Sistema de apoyo a la decisión con inteligencia artificial en la atención primaria de salud: percepción de los enfermeros
PDF (Portugués)
PDF (Inglés)
PDF
EPUB (Portugués)
EPUB (Inglés)
EPUB
HTML (Portugués)
HTML (Inglés)
HTML

Palabras clave

Atención Primaria de Salud
Proceso de Enfermería
Registros de Enfermería
Inteligencia Artificial
Sistemas de Apoyo a Decisiones Clínicas
Investigación Cualitativa

Cómo citar

1.
Franco APMM de L, Nascimento FC do, Fracaroli YR, Silva LE da, Terra F de S, Costa ICPS. Sistema de apoyo a la decisión con inteligencia artificial en la atención primaria de salud: percepción de los enfermeros. Online Braz J Nurs [Internet]. 2026 Nov. 4 [cited 2026 Nov. 7];25(Suppl1):e20267036. Available from: https://objnursing.uff.br/nursing/article/view/7036

Resumen

Objetivo: Analizar las percepciones de enfermeros de la Atención Primaria de Salud sobre un sistema de apoyo a la toma de decisiones clínicas basado en inteligencia artificial, identificando desafíos y barreras para su implementación. Método: Estudio cualitativo realizado mediante entrevistas semiestructuradas presenciales, en el entorno laboral, con 20 enfermeros. Las entrevistas fueron grabadas, transcritas y sometidas a un análisis de contenido temático, conforme a lo propuesto por Bardin. Resultados: Se identificaron tres categorías: Percepción sobre el sistema y su impacto en la práctica clínica, destacando el potencial de la herramienta para apoyar el razonamiento clínico, cualificar el Proceso de Enfermería y estandarizar los registros; Barreras y desafíos en la implementación y el uso del sistema, evidenciando dificultades relacionadas con la ausencia de interoperabilidad, las limitaciones de la infraestructura tecnológica y el aumento de la carga de trabajo; y Sugerencias de mejora y recomendaciones futuras, que señalan la necesidad de integración entre sistemas, mejoras en la usabilidad y estrategias que favorezcan su incorporación a los flujos de trabajo en la Atención Primaria de Salud. Conclusión: Los sistemas basados en inteligencia artificial presentan potencial para apoyar la práctica clínica en la Atención Primaria de Salud; sin embargo, su incorporación efectiva depende de la integración de los sistemas, de inversiones en infraestructura digital y de estrategias de implementación alineadas con el contexto organizacional.

PDF (Portugués)
PDF (Inglés)
PDF
EPUB (Portugués)
EPUB (Inglés)
EPUB
HTML (Portugués)
HTML (Inglés)
HTML

Referencias

Silva JF, Costa AC. Processo de enfermagem: caracterização da aplicação na atenção primária à saúde. Enferm Foco. 2024;15:e2024111:1-7. https://doi.org/10.21675/2357-707X.2024.v15.e-2024111

Kumar M, Saini A, Jeet K. Sustaining mental health amidst high-pressure job scenarios: a narrative review. Int J Community Med Public Health. 2024;11(8):3319-25. https://doi.org/10.18203/2394-6040.ijcmph20242197

Laukvik LB, et al. Utilizing nursing standards in electronic health records: a descriptive qualitative study. Int J Med Inform. 2024;184:105350. https://doi.org/10.1016/j.ijmedinf.2024.105350. PMID: 38306850.

Oliveira JAN, et al. Impacto da satisfação e motivação no estresse ocupacional da enfermagem do bloco operatório: estudo piloto. Rev Bras Enferm. 2025;78(1):1-6. https://doi.org/10.1590/0034-7167-2023-0415pt

Russell CK, McNeill M. Implementing a care plan system in a community hospital electronic health record. Comput Inform Nurs. 2023;41(2):102-9. https://doi.org/10.1097/CIN.0000000000000904. PMID: 35551143.

Tengeh LN, Bimerew M. Primary healthcare nurses’ perceptions about their ability to utilise electronic health records. Obzornik Zdrav Nege. 2022;56(3):176-83. https://doi.org/10.14528/snr.2022.56.3.3123

Golden G, et al. Applying artificial intelligence to clinical decision support in mental health: what have we learned? Health Policy Technol. 2024;13(2):100844. https://doi.org/10.1016/j.hlpt.2024.100844

Ouanes K, Farhah N. Effectiveness of artificial intelligence (AI) in clinical decision support systems and care delivery. J Med Syst. 2024;48(1):74. https://doi.org/10.1007/s10916-024-02098-4. PMID: 39133332.

Hassan M, Kushniruk A, Borycki E. Barriers to and facilitators of artificial intelligence adoption in health care: scoping review. JMIR Hum Factors. 2024;11:e48633. https://doi.org/10.2196/48633. PMID: 39207831.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57. https://doi.org/10.1093/intqhc/mzm042. PMID: 17872937.

Google. Gemini [software]. Mountain View (CA): Google; 2025 [cited 2025 Mar 15]. Available from: https://gemini.google.com/

Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2016.

Borghouts J, Eikey E, Mark G, et al. Barriers to and facilitators of user engagement with digital mental health interventions: systematic review. J Med Internet Res. 2021;23(3):e24387. https://doi.org/10.2196/24387. PMID: 33759801.

Schlieter H, Marsch L, Whitehouse D, et al. Scale-up of digital innovations in health care: expert commentary on enablers and barriers. J Med Internet Res. 2022;24(3):e24582. https://doi.org/10.2196/24582. PMID: 35275065.

Hassanein S, El Arab RA, Abdrbo A, et al. Artificial intelligence in nursing: an integrative review of clinical and operational impacts. Front Digit Health. 2025;7:1552372. https://doi.org/10.3389/fdgth.2025.1552372. PMID: 40124108.

Wei Q, Pan S, Liu X, et al. The integration of AI in nursing: addressing current applications, challenges, and future directions. Front Med (Lausanne). 2025;12:1545420. https://doi.org/10.3389/fmed.2025.1545420. PMID: 40007584.

HL7 International. HL7 standards overview [Internet]. 2024 [cited 2026 Mar 30]. Available from: https://www.hl7.org/about/standardsoverview.cfm

Mandel JC, Kreda DA, Mandl KD, Kohane IS, Ramoni RB. SMART on FHIR: a standards-based interoperable apps platform for electronic health records. J Am Med Inform Assoc. 2016;23(5):899-908. https://doi.org/10.1093/jamia/ocv189. PMID: 26911829.

Torab-Miandoab A, Samad-Soltani T, Jodati A, Rezaei-Hachesu P. Interoperability of heterogeneous health information systems: a systematic literature review. BMC Med Inform Decis Mak. 2023;23(1):18. https://doi.org/10.1186/s12911-023-02115-5. PMID: 36694161.

Alotaibi N, Wilson CB, Traynor M. Enhancing digital readiness and capability in healthcare: a systematic review of interventions, barriers, and facilitators. BMC Health Serv Res. 2025;25(1):500. https://doi.org/10.1186/s12913-025-12663-3. PMID: 40186200.

Borges do Nascimento IJ, Abdulazeem H, Vasanthan LT, et al. Barriers and facilitators to utilizing digital health technologies by healthcare professionals. NPJ Digit Med. 2023;6:161. https://doi.org/10.1038/s41746-023-00899-4. PMID: 37723240.

Alobayli F, O’Connor S, Holloway A, Cresswell K. Electronic health record stress and burnout among clinicians in hospital settings: a systematic review. Digit Health. 2023;9:20552076231220241. https://doi.org/10.1177/20552076231220241. PMID: 38130797.

Gesner E, Dykes PC, Zhang L, Gazarian P. Documentation burden in nursing and its role in clinician burnout syndrome. Appl Clin Inform. 2022;13(5):983-90. https://doi.org/10.1055/s-0042-1757157. PMID: 36261113.

Brasil. Lei nº 13.709, de 14 de agosto de 2018: Lei Geral de Proteção de Dados Pessoais. Brasília (DF); 2018.

Brasil. Ministério da Saúde. Comissão Intergestores Tripartite. Resolução nº 6, de 25 de agosto de 2016: institui o Conjunto Mínimo de Dados da Atenção à Saúde. Brasília (DF); 2016.

Elhaddad M, Hamam S. AI-driven clinical decision support systems: an ongoing pursuit of potential. Cureus. 2024;16(4):e57728. https://doi.org/10.7759/cureus.57728. PMID: 38711724.

Spazapan MP, Marques D, Almeida-Hamasaki BP, Carmona EV. Nursing process in primary care: perception of nurses. Rev Bras Enferm. 2022;75(6):e20201109. https://doi.org/10.1590/0034-7167-2020-1109. PMID: 35766750.

Freitas da Silva G, Carvalho Barbosa de Sousa N, Ketlen de Melo Oliveira T, et al. Fatores que interferem no gerenciamento do cuidado realizado pelo enfermeiro na atenção primária. Saude Pesqui. 2024;17(3):e12513. https://doi.org/10.17765/2176-9206.2024v17n3.e12513

Ammenwerth E, Zwan L. Integration of digital tools into clinical reasoning education: a rapid review. Stud Health Technol Inform. 2025;324:49-50. https://doi.org/10.3233/SHTI250159. PMID: 40270383.

Hants L, Bail K, Paterson C. Clinical decision-making and the nursing process in digital health systems: an integrated systematic review. J Clin Nurs. 2023;32(19-20):7010-35. https://doi.org/10.1111/jocn.16823. PMID: 37485751.

Agarwal R, Bjarnadottir M, Rhue L, Dugas M, Crowley K, Clark J, et al. Addressing algorithmic bias and the perpetuation of health inequities: an AI bias aware framework. Health Policy Technol. 2023;12(1):100702. https://doi.org/10.1016/j.hlpt.2022.100702

Chen F, Wang L, Hong J, Jiang J, Zhou L. Unmasking bias in artificial intelligence: a systematic review of bias detection and mitigation strategies in electronic health record-based models. J Am Med Inform Assoc. 2024;31(5):1172-83. https://doi.org/10.1093/jamia/ocae060. PMID: 38520723.

Celi LA, Cellini J, Charpignon ML, et al. Sources of bias in artificial intelligence that perpetuate healthcare disparities—a global review. PLOS Digit Health. 2022;1(3):e0000022. https://doi.org/10.1371/journal.pdig.0000022. PMID: 36812532.

World Health Organization. Ethics and governance of artificial intelligence for health [Internet]. Geneva: WHO; 2021 [cited 2026 Apr 01]. Available from: https://iris.who.int/server/api/core/bitstreams/f780d926-4ae3-42ce-a6d6-e898a5562621/content

Kang H, Batbaatar E, Choi D, et al. Synthetic tabular data based on generative adversarial networks in health care: generation and validation using the divide-and-conquer strategy. JMIR Med Inform. 2023;11:e47859. https://doi.org/10.2196/47859. PMID: 37999942.

Guillaudeux M, Rousseau O, Petot J, et al. Patient-centric synthetic data generation, no reason to risk re-identification in biomedical data analysis. NPJ Digit Med. 2023;6(1):37. https://doi.org/10.1038/s41746-023-00771-5. PMID: 36899082.

Wei J, Wang X, Schuurmans D, et al. Chain-of-thought prompting elicits reasoning in large language models. Adv Neural Inf Process Syst. 2022. https://doi.org/10.48550/arXiv.2201.11903

Tang L, Li J, Fantus S. Medical artificial intelligence ethics: a systematic review of empirical studies. Digit Health. 2023;9:20552076231186064. https://doi.org/10.1177/20552076231186064. PMID: 37434728.

Abujaber AA, Nashwan AJ. Ethical framework for artificial intelligence in healthcare research: a path to integrity. World J Methodol. 2024;14(3):94071. https://doi.org/10.5662/wjm.v14.i3.94071. PMID: 39310239.

Voorheis P, Petch J, Pham Q, Kuluski K. Maximizing the value of patient and public involvement in the digital health co-design process: a qualitative descriptive study with design leaders and patient-public partners. PLOS Digit Health. 2023;2(10):e0000213. https://doi.org/10.1371/journal.pdig.0000213. PMID: 37878566.

Conselho Federal de Enfermagem (BR). Resolução COFEN nº 736/2024 [Internet]. Brasília: COFEN; 2024 [cited 2026 Apr 01]. Available from: https://www.cofen.gov.br/resolucao-cofen-no-736-de-17-de-janeiro-de-2024/

Kilfoy A, Hsu TC, Stockton-Powdrell C, et al. An umbrella review on how digital health intervention co-design is conducted and described. NPJ Digit Med. 2024;7:374. https://doi.org/10.1038/s41746-024-01385-1. PMID: 39715947.

Brasil. Ministério da Saúde. Estratégia de saúde digital para o Brasil 2020-2028 [Internet]. Brasília: MS; 2020 [cited 2026 Apr 01]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/estrategia_saude_digital_Brasil.pdf

World Health Organization. Global strategy on digital health 2020–2025 [Internet]. Geneva: WHO; 2021 [cited 2026 Apr 01]. Available from: https://iris.who.int/server/api/core/bitstreams/1f4d4a08-b20d-4c36-9148-a59429ac3477/content

Agarwal S, Glenton C, Tamrat T, et al. Decision-support tools via mobile devices to improve quality of care in primary healthcare settings. Cochrane Database Syst Rev. 2021;(7):CD012944. https://doi.org/10.1002/14651858.CD012944.pub2. PMID: 34314020.

Gomez-Cabello CA, Borna S, Pressman S, et al. Artificial-intelligence-based clinical decision support systems in primary care: a scoping review of current clinical implementations. Eur J Investig Health Psychol Educ. 2024;14(3):685-98. https://doi.org/10.3390/ejihpe14030045. PMID: 38534906.

Türk G, Taşkıran N, Er O, et al. Developing an artificial intelligence-based clinical decision support system for nursing diagnoses. Nurs Outlook. 2025;73(6):102585. https://doi.org/10.1016/j.outlook.2025.102585. PMID: 41202464.

Dinari F, Bahaadinbeigy K, Bassiri S, et al. Benefits, barriers, and facilitators of using speech recognition technology in nursing documentation and reporting: a cross-sectional study. Health Sci Rep. 2023;6(6):e1330. https://doi.org/10.1002/hsr2.1330. PMID: 37313530.

Ehrler F, Wu DTY, Ducloux P, Blondon K. A mobile application to support bedside nurse documentation and care: a time and motion study. JAMIA Open. 2021;4(3):ooab046. https://doi.org/10.1093/jamiaopen/ooab046. PMID: 34345804.

Shah SJ, Devon-Sand A, Ma SP, et al. Ambient artificial intelligence scribes: physician burnout and perspectives on usability and documentation burden. J Am Med Inform Assoc. 2025;32(2):375-80. https://doi.org/10.1093/jamia/ocae295. PMID: 39657021.

Rotenstein LS, Holmgren AJ, Horn DM, et al. System-level factors and time spent on electronic health records by primary care physicians. JAMA Netw Open. 2023;6(11):e2344713. https://doi.org/10.1001/jamanetworkopen.2023.44713. PMID: 37991757.

Gaffney A, Woolhandler S, Cai C, et al. Medical documentation burden among US office-based physicians in 2019: a national study. JAMA Intern Med. 2022;182(5):564-6. https://doi.org/10.1001/jamainternmed.2022.0372. PMID: 35344006.

Liu TL, Hetherington TC, Stephens C, et al. AI-powered clinical documentation and clinicians’ electronic health record experience: a nonrandomized clinical trial. JAMA Netw Open. 2024;7(9):e2432460. https://doi.org/10.1001/jamanetworkopen.2024.32460. PMID: 39240568.

Creative Commons License

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.

Derechos de autor 2026 Anna Paula Mendes Marques de Lima Franco, Francini Castilha do Nascimento, Yasmim Ribeiro Fracaroli, Luiz Eduardo da Silva, Fábio de Souza Terra, Isabelle Cristinne Pinto Sampaio Costa