Applications and Impacts of Blockchain and Smart Contract Technologies in Nursing Practice: A Scoping Review

Abstract

Digital transformation is reshaping healthcare systems worldwide, with nursing practice positioned at the forefront of technology-driven innovation. As nurses increasingly engage in data management, coordination of care, and decision-making across complex health systems, the need for secure, transparent, and trustworthy digital infrastructures has become paramount (Khezr et al., 2019). Among emerging technologies, blockchain, a decentralised and tamper-resistant ledger system, and smart contracts, which enable automated and verifiable transactions, present promising opportunities to enhance trust, accountability, and interoperability within nursing workflows (Khezr et al., 2019; Saeed et al., 2022). Smart contract’s core features: immutability, transparency, and decentralisation, make it particularly suited for addressing long-standing challenges in healthcare data management and nursing administration. In nursing contexts, potential applications include secure sharing of patient records, real-time tracking of clinical documentation, automated credential verification, and protection of consent and privacy (Kuo et al., 2017; Naresh et al., 2025). It may further facilitate process automation in areas such as nursing resource allocation, performance auditing, and continuing education accreditation. Despite its promise, the adoption of blockchain technology in nursing remains in its infancy. Most studies have centered on technical or conceptual models rather than empirical evaluations, and few have examined the direct or indirect impacts on nursing efficiency, patient safety, or care coordination (Hasselgren et al., 2020). Implementation challenges, such as scalability, interoperability with existing hospital information systems, regulatory ambiguity, and user acceptance also persist (Saeed et al., 2022). Moreover, the ethical implications related to data ownership and governance in decentralised environments warrant careful consideration in nursing settings. Given these gaps, a scoping review is needed to synthesise current evidence on the applications and impacts of blockchain and smart contract technologies in nursing practice. This review will explore their roles across nursing service delivery, management, and education, with particular attention to how these technologies influence efficiency, trust, accountability, and data security. By consolidating interdisciplinary insights, this study seeks to guide future research and inform policy and practice frameworks for integrating blockchain and smart contract technologies into the nursing profession.