Adoption of Digital Technologies in Public Health Crises: An International Large-Scale Survey

To examine nurses' adoption and use of digital technologies across six countries during the COVID-19 pandemic and identify lessons to strengthen preparedness for future public health crises.

Nurses in Australia, Finland, New Zealand, Switzerland, the United Kingdom and the United States completed an international cross-sectional survey in 2022-2023. Recruitment used snowball sampling via professional networks, associations and social media. The 41-item questionnaire captured information on technologies adopted during the pandemic, their perceived usability and contextual factors influencing their implementation.

In total, 1,423 nurses reported on 1,128 technologies. Usability varied across countries and technology categories, with average System Usability Scale (SUS) scores at the benchmark for average usability. Some countries reported higher usability than others, suggesting differences in digital infrastructure maturity and workflow integration. Across settings, respondents described challenges related to digital literacy and skills, technical barriers and connectivity, organizational readiness, training, usability and accessibility, as well as dependency on technology. These influenced adoption and effective use during the pandemic.

Nurses' experiences revealed variations in usability and implementation challenges, demonstrating that nurses were underprepared for rapid digital transformation. Strengthening digital literacy, technical infrastructure and organizational readiness supports safe and effective technology integration in future public health crises.