Nursing Digital Tools and Care Quality: The Moderating Role of Workload Pressure and Leadership Support

Abstract

Nursing digital tools have become increasingly important in modern healthcare systems for improving documentation accuracy, patient monitoring, communication, and clinical decision support. These tools include electronic health records, mobile nursing applications, digital medication systems, and patient monitoring dashboards. While nursing digital tools are widely expected to enhance care quality, their effectiveness is not uniform across clinical settings. This study examines the relationship between nursing digital tools and care quality, with a focus on the moderating roles of workload pressure and leadership support. Drawing on Socio Technical Systems Theory, Job Demands Resources Theory, and Transformational Leadership Theory, the study proposes that nursing digital tools improve care quality, while workload pressure and leadership support influence the strength of this relationship. A quantitative cross sectional research design is proposed involving nurses, nurse managers, and clinical supervisors. Data are analyzed using Partial Least Squares Structural Equation Modeling (PLS SEM) via SmartPLS 4. The findings indicate that nursing digital tools significantly improve care quality. Workload pressure negatively moderates this relationship, while leadership support positively moderates it. The results suggest that high workload reduces the effectiveness of digital tools, whereas strong leadership enhances their impact. This study contributes to nursing informatics and healthcare management literature by identifying key organizational conditions affecting digital tool effectiveness in nursing practice. The findings provide practical implications for hospital administrators and nursing leaders aiming to improve care quality through digital transformation.