Computer networking as infrastructure for clinical information exchange in nursing practice: a narrative review from network architecture to nursing outcomes

Computer networks in clinical environments are commonly treated as passive data conduits. This narrative review examines them instead as technical infrastructure that conditions how nurses exchange clinical information, communicate across disciplines, and access professional knowledge. Six bibliographic databases and the primary standards corpora of HL7, IHE, IETF, IEEE, ISO/IEC and NIST were consulted for English-language sources published between January 2015 and February 2026, together with regulatory instruments in force in the United States and the European Union. Sources were identified purposively, through topic-based searching, citation chasing, and targeted retrieval of standards and regulatory documents from issuing bodies, rather than through a protocol-driven search; 83 reference entries representing 82 distinct works were retained, comprising 33 empirical clinical studies, 36 conceptual or architectural sources, 12 normative specifications, and 2 regulatory instruments. Retained sources were assigned to four evidence classes, each appraised against class-specific criteria, and every substantive claim is labelled as empirically demonstrated (E), architecturally inferred (A), or proposed (P). Three findings follow, and their evidentiary status differs. First, interoperability maturity, availability, and security architecture are architecturally implicated in the completeness and timeliness of nursing information at the point of care (A); direct empirical evidence isolating network properties from co-implemented application and workflow changes was not identified, and the available clinical evidence concerns composite interventions concentrated in high-income settings (E). Second, reported latency, bandwidth, and jitter figures are application-dependent design targets rather than clinical requirements, and no normative source for the figures most frequently cited was identified (S). Third, capabilities in 5G, edge computing, and distributed ledgers remain predominantly pre-deployment in nursing contexts (P). The review accordingly does not conclude that network architecture determines nursing or patient outcomes; it concludes that the architectural case is substantially stronger than the empirical one. A three-stage analytical model, with candidate measurable indicators, is proposed as a framework requiring empirical validation rather than as a demonstrated causal account.