By Destinie Wallis. Edited by Asim BN.
Artificial Intelligence (AI) has been changing healthcare, and recent research from Arkansas State University shows most nurses agree with the changes, but the same questionnaire shows many nurses fear there are no adequate protections for either them or their patients. Therefore, the enthusiasm for AI is tempered by fear. This suggests that healthcare organizations must act quickly to change their policies and education programs, which are the front lines for patient care.
Arkansas State University completed a study titled "Nurses and the AI Policy Gap: How Education Can Bridge Safety and Innovation." The study consisted of a survey of 135 registered nurses on how artificial intelligence was changing their everyday work. The results of the study show that the clinical environment in which nurses work is evolving with increasing use of technology, and, at the same time, an equally large gap in the guidelines, trust, and accountability.
AI is being adopted rapidly in nursing without the correct support in place
Most of the nurses who participated in the study (80%) stated that they used AI tools in some aspect of patient care, and more than 25% of those nurses stated they use AI tools daily. The types of clinical applications that are being supported by AI tools include:
- Charting: 61% stated they used AI-assisted charting, which is currently the largest application of AI in nursing.
- Predictive alerts: 38% stated they used predictive models to alert them to possible patient deterioration before it occurs.
- Diagnosis: 36% stated they use AI to aid in the diagnosis of patient conditions.
- Monitoring: 30% stated they use AI to monitor patients remotely.
- Bots for triage and intake: 26% stated they used AI-based bots for intake and triage.
Although 50% of the respondents stated they believed that their employer had clearly defined policies regarding the use of AI, and although over 60% of the respondents stated that they believed they would have legal protection if an AI system contributed to patient harm, the lack of clear policies and legal protection represents a serious risk to patient safety and could represent a legal liability.
Legal and ethical uncertainties are limiting AI use
The rapid adoption of AI in healthcare has moved much faster than the development of regulatory frameworks to support the safe and effective use of AI. Although many nurses believe that AI has the potential to improve efficiency and decision making in patient care, many nurses also have major concerns with the ethical and legal implications of AI.
Major AI concerns include:
- Patient harm: 63%
- Data breach: 51%
- Legal protection for nurses if an AI system contributes to patient harm: 49%
- Dependence on automation: 48%
Over one-third of the respondents stated that they have avoided using certain features of AI systems because of concerns related to the law or patient safety.
The lack of regulatory frameworks for AI is additionally demonstrated through the fact that less than thirty percent of the respondents thought that current law adequately protected patients from AI related risk, and 45% of the respondents disagreed. These concerns are not theoretical. Algorithmic bias, data security breaches, and accountability issues have yet to be resolved, and therefore nurses are increasingly being asked to use systems that may pose unforeseen risks to either themselves or their patients.
Education must fill the gap for responsible AI use
Educational resources for teaching nurses about AI systems are inadequate. Only approximately half of the responding nurses reported receiving formal training from their employer regarding the use of AI. A significant number of the nurses reported learning about AI through experience (approximately 20%), peer learning (approximately 20%), vendor training (approximately 6%), and no training (approximately 3%).
These varying levels of training lead to anxiety among the nurses regarding the use of AI systems, since only approximately 31% of the nurses felt "very comfortable" with AI systems, and the remainder of the nurses reported they are still adjusting to AI systems. Therefore, we have a workforce that is aware of technology but lacks the knowledge needed to safely and effectively utilize AI systems in high-risk situations.
Educating nurses for responsible AI use
Some key strategies for nurse educators include:
- Understanding AI systems: Students need to learn about the evaluation of the accuracy of an AI system, the consistency of an AI system, and the likelihood of an AI system failing. In addition, students need to have an awareness of the possibility of an AI system having bias.
- Ethics of AI: Students need to learn about the ethics of AI (such as privacy, consent, and transparency of AI algorithms).
- Responsible use of AI: Faculty can provide students with examples of how to responsibly use AI systems. Faculty can share with students their own experiences with both success and failure in implementing AI into clinical practice.
Interdisciplinary collaboration amongst health care organizations and academic institutions
Health care organizations and academic institutions must establish guidelines and standards for this type of collaboration and education. These standards must be established through consultation and emphasis on transparency, accountability and equity, as the algorithms used in AI reasoning contain embedded social and racial biases.
Warning to health care organizations and policy makers
There is a clear interest from health care organizations to advance innovation in their field. However, the lack of support necessary to take this next step in development has been identified within this study. As the nursing profession is open to the idea of AI, they do need a framework of understanding, legal guidelines and limits to incorporate AI into nursing practice.
Failure to address these concerns can have far-reaching consequences that affect patient safety, as well as the trust of the clinicians working within these organizations, when these organizations fail to provide adequate support in incorporating AI technology into the clinicians’ workload. The advancement in technology requires the advancement in the education and policy fields. Nurses need AI, but cannot utilize AI without support.
About author: Destinie Wallis has been working in the tech space for nearly ten years and focuses her attention on how new technologies like AI are transforming industries, workflows, and everyday decision-making.
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