A Digital Health Literacy Framework for Nursing Practice

Abstract

Digital transformation in healthcare has reshaped immunization services, yet the mechanisms through which digitally enabled information environments improve nursing practice remain insufficiently integrated. This paper proposes a Digital Health Literacy Framework for Nursing Practice in which Digital Health Immunization Technology Capabilities—monitoring capability, integration capability, and decision-support capability—improve Nursing Practice Effectiveness through Decision-Making Quality, while Nursing Innovation Climate strengthens the extent to which these capabilities translate into better decisions. Grounded in a socio-technical perspective, the framework treats digital health literacy in practice as the ability of nurses to access, interpret, integrate, and act on digital information within immunization workflows rather than as an isolated technical skill. The paper reviews relevant theoretical foundations, develops hypotheses for the proposed direct relationships, identifies the moderating role of innovation climate, and highlights gaps in prior literature. Existing studies have examined digital systems, workflow issues, or adoption barriers separately, but they have rarely integrated concrete technology capabilities, organizational climate, decision-making quality, and nursing outcomes within one coherent model. The proposed framework explains how monitoring functions, interoperability, and decision-support tools can improve nursing practice when they are embedded in an innovation-supportive environment that enables sound, timely, and data-driven clinical decisions. The paper concludes with implications for nursing leaders, policymakers, and researchers seeking to strengthen digitally enabled immunization services.