Nurse Spotlight:
Technology in Nursing – Innovations Transforming Care Delivery, Workforce Efficiency, and Patient Outcomes
Nurses Service Organization (NSO), in collaboration with CNA, has published our Nurse Professional Liability Claim Report: 5th Edition. It includes statistical data and case scenarios from CNA closed claim files, as well as risk management recommendations designed to help nurses reduce their malpractice exposures and improve patient safety.
You may access the complete 5th Edition Report, and additional Risk Control Spotlights.
This Spotlight focuses on the benefits, limitations, and professional liability implications of technology on nursing practice.
Continue readingThe Digital Evolution of Nursing
Nursing practice continues to evolve in response to the economic, technological, social and organizational forces shaping healthcare delivery. Over the past several decades, the profession has transitioned from paper-based healthcare information records and in-person only patient care to a technology-enabled environment with multiple aspects of care being provided virtually and with the use of artificial intelligence (AI). Several factors are driving the rapid adoption of these technologies, including but not limited to:
- Nursing workforce shortages and experience gaps resulting from seasoned nurses leaving the field after the pandemic and being replaced by nurses new to the profession.
- Challenges related to healthcare access in rural and underserved areas.
- Rising healthcare costs including prescription drugs.
- Increasing patient acuity.
- Ongoing financial pressures tied to achieving quality outcomes for reimbursement.
The longstanding expectation to “do more with less” continues to drive staffing models. As healthcare organizations face these demands as well as business-related challenges, nurse administrators are reimagining care delivery models and utilizing technology to improve efficiency and enhance patient safety.
Innovative technology in healthcare offers opportunities to improve patient safety and outcomes, enhance care coordination, streamline documentation, and support clinical decision-making. At the same time, it has the potential to introduce new challenges related to workflow, communication, data privacy, cybersecurity, role delineation, and the potential for overreliance on automated systems. Effectively utilizing these technologies requires not only technical proficiency and informatics knowledge but keeping top of mind that technology should be viewed as enhancements not replacements for—professional nursing clinical judgment.
Technology in Current Nursing Practice
Telehealth platforms, remote patient monitoring, AI scribes, clinical decision support tools, “Smart” patient rooms and robotic medication delivery systems are a few examples of how technology Nurse Spotlight: Technology in Nursing – Innovations Transforming Care Delivery, Workforce Efficiency, and Patient Outcomes CNA and NSO Nurse Spotlight: Technology in Nursing 2 is increasingly being integrated into patient care delivery. AI-powered ambient listening systems can capture nurse-patient conversations and generate clinical documentation. Smart patient rooms that utilize digital whiteboards, voice-activated controls, and wireless and remote patient monitoring with automated warnings are being piloted and implemented in acute care, outpatient settings, home care and hospital-at-home programs. In addition to the benefits for nurses, smart room technology provides patients with real-time access to their treatment plan, test results and educational information, allowing them the opportunity to feel more involved in their care. In addition, the widespread adoption of telehealth offers benefits for patients such as less travel and “just in time” patient education.
Remote patient monitoring technologies encompass a wide range of devices and digital platforms that collect and transmit patient information outside of traditional healthcare settings allowing for real time interventions. Examples include blood pressure monitors, pulse oximeters, continuous glucose monitors, cardiac monitoring devices, remote weight monitoring, smart medication management systems, wearable sensors, mobile health applications and fall detection systems. These technologies allow clinicians to monitor patient status, identify concerning trends, and intervene in a timely manner.
Virtual Nursing
Another example of how technology is being used to create clinical efficiencies is the growing adoption of virtual nursing. The American Nurses Association (ANA) defines virtual nursing as “leveraging remote technology and tools to provide safe and quality patient care through the application of the nursing process by emphasizing communication, compassion, and collaboration throughout the continuum of care.” Virtual nursing is a care delivery modality that uses telecommunications technology, audio-video platforms, and electronic healthcare information systems to enable experienced nurses and advanced practice providers [APPs] to provide remote clinical support and mentorship from command centers. Working in partnership with clinical care teams, virtual nurses and APPs assist in-person nurses with chronic disease management, education, care coordination, documentation, admissions, discharges, and clinical surveillance, allowing in-person nurses to focus on direct patient care activities. By extending nursing expertise beyond the bedside, virtual nursing programs aim to improve patient outcomes, enhance workforce efficiency, and help address ongoing staffing challenges and burnout. For example, virtual nurses can provide care in these areas seamlessly without the interruptions that inperson nurses are likely to encounter. In terms of improving nursing retention, this model allows experienced nurses who may no longer be able to perform the physical demands of bedside care to continue contributing to patient care by leveraging their clinical expertise to guide, mentor, and support novice nurses.
According to a recent survey by Wolters Kluwer Lippincott® Solutions, sixty-six percent of nurse administrators are utilizing technology and telehealth to create virtual nursing models of care. Nursing competency in informatics and care coordination is critical for the success of this model of care and may require upskilling existing staff or hiring informatics nurses. Ongoing nursing education for both in-person and virtual nurses should include remote assessment and monitoring skills for physical and behavioral health conditions as well as effective communication skills to ensure that hand-offs between nurses are accurate and comprehensive.
Risk Management and Patient Safety Considerations:
Technology use may introduce challenges impacting patient safety and contribute to professional liability exposure when systems, devices, or users do not function as intended. Technology-related risks include, but are not limited to, the following: (See infographic.)
- Failures or delays in managing product and device recalls or safety alerts, including lack of formal processes to prevent recalled devices from being re-introduced into clinical use/ circulation before recall issues are addressed.
- Cybersecurity risks and outdated software, which may compromise the confidentiality, integrity, and availability of patient information and disrupt clinical care.
- Misalignment of technology use for specific aspects of patient care or patient populations, as certain physical, neurological, and behavioral health assessments may require direct physical contact and cannot be fully completed through virtual observation alone. Failure to recognize the limitations of remote assessment may contribute to incomplete patient assessments and missed or delayed treatments.
- Communication breakdowns and incomplete hand-offs related to lack of care coordination in virtual care models.
- Interoperability gaps resulting in incomplete, inaccurate, or duplicative data, which may contribute to clinical decisionmaking errors.
- Overreliance on AI-enabled technologies and automated processes, potentially resulting in diminished critical thinking, nursing deskilling, or failure to identify inaccurate recommendations when outputs are accepted without independent validation.
- Lack of sufficient “downtime” procedures and back-up resources to enable appropriate patient care to continue without interruption in the event the technology stops functioning.
- Data overload and alert fatigue, which may desensitize nurses to important warnings.
- Training and competency gaps, which may lead to improper technology use, incomplete assessments, documentation inaccuracies and failure to recognize technology limitations.
Breakdowns in technology-related nursing care may contribute to delayed treatment, medication errors, communication failures, privacy breaches, documentation inaccuracies, and missed changes in patient condition. For example, virtual nursing may present challenges when assessing a patient’s mental health status. During a video encounter, a nurse may be unable to fully observe subtle nonverbal cues, environmental factors, or self-harming behaviors that could indicate worsening depression or escalating suicide risk, potentially resulting in an incomplete assessment and delayed intervention. Similarly, virtual patient education may be less effective when technology barriers interfere with communication. A patient receiving virtual diabetes education who experiences poor audiovisual connectivity may misunderstand insulin administration instructions, increasing the risk of medication errors and adverse patient outcomes. In professional liability claims, questions may arise regarding whether nurses appropriately used available technologies, responded to system-generated alerts, validated automated recommendations, maintained competency with new tools, or followed organizational policies and procedures and documented plan of care and outcomes. These examples highlight the importance of recognizing the limitations of technology, validating patient understanding, and ensuring appropriate escalation to in-person assessment when clinically indicated. The following recommendations offer guidance to support nurses and nurse administrators in utilizing existing technology and integration of emerging technologies into clinical practice.
If you are contacted during the investigative stage, consult with an attorney before you respond to the SBON, ensuring to reply within the deadline set by the Board.
Nurse Spotlights
For risk control strategies related to:
- Protecting Your License
- Documentation
- Artificial Intelligence
- Technology in Nursing
- Liability for Charge Nurses
- Well-being and Mental Health
License Protection vs. Professional Liability.
What’s the difference?
License Protection
Inquiry by the State Board of Nursing arising from a complaint.
Allegation can be directly related to a nurse’s clinical responsibilities and professional services, and/or they may be of a nonclinical nature (i.e., substance abuse, unprofessional conduct or billing fraud).
The State Board of Nursing can suspend or revoke a license. Its primary mission is to protect the public from unsafe practice of the professional.
Professional Liability
Civil lawsuit arising from a patient’s malpractice claim.
Allegations are related to clinical practice and professional responsibilities.
The civil justice system cannot suspend or revoke your license to practice. Rather, professional liability lawsuits serve to fairly compensate patients who assert that they have suffered injury or damage as the result of professional negligence.
The process can take months or even years to fully resolve, lengthening the process and increasing the associated costs.
Allegations
Professional conduct complaints have the highest distribution of all license protection closed matters in the 2025 dataset, at 38.0 percent. Collectively, professional conduct, scope of practice, and treatment and care allegations account for 61.8 percent of all license protection closed matters. Refer to Figure 20.
State Board of Nursing Actions
Figure 25 shows SBON disciplinary actions which can range from no action against the nurse, up to and including revocation of the nurse’s license to practice. The majority of matters in the 2025 analysis, 53.0 percent, resulted in the SBON deciding to take no action. In 16.3 percent of matters, the nurse received a Letter or reprimand. The more serious outcomes include: Probation 12.0 percent, Suspension 5.9 percent, License Surrendered 0.4 percent, and Revocation 1.9 percent.
In some cases, the SBON may impose multiple disciplinary actions, such as a reprimand coupled with a fine. Depending upon the state in which you practice, most outcomes involving discipline against a nurse’s license are a matter of public record and reported to NURSYS® and the National Practitioner Data Bank (NPDB). The SBON also may report disciplinary actions to other agencies, regulatory authorities, or other SBONs, which may decide to initiate their own investigation and take action.
Nurses who have had adverse disciplinary actions may appeal those decisions. The standards for appealing a SBON decision are defined by your state and will outline the specific requirements, time frames, and processes.
Depending upon the state in which you practice, most outcomes involving discipline against a nurse’s license are a matter of public record and reported to NURSYS® and the National Practitioner Data Bank (NPDB).
20
License Protection Matters
by Primary Allegation
25
Comparison of the 2015, 2020, and 2025 Distribution of State Board of Nursing Actions
Matter closed no action
49.2%
45.6%
53.0%
Letter or reprimand
14.2%
15.5%
16.3%
Probation
10.8%
12.0%
12.0%
Suspension
4.6%
3.2%
5.9%
Consent agreement
5.5%
6.5%
5.7%
Fine
1.7%
5.3%
2.6%
CE
6.8%
4.7%
2.2%
Revocation
1.7%
1.5%
1.9%
License surrendered
3.2%
4.8%
0.4%
Distribution of actions taken are based on categories observed in the current report and may not include actions noted in prior reports.
Risk Management Recommendations
Below are some proactive concepts and behaviors to include in your customary nursing practice, as well as steps to take if you believe you may be involved in a SBON matter related to your practice of nursing:
Everyday Practice
- Practice within the requirements of your state’s nurse practice act, in compliance with organizational policies and procedures, and within the national standard of care. If regulatory requirements and organizational scope of practice differ, comply with the most stringent of the applicable regulations or policy. If in doubt, contact your SBON or specialty professional nursing association for clarification.
- Document your patient care assessments, observations, communications and actions in an objective, timely, accurate, complete, and appropriate manner. Never alter the healthcare information record after the fact unless it is necessary for the patient’s care. If it is essential to add information to the record, properly label the delayed entry, but never add any documentation to a record for any reason after a complaint has been made. If additional information related to the patient’s care emerges after you become aware that SBON action is pending, discuss the need for additional documentation with your manager, the organization’s risk manager and your legal counsel.
- Maintain files that can be helpful to your character. Retain copies of letters of recommendation, performance evaluations, thank-you letters from patients, awards, records of volunteer work and continuing education certificates.
- Immediately contact your professional liability insurer if you:
- Become aware of a filed or potential professional liability matter against you.
- Receive a subpoena to testify in a deposition or trial.
- Have any reason to believe that there may be a potential threat to your license to practice nursing.
- Refrain from discussing the matter with anyone other than your defense attorney or the professionals managing your matter.
- Promptly return telephone calls from your defense attorney and professionals managing your matter.
- Contact your attorney or designated professional before responding to telephone calls, e-mail messages or requests for documents from any other party.
- Provide your insurer with as much information as you can when reporting such matters, including contact information.
- Never testify in a deposition without first consulting your insurer or legal counsel.
- Copy and retain all legal documents for your records, including:
- The summons and complaint
- The subpoena
- Attorney letter(s)
- Any other legal documents pertaining to the matter
License Protection Coverage
Professional liability insurance that includes coverage for license protection helps to insure nurses against licensing board complaints by:
- Reimbursing you up to the applicable limit for your defense of disciplinary charges arising out of a covered incident.
- Covering costs associated with a disciplinary inquiry, up to $25,000 annual aggregate.
- Covering expenses such as legal representation, lost wages and travel.
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