Knowledge, Attitude, and Ethical Challenges of Artificial Intelligence Use in Nursing Practice Among Staff Nurses in Selected Hospitals of Lucknow District, Uttar Pradesh: A Mixed-Methods Study

Background: Artificial intelligence (AI) is increasingly being incorporated into healthcare to support clinical decisionmaking, patient monitoring, documentation, prediction, and healthcare management. Nurses are important end-users of these technologies, making their knowledge, attitudes, and understanding of ethical issues relevant to safe implementation. Objective: To assess knowledge, attitude, and perceived ethical challenges related to AI use among staff nurses in selected hospitals of Lucknow District, Uttar Pradesh, and to examine associations and relationships among these variables. Methods: A mixed-methods, descriptive and analytical study was conducted among 150 registered staff nurses in selected private hospitals of Lucknow District. Participants were selected using stratified random sampling. Data were collected using a demographic proforma, a 25-item structured knowledge questionnaire, a 10-item five-point Likert attitude scale, a 10-item ethical challenges checklist, and a semi-structured interview guide. Descriptive statistics, chi-square tests, and Pearson correlation were used for the quantitative analysis. Results: The mean knowledge score was 21.50 (SD 2.31; range 15–25), the mean attitude score was 38.30 (SD 5.21; range 30–47), and the mean ethical-challenge score was 23.00 (SD 4.33; range 16–30). Significant associations with knowledge were observed for nursing qualification, years of clinical experience, type of hospital, AI/digital-health training, use of AI-based tools, computer-use frequency, and source of AI awareness (p<0.05). Attitude was significantly associated with nursing qualification, type of hospital, AI/digital-health training, use of AI-based tools, computer-use frequency, and source of AI awareness. Ethical-challenge scores were significantly associated with nursing qualification, years of clinical experience, type of hospital, AI/digital-health training, use of AI-based tools, computer-use frequency, and source of AI awareness. Knowledge correlated positively with attitude (r=0.68, p<0.001), knowledge with ethical challenges (r=0.54, p<0.001), and attitude with ethical challenges (r=0.61, p<0.001). Conclusion: Staff nurses demonstrated good knowledge and generally positive attitudes toward AI, while reporting moderate ethical concerns. Structured AI education, digital competency development, ethical guidance, and institutional support are warranted for responsible integration of AI into nursing practice.