Mixed Reality in Nursing Practice: A Mixed Methods Systematic Review

Aim(s): To review the current evidence on mixed reality (MR) applications in nursing practice, focusing on efficiency, ergonomics, satisfaction, competency, and team effectiveness. Design: Mixed methods systematic review of empirical studies evaluating MR interventions in nursing practice. Methods: The systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with PROSPERO. Studies were included if they assessed nursing outcomes related to MR interventions. Exclusion criteria encompassed reviews, studies focusing solely on virtual reality, and those involving only nursing students. The Cochrane ROBINS-I, RoB 2, and CASP tools assessed the risk of bias and methodological quality. Data Sources: A comprehensive search of 12 databases (MEDLINE, Embase, CINAHL, Cochrane Library, Web of Science, and others) covered literature published between January 2013 and January 2023. Results: Eight studies met inclusion criteria, exploring diverse MR implementations, including smart glasses and mobile applications, across various nursing specialisations. MR demonstrated potential benefits in efficiency, such as faster task completion and improved accuracy. Satisfaction outcomes were limited but indicated promise. Ergonomic challenges were identified, including discomfort and technical issues. Studies on competency showed mixed results, with some evidence of improved skill acquisition. Team effectiveness and health equity outcomes were underexplored. Conclusion: While MR shows potential in enhancing nursing practice, evidence is heterogeneous and clinical relevance remains unclear. Further rigorous comparative studies are necessary to establish its utility and address barriers to adoption. Implications for the Profession and/or Patient Care: MR technology may enhance nursing efficiency, competency and satisfaction. Addressing ergonomic and technical challenges could optimise adoption and benefit patient care. Reporting Method: This review adheres to PRISMA guidelines. Patient or Public Contribution: No Patient or Public Contribution. Trial and Protocol Registration: PROSPERO registration: #CRD42022324066.