHealth; telemedicine; apps; mobile applications; games; self-management; antineoplastic agents; thematic synthesis; home parenteral nutrition; systematic reviews; meta-analysis

Special Issue Information

Dear Colleagues,

This Special Issue aims to gather scientific contributions that explore the development, implementation, and evaluation of digital technologies in the nursing profession. Submissions that integrate technological innovation, gamification, creativity, and new digital approaches will be particularly relevant.

The scope of this issue encompasses multiple dimensions of nursing, including clinical practice, education and professional development, care management and leadership, and applied research.

With this initiative, we seek to stimulate reflection and knowledge production that reinforce nursing’s role as a leading force in digital health innovation, contributing to more participatory, inclusive care that is focused on meaningful health and well-being outcomes.

Dr. Carla Sílvia Fernandes
Dr. Bruno Magalhães
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nursing Reports is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • digital health
  • nursing informatics
  • gamification in healthcare

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Published Papers (5 papers)

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Research

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21 pages, 783 KB  
Article
Digital Hesitancy Among Nurses and Physicians in Anesthesia and Intensive Care: A Cross-Sectional Study from Romania
by Corina Vernic, Ovidiu Bedreag, Dorina Cristina Sulițanu, Ion Petre, Liliana Ioana Muntean and Sorin Ursoniu
Nurs. Rep. 2026, 16(8), 290; https://doi.org/10.3390/nursrep16080290 - 19 Aug 2026
Viewed by 205
Abstract
Background and Objectives: Digitalization studies often emphasize perceived benefits while overlooking professionals who cannot determine whether digital tools are useful. This study quantified digital hesitancy among anesthesia and intensive-care professionals, examined its relationship with professional role and experience, and compared it with reported [...] Read more.
Background and Objectives: Digitalization studies often emphasize perceived benefits while overlooking professionals who cannot determine whether digital tools are useful. This study quantified digital hesitancy among anesthesia and intensive-care professionals, examined its relationship with professional role and experience, and compared it with reported barriers and technology use. Methods: A single-centre cross-sectional survey included 161 professionals (80.1% of 201 eligible departmental staff): 55 nurses and 106 physicians. A four-item Uncertainty Index measured inability to appraise digital benefits in patient safety, clinical decisions, management, and education. Barrier Burden and Resource-Efficiency indices were also calculated. Group differences were assessed using nonparametric tests, and predictors of high uncertainty were examined by multivariable logistic regression. Results: Nurses had substantially higher uncertainty than physicians (mean Uncertainty Index 1.60 vs. 0.49, difference 1.11, 95% CI 0.80 to 1.42; p < 0.001), particularly regarding educational and clinical benefits. Reported barriers were similar across professional groups, with technical problems being the most common. Any reported prior use of training simulators, irrespective of frequency or recency, was markedly lower among nurses than physicians (1.8% vs. 47.2%; absolute gap 45.4 percentage points, 95% CI 35.2 to 55.5; p < 0.001). After adjustment, physician status remained strongly associated with lower odds of high uncertainty, whereas overall seniority was not significant. In an exploratory within-nurse analysis, uncertainty was higher among more experienced nurses, reaching its highest level among those with more than 20 years of practice (Spearman ρ = 0.49, 95% CI 0.24 to 0.68; p < 0.001); the seniority bands were small (n = 7 to 18), so this gradient is hypothesis-generating. Conclusions: Digital hesitancy was concentrated among nurses and was distinct from shared technical barriers; within nurses it was higher at greater seniority. Because patient-safety outcomes and intervention effects were not measured, targeted simulator-based training and role-specific feedback should be regarded as hypotheses for prospective evaluation alongside, rather than established alternatives to, generic infrastructure improvements. Full article
(This article belongs to the Special Issue Nursing Digital Innovation: From Care Delivery to Professional Development)
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22 pages, 303 KB  
Article
Nursing Informatics Competence and Digital Health Readiness Among Chinese Undergraduate Nursing Students: A Convergent Mixed-Methods Study
by Yanjing Lv, Minyi Li, Yang Yue, Cynthia Hallensleben, Huohuo Dai and Hongxia Shen
Nurs. Rep. 2026, 16(8), 268; https://doi.org/10.3390/nursrep16080268 - 31 Jul 2026
Viewed by 513
Abstract
Background/Objectives: Nursing informatics (NI) competence is becoming increasingly essential for nursing students; however, previous research has largely relied on quantitative surveys and provided limited insights into why positive attitudes may not be accompanied by practical competence. This study examined Chinese undergraduate nursing [...] Read more.
Background/Objectives: Nursing informatics (NI) competence is becoming increasingly essential for nursing students; however, previous research has largely relied on quantitative surveys and provided limited insights into why positive attitudes may not be accompanied by practical competence. This study examined Chinese undergraduate nursing students’ self-assessed NI competence and qualitatively explored their conceptual understanding, perceptions, and experiences related to NI and digital health. Methods: A convergent parallel mixed-methods design was employed in Guangzhou, China. Quantitative data were collected from 149 undergraduate nursing students across two nursing schools using the Chinese Self-Assessment of Nursing Informatics Competencies Scale (SANICS), whereas qualitative data were gathered from 23 students at one of the participating schools through six semi-structured focus groups. Quantitative data were analyzed using descriptive statistics and exploratory Spearman correlations, while qualitative data were analyzed thematically. Findings from both strands were integrated during interpretation using a joint display matrix. Results: The mean self-assessed NI competence score was 2.78 ± 0.54 (scale 1–5). Among the five SANICS subscales, attitudes toward NI scored highest (4.16 ± 0.76), whereas applied computer skills scored lowest (2.02 ± 0.80), confirming an attitude-competence paradox. Exploratory correlation analyses showed neither year of study nor clinical exposure was significantly associated with the total competence score, although both were negatively associated with attitudes. Three qualitative themes contextualized this paradox: (1) a fragmented conceptual understanding centered primarily on basic functions and tools; (2) positive but cautious perceptions that recognized the value of NI while expressing concerns about humanistic care; and (3) passive skill acquisition, limited hands-on learning, and insufficient awareness of higher-order informatics roles. Conclusions: In this two-school sample, students valued NI but reported limited applied and clinically situated competence. The findings suggest that curricula should move beyond generic computer courses and unstructured exposure toward practice-embedded NI education, including electronic health record simulation, digital documentation, data security, and clinically relevant digital skills. Full article
(This article belongs to the Special Issue Nursing Digital Innovation: From Care Delivery to Professional Development)
29 pages, 964 KB  
Article
Remote Patient Education for People Living with an Ostomy: An Italian Expert Consensus Using a Modified Delphi Method
by Giulia Villa, Andrea Poliani, Alessia Campoli, Annarita Coppola, Francesco Carlo Denti, Rossella Guzzi, Danila Maculotti, Marina Perrotta, Clara Salazar, Giovanni Sarritzu, Monica Sgherri, Antonio Valenti, Pier Raffaele Spena and Duilio Fiorenzo Manara
Nurs. Rep. 2026, 16(6), 203; https://doi.org/10.3390/nursrep16060203 - 15 Jun 2026
Viewed by 653
Abstract
Introduction: Remote education is increasingly used in ostomy care, but its components, timing, governance, and evaluation remain inconsistently defined. This study aimed to develop practice-oriented recommendations for implementing remote patient education for people living with an ostomy. Methods: An Italian expert consensus using [...] Read more.
Introduction: Remote education is increasingly used in ostomy care, but its components, timing, governance, and evaluation remain inconsistently defined. This study aimed to develop practice-oriented recommendations for implementing remote patient education for people living with an ostomy. Methods: An Italian expert consensus using a modified Delphi method and reported according to the ACCORD guidelines was conducted. An expert panel (n = 11), recruited nationally, included stomatherapists (n = 6) and people living with an ostomy (n = 5). Round 1 comprised a remotely conducted focus group to generate and refine statements informed by a targeted literature search. Rounds 2 and 3 were anonymous online surveys in which panelists rated statements on a four-point Likert scale and could provide comments or propose additional items. Consensus was predefined as ≥75% agreement. Results: Response rates were 100% across the three rounds (October–November 2025). The panel achieved consensus on 8 definitions and 14 statements, organized into six domains: (1) model of care and eligibility; (2) privacy and data protection; (3) program structure, outcomes, and evaluation; (4) educational content and teaching strategies; (5) timing, intensity, follow-up, and caregiver involvement; and (6) dignity, relational quality, and professional and organizational requirements. Recommendations supported a hybrid-by-default model with eligibility criteria, privacy-by-design using secure platforms and traceable documentation, structured programs with tailored multimodal content, staged pathways lasting 2–6 months after an initial in-person foundation, dignity-preserving options during remote encounters, professional training in communication and digital empathy, and integration into clinical planning and records. Conclusions: This consensus provides the first ostomy-specific, implementation-focused recommendations for standardizing remote patient education in Italy, with an emphasis on equity, privacy, dignity, evaluation, and workforce competencies. Full article
(This article belongs to the Special Issue Nursing Digital Innovation: From Care Delivery to Professional Development)
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14 pages, 629 KB  
Article
Effectiveness of a Gamified Educational Intervention on Palliative Care Knowledge Among Nursing Students: A Single-Group Pre–Post Intervention Study
by Janet Vaca-Auz, Karen Jaramillo-Jácome, Melisa Chacón-Guerra and Jorge L. Anaya-González
Nurs. Rep. 2026, 16(4), 105; https://doi.org/10.3390/nursrep16040105 - 25 Mar 2026
Viewed by 1350
Abstract
Traditional palliative care education may limit the development of clinical competencies and attitudes required to alleviate suffering and improve quality of life. Gamification has been proposed as an alternative educational strategy in this field. Background/Objectives: This study aimed to assess the association [...] Read more.
Traditional palliative care education may limit the development of clinical competencies and attitudes required to alleviate suffering and improve quality of life. Gamification has been proposed as an alternative educational strategy in this field. Background/Objectives: This study aimed to assess the association between gamification-based intervention and palliative care knowledge among nursing students at a public university. Methods: This single-group, pre–post-intervention study was conducted in the Nursing Program of the Universidad Técnica del Norte, Ecuador, including 136 students from the accessible population. Palliative care knowledge was assessed before and after the intervention using the validated Palliative Care Quiz for Nursing (PCQN-SV). Student satisfaction and Moodle usability were assessed using a 10-item Likert-type questionnaire. The gamified educational intervention was delivered online over 60 h. Data were analyzed using descriptive statistics and Wilcoxon signed-rank tests for paired comparisons, and exploratory logistic regression analyses were conducted to evaluate contextual differences across hospitals. Statistical significance was set at α = 0.05. Results: The mean age was 22.9 years (SD = 1.89), and 73.5% were female. Knowledge scores increased significantly after the intervention (Wilcoxon signed-rank test, p < 0.001; r = 0.35). The proportion of students achieving sufficient knowledge (≥13 correct responses) increased from 27.2% (37/136) at baseline to 49.3% (67/136) post-intervention. Contextual analysis indicated variability across clinical training sites, with Lago Agrio showing higher odds of sufficient knowledge (aOR = 3.25; 95% CI [1.26–8.41]; p = 0.015). Conclusions: The gamified intervention was associated with increased palliative care knowledge among nursing students. Heterogeneity across hospitals suggests that contextual factors may influence the magnitude of change. Full article
(This article belongs to the Special Issue Nursing Digital Innovation: From Care Delivery to Professional Development)
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Review

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19 pages, 1896 KB  
Review
Virtual Reality in Chronic Conditions: An Umbrella Review
by Ilaria Marcomini, Giulia Villa, Laura Ingrande, Gaia Latini, Andrea Poliani, Duilio Fiorenzo Manara and Debora Rosa
Nurs. Rep. 2026, 16(2), 57; https://doi.org/10.3390/nursrep16020057 - 10 Feb 2026
Viewed by 1176
Abstract
Background. Virtual reality (VR) is emerging as a non-pharmacological tool to support rehabilitation and self-management. Evidence of its effectiveness, however, remains fragmented. This umbrella review synthesized systematic reviews and meta-analyses on VR interventions in chronic conditions. Methods. Following the Joanna Briggs Institute Manual [...] Read more.
Background. Virtual reality (VR) is emerging as a non-pharmacological tool to support rehabilitation and self-management. Evidence of its effectiveness, however, remains fragmented. This umbrella review synthesized systematic reviews and meta-analyses on VR interventions in chronic conditions. Methods. Following the Joanna Briggs Institute Manual for Evidence Synthesis, comprehensive searches were conducted in MEDLINE, CINAHL, Cochrane Database, Web of Science, and Scopus. Eligible studies were systematic reviews and meta-analyses assessing VR interventions. Two reviewers independently performed screening, quality appraisal, and data extraction. Results. Seventeen reviews, including 229 primary studies, were analyzed. Stroke and chronic obstructive pulmonary disease were most frequently investigated. VR tools ranged from web- and smartphone-based systems to wearable devices and interactive games. Significant improvements were reported in respiratory outcomes, functional mobility, balance, and psychological symptoms. Cognitive effects were mixed. Reported adverse events, mainly cybersickness and dizziness, were mild. Conclusions. VR may improve physical, respiratory, psychological, and selected cognitive outcomes in chronic conditions. Despite study heterogeneity, evidence supports its integration into chronic care. Future work should standardize protocols, assess long-term effects, broaden target populations, and address equity and ethical issues to fully realize VR’s potential as a person-centered tool. Full article
(This article belongs to the Special Issue Nursing Digital Innovation: From Care Delivery to Professional Development)
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