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

Objectives: 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. Methods: 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. Results: 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. Conclusions: 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. Public Interest Summary : During a public health emergency, technology is often rapidly deployed to help healthcare professionals provide care. This study examined how nurses in six countries used digital technologies during the COVID-19 pandemic to better prepare for future public health crises. In 2022-2023, 1,423 nurses across Australia, Finland, Switzerland, New Zealand, the United Kingdom (UK) and the United States of America (USA) completed an online survey. They gave information on 1,128 technologies. The study found big differences in how easy the technologies were to use and implement. Common problems included nursing workforce digital skills, technical issues and how ready organizations were to use technologies and provide training for users. Fixing these issues is critical to help nurses use technology more effectively in future global health emergencies. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.