{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:00:19Z","timestamp":1790373619421,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Nursing Review"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This qualitative study aimed to explore how nurses reason ethically about potential digital ethical risks arising from the routine use of digital systems in clinical practice and the strategies they propose to address these risks in response to vignette\u2010based scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Digital systems shape nursing documentation, monitoring, communication, education, and decision\u2010making. Although they support care, digital ethical risks may arise when digital outputs are accepted without clinical verification, patients are not adequately informed, or data protection is weak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A vignette\u2010elicited qualitative design was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was conducted in September 2025 with 16 nurses working in three public hospitals in Central Anatolia, T\u00fcrkiye. Data were generated through face\u2010to\u2010face interviews using seven vignette\u2010based scenarios and analyzed using Braun and Clarke's reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three main themes were generated through the analysis of nurses\u2019 ethical reasoning in response to the vignette\u2010based scenarios: (i) nurses\u2019 purposes for using digital systems, (ii) digital ethical risks in nursing, and (iii) strategies to prevent digital ethical risks. The findings within Themes 2 and 3 were organized into four subthemes\u2014nonmaleficence and beneficence, autonomy and respect for persons, justice and equity, privacy and confidentiality\u2014and further structured across three researcher\u2010developed categories: nurse, digital system, and organization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Participants\u2019 interpretations of the vignette\u2010based scenarios highlighted potential digital ethical risks that may require nurses to combine clinical judgment with ethical reasoning when using digital systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing<\/jats:title>\n                    <jats:p>Participants\u2019 responses may inform digital ethics education by highlighting the importance of verifying digital data through bedside assessment, questioning potentially unsafe digital outputs, protecting confidentiality, obtaining meaningful consent, and recognizing potential risks in documentation, alarms, communication, and data sharing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Health Policy<\/jats:title>\n                    <jats:p>Participant\u2010identified priorities may inform institutional consideration of protocols for documentation, alarm management, mobile communication, image sharing, access control, patient information, accessibility, and accountability in digital nursing care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/inr.70224","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:09:36Z","timestamp":1787839776000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurses\u2019 Ethical Reasoning About Digital Ethical Risks: A Vignette\u2010Elicited Qualitative Study"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8796-0324","authenticated-orcid":false,"given":"Bet\u00fcl","family":"Bal","sequence":"first","affiliation":[{"name":"Nursing Department, Akda\u011fmadeni School of Health Yozgat Bozok University Yozgat T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-4315","authenticated-orcid":false,"given":"Nagihan","family":"K\u00f6ro\u011flu Kaba","sequence":"additional","affiliation":[{"name":"Management and Organization Department, Vocational School of Health Services Bayburt University  Bayburt T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6378-0636","authenticated-orcid":false,"given":"Emine","family":"Apaydin","sequence":"additional","affiliation":[{"name":"Medical Services and Techniques Department, Vocational School of Health Services Bayburt University  Bayburt Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010024\u201001339\u2010x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.40486"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/inr.70111"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnr.2025.08.001"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2196\/56473"},{"key":"e_1_2_11_7_1","unstructured":"American Nurses Association.2022.The Ethical Use of Artificial Intelligence in Nursing Practice.American Nurses Association Silver Spring MD 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