An Integrative Review of Automation Integration in Emergency Nursing Practice: Evidence Synthesis and Contextual Application to Rafidia Governmental Hospital, Palestine

Abstract

Aim

To synthesize evidence on automation integration in emergency nursing and propose a contextually appropriate implementation framework for a governmental hospital in Palestine.

Design

Integrative review.

Methods

Following the Whittemore and Knafl methodology, we conducted a comprehensive search across PubMed, CINAHL, Scopus, Web of Science, IEEE Xplore, and regional databases from January 2015 to March 2025. Two independent reviewers screened articles, with conflicts resolved through discussion. The quality of included studies was appraised using the Mixed Methods Appraisal Tool (MMAT). A total of 47 sources were included and analyzed thematically using NVivo 14, guided by sociotechnical systems theory and ethics of care principles.

Results

Five themes emerged: (1) types of automation with proven efficacy in emergency nursing; (2) outcomes including workflow efficiency gains (up to 40% time savings reported in high-resource settings) and safety improvements (30%–50% error reduction); (3) contextual barriers (infrastructure, financial constraints, and workforce readiness) and facilitators (nurse involvement and phased implementation); (4) ethical considerations specific to Arab healthcare contexts; and (5) alignment of local pilot experiences at Rafidia Hospital with global evidence. Key gaps identified include the absence of formal governance, limited evaluation infrastructure, and a lack of embedded sustainability planning, gaps that are particularly consequential in politically constrained, resource-limited environments.

Conclusion

Automation holds significant promise for emergency nursing in Palestine, but success depends on contextual adaptation, nurse-led design, and sustainable planning.