The Transition of Critical Care Nursing to the Digital Era: Development Approaches
Keywords:
Critical care nursing, Transition theory, Nursing transition, Artificial intelligence, Health informatics systemsAbstract
Critical care nursing is undergoing a profound transformation in the digital era, shifting from traditional practice grounded in clinical experience, paper-based documentation, and personal judgment toward data-driven care supported by artificial intelligence (AI) technologies.
This article aims to analyze developmental strategies associated with integrating AI technology and health information systems into critical care nursing processes, guided by Meleis’s Transition Theory as the conceptual framework.
The analysis reveals that technology integration is not merely the addition of clinical tools, but rather a transformational process at both individual and organizational levels. Nurses must balance technology-driven care with humanistic care approaches. Meleis's theory elucidates this process through key components including awareness, engagement, adaptation, and systemic support, with digital competencies and professional ethics serving as critical determinants of success. This article proposes that critical care nurses assume the role of "transition facilitators" who can ethically and judiciously integrate technology to enhance the quality and safety of patient care. Furthermore, it provides guidance for developing nursing policies and education that align with the challenges of the artificial intelligence technology era.
References
โบตั๋น บุญฮู้, ทิพา ต่อสกุลแก้ว, และศากุล ช่างไม้. (2563). ผลของโปรแกรมการส่งเสริมการเปลี่ยนผ่านต่อความมั่นใจและการเผชิญปัญหาในการเปลี่ยนผ่านของภาวะสุขภาพในผู้ป่วยโรคหลอดเลือดสมองตีบที่เป็นครั้งแรก. วารสารพยาบาลโรคหัวใจและทรวงอก, 31(2), 187-204.
พิชญา หุยากรณ์. (2562). การเปลี่ยนผ่านบทบาทและการเรียนรู้ตลอดชีวิตหลังเกษียณอายุของอาจารย์มหาวิทยาลัย [วิทยานิพนธ์ปริญญามหาบัณฑิต ไม่ได้ตีพิมพ์]. มหาวิทยาลัยธรรมศาสตร์.
อัจฉราวดี ศรียะศักดิ์, พัชรี ชูกันหอม, ฉวีวรรณ ศรีดาวเรือง, และหทัยรัตน์ ขาวเอี่ยม. (2563). การประยุกต์ใช้ทฤษฏีการเปลี่ยนผ่านกับการเป็นพ่อแม่วัยรุ่น. วารสารพยาบาลทหารบก, 21(2), 1-8.
Al Aseri, Z. (2025). Artificial intelligence-assisted prediction models in intensive care: Applications and outcomes. Journal of Critical Care Research, 51(3), 201–210.
Berkhout, W. E. M., Smith, R., & Chen, J. (2025). Operationalization of artificial intelligence applications in the intensive care unit: A systematic review. JAMA Network Open, 8(4), e2836754.https://doi.org/10.1001/jamanetworkopen.2025.2836754
Baraka, A. A. E., Hassan, R., & Omar, F. (2025). Acceptance and readiness of critical care nurses to use artificial intelligence. International Nursing Review, 72(1), 55–67. https://doi.org/10.1111/inr.13025
Cecconi, M., Duane, B., & Rhodes, A. (2025). Implementing artificial intelligence in critical care medicine: A consensus of 22 experts. Critical Care, 29(1), 5532. https://doi.org/10.1186/s13054-025-05532-9
El-Ashry, A. M., Hassan, R., Baraka, A. E., & Said, N. (2025). Artificial intelligence integration in critical care nursing: An evidence synthesis. Evidence-Based Nursing, 28(1), 45–53. https://doi.org/10.1136/ebnurs-2024-103612
Gaur, R., Mahajan, A., & Singh, S. (2024). Data ethics and patient privacy in AI-driven healthcare systems. Journal of Nursing Ethics, 31(2), 145–156. https://doi.org/10.1111/jne.12345
Hassan, E. A., Baraka, A. E., & Said, N. (2024). Leading with AI in critical care nursing: Challenges, opportunities, and the human factor. BMC Nursing, 23(2), 2363–2372. https://doi.org/10.1186/s12912-024-02363-2
Hassanein, A. M., El-Sayed, S. M., & Nassar, H. A. (2025). Ethical and professional challenges of artificial intelligence integration in nursing practice: A systematic review. Journal of Nursing Ethics, 32(2), 215–229. https://doi.org/10.1177/09697330241234567
Kleib, M., & Nagle, L. (2024). The digital transformation of nursing: Policy frameworks and readiness assessments. Journal of Nursing Management, 32(1), 101–114. https://doi.org/10.1111/jonm.13965
Kotp, M. H., Ismail, H. A., & Basyouny, H. A. (2025). Empowering nurse leaders: Readiness for AI https://doi.org/10.1186/s12912-024-02653-x
Meleis, A. I., Sawyer, L. M., Im, E.-O., Hilfinger Messias, D. K., & Schumacher, K. (2000). Experiencing transitions: An emerging middle-range theory. Advances in Nursing Science, 23(1), 12–28. https://doi.org/10.1097/00012272-200009000-00006
Meleis, A. I. (2010). Transitions theory: Middle-range and situation-specific theories in nursing research and practice. Springer.
Meleis, A. I. (2025). Afaf Meleis’s transition theory. In M. C. Smith (Ed.), Nursing theories and nursing practice (6th ed., pp. 289–307). F. A. Davis Company.
Miskelly, P., Hooper, S., & Adams, K. (2025). Building data reasoning competency for nurses in AI-enabled healthcare environments. Nurse Education Today, 136, 106774. https://doi.org/10.1016/j.nedt.2025.106774
Park, Y., Kim, J., & Choi, S. (2025). Artificial intelligence in critical care nursing: A scoping review. Australian Critical Care, 38(2), 95–107. https://doi.org/10.1016/j.aucc.2025.01.003
Pinsky, M. R., Held, N., & Gajic, O. (2024). Critical care and artificial intelligence: Promise, pitfalls, and the path forward. Intensive Care Medicine, 50(11), 1201–1210. https://doi.org/10.1007/s00134-024-07102-5
Porcellato, E., Nguyen, T., & D'Amico, L. (2025). Exploring applications of artificial intelligence in critical care nursing: A systematic review. Nursing Reports, 15(2), 55–67. https://doi.org/10.3390/nursrep15020055
Rajkomar, A., Hardt, M., & Howell, M. (2024). Ensuring fairness in machine learning for healthcare.Nature Medicine, 30(1), 12–20. https://doi.org/10.1038/s41591-023-02517-9
Ramadan, O. M. E. (2024). Facilitators and barriers to AI adoption in nursing practice: A qualitative study of registered nurses’ perspectives. BMC Nursing, 23, Article 245. https://pmc.ncbi.nlm.nih.gov/articles/PMC11654280/
Schumacher, K. L., & Meleis, A. I. (1994). Transitions: A central concept in nursing. Image: The Journal of Nursing Scholarship, 26(2), 119–127. https://doi.org/10.1111/j.1547-5069.1994.tb00929.x
Smith, L., Torres, C., & Daly, B. (2024). Transition of ICU patients and families: Applying Meleis’ theory of transition. AACN Advanced Critical Care, 35(2), 97–106. https://doi.org/10.4037/aacnacc2024324
You, H., Docherty, S. L., Ashana, D. C., & Oyesanya, T. O. (2024). Transition of intensive care unit patients and their families to home after acute hospital care. AACN Advanced Critical Care, 35(2), 97-108.
