Healthcare Systems at the Intersection of Just Culture and Artificial Intelligence: Emerging Challenges for Nursing Management

Abstract

Abstract: The integration of Artificial Intelligence (AI) into healthcare presents both opportunities and challenges for maintaining a Just Culture as a framework that promotes patient safety through non-punitive learning from errors while ensuring accountability for reckless or wilful misconduct. This commentary aims to explore how AI can be aligned with the principles of a Just Culture to strengthen fairness, transparency, and continuous learning in nursing practice and management. The interconnection between AI and a Just Culture has been discussed through the lenses of transformational change; ethical, educational, and professional challenges; ethical and regulatory guidance; implications for research and nursing management. It has been concluded that when implemented thoughtfully, AI can reinforce a Just Culture by supporting transparent, evidence-based decision-making and promoting organizational learning. Conversely, inadequate governance or poor communication about AI’s capabilities and limitations may erode trust and diminish staff engagement. Nurse managers are pivotal in mediating this balance ensuring that AI technologies are used responsibly, staff are educated on ethical and professional implications, and that systems are designed to enhance, rather than undermine human judgment and accountability. A well-governed integration of AI within a Just Culture can thus promote fairness, improve safety outcomes, and sustain a learning-oriented healthcare environment. This commentary can enhance our understanding and clarify how nurse managers can actively shape the integration of AI through the lens of a Just Culture. Keywords: Artificial Intelligence, AI, governance, just culture, nursing management, patient safety

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