INTEGRATING ARTIFICIAL INTELLIGENCE–ASSISTED CLINICAL DECISION SUPPORT IN NURSING PRACTICE: IMPACTS ON PATIENT SAFETY AND CARE QUALITY IN SMART HEALTHCARE SYSTEMS

Binamin Binamin (1), Budi Darmawan (2), Dewadharu Achsyan (3), Ahmad Faisol (4)
(1) Politeknik Angkatan Laut, Indonesia,
(2) Politeknik Angkatan Laut, Indonesia,
(3) Politeknik Angkatan Laut, Indonesia,
(4) Politeknik Angkatan Laut, Indonesia

Abstract

Artificial intelligence–assisted clinical decision support systems are increasingly integrated into smart healthcare environments, offering new opportunities to enhance patient safety and care quality while transforming nursing practice. Persistent challenges such as medical errors, delayed clinical responses, and variability in care highlight the need for effective decision support tools. This study aims to examine the impact of artificial intelligence-assisted systems on patient safety, care quality, and nursing decision-making processes. A mixed-methods design was employed, combining quantitative analysis of clinical indicators with qualitative insights from nurses across multiple hospital units. Data were collected from 120 nurses and corresponding patient records before and after system implementation, supported by surveys and interviews. Findings reveal significant reductions in medication errors and adverse events, alongside improvements in response time, care quality, and nurse decision confidence. Inferential analysis confirms that system usability and training significantly influence outcomes, while experience level moderates system effectiveness. The study concludes that artificial intelligence–assisted decision support enhances clinical performance by complementing nursing expertise and enabling data-driven decision-making. Effective integration depends on user readiness, organizational support, and alignment with clinical workflows, highlighting the need for human-centered implementation strategies in smart healthcare systems.

Full text article

Generated from XML file

References

Ahuja, K., Bala, I., & Mijwil, M. M. (2024). Industry 4.0 in Manufacturing, Communication, Transportation, and Healthcare. In A. Kumar Rana, V. Sharma, A. Rana, M. Alam, & S. Lata Tripathi, Convergence of Blockchain and Internet of Things in Healthcare (1st ed., pp. 25–53). CRC Press. https://doi.org/10.1201/9781003466949-2

Amini Rarani, S. (2025). Smart technologies and digital innovations for improving perioperative patient safety: A review. Patient Safety in Surgery, 19(1), 31. https://doi.org/10.1186/s13037-025-00454-y

Bind, V., Sharma, A. K., Mishra, K., Pandey, P., Jayprakash, & Tiwari, A. (2024). Smart Health Band for Epilepsy and Seizure, Fits Detection with Alert System and Live Location using IoT and Cloud Computing. 2024 International Conference on IoT, Communication and Automation Technology (ICICAT), 1563–1569. https://doi.org/10.1109/ICICAT62666.2024.10923282

Bishnoi, D., Bansal, D., Dhiman, D., Bhawna, Kaushik, U., & Kukreti, N. (2026). Smart hospitals and healthcare facilities impact of artificial intelligence in healthcare management. In R. Thapar, A. V. S. Kumar, F. Alturise, & O. S. Saleh, Handbook on Integrating Smart Technologies for Sustainable Development (1st ed., pp. 114–133). CRC Press. https://doi.org/10.1201/9781003586951-7

C. Paraiso, C. J., A. Mejia, M. J., P. Pagatpatan, M. D., A. Remo, C. K., & Apan, J. V. (2024). Design of an RFID-Based Smart Queueing System Integrated with Computer Vision Utilizing Dynamic Source Routing Algorithm. TENCON 2024 - 2024 IEEE Region 10 Conference (TENCON), 649–652. https://doi.org/10.1109/TENCON61640.2024.10903103

Chithaluru, P., Narsimhulu, P., Sudhakar Yadav, N., Chawla, P., & Tiwari, R. (2024). Fog computing. In S. Harnal, R. Tiwari, L. Garg, & A. Mathur, Cloud and Fog Optimization-based Solutions for Sustainable Developments (1st ed., pp. 280–298). CRC Press. https://doi.org/10.1201/9781003494430-14

Ciccarelli, M., Bramanti, A., Carrizzo, A., Garofano, M., Visco, V., Izzo, C., Rusciano, M. R., Galasso, G., Loria, F., Bruno, G., & Vecchione, C. (2025). Artificial intelligence-based remote monitoring for chronic heart failure: Design and rationale of the SMART-CARE study. Frontiers in Digital Health, 7, 1719562. https://doi.org/10.3389/fdgth.2025.1719562

Cilluffo, S., Bassola, B., Lyons, K. S., Lee, C. S., Vellone, E., Pucciarelli, G., Clari, M., Dimonte, V., & Lusignani, M. (2024). The role of NURSE–PATIENT mutuality on SELF?CARE behaviours in patients with chronic illness. Journal of Clinical Nursing, 33(12), 4772–4780. https://doi.org/10.1111/jocn.17181

Costantino, J., Welson, G., & De Freitas, E. P. (2025). An Adaptive Thresholding and Fog-enabled Remote Healthcare Monitoring System. 2025 IEEE International Black Sea Conference on Communications and Networking (BlackSeaCom), 1–4. https://doi.org/10.1109/BlackSeaCom65655.2025.11193899

Dermody, G., Wadsworth, D., El Haddad, M., Prichard, R., Benson, A., Benson, T., & Craswell, A. (2026). Bridging the Digital Divide: A Multi?Method Evaluation of Nursing Readiness for Digital Health Technology. Journal of Advanced Nursing, 82(4), 3752–3766. https://doi.org/10.1111/jan.70105

Dona Lemus, O. M., Cao, M., Cai, B., Cummings, M., & Zheng, D. (2024). Adaptive Radiotherapy: Next-Generation Radiotherapy. Cancers, 16(6), 1206. https://doi.org/10.3390/cancers16061206

Gholap, A. D., Uddin, M. J., Faiyazuddin, M., Omri, A., Gowri, S., & Khalid, M. (2024). Advances in artificial intelligence for drug delivery and development: A comprehensive review. Computers in Biology and Medicine, 178, 108702. https://doi.org/10.1016/j.compbiomed.2024.108702

Khan, W., Leem, S., See, K. B., Wong, J. K., Zhang, S., & Fang, R. (2026). A Comprehensive Survey of Foundation Models in Medicine. IEEE Reviews in Biomedical Engineering, 19, 283–304. https://doi.org/10.1109/RBME.2025.3531360

Lechien, J. R., Chiesa-Estomba, C.-M., Baudouin, R., & Hans, S. (2024). Accuracy of ChatGPT in head and neck oncological board decisions: Preliminary findings. European Archives of Oto-Rhino-Laryngology, 281(4), 2105–2114. https://doi.org/10.1007/s00405-023-08326-w

Leenen, J. Pl., Schoonhoven, L., & Patijn, G. A. (2024). Wearable wireless continuous vital signs monitoring on the general ward. Current Opinion in Critical Care, 30(3), 275–282. https://doi.org/10.1097/MCC.0000000000001160

Liu, X., Liu, H., Yang, G., Jiang, Z., Cui, S., Zhang, Z., Wang, H., Tao, L., Sun, Y., Song, Z., Hong, T., Yang, J., Gao, T., Zhang, J., Li, X., Zhang, J., Sang, Y., Yang, Z., Xue, K., … Wang, G. (2025). A generalist medical language model for disease diagnosis assistance. Nature Medicine, 31(3), 932–942. https://doi.org/10.1038/s41591-024-03416-6

Lonhare, A., Ghosh, V., & Sonber, V. (2025). Impact and Application of 5G-Enabled Technologies in Healthcare. In M. Rai & J. K. Pandey, Revolutionary Impact of 5G on Advancement of Technology in Healthcare (1st ed., pp. 373–388). Apple Academic Press. https://doi.org/10.1201/9781003637455-18

Mason, K. N., & Kotlarek, K. J. (2024). Where is the Care? Identifying the Impact of Rurality on SLP Caseloads and Treatment Decisions for Children with Cleft Palate. The Cleft Palate Craniofacial Journal, 61(12), 1969–1980. https://doi.org/10.1177/10556656231189940

Mendes, B. B., Zhang, Z., Conniot, J., Sousa, D. P., Ravasco, J. M. J. M., Onweller, L. A., Lorenc, A., Rodrigues, T., Reker, D., & Conde, J. (2024). A large-scale machine learning analysis of inorganic nanoparticles in preclinical cancer research. Nature Nanotechnology, 19(6), 867–878. https://doi.org/10.1038/s41565-024-01673-7

Naqvi, M., Borton, R., Lines, S., Dallas, J., Mandizha, J., Almond, H., Edwards, C., Adams, W., Gibbons, M., Russell, A.-M., & West, A. (2025). Home Monitoring in Interstitial Lung Disease: Protocol for a Real-World Observational Study. JMIR Research Protocols, 14, e65339. https://doi.org/10.2196/65339

Ou, J., Zhang, J., Alswadeh, M., Zhu, Z., Tang, J., Sang, H., & Lu, K. (2025). Advancing osteoarthritis research: The role of AI in clinical, imaging and omics fields. Bone Research, 13(1), 48. https://doi.org/10.1038/s41413-025-00423-2

Park, C. S.-Y., Kim, M.-G., & Han, H. W. (2025). Transforming nursing practice through cutting-edge AI in healthcare: Opportunities, challenges, and ethical implications. Contemporary Nurse, 61(1), 1–6. https://doi.org/10.1080/10376178.2024.2424787

Qiao, R., Niu, S., Yang, Y., Wu, Y., Zhang, S., & Chen, Y. (2025). Design of the Nursing Products and System in Infection Ward in Post-epidemic Era. In M. Schrepp (Ed.), Design, User Experience, and Usability (Vol. 15796, pp. 346–364). Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-93227-4_24

Selles, M., Van Osch, J. A. C., Maas, M., Boomsma, M. F., & Wellenberg, R. H. H. (2024). Advances in metal artifact reduction in CT images: A review of traditional and novel metal artifact reduction techniques. European Journal of Radiology, 170, 111276. https://doi.org/10.1016/j.ejrad.2023.111276

Singh, P. P., Kumar Dixit, R., Gupta, D., & Gupta, M. (2025). Smart Healthcare in the IoMT Era: Towards a Connected Medical Ecosystem. 2025 International Conference on Intelligent and Secure Engineering Solutions (CISES), 1543–1548. https://doi.org/10.1109/CISES66934.2025.11265286

Susnjak, T., & Griffin, E. (2025). Towards clinical prediction with transparency: An explainable AI approach to survival modelling in residential aged care. Computer Methods and Programs in Biomedicine, 263, 108653. https://doi.org/10.1016/j.cmpb.2025.108653

Tunali, V., Arslan, N. Ç., Ermi?, B. H., Dervi? Hakim, G., Gündo?du, A., Hora, M., & Nalbanto?lu, Ö. U. (2024). A Multicenter Randomized Controlled Trial of Microbiome-Based Artificial Intelligence-Assisted Personalized Diet vs Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet: A Novel Approach for the Management of Irritable Bowel Syndrome. American Journal of Gastroenterology, 119(9), 1901–1912. https://doi.org/10.14309/ajg.0000000000002862

West, H. W., Dangas, K., & Antoniades, C. (2024). Advances in Clinical Imaging of Vascular Inflammation. JACC: Basic to Translational Science, 9(5), 710–732. https://doi.org/10.1016/j.jacbts.2023.10.007

Xu, M., Cao, C., Wu, P., Huang, X., & Ma, D. (2025). Advances in cervical cancer: Current insights and future directions. Cancer Communications, 45(2), 77–109. https://doi.org/10.1002/cac2.12629

Ying, H., Liu, X., Zhang, M., Ren, Y., Zhen, S., Wang, X., Liu, B., Hu, P., Duan, L., Cai, M., Jiang, M., Cheng, X., Gong, X., Jiang, H., Jiang, J., Zheng, J., Zhu, K., Zhou, W., Lu, B., … Cai, X. (2024). A multicenter clinical AI system study for detection and diagnosis of focal liver lesions. Nature Communications, 15(1), 1131. https://doi.org/10.1038/s41467-024-45325-9

Željka, O., Ivan, P., & David, B. (2025). Implementing Smart Technologies in Rural Elderly Care: Findings from an Integrative Literature Review (2019.-2024.). IFAC-PapersOnLine, 59(27), 266–271. https://doi.org/10.1016/j.ifacol.2025.12.114

Zhao, S., Liang, Q., Tao, H., Fan, S., Xia, Y., Zeng, L., Wang, G., Liu, H., Huang, H., & Xiao, J. (2024). Transition shock among nursing interns and its relationship with patient safety attitudes, professional identity and climate of caring: A cross-sectional study. BMC Nursing, 23(1), 64. https://doi.org/10.1186/s12912-024-01722-5

Zheng, Y., Qiu, B., Liu, S., Song, R., Yang, X., Wu, L., Chen, Z., Tuersun, A., Yang, X., Wang, W., & Liu, Z. (2024). A transformer-based deep learning model for early prediction of lymph node metastasis in locally advanced gastric cancer after neoadjuvant chemotherapy using pretreatment CT images. eClinicalMedicine, 75, 102805. https://doi.org/10.1016/j.eclinm.2024.102805

Zubair Rahman, A. M. J., Gupta, M., Aarathi, S., Mahesh, T. R., Vinoth Kumar, V., Yogesh Kumaran, S., & Guluwadi, S. (2024). Advanced AI-driven approach for enhanced brain tumor detection from MRI images utilizing EfficientNetB2 with equalization and homomorphic filtering. BMC Medical Informatics and Decision Making, 24(1), 113. https://doi.org/10.1186/s12911-024-02519-x

Authors

Binamin Binamin
binamintarigan@gmail.com (Primary Contact)
Budi Darmawan
Dewadharu Achsyan
Ahmad Faisol
Binamin, B., Darmawan, B. ., Achsyan, D. ., & Faisol, A. . (2026). INTEGRATING ARTIFICIAL INTELLIGENCE–ASSISTED CLINICAL DECISION SUPPORT IN NURSING PRACTICE: IMPACTS ON PATIENT SAFETY AND CARE QUALITY IN SMART HEALTHCARE SYSTEMS. Journal of World Future Medicine, Health and Nursing, 4(2), 103–116. https://doi.org/10.70177/health.v4i2.3622

Article Details