A Systematic Review of Electronic Nursing Care Plan Applications: Development, Features, and Suitability for Rural African Settings

A bstract Background: Electronic nursing care plan (ENCP) applications are integral tools in modern healthcare settings, offering standardized documentation, enhanced communication, and improved patient care. Objective: This review evaluated the development, nursing diagnosis features, and suitability of existing ENCP applications for rural African settings. Materials and Methods: We searched PubMed and Scopus databases for relevant articles published between 1983 and 2025. Out of an initial 315 identified records, six articles met the inclusion criteria and were reviewed. Key features assessed include the design phases, design tools applied, nursing diagnosis features, nursing speciality intended, and the suitability of ENCP applications for rural African nursing settings. Results: Findings indicate that six ENCP applications were available, each with varying features and functions. While the applications offer robust features for care planning and documentation, gaps existed in the comprehensiveness of nursing diagnosis support. One out of the six included studies (16%) consulted the end-user (clinical nurses) before planning the flow diagram (a requirement for a user-centered software development life cycle). Five out of the six included studies (83%) reported ENCP applications with a limited list of nursing diagnosis expressions. The only ENCP application with an extensive nursing diagnosis list had not been tested outside the simulation room, hence causing a knowledge gap. One (16%) of the ENCPs was potentially suitable for Africa as it could function both online and offline. Conclusion: Future developments in ENCP applications should prioritize end-user consultation and an extensive nursing diagnosis list to optimize the use across all nursing specialties and settings. The review protocol was registered on the Open Science Framework (OSF): http://doi.org/10.17605/OSF.IO/CZA7D.