Nurses’ Experiences With Artificial Intelligence and the Association Between Clinical Decision‐Making and Missed Nursing Care: A Convergent Mixed‐Methods Study

Abstract

Introduction Artificial intelligence (AI) is increasingly being incorporated into clinical nursing practice, but evidence remains limited on how nurses experience AI‐supported systems and how decision‐making orientation relates to missed nursing care (MNC). Aim To explore nurses’ experiences with AI‐supported clinical decision support (CDS) and examine associations among clinical decision‐making orientation, professional characteristics, and MNC. Design A convergent parallel mixed‐methods study. Methods The study was conducted in six hospitals in Beni Suef Governorate, Egypt. The quantitative sample included 210 intensive care unit (ICU) nurses who completed the Nursing Decision‐Making Instrument–Revised 2014 (NDMI‐R) and the Missed Intensive Nursing Care Scale (MINCS). Fourteen nurses completed semistructured interviews, and all transcripts were included in the thematic analysis. Results NDMI‐R scores showed a small negative bivariate correlation with MNC (r = −0.178, p < 0.01), but the adjusted association was not statistically significant (β = −0.124, p = 0.063). The regression model explained 16.9% of the variance in MNC (adjusted R 2 = 14.5%). Years of experience (β = 0.198, p = 0.004) and bachelor’s degree or above compared with a technical nursing diploma (β = −0.255, p < 0.001) were significant predictors. The other education contrast, AI training/support and MISSCARE Reasons were not statistically significant. In interviews, nurses described AI‐related tools as potentially helpful for alerts, information review, workflow, and communication while also raising concerns about trust, overreliance, empathy, and training. Conclusion Nurses perceived potential benefits from AI‐supported tools, but the quantitative findings did not establish an independent effect of AI or a statistically significant adjusted association between decision‐making orientation and MNC. These findings support cautious, nurse‐centered implementation and further longitudinal evaluation. Implications for Nursing Management Managers should pair any AI‐supported CDS implementation with role‐specific training, clear accountability, usability monitoring, and safeguards that preserve clinical judgment and humanistic care.