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Responsible use of artificial intelligence (AI) decision support systems (AI-DSSs) in long-term care requires careful consideration of both benefits and risks. Nurses and stakeholders identified seven key prerequisites for ethically integrating AI-DSSs into nursing practice.

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Area of Science:

  • Gerontology and Healthcare Technology
  • Nursing Informatics and Artificial Intelligence
  • Ethical AI Implementation in Clinical Settings

Background:

  • Artificial intelligence (AI)-based decision support systems (AI-DSSs) offer potential benefits for healthcare quality and efficiency.
  • The ethical and social challenges of deploying AI-DSSs, particularly in long-term care (LTC) for older adults, require specific guidance.
  • Existing frameworks for responsible AI innovation lack detailed application to the nursing process in LTC settings.

Purpose of the Study:

  • To explore the prerequisites for responsible AI-assisted decision-making in nursing practice within LTC.
  • To gather perspectives from nurses and other professional stakeholders on the integration of AI-DSSs in LTC.
  • To identify opportunities, risks, and mitigation strategies for AI-DSSs in the context of older adult care.

Main Methods:

  • Conducted semistructured interviews with 24 care professionals in Dutch LTC.
  • Utilized two hypothetical AI-DSS scenarios and six principles of responsible AI to guide discussions.
  • Performed thematic analysis to identify themes related to AI-DSS opportunities, risks, and prerequisites.

Main Results:

  • Care professionals hold nuanced views on AI-DSSs, balancing perceived opportunities and risks.
  • Identified opportunities and risks span early care needs identification, care strategy development, shared decision-making, and caregiver workload.
  • Seven categories of prerequisites for responsible AI-DSS implementation were identified: data deliberation, balanced proactivity, incremental trust-based advancement, customization, bias mitigation, human-centric learning, and routinization.

Conclusions:

  • The success of AI-assisted decision-making in nursing hinges on the specific design and deployment of AI-DSSs.
  • Responsible AI-DSS use in LTC necessitates a 'balancing act' to manage opportunities and drawbacks effectively.
  • Cohesive action from developers and users is crucial to address interrelated prerequisites for responsible AI-DSS embedding in practice.