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Objective The aims of this quasi-experimental before-and-after study were to first determine whether the use of eye tracking technology combined with video debriefing techniques has the potential to improve the quality of feedback and enhance situation awareness (SA) in simulated settings and second to determine students' satisfaction towards simulated learning. Methods Nursing and paramedicine students from three universities participated in three 8-minute simulation scenarios of acutely deteriorating patients. Eye tracking glasses video recorded the scenarios and tracked right eye movement. On completion, participants were questioned using the Situation Awareness Global Assessment Technique, completed the Satisfaction with Simulation Experience Scale (SSES), and provided textual feedback and received video-based verbal feedback. Results Participants lacked awareness of presenting medical conditions and patient environments and had poor recall of patient vital signs. Significant improvements in SA scores were demonstrated between the first and third scenarios ( P  = 0.04). Participants reported greater insight into their performance and were satisfied with simulated learning. Conclusions Use of visual field review techniques appears to enhance the use of realistic simulated practice as a means of addressing significant performance deficits. Eye tracking and point of view recording techniques are feasible and with applicable debriefing techniques could enhance clinical and situated performance. [ABSTRACT FROM AUTHOR]

Numerous socio-legal factors make the process of surrogate decision-making for people living in dementia very complicated in Japan. In this discussion paper, we argue that the lack of early consultation between patients, surrogate decision-makers and healthcare providers and the overreliance of patients and their families on doctors to assume the decision-making role lead to healthcare practices that may not align with the patient's wishes. Further, we argue that lack of laws on surrogate decision-making, changing family structure and the liabilities associated with the care of people living with dementia contribute to the complexity of the decision-making process in Japan. Finally, given the rapidly changing social and healthcare norms in Japan, we call for greater involvement of nurses and care workers in the decision-making process to ensure patient-centric treatment and care are adopted. [ABSTRACT FROM AUTHOR]

Objective Healthcare institutions worldwide are moving to electronic health records (EHRs). These transitions are particularly numerous in the US where healthcare systems are purchasing and implementing commercial EHRs to fulfill federal requirements. Despite the central role of EHRs to workflow, the cognitive impact of these transitions on the workforce has not been widely studied. This study assesses the changes in cognitive workload among pediatric nurses during data entry and retrieval tasks during transition from a hybrid electronic and paper information system to a commercial EHR. Materials and methods Baseline demographics and computer attitude and skills scores were obtained from 74 pediatric nurses in two wards. They also completed an established and validated instrument, the NASA-TLX, that is designed to measure cognitive workload; this instrument was used to evaluate cognitive workload of data entry and retrieval. The NASA-TLX was administered at baseline ( pre -implementation), 1, 5 and 10 shifts and 4 months post- implementation of the new EHR. Results Most nurse participants experienced significant increases of cognitive workload at 1 and 5 shifts after “go-live”. These increases abated at differing rates predicted by participants’ computer attitudes scores ( p = 0.01). Conclusions There is substantially increased cognitive workload for nurses during the early phases (1–5 shifts) of EHR transitions. Health systems should anticipate variability across workers adapting to “meaningful use” EHRs. “One-size-fits-all” training strategies may not be suitable and longer periods of technical support may be necessary for some workers. [ABSTRACT FROM AUTHOR]

This is the last in a short series of papers on measurement theory and practice with particular relevance to intervention research in nursing, midwifery, and healthcare. Understanding how it is that people respond to the questions posed by researchers is fundamental to progress in the social and health sciences. For decades methodologists in psychology, marketing, education, and survey research have studied this issue. In this paper I review this diverse empirical literature to synthesize basic principles for creating rating scales which can reduce measurement error and increase the quality of resulting data. After introducing a theoretical framework known as the cognitive aspects of survey methods (CASM), I review the fundamentals of psychological scaling theory and discuss how it has been used to study the meanings of verbal response options and provide an illustration of how the quality of measurements may be influenced by our choice of the verbal phrases we present as response options. Next, I review the research on the optimal number of response options to use in various measurement situations and how verbal and numeric anchors can combine to influence data quality. Finally, I summarize the issues covered and present recommendations for best practice when creating and using rating scales in research. [ABSTRACT FROM AUTHOR]

Abstract: Background: Paper based simulated patients are widely used to analyse nurses’ clinical judgements. However, developments in the physical simulation of clinical environments offer exciting, but relatively underexploited, opportunities for exploring nurses’ judgements. Critical event risk assessment is an element of acute care practice which lends itself well to simulation and in which more clinical experience is often assumed to lead to better quality judgements. Objectives: To model nurses’ judgements of critical event risk using physical and paper simulation and to examine whether improving fidelity via physical clinical simulation impacts on the apparent benefits of clinical experience on nurses’ judgement performance. Design: A comparative clinical judgement analysis. Setting: A university in Northern England. Methods: Sixty-three nursing students and 34 experienced nurses made dichotomous risk assessment judgements (“at risk” or “not at risk”) in response to 25 paper and physical simulated scenarios. These were randomly generated from a dataset of real patient case records. Clinical outcomes (the judgement criteria) for a ‘correct’ judgement were derived from the same case records. Logistic regression models were constructed to derive statistics for each nurse representing various measures of judgement performance: achievement (r a ), consistency (R s ) and clinical information use (G). These statistics were known as Lens Model statistics (from the psychological theory of Brunswik''s Lens Model of judgement). Performance measures for novice and experienced nurses were compared. Results: No significant differences in judgemental achievement (r a ) between experienced nurses and students were observed in either paper or high fidelity clinical simulations. Similarly, there were no significant differences in the nurses’ abilities to correctly match the ways they synthesised clinical information with the optimum synthesis required by the task (policy matching) (G). When faced with “paper patients” experienced nurses exercised more cognitive control/consistency (R s ) than students (P =0.04). However, this heightened control in experienced nurses was absent when those same nurses made judgements in the higher fidelity clinical simulation environment. Conclusion: Clinical experience made no difference to nurses’ judgement achievement (accuracy) in either the lower fidelity paper scenarios or the higher fidelity setting of the clinical simulation unit. The significant impact of clinical experience on judgement consistency was negated by the increases in fidelity offered through clinical simulation. [Copyright &y& Elsevier]

Abstract: Nurses globally are required and expected to report nursing errors. As is clearly demonstrated in the international literature, fulfilling this requirement is not, however, without risks. In this discussion paper, the notion of ‘nursing error’, the practical and moral importance of defining, distinguishing and disclosing nursing errors and how a distinct definition of ‘nursing error’ fits with the new ‘system approach’ to human-error management in health care are critiqued. Drawing on international literature and two key case exemplars from the USA and Australia, arguments are advanced to support the view that although it is ‘right’ for nurses to report nursing errors, it will be very difficult for them to do so unless a non-punitive approach to nursing-error management is adopted. [Copyright &y& Elsevier]

Abstract: Background: The last 30 years have seen a proliferation of literature about spirituality in the nursing press. A dominant theme has been the need to differentiate spirituality from religion and this has provoked a number of authors to attempt to define and describe religion. As nursing advocates respect for the person''s religious beliefs the way in which it is portrayed is very relevant. Aims: This work explores how religion is defined and discussed in the nursing literature about spirituality to consider whether the way religion is portrayed could be said to demonstrate ‘respect’ for religious beliefs. Methods: Texts about religion were examined in relation to theories of religion from anthropology, sociology and religious studies. These disciplines have produced substantive or irreducible accounts in contrast to functional and reductive theories about religion. Results: The result of this analysis is that there appears to be a tendency to talk about religion without using sources which itself suggests a lack of respect as well as an inclination to view it only in reductive and functional terms. This is proved by the similarity of ideas in the nursing literature to the functionalist and reductionist theories of Frazer, Tylor, Marx, Durkheim and Freud. This approach is criticised with reference to the work of Otto, Bellah, Berger and Pals who suggest that religion should be seen as irreducibly to do with the sacred. It is proposed that this is a more appropriate outlook to take for an occupation which professes to respect the religious beliefs of all individuals. However, viewing religion in this more meaningful way, acknowledging their spirituality has implications for attempts to differentiate religion and spirituality. Conclusion: Reductive accounts of religion imply, probably inadvertently but nevertheless negative, attitudes towards religious belief. A more serious and deeper exploration of the meaning of religion from the standpoint of irreducibility might be more respectful and tolerant of religious belief. This is particularly salient in a society where religious practice is increasing both in the indigenous population and as a result of immigration. [Copyright &y& Elsevier]

Abstract: In this article, a critique of cancer nursing literature on the issue of sexuality is presented, with particular reference to literature on cancers common to women. The paper begins with an account of two competing perspectives on sexuality. The first is a version of sexuality rooted in sexology, underpinned by biomedical science that makes a claim to having identified ‘normal’ sexuality. The second is a version of sexuality developed within feminist scholarship that tends to reject biological determinism as a basis for understanding sexuality, instead favouring constructionist perspectives, with the socio-political context of sexual relations problematised. The focus of the article then shifts to cancer nursing literature on sexuality that deals primarily with cancers common to women, to appraise the extent to which either of the above perspectives on sexuality is invoked. Within this body of nursing knowledge, I argue that there has largely been an uncritical endorsement of biomedical constructions of sexuality, rooted in orthodox sexology, with a dominant focus on sexual functioning and on sexual rehabilitation for women with cancer. Moreover, in this knowledge base, phallocentric heterosexuality over and above other forms of sexual expression is privileged, and the socio-political context of unequal gender power relations is largely excluded. References to the social sphere as a dimension of nursing care are focused almost exclusively on maintaining normality, and reflect the emphasis on functional restoration. The largely individualistic, uncritical and biocentric emphasis in this literature may serve inadvertently to reinforce and maintain existing gender inequalities in heterosexual relationships. Finally, I consider the difficulties for oncology nurses in dealing with contradictory truth claims or conventional wisdoms about sexuality from the disparate disciplines of which holism is comprised. [Copyright &y& Elsevier]

• Nurses are often the first responders during times of disasters who play a vital role in preserving life and sustaining all aspects of the health of the disaster-affected community. • This paper underscores the role of nursing curricula and evidence-based teaching learning strategies that can promote the next generation of nurses' preparedness for disaster nursing. Those strategies include classroom-based theory and didactic courses/course content on disaster nursing, integration of interprofessional education in disaster nursing curriculum, clinical experience, simulation and mock disaster training, and involvement of nursing students in research specific to disaster. • The inclusion of disaster management in the nursing curriculum is vital to prepare nurses who are competent, skillful and knowledgeable in providing quality care to disaster-affected communities. Trained nurses with adequate disaster education can serve as a healthcare asset during disasters and are better prepared to deliver healthcare services that are timely, need-based, culturally sensitive, and cost-effective. Disasters can occur anywhere and without warning, requiring proactive action to reduce errors and save lives. Nurses are often the first responders during times of disasters who play a vital role in preserving life and sustaining all aspects of the health of the disaster-affected community. The inclusion of disaster education in the nursing curriculum is vital to prepare nurses who are competent, skillful and knowledgeable in providing quality care to disaster-affected communities. This paper underscores the role of the nursing curriculum and evidence-based teaching learning strategies in preparing the next generation of nurses in providing quality care to the vulnerable population affected by the disaster. Moreover, the paper presents the role of theory and didactic course/course content on disaster nursing, integration of interprofessional education in disaster nursing curriculum, clinical experience, simulation and mock disaster training, and participation in research specific to disaster nursing. [ABSTRACT FROM AUTHOR]

Guided image denoising recovers clean target images by fusing guidance images and noisy target images. Several deep neural networks have been designed for this task, but they are black-box methods lacking interpretability. To overcome the issue, this paper builds a more interpretable network. To start with, an observation model is proposed to account for modality gap between target and guidance images. Then, this paper formulates a deep prior regularized optimization problem, and solves it by alternating direction method of multipliers (ADMM) algorithm. The update rules are generalized to design the network architecture. Extensive experiments conducted on FAIP and RNS datasets manifest that the novel network outperforms several state-of-the-art and benchmark methods regarding both evaluation metrics and visual inspection. • This is the first paper to raise the concept of modality gap. • This paper profoundly studies the statistical distribution of modality gap. • The proposed networks outperform the SOTA methods. [ABSTRACT FROM AUTHOR]

The health of nurses impacts the care of patients in healthcare settings today both inside and outside of hospitals. Many papers are written about nurses' burnout, depression, poor physical and mental health, weight gain, unhealthy eating patterns, back injury, moral negativity, and lack of job satisfaction. However, little attention has been paid to self-care in nurses. The goal of this paper is to discuss the importance of nurses caring for themselves as they work under stressful conditions regularly. Job satisfaction is necessary for nurses to have a healthy work-life balance and a desire to go to work. There are evidence-based interventions that can make a difference in a nurse's quality of life that can be implemented independently or within the work setting. Suggestions made by researchers include working less than 40 hr/week in a clinical setting, working a consistent time of day without rotations, expressing emotions, taking time to exercise, participating in a support group, and incorporating a place designated as a sanctuary in the clinical setting. Personal ways to improve health includes preparing healthy meals before working a shift, getting proper sleep, utilizing cognitive behavioral therapy, participating in mindfulness training, and practicing stress reduction techniques. • Nurses are critical to the care of patients in healthcare. • Evidence-based practice self-care methods can improve a nurse's career. • Work environment impacts job satisfaction and turnover rate. • Physical health, mental health, and work-life balance are key to positive wellbeing. [ABSTRACT FROM AUTHOR]

The transfer nursing robot plays a vital role in facilitating the movement of elderly individuals or patients who are unable to walk, aiding in transfers between beds, wheelchairs, and operating tables, among others. Given the current societal challenges posed by an aging population and a shortage of caregivers, transfer nursing robots have gained significant attention. This paper provides a comprehensive overview of transfer nursing robots, categorizing them into six distinct types based on their working methods. Each type's working principles and characteristics are described in detail. The transfer nursing robot is a complex integrated system, requiring analysis of key technologies. This paper investigates the application of these technologies in transfer robots and specific types, including structural design, human body force analysis, machine perception, control strategies, human–robot interaction, and comfort considerations. Additionally, it discusses current limitations in the field and identifies future trends for transfer nursing robots. [ABSTRACT FROM AUTHOR]

The aim of this FEPSAC Position Statement is to summarize current knowledge about athletes' dual careers (DCs) in the European context and propose recommendations for future DC research, practice, and policy. Inspired by the European Union's Guidelines on Dual Careers of Athletes (European Commission, 2012), researchers, practitioners, and policy makers collaborated over the last decade to create the European DC discourse as a context-informed and negotiated body of DC knowledge. In this paper, we proceed from analyzing this body of knowledge using recent review papers and European DC psychological research projects to formulating seven postulates summarizing DC research findings on factors influencing athletes in their striving for DC excellence. These factors include (1) context, (2) pathways and transitions, (3) challenges, (4) resources and coping, (5) support and empowerment, (6) student–athletes' mental health, and (7) DC development environments. In the final section, we acknowledge the contributions of European DC discourse in serving athletes in their pursuit of DC excellence and European DC culture. We also provide a critical discussion on DC knowledge gaps and, on behalf of FEPSAC, offer recommendations for DC research, practice, and policy in Europe. • Role of FEPSAC and European Commission in promoting dual career topic is stressed. • Current knowledge on athletes' dual careers in the European context is summarized. • Pursuit of dual career excellence is supported by seven research-based postulates. • Recommendations for future dual career research, practice, and policy are provided. [ABSTRACT FROM AUTHOR]

There is no settled definition of nursing science that describes how this field of scientific research is unique. This paper attempts to correct this problem. It uses a combination of historical analysis and abductive argument to support the thesis that nursing science is a sui generis social science that studies how to reconcile clinical ideals or norms that are applicable to practice in nursing with the messiness of human behavior. [ABSTRACT FROM AUTHOR]

To understand the effectiveness of interventions to increase retention of early career nurses, implemented during the pre-registration programme. Retention of nurses is an issue of global concern. The transition period spanning the final year of pre-registration nurse education programmes and the first year of qualified practice is a point of high risk for attrition from the profession. A systematic review without meta-analysis and a thematic synthesis of wider literature, reported using SWiM and ENTREQ guidelines. A convergent segregated approach was used to capture qualitative and quantitative study designs. A systematic review of quantitative papers reporting intervention and retention data and scoping review of a wider body of literature related to interventions supporting transition to qualified practice were conducted. Searches used Medline and CINAHL databases in October 2021. Data extracted from wider literature were inductively collated into themes relating to the intervention type and synthesised. Six papers were included in the systematic review and 27 papers were included in the scoping review. Interventions included internships, externships, clinical immersion programmes, capstone projects, preceptorships and psychological wellbeing programmes. There was a lack of consensus about the benefits of implementing interventions during the final year of pre-registration programmes, but some evidence that interventions incorporating preceptors, expose students to the clinical environment and involve academic/clinical collaboration, report positive outcomes related to transition to qualified practice, which potentially has an impact on motivation to stay in the profession. Greater understanding of interventions supporting student nurses to reduce likelihood of leaving once qualified has been achieved. There is some evidence these interventions lead to increases in retention, but this is limited by the quality of the reporting and the scarcity of data. Consideration should be given to maximizing students' exposure to clinical practice and the benefits that interventions with alternative approaches such as psychological wellbeing programmes may bring. This review has potential to influence effective implementation of interventions to increase retention of early career nurses if clinical practice and academic settings review proposed or actual interventions to maximise added value. the manuscript has been written in adherence with the EQUATOR guidelines following the SWiM reporting guidelines for the systematic review and the ENTREQ guidelines for the scoping review. [ABSTRACT FROM AUTHOR]

In this paper, we introduce an area and power efficient algorithm to design a hard multiple generator for radix-8 modulo 2 n − 1 multiplier, which is based on parallel prefix computation of carry propagate. Only odd carry is used to generate hard multiple bits. The proposed architecture uses ⌈log 2 n ⌉-2 prefix level with n 2 prefix operators. The Post-synthesis result of proposed architecture shows 27.91 % –36.89 % , 9.64 % –22.45 % and 0.02 % –88.62 % of saving in area, power and PDP, respectively while post-layout result shows 27.66 % –36.88 % , 14.45 % –33.53 % and 11.40 % –81.11 % of saving in area, power and PDP, respectively. • This paper introduces an area and power efficient algorithm to design a hard multiple generator for the radix-8 modulo 2 n − 1 multiplier. • The algorithm is based on parallel prefix computation of carry propagate. Only odd carry is used to generate hard multiple bits at both the positions. • The proposed architecture uses ⌈log 2 n ⌉ − 2 prefix level with n 2 prefix operators while exiting technique [5] uses ⌈log 2 n ⌉ − 1 prefix level and n prefix operators. • The proposed architecture always shows saving in terms of area and power at all specified bit lengths. • The post-synthesis and post-layout result shows 27.91%–36.89% and 27.66%–36.88% of saving in area, and 9.64%–22.45% and 14.45%–33.53% of saving in powe, respectively. • The percentage of saving in the area remain constant in intermediate values near the boundary of bit length 2 n . The saving in the area increase as the number of bits increases. The decrease in cell area is mainly due to two factors: first is less the number of prefix stages, and second is a decrease in the number of prefix operators at a particular stage. The precentage saving in the area and power increases as the number of bits increases. It happens due to the less number of prefix stages and number of prefix operator , and less swithcing activity compared to the exiting architecture. • The PDP is compared with three different techniques [5,13,14]. The post-synthesis and post-layout result shows 0.02%–88.62% and 11.40%–81.11% of saving PDP, respectively.The performance of the design is improved at the expense of delay. [ABSTRACT FROM AUTHOR]

• Expanding research capacity building in United States nursing and midwifery is critical for meeting the Sustainable Development Goals. • Three opportunities to strengthen research capacity in United States nursing and midwifery are identified in this paper that can expand the impact of our work. • Failure to address the weaknesses in our research capacity means that nurses and midwives will not have the necessary expertise to be included in national initiatives impacting multiple aspects of the Sustainable Development Goals. To meet the United Nations Sustainable Development Goals (SDGs) in the United States, research by nurses and midwives has a real opportunity to make a significant impact. This paper identifies opportunities to strengthen research capacity in the United States amongst nurses and midwives in ways that will help meet the SDGs and ensure its sustainability. Research capacity means that in a country, there are individuals and teams capable of defining problems, setting priorities, establishing objectives for the goals of the research study, and following rigorous scientific procedures. By strengthening U.S. research capacity by addressing critical weaknesses in content expertise, nursing and midwifery's voices in policy dialogues, and global research initiatives will be have greater assurance of being included. [ABSTRACT FROM AUTHOR]

• The paper presents a study investigating the intricate relationship between work demands, off-work demands, persistent fatigue, sleep patterns, and daily unsafe driving behaviors among hospital nurses. • By using an intensive diary study employing a multilevel longitudinal approach, the study identifies sleep duration as a key factor that mitigates the indirect relationships between demands, persistent fatigue, and unsafe driving. The study, however, did not find statistically significant evidence regarding the conditional indirect effect of sleep quality on unsafe driving via persistent fatigue. • These findings highlight the critical role of sleep duration as a potential mitigating factor against fatigue-induced unsafe driving among nurses, emphasizing the importance of sleep in promoting commuter safety. Hospital nurses frequently experience persistent fatigue and suboptimal sleep, potentially leading to unsafe driving behaviours. The increasing demands placed on nursing services may exacerbate this issue, given the global shortage of nurses, yet this complex relationship and how it affects nurses on a day-to-day basis remains largely underexplored. This study investigates the relationships between work demands, off-work demands, persistent fatigue, and daily unsafe driving among nurses while commuting. Using a multilevel diary study spanning five to seven consecutive days, 172 hospital nurses provided 976 data points with three momentary points per day (T1-T3). Hierarchical Linear Modeling (HLM) and Monte-Carlo methods for assessing mediation (2–1-1) and moderated mediation were applied to explore the complex interactions between work demands, off-work demands, persistent fatigue, sleep duration, sleep quality, and unsafe driving. The model was controlled for various factors such as age, gender, number of children, commuting impedance, within-person work demands, and off-work demands. Results revealed positive associations between between-person work demands, off-work demands, persistent fatigue, and unsafe driving while commuting to work on the next shift. Sleep duration was identified as a key factor mitigating the indirect relationships between individual demands, persistent fatigue, and unsafe driving. However, the study did not find significant evidence regarding sleep quality's influence on unsafe driving through persistent fatigue. Overall, this research sheds light on the intricate relationships among work demands, persistent fatigue, sleep, and daily unsafe driving, emphasizing the critical role of sleep in attenuating fatigue-induced risks during nurses' commutes. [ABSTRACT FROM AUTHOR]

• High emergency nursing turnover is problematic and can compromise patient care. • Workplace violence and burnout are common issues that can negatively impact nursing turnover. • There is a paucity of evidence that explores the factors that protect against nursing turnover in the emergency department. • Nursing turnover within the emergency department environment is multifactorial. • Factors that impact nursing turnover differ amongst geographical location, cultures and emergency departments. Internationally, the emergency nursing workforce shortage is of critical concern. To synthesise the evidence and assess the scope of literature regarding factors that contribute to turnover and retention amongst emergency nurses. A scoping review using the Joanna Briggs Institute approach was undertaken. Five databases (Embase, MEDLINE, PsycINFO, CINAHL, and Business Source Complete) were searched for papers published in English between January 2011 and June 2023 where the population was nurses, context was the emergency department, and the concept was turnover or retention. A quality appraisal was performed on included studies. A total of 31 articles met the inclusion criteria. Twenty-six studies focussed on turnover and five studies focussed on retention. Factors that contribute to ED nursing turnover included workplace violence, personal aspects (e.g., burnout or depression), organisational characteristics, and environmental/ job characteristics. Factors that contributed to ED nursing retention included mentoring programs, the advancement in nursing skills, and the transition to practice speciality (emergency) programs. A large body of literature exists regarding ED nurses' reasons for leaving their area of practice, yet limited evidence exist on retention. Research exploring factors that promote retention of emergency nurses that leads to subsequent stability and growth in the emergency nursing workforce is needed. [ABSTRACT FROM AUTHOR]

Pharmacogenomics is the bioscience investigating how genes affect medication responses. Nurses are instrumental in medication safety. Pharmacogenomics is slowly being integrated into healthcare, and knowledge and understanding of it is now pertinent to nursing practice. This paper aims to map the scholarly literature on pharmacogenomics in relation to nurses. A scoping review was conducted in four databases: CINAHL, Embase (Ovid), ProQuest Health and Medicine and PubMed using the search terms pharmacogenomic* , pharmacogenetic* , PGx* , and nurs* , resulting in 263 articles of which 77 articles met the inclusion criteria. Most articles (85 %, n = 65) were non-empirical and 12 presented empirical data (15 %, n = 12). The articles were USA-centric (81 %, n = 62) and represented a broad range of nursing specialties. The majority of scholarly literature on nurses and pharmacogenomics is narrative reviews. Further empirical research is warranted to investigate nurses' current knowledge levels and potential involvement with pharmacogenomics in clinical practice. • This scoping review found that the scholarly literature on nurses and pharmacogenomics predominantly exists of narrative reviews and limited empirical data specific to nurses. • An increased number of articles on nurses and pharmacogenomics have been published in recent years, however, the focus has been on educating nurses rather than offering explicit guidelines to propel the topic forward into nursing practice. • The majority of articles on nurses and pharmacogenomics were published in the US or by authors with an American affiliation, and nurses from other countries and healthcare contexts are encouraged to engage with and conduct research on the topic. • Our review seeks to inspire and motivate nurses to proactively engage with and embrace the evolving landscape of clinical pharmacogenomics as it pertains their nursing practice and context, across clinical, educational or research areas. [ABSTRACT FROM AUTHOR]

Globally there are mounting concerns about nurses' job satisfaction because of its pivotal role in nurse turnover and the quality of care of patients. To identify a more comprehensive and extensive knowledge of the job satisfaction of qualified general nurses working in acute care hospitals and its associated factors drawing upon empirical literature published in the last five years. Literature review. A comprehensive electronic database search was conducted in PubMed (2012–2017), Web of Science (2012–2017), CINAHL (2012–2017), Embase (2012–2017), PsycINFO (2012–2017) and the Applied Social Sciences Index (2012–2017), CNKI (2012–2017), WanFang (2012–2017), SinoMed (2012–2017) and VIP (2012–2017) to retrieve relevant articles published in both English and Chinese between January 2012 and October 2017. Key terms and phrases associated with job satisfaction, occupational stress, professional commitment, role conflict and role ambiguity were utilized in the subject search in combination with nurses following guidelines for searching the OVID interface. The abstracts or full texts of research papers were reviewed prior to their inclusion in the review according to inclusion criteria and quality assessment using the Strobe guidelines. A total of 59 papers were included in this review. The impact of job satisfaction upon sickness absence, turnover intention, as well as the influencing factors of job satisfaction such as working shift and leadership, job performance, organizational commitment, effort and reward style has been identified in a number of research studies yielding equivocal findings. Job satisfaction of hospital nurses is closely related to work environment, structural empowerment, organizational commitment, professional commitment, job stress, patient satisfaction, patient-nurse ratios, social capital, evidence-based practice and ethnic background. Various mediating or moderating pathways have been identified with nurses' job satisfaction being mediated by various factors. It is vital to increase nurses' job satisfaction because this has the potential both to improve patients' perceptions of care quality and ensure an adequate nursing workforce. The indirect relationships and predictors of job satisfaction contribute to a more comprehensive understanding of the complex phenomenon of job satisfaction, which in turn may aid the development of effective strategies to address the nursing shortage and increase the quality of patient care. [ABSTRACT FROM AUTHOR]

Abstract This paper discusses the development of corpus-based curriculum for ESP, with a focus on two underresearched areas: health care communication and the use of corpus materials for pronunciation. Three aspects of corpus-based curriculum development are explored: corpus-based needs analysis; corpus-based materials development; and corpus-based assessment and evaluation (Flowerdew, 2012; Tono, 2011). First, this paper briefly reports on a quantitative corpus-based analysis of 104 nurse-patient interactions that was conducted to identify needs of nurses in clinical interactions, with a focus on the findings related to pronunciation (pitch range, tone choice, and prominence/sentence stress). Key differences were found between international and U.S. nurse discourse in the use of these features. Next, the paper describes the curriculum for a Pronunciation for Nurses course, with an emphasis on corpus-based materials development from the corpus described above. Finally, the paper discusses the corpus-based assessment of participants' progress and an evaluation of the Pronunciation for Nurses curriculum, including pre and post-tests, interviews with nurse participants, interviews with ESL teachers, and course evaluations. The methods discussed in the paper have implications for other ESP contexts and other aspects of language use. Highlights • Α corpus analysis of prosodic features was conducted on nurse–patient interactions. • Τhe discourse of internationally educated nurses (IENs) and U.S. nurses was compared. • The findings showed that IENs marked greater prominence and narrower pitch range. • The findings and corpus materials were integrated into a pronunciation course. • The course yielded more pragmatically appropriate pronunciation. [ABSTRACT FROM AUTHOR]

Abstract Registered Nurses (RNs) are regulated health professionals who are educated and accountable for safe medication administration (MA). Binding their practice are standards, policies, procedure and legislation. MA competence is taught and assessed during professional pre-registration education programs. However, different philosophies, theories and models are used by education providers making curriculum content disparate and competency frameworks diverse. Additionally, healthcare contexts are increasingly complex and clinical environments unpredictable. Competency models must respect contemporary practice. This paper focusses on the outcomes of Australian PhD research that combined Appreciative Inquiry (AI) principles with a qualitative study to identify MA safety strategies. In this 2-phase descriptive study, twenty RNs were observed then interviewed about their MA experiences. This paper discusses the interview findings. The participants explained how they assessed patient's needs and implemented strategies to administer medications safely. They presented their actions as being underpinned by a desire to do 'the right thing for the patient' despite their practice going beyond traditional procedural frameworks and not reflecting organisational protocols. Instead, they developed common strategies to enhance safe MA. The participants' described using clinical reasoning and patient-centredness during MA. This study contributes to the knowledge needed for future practice development by highlighting what works. Highlights • Nurses apply professional knowledge, skills and attitudes that go beyond organisational protocols. • Nurses use clinical reasoning to facilitate safe MA. • Nurses practice person-centred care throughout all phases of MA. • The 5-rights framework that is ubiquitous in nursing programs does not reflect authentic practice. • Best practice models should be informed by what works well in practice. [ABSTRACT FROM AUTHOR]

The recent 50th anniversary of the 1967 Abortion Act provides the opportunity to revisit what has been termed the ‘remarkable authority’ this Act ascribes to doctors. This paper does so using as its starting point a seminal commentary on this question by the renowned medical sociologist Sally Macintyre, published in this journal in 1973 as ‘The Medical Profession and the 1967 Abortion Act in Britain’. We revisit themes from that paper through an analysis of the findings of interviews with 14 doctors who, throughout lengthy careers, have provided abortions and led the development of the abortion service in England and Wales. We contrast our findings with Macintyre's, and argue that our interviews highlight the shifting meaning of medical authority and medical professionalism. We show that those doctors most involved in providing abortions place moral value on this work; uphold the authority of women (not doctors) in abortion decision-making; view nurses and midwives as professional collaborators; and consider their professional and clinical judgement impeded by the present law. We conclude that medical sociologists have much to gain by taking abortion provision as a focus for the further exploration of the shifting meaning of medical authority. [ABSTRACT FROM AUTHOR]

This paper examines the daily practices of caring for COVID-19 patients in Wuhan, China, in early 2020 and the challenges that nurses faced. The paper shows that the affective contagion, especially among patients, introduced unexpected challenges for nurses in caring for COVID-19-infected patients. Nurses had to contend with the challenges of treating both physical and psychological problems in patients simultaneously. As a result, it was necessary for nurses to adapt to the different rhythm of COVID-19 wards to address these challenges and do so through taking on a range of general and specific nursing tasks and playing a diverse range of roles on the wards, from garbage collector to "psychological counselor." Thus, the paper brings attention to the experiences and demands of providing nursing care in an emergency pandemic context, in particular the necessity of responding to both the physical and the psychological needs of patients. These insights could better prepare health services in China and elsewhere in the world for responding effectively to potential future pandemics. • The affective contagion introduced unexpected challenges for nurses in COVID-19 wards. • Nurses adapt to the different working rhythm in COVID-19 wards than in "normal" wards. • A hierarchy of necessity emerged in the context of caring for COVID-19 patients. [ABSTRACT FROM AUTHOR]

This paper presents a new architecture to perform modular multiplication using Montgomery multiplication in Residue Number System (RNS). Two new balanced four-moduli RNS bases are selected, and the process of RNS Montgomery multiplication, including the required RNS to RNS conversions, is designed and implemented. Field-programmable gate array (FPGA) implementation using the adder-based residue/binary to binary/residue converters and ROM-free in the pipelined architecture has achieved better performance compared to the state-of-the-art works in literature. • Selection of two new balanced RNS bases to exploit the benefits of the well-formed moduli. • Design and implementation of efficient reverse converters required in the process of RNS Montgomery multiplication. • Design a pipelined architecture of RNS Montgomery multiplication to achieve higher performance. [ABSTRACT FROM AUTHOR]

To gain a deeper understanding of RNs communication related to patient safety. To determine: (1) the associations between the communication of registered nurses (RNs) within their health care teams and the frequency that they reported safety events; (2) the associations between RNs' communication within their health care teams and their perceptions of safety within the hospital unit; and (3) whether RNs' communication had improved from 2016 to 2018. We used the United Kingdom's Safety Culture model as the theoretical framework for this study. Our secondary data analysis from the Agency for Healthcare Research and Quality's Hospital Survey on Patient Safety Culture included 2016 (n = 5298) and 2018 (n = 3476) using multiple regression models to determine associations between responses for Communication Openness and Feedback & Communication About Error, and outcome responses for Frequency of Events Reported and Overall Perceptions of Safety. Our findings were: 1). In both 2016 and 2018 datasets, Feedback About Error had a greater impact on Reporting Frequency than Open Communication; 2). Feedback About Error had a greater impact on Safety Perceptions than Open Communication; 3). Open Communication and Feedback About Error and their associations with Reporting Frequency and Safety Perceptions showed little change; and, 4). The proportion of variance was low, indicating factors other than Open Communication and Feedback About Error were involved with Reporting Frequency and Safety Perceptions. Pediatric RNs' communication, reporting, and perceptions of patient safety have not improved. (245 words). What is already known about the topic? • Hospitalized children in the United States suffer preventable harm with efforts to reduce iatrogenic injury in children's care not effective. • Nurses fear retaliation when reporting patient safety events in the pediatric care setting. What this paper adds: • Open communication within health care teams did not improve RNs' reporting of incidents that cause children harm. • Feedback from hospital leadership about reported safety events improves RN's perceptions of children's safety and encourages reporting. • RNs will not report safety events unless they feel psychologically safe to report them. Until this happens, children will continue to be harmed. [ABSTRACT FROM AUTHOR]

English high-secure hospitals have contained individuals deemed mentally disordered, and dangerous, since the mid-nineteenth century. With the development of gender sensitive services female patients have been moved out of these institutions into smaller secure settings. Female staff continue to work in high secure hospitals, but are often in a minority in these services. Little is known about how female staff experience the everyday world of work. This paper is based on in-depth interviews with female nurses employed in a unit caring for detained male sexual offenders with a diagnosis of personality disorder. It forms part of a much larger discourse-analytic study of nine patients, with a history of sexual offending, and eighteen mental health nurses, which focused on talk about pornography and criminality. The findings from this project have been previously reported in Mercer and Perkins (2014). This paper demonstrates how patriarchy remains an enduring cultural characteristic of caring for men detained under the Mental Health Act (1983, 2007) because of sexually violent crimes against women and children. It textures the ward environment and the relationships between people who work within it, constructing women as 'outsiders' and producing a masculine culture which leaves female staff feeling vulnerable and at risk. The analytic focus of the paper is concerned with exploring how women experience working in the male-dominated environment of a high-security Personality Disorder Unit (PDU). Three discursive repertoires are identified: the institutional space as male, the impact of working with men detained as a result of sexual offending, and the construction of therapeutic work as a 'job for the boys'. In this world, female staff, as a product of their gender, constructed themselves both as at risk and inviting risk. [ABSTRACT FROM AUTHOR]

Background A growing body of literature has identified a range of beneficial physiological and psychological outcomes from the regular practice of mindfulness meditation. For healthcare professionals, mindfulness meditation is claimed to reduce stress, anxiety and burnout, and enhance resilience. Objective The objective of this integrative review was to critically appraise the literature that related to the effectiveness of mindfulness meditation programs for nurses and nursing students. Design This review was conducted using Whittemore and Knafl's framework for integrated reviews. Data Sources Using the terms mindfulness, mindfulness-based-stress reduction, Vipassana, nurses, and nurse education a comprehensive search of the following electronic databases was conducted: CINAHAL, Medline, PsycINFO, EMBASE. EMCARE, ERIC and SCOPUS. Review Methods The initial search located 1703 articles. After screening and checking for eligibility 20 articles were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers and McMaster's Critical appraisal form for quantitative papers. The final number of papers included in the review was 16. Results The results of this review identified that mindfulness meditation has a positive impact on nurses' and nursing students' stress, anxiety, depression, burnout, sense of well-being and empathy. However, the majority of the papers described small scale localised studies which limits generalisability. Conclusion Contemporary healthcare is challenging and complex. This review indicated that mindfulness meditation is an effective strategy for preventing and managing the workplace stress and burnout, which so often plague nursing staff and students. Further studies with larger sample sizes using rigorous research methods would be useful in extending this work. [ABSTRACT FROM AUTHOR]

This paper reports on a research study conducted with a group of nurses in Sweden enrolled in a newly developed blended learning master's programme to become advanced practice nurses (APNs). As background, the paper presents the regional needs the programme is intended to address and describes how the programme was designed. The aim was to understand how, from students' perspective, the nurse master's programme structured knowledge for their future position as APNs. The research question focuses on how the master's programme prepares students by meeting their diverse needs for knowledge. Empirical material was collected at two times during the students' first and second years of study through semi-structured qualitative interviews. The findings highlight the process in which these master's students gained a more advanced identity of becoming APNs. This process demonstrates how students perceive their current position as nurses based on a discourse of knowledge in relation to the practical and theoretical knowledge they encounter in the master's programme. This article concludes by recommending that attention should be paid to developing APN role models in the current Swedish healthcare system. [ABSTRACT FROM AUTHOR]

Low back pain is a prevalent issue worldwide, impacting all healthcare professionals, in particular nurses, and leading to disability. This study aimed to explore the predictive contribution of demographic factors, the presence of LBP, and knowledge about LBP in forecasting the level of disability among nurses in Oman. A cross-sectional study was conducted using a paper-based questionnaire comprising two valid tools: the Low Back Pain Knowledge Questionnaire and the Oswestry Low Back Disability Questionnaire. A total of 236 nurses working in two tertiary hospitals in Oman participated in the study. The findings indicate that 66.8% of nurses had low back pain. The low back pain knowledge score was 13.81(SD 4.42). The mean disability score was 9.13 (SD 8.56), indicating mild disability. There is a negative significant association between low back pain knowledge (r = -0.24, p <.004) and disability level. The low back pain presence was also significantly associated with disability level (t (233) = 4.606, p <.001). The results of the regression indicated the two predictors (i.e., knowledge level and low back pain) explained 13 % of the variation in nurses' disability level [F (3,230) = 11.447, p =.01]. Low back pain is prevalent among nurses in Oman, and it is associated with disability. Preventive strategies need to be implemented. [ABSTRACT FROM AUTHOR]

• Nurses are essential to keeping patients safe from antibiotic harm. • Organizational context & culture influence nurse engagement in antibiotic stewardship. • Antibiotic stewardship practices can be integrated into nurses' daily workflow. • The SCAN-P Framework provides a guide for nursings' antibiotic stewardship practice. There is a pervasive view among some nurses and health care disciplines that antibiotic stewardship (AS) is solely a physician or pharmacist responsibility. There is an urgent need to alter this view so that nurses can seize every opportunity to prevent patient harm from antibiotics and optimize antibiotic use. One challenge to achieving full nurse engagement as equal members of the AS team is lack of an organizing framework to illustrate relationships of phenomena and concepts inherent to adoption of AS nursing practices. We sought to create a framework derived from the peer-reviewed literature, systematic and scoping reviews, and professional standards, consensus statements and white papers. The emerging framework went through multiple iterations as it was vetted with nurse clinicians, scholars and educators, physicians, pharmacists, infection preventionists and AS subject matter experts. Our evidence-based Antibiotic Stewardship Nursing Practice SCAN-P Framework provides the much-needed context and clarity to help guide local-level nurses to participate in and lead AS nursing practice. Nurses worldwide are ideally situated to provide holistic person-centered care, advocate for judicious use of antibiotics to minimize antibiotic resistance, and be AS educators of their patients, communities and the general public. The Antibiotic Stewardship Nursing Practice SCAN-P Framework provides a tool to do so. [ABSTRACT FROM AUTHOR]

Background: Apparent overconfidence and underconfidence in clinicians making clinical judgements could be a feature of evaluative research designs that fail to accurately represent clinical environments. Objectives: To test the effect of improved realism of clinical judgement tasks on confidence calibration performance of nurses and student nurses. Design: A comparative confidence calibration analysis. Settings: The study was conducted in a large university of Northern England. Methods: Ninety-seven participants rated their confidence - using a scale that ranged from 0 (no confidence) to 100 (totally confident) on dichotomous clinical judgements of critical event risk. The judgements were in response to 25 paper-based and 25 higher fidelity scenarios using a computerised patient simulator and clinical equipment. Scenarios, and judgement criteria of 'correctness', were generated from real patient cases. Using a series of calibration measures (calibration, resolution and over/underconfidence), participants' confidence was calibrated against the proportion of correct judgements. The calibration measures generated by the paper-based and high fidelity clinical simulation conditions were compared. Results: Participants made significantly less accurate clinical judgements of risk in the high fidelity clinical simulations compared to the paper simulations (P = 0.0002). They were significantly less confident in high fidelity clinical simulations than paper simulations (P = 0.03). However, there was no significant difference of over/underconfidence for participants between the two simulated settings (P = 0.06). Participants were no better calibrated in the high fidelity clinical simulations than paper simulations, P = 0.85. Likewise, participants had no better ability of discriminating correct judgements from incorrect judgements as measured by the resolution statistic in high fidelity clinical simulations than paper simulations, P = 0.76. Conclusions: Improving the realism of simulated judgement tasks led to reduced confidence and judgement accuracy in participants but did not alter confidence calibration. These findings suggest that judgemental miscalibration of confidence in nurses may be a systematic cognitive bias and that simply making scenarios more realistic may not be a sufficient condition for correction. [ABSTRACT FROM AUTHOR]

Professional nursing bodies have had a well-established, collective history of advancing the nursing profession through career development, advocacy, and continuing education. The purpose of this review paper is to provide a historical overview of these entities, leading up to the formation of specialty nursing associations and the emergence of the Association of Women's Health Obstetric and Neonatal Nurses (AWHONN). The Association of Women's Health Obstetric and Neonatal Nurses is a leader in research, education, and advocacy in the field of women's health, obstetric, and neonatal nursing that has focused on promoting the health and well-being of women, newborns, and their families for the past fifty years. [ABSTRACT FROM AUTHOR]

Countries strive to find suitable solutions to offer health services to their populations. Pharmacist-led services are a possible solution to supplement the care offer with a clear advantage of proximity, with demonstrated expertise in medication use. This paper aims to audit the scope of antithrombotic care services available; and to describe the arrangements adopted for meeting the needs of the population. A multi-stage project involved the development of the list of services, generated during a face-to-face expert meeting; the definition of each service by literature search; and their clustering into three main groups (general, specific and support); resulting in an online audit of each service's availability, the settings where the service was available and the possible providers. The audit was distributed to a taskforce devoted to antithrombotic care representing 22 countries, with response obtained for all. Most reported general services were Transfer of care and Comprehensive Medication Review. Among specific services, Point-of-care testing for INR and renal function and Patient Education on antithrombotic care (antiplatelets and anticoagulants) were the most frequent. Interprofessional Education as a support service was very common, but the use of the Choosing Wisely initiative to inform evidence-based decisions was still limited. There was wide diversity found in arrangements for the provision of services to support patients taking antithrombotic medication, albeit specific services were reported in over half the surveyed countries. [ABSTRACT FROM AUTHOR]

Background Nurses’ physical performance at work has implications both for nurses’ occupational health and patient care. Although nurses are the largest healthcare workforce, are present 24-hours a day, and engage in many physically demanding tasks, nurses’ occupational physical activity levels are poorly understood. Objectives The aim of this systematic review was to examine nurses’ occupational physical activity levels, and explore how nurses accumulate their physical activity during a shift. Design This narrative systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Statement. Data sources EBSCOHost (MEDLINE, CINAHL, Age Line, Academic Search Complete, Global Health, Health Business Centre, Health Policy Reference Centre, Health Source (Consumer and Nursing/Academic Edition) and SPORTDiscus), Embase, Informit, ProQuest Health and Medical, Science Direct, Scopus, and Web of Science databases. Review methods A systematic search of seven databases were completed to locate peer-reviewed journal articles documenting nurses’ occupational physical activity levels from January 1990. Papers were included if they were original research papers; measured physical activity objectively and/or subjectively; reported nurses’ occupational physical activity; and were published in English. Articles were excluded if nurses’ data were not reported separately from other professional groups. Two researchers independently screened the articles, extracted data, and undertook the methodological quality assessments. Results Fifteen studies met the inclusion criteria. Nursing work predominantly comprised of light-intensity physical activity. In nine studies how nurses’ accumulated occupational physical activity were documented and showed that the majority of a nurses’ shift was spent standing or walking whilst completing direct patient care tasks. However, the definition of the nursing populations studied were often poorly reported, and few researchers reported the validity and the reliability of the measurement tools used. Conclusions Nurses’ occupational physical activity levels largely consist of light-intensity physical activity interspersed with moderate-intensity tasks. It is not known whether physical activity during one shift affects the activity levels in the following shift. This systematic review is the first step towards understanding the physical demands of nursing work, and how nurses’ physical activity may impact workplace wellbeing and patient safety. Limitations A meta-analysis was not possible due to the variability in how physical activity outcomes were presented. Several studies had heart rate outcomes that were converted, where possible, by the authors into physical activity outcomes. Registration This systematic review is registered with PROSPERO; Registration number: CRD42016045427 [ABSTRACT FROM AUTHOR]

Background To provide adequate nursing care it is important for nursing staff to communicate effectively with people with dementia. Due to their limited communication skills, people with dementia have difficulties in understanding communication and expressing themselves verbally. Nursing staff members often report communication difficulties with people with dementia, which emphasises the urgent need for interventions to improve their communication with people in this specific target group. Objectives To provide an up-to-date overview of communication interventions that are applicable during daily nursing care activities, irrespective of care setting, and to describe the effects on communication outcomes in people with dementia and nursing staff. Design Systematic literature review Data sources The Cochrane Library, CINAHL, PsycINFO, and Pubmed databases were searched for all articles published until the 23rd of February 2016. Review methods Papers were included, if: (1) interventions focused on communication between nursing staff and people with dementia and were applicable during daily nursing care; (2) studies were (randomised) controlled trials; (3) papers were written in English, Dutch, or German. Data were extracted on content and communication outcomes of interventions, and on methodological quality of the studies. The data extraction form and methodological quality checklist were based on the Method Guidelines for Systematic Reviews for the Cochrane Back Review Group. Results Six studies on communication interventions were included. All of the studies incorporated a communication skills training for nursing staff with a broad range in frequency, duration and content. In addition, there was wide variation in the communication outcome measures used. Four studies measured non-verbal communication, all found positive effects on at least some of the communication outcomes. Four studies measured verbal communication, of which three found positive effects on at least one of the measured outcomes. Methodological quality assessment demonstrated a high risk of bias in five of the six studies. Conclusions Few studies have been identified with wide variation in interventions and outcome measures. In addition, the methodological shortcomings make it difficult, to draw conclusions about the effectiveness. More research is needed to develop and evaluate communication interventions. Additionally, it is useful to reach consensus on defining and measuring communication. [ABSTRACT FROM AUTHOR]

Nurses are the largest health professional body globally. Despite the significant role they play in healthcare, nurses exhibit poor dietary habits and have high rates of chronic diseases. Understanding the factors underlying healthy eating for nurses in the workplace is important to implement effective interventions. To identify enablers and barriers related to healthy eating among nurses employed in a hospital setting. A systematic literature review of qualitative, quantitative, and mixed methods research (PROSPERO ID: CRD42021290913). A comprehensive systematic search was conducted across PubMed, CINAHL, Embase, Web of Science and ProQuest databases for papers published after January 2015. Two authors independently screened titles and abstracts of 4139 deduplicated studies, performed critical appraisals on eligible studies using the Mixed Methods Appraisal Tool and extracted data relevant to the research question. This review includes papers that examined nurses' eating behaviours specifically, were conducted in a hospital setting and distinguished healthy eating from other behaviours. Data synthesis was conducted through descriptive summarisation of studies and enablers and barriers were classified according to the socio-ecological model. A total of 29 studies were identified with 8024 participants. 8 studies were qualitative, 18 quantitative, and 3 were mixed method design. At an environmental level, barriers were high accessibility and availability of unhealthy foods, high cost and low availability of healthy foods and lack of storage and preparation facilities, while an enabler was close proximity to healthy options. Novel organisational enablers were considered roster planning which allowed for established routines around meals, and structured workplace programs that encouraged improvement in health behaviours, while barriers were shift work, inconsistent rosters and high work demands. An interpersonal enabler was supportive networks while barriers were work culture, social norms of celebrations and gifts of food from patients. Finally, intrapersonal barriers were stress and fatigue, personal values, beliefs, attitudes, and individual characteristics, with the latter two also acting as enablers. This review identifies the complexity and interconnectedness of enablers and barriers to healthy eating across four domains of the socio-ecological model. Multi-faceted strategies which address factors across several domains are recommended for healthcare organisations to facilitate healthy eating among nurses. Further research is needed to assess these strategies and understand the extent to which eating behaviours can be improved. [ABSTRACT FROM AUTHOR]

Background Nurses play a dominant role in the healthcare sector. However, the working condition of nurses in India is far from satisfactory due to a variety of factors. This is further compounded by the lack of respect for nurses and their profession. Therefore, there is a need to examine factors that could mitigate this situation. Objective The objective of this paper is to examine the relationship between authentic leadership and employee creativity, while determining the mediating effect of knowledge sharing behaviour and moderating effect of use of information technology on this association. Design A questionnaire-based survey was used to collect the data. Macro process (Hayes) was used to examine the mediating role of knowledge sharing behaviour and the moderating role of use of information technology in the relationship between authentic leadership and employee creativity. Settings Data was collected from 43 small- and medium-sized hospitals in the state of Uttarakhand, India. Participants The participants in the present study were 405 nurses and their 81 supervisors from the above hospitals. Results Results indicate that authentic leadership is positively linked to the creativity of employees. Further, knowledge sharing behaviour is found to mediate the relationship between authentic leadership and employee creativity, while use of information technology acts as a moderator between knowledge sharing behaviour and employee creativity. The findings of this investigation can help healthcare managers understand the importance of knowledge creation and knowledge sharing among healthcare workers. This paper draws attention to the need for hospital administrators to establish an appropriate information technology infrastructure to effectively manage the knowledge pool of the organization. This study also highlights the importance of effective leadership style, namely authentic leadership, in positively influencing employee creativity in healthcare institutions, a service oriented industry. Conclusion This study contributes to existing research on authentic leadership and employee creativity by showing that knowledge sharing behaviour and use of information technology are important and relevant variables that affect the degree of influence that authentic leadership has on employee creativity. [ABSTRACT FROM AUTHOR]

Objectives Interprofessional collaboration between midwives and health visitors working in maternal and child health services is widely encouraged. This systematic review aimed to identify existing and potential areas for collaboration between midwives and health visitors; explore the methods through which collaboration is and can be achieved; assess the effectiveness of this relationship between these groups, and ascertain whether the identified examples of collaboration are in line with clinical guidelines and policy. Design A narrative synthesis of qualitative and quantitative studies. Data sources Fourteen electronic databases, research mailing lists, recommendations from key authors and reference lists and citations of included papers. Review methods Papers were included if they explored one or a combination of: the areas of practice in which midwives and health visitors worked collaboratively; the methods that midwives and health visitors employed when communicating and collaborating with each other; the effectiveness of collaboration between midwives and health visitors; and whether collaborative practice between midwives and health visitors meet clinical guidelines. Papers were assessed for study quality. Results Eighteen papers (sixteen studies) met the inclusion criteria. The studies found that midwives and health visitors reported valuing interprofessional collaboration, however this was rare in practice. Findings show that collaboration could be useful across the service continuum, from antenatal care, transition of care/handover, to postnatal care. Evidence for the effectiveness of collaboration between these two groups was equivocal and based on self-reported data. In relation, multiple enablers and barriers to collaboration were identified. Communication was reportedly key to interprofessional collaboration. Conclusions Interprofessional collaboration was valuable according to both midwives and health visitors, however, this was made challenging by several barriers such as poor communication, limited resources, and poor understanding of each other’s role. Structural barriers such as physical distance also featured as a challenge to interprofessional collaboration. Although the findings are limited by variable methodological quality, these were consistent across time, geographical locations, and health settings, indicating transferability and reliability. [ABSTRACT FROM AUTHOR]

Software Defined Networks (SDN) is a networking paradigm that separates the control plane from the forwarding plane. There is little research on structuring the SDN data plane for security. The Robust Network and Segmentation Algorithm (RNS) is an algorithm based on Product Family Algebra (PFA) that implements layered defence and segmentation strategies to segment resources towards designing secure networks. In this paper, we present an additional plane in charge of the configuration and governance of SDN data planes that we call Dynamic Configuration and Governance (DCG) plane. It is intended to give agility to dynamic networks. It implements the RNS algorithm in SDN environment. Moreover, we propose and suggest three architectures that use DCG plane. Then we assess the three architectures. The assessment results identify an architecture that is suitable for dynamic networks and another for networks that are more stable regarding changes to policy and network topology. [ABSTRACT FROM AUTHOR]

Nurses face various ethical conflicts when taking care of patients, and such conflicts require moral courage. This systematic review was conducted with the aim of investigating moral courage and its related factors among nurses. To find related studies, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The PubMed, Web of Science, Google Scholar, Scopus, Embase and Science Direct databases were searched using keywords such as Courage, Moral Courage, and Nurses, and no lower time limit was imposed when conducting the searches. The identified studies were published between January 2000 and March 2023. Quality of articles was assessed using the STROBE checklist. The pooled sample size for the 19 included studies was 7863. All studies were observational and cross-sectional. The results showed that three categories of factors most related to moral courage are individual, moral, and factors related to the organization. Underlying factors of each category are also provided within this paper. Moral courage is an integral part of nursing, which as a profession, is becoming even more challenging with the advancement of science and technology. Therefore, there is a need for nurses and especially nursing managers to be considerate of factors affecting moral courage of nurses, with a view to strengthening the positive factors and reducing the negative impacts. • Finding relevant studies was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. • The PubMed, Web of Science, Google Scholar, Scopus, Embase, and Science Direct databases were searched. • The results showed that three categories of factors most related to moral courage are individual, moral, and factors related to the organization. [ABSTRACT FROM AUTHOR]

This paper aims to assess the current knowledge, attitudes, and behaviors of nursing staff regarding sarcopenia and explore associating factors that influence them. Sarcopenia has an insidious onset and is easily overlooked. However, it is has become very common in older people, seriously jeopardizing the quality of life in patients. The present situation of nurses in China is inadequate, even though they are the primary professionals tasked with screening for sarcopenia, the ability to recognize and effectively manage the disease, and the critical role they play in preventing and controlling sarcopenia in patients. We conducted a cross-sectional design of nurses. Facilitated sampling was used in seven hospitals in Jiangsu Province, China. A total of 409 hospital nursing staff participated in the survey from December 2022 to March 2023. The main survey instruments were the nursing staff about the knowledge of sarcopenia, beliefs, a behavior questionnaire, and a self-designed general information questionnaire. Descriptive of general data, t-test, and ANOVA for influencing factors of three dimensions, whereas multiple linear regression analyses were performed using SPSS23.0 software. Questionnaires were distributed to 460 nurses, and of the 426 (92.6%) questionnaires returned, 409 (96.0%) were valid. The total mean score of nurses' knowledge, beliefs, and behavior about sarcopenia was 125.42 (SD 18.97), the mean score of knowledge latitude was 29.09 (SD 7.80), the mean score of attitude dimension was 57.53 (SD 7.63), and the mean score of behavior latitude was 38.80 (SD 10.71). Multiple linear regression analysis revealed that the nurse's position, Knowledge of sarcopenia, whether or not they were specialist nurses and years of experience in the workplace were the most significant factors correlated with the level of knowledge, belief, and practice (P < 0.05). In China, nurses have little knowledge about sarcopenia, but their attitude towards sarcopenia care is positive. However, there is potential for improvement in nursing behavior toward sarcopenia management. Managers are advised to develop targeted training programs for nurses. Further, it improves their screening and diagnosing abilities, allowing them to prevent and control sarcopenia more effectively. [ABSTRACT FROM AUTHOR]

Mandated minimum nurse-to-patient ratios have been the subject of active debate in the U.S. for over twenty years and are under legislative consideration today in several states and at the federal level. This paper uses the 1999 California nurse staffing mandate as an empirical setting to estimate the causal effects of minimum ratios on hospitals. Minimum ratios led to a 58 min increase in nursing time per patient day and 9 percent increase in the wage bill per patient day in the general medical/surgical acute care unit among treated hospitals. Hospitals responded on several margins: increased use of lower-licensed and younger nurses, reduced capacity by 16 beds (14 percent), and increased bed utilization rates by 0.045 points (8 percent). Using administrative data on discharges for acute myocardial infarction (AMI), I find a significant reduction in length of stay (5 percent) and no effect on the 30-day all-cause readmission rate. The null effect on readmissions suggests that length of stay declined not because hospitals were discharging AMI patients "quicker and sicker", rather, AMI patients recovered more quickly due to an improvement in care quality per day. [ABSTRACT FROM AUTHOR]

To explore nurses' knowledge and attitudes towards pressure injury prevention before and after implementing an educational intervention. A pre-and post-intervention study. Pre-intervention data collection involved administering an instrument, including demographic information, the Pressure Ulcer Knowledge Assessment Tool version 2, and the Attitudes towards Pressure Ulcer Prevention instruments. Following the analysis of pre-intervention data, an educational intervention was implemented. Post-intervention data were collected using the same instrument. Intensive care units at three Saudi Arabian hospitals. Nurses' knowledge and attitudes towards pressure injury prevention. The pre-intervention phase included 190 participants, and the post-intervention phase included 195 participants. Participants completed a paper-based survey at two different time points between June 2021 and March 2022. The mean pre-intervention scores for nurses' knowledge and attitudes towards pressure injury prevention were 43.22% and 74.77%, respectively. Following the educational intervention, the knowledge and attitude scores increased significantly to 51.22% and 79.02%, respectively. Higher knowledge of pressure injury prevention was positively associated with positive attitudes towards prevention practices. Age, clinical nursing experience, and experience in intensive care units were identified as factors correlated with knowledge of pressure injury prevention. A Bachelor's qualification or higher predicted better knowledge and attitudes towards pressure injury prevention. Nurses' knowledge and attitudes towards pressure injury prevention greatly improved following tailored, evidence-based education. The educational intervention featured multiple on-site bedside discussions, case studies, small-group presentations, and the provision of printed resources. Nurses' knowledge and attitudes towards pressure injury prevention should be examined, and education provided to ensure evidence-based prevention practices are implemented. Tailored small-group education sessions delivered conveniently could be an effective approach. Efforts should focus on attracting and retaining experienced, highly qualified nurses to ensure the adoption of evidence-based prevention practices. [ABSTRACT FROM AUTHOR]

Systematically synthesize research about factors that influence CPD over a nursing career. Continuing professional development (CPD) in nursing is defined as 'a life-long process of active participation in learning activities that assist in developing and maintaining continuing competences, enhancing professional practice and supporting achievement of career goals'. Research has shown that inability to access resources and activities for CPD influences quality of care and adversely affects nurses' satisfaction, recruitment and retention. Although more and more research regarding CPD is done, a comprehensive overview about the needs of nurses for successful CPD is missing. Scoping review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews ensuring all quality standards are met. Between February and April 2020 the electronic databases CINAHL, PubMed, Scopus, Psychinfo and Eric were searched as well as reference lists of included papers. Papers published in peer-reviewed journals were included without restrictions on publication date, design or setting. Thematic analysis was done to synthesize the data. The search yielded 2673 papers of which 60 papers were included. Analyses showed that factors that influence CPD differ over a nursing career, which led to the identification of three groups: newly graduated nurses; experienced nurses; and experienced nurses with ambitions for advanced roles. Furthermore, analyses showed that factors for all three groups are related to personal and contextual facilitators and barriers. Newly graduated nurses find it important to be an accepted member of the team. They experience barriers when integrating into the nursing profession, where they for instance experience workplace incivility. Experienced nurses experience contextual barriers related to a lack of supportive structures and inaccessibility of CPD resources. There is limited time and availability of role models and a lack of support from managers and other colleagues. Moreover, the clinical care dynamics influence their ability to pursue CPD. For the experienced nurses with ambitions for advanced roles, an important barrier is that nursing culture emphasizes direct patient care. Often it is unclear what the value is of new nursing roles which makes it difficult for them to develop these. All nurses strive for CPD. However, organizations need to recognize nurses' personal goals and unique strategies as this leads to different needs in CPD. In addition, resources must be made available and accessible before CPD can be successfully pursued by all nurses. Factors that influence Continuing Professional Development differ over a nursing career and are related to personal and contextual facilitators and barriers. All nurses pursue CPD, but all have personal goals, use unique strategies and therefore have different needs. [ABSTRACT FROM AUTHOR]

Background Registered nurse job turnover is an ongoing problem in the USA resulting in significant financial costs to both organizations and society. Most research has focused on organizational turnover with few studies about internal or unit-level turnover. Turnover of new nurses in hospitals has particular importance as almost 80% of new nurses work in hospitals and have higher turnover rates when compared to experienced nurses. This paper focuses on new nurses’ unit-level turnover rates in hospitals. Objectives The purpose of this study is to: (1) identify factors that predict new nurses staying in the same units, positions, and job titles to inform unit-level retention strategies, and (2) examine the changes in work environment perceptions over time between nurses who remain in the same unit, position, and title to those who changed unit, position and/or title. Study design A panel survey design was used to analyze changes over time. Participants Participants were newly licensed registered nurses who were licensed for the first time between August 1st, 2004 and July 31st, 2005. The nurses came from metropolitan statistical areas or rural areas that were nested to reflect a nationally representative USA sample (58% response rate). The analytic sample for this study was 1335. Data sources Data were collected in January 2006 and 2007 following the Dillman total design approach. All potential respondents received paper surveys and non-responders received repeated mailings. Results Using multinomial regression the five variables with the largest effects on unit retention were (1) variety (positive), (2) having another job for pay (negative), (3) first basic degree (having a bachelors or higher degree increased the probability of staying), (4) negative affectivity (positive), and (5) job satisfaction (positive). Nurses who changed unit, and/or position, and/or title reported more positive change scores on a variety of work attitudes. Discussion Almost 30% of new nurses working in hospitals leave their unit, and/or position, and/or title during their first year of work. Our results point to the variables on which managers can focus to improve unit-level retention of new nurses. Although participants were from a nationally representative sample of nurses who were newly licensed in 2004–2005, with the geographical shifts in the USA population in the last 10 years the sample may not be geographically representative of new nurses who graduated in 2015. [ABSTRACT FROM AUTHOR]

Background Dutch practice nurses sub-optimally adhere to evidence-based smoking cessation guidelines. Web-based computer-tailoring could be effective in improving their guideline adherence. Therefore, this paper aims to describe the development of a web-based computer-tailored program and the design of a randomized controlled trial testing its (cost-)effectiveness. Methods Theoretically grounded in the I-Change Model and Self-Determination Theory, and based on the results of a qualitative needs assessment among practice nurses, a web-based computer-tailored program was developed including three modules with tailored advice, an online forum, modules with up-to-date information about smoking cessation, Frequently Asked Questions (FAQs) and project information, and a counseling checklist. The program's effects are assessed by comparing an intervention group (access to all modules) with a control group (access to FAQs, project information and counseling checklist only). Smoking cessation guideline adherence and behavioral predictors (i.e. intention, knowledge, attitude, self-efficacy, social influence, action and coping planning) are measured at baseline and at 6- and 12-month follow-up. Additionally, the program's indirect effects on smokers' quit rates and the number of quit attempts are assessed after 6 and 12 months. Discussion This paper describes the development of a web-based computer-tailored adherence support program for practice nurses and the study design of a randomized controlled trial testing its (cost-)effectiveness. This program potentially contributes to improving the quality of smoking cessation care in Dutch general practices. If proven effective, the program could be adapted for use by other healthcare professionals, increasing the public health benefits of improved smoking cessation counseling for smokers. [ABSTRACT FROM AUTHOR]

Objectives and design This review paper provides an overview of the current state of knowledge on work environment antecedents of workplace bullying and proposes an integrative model of bullying applied to registered nurses. Data sources and review methods A literature search was conducted on the databases PsycInfo, ProQuest, and CINAHL. Included in this review were empirical studies pertaining to work-related antecedents of workplace bullying in nurses. Results A total of 12 articles were maintained in the review. An examination of these articles highlights four main categories of work-related antecedents of workplace bullying: job characteristics, quality of interpersonal relationships, leadership styles, and organizational culture. A conceptual model depicting the interplay between these factors in relation to bullying is also presented. Suggestions regarding other factors to incorporate within the model (e.g., individual factors, outcomes of bullying) are provided to increase our understanding of bullying in registered nurses. Conclusions This paper hopes to guide future efforts in order to effectively prevent and/or address this problem and ultimately ensure patient safety and quality of care provided by health care organizations. [ABSTRACT FROM AUTHOR]

South Africa's legal framework on sexual and reproductive health (SRH) care for teenagers is complex. On the one hand, the law protects their right to make decisions regarding reproduction e e.g. giving girls of any age the right to terminate a pregnancy, and allowing adolescents to consent to receive contraception from age 12. On the other hand, the Sexual Offences Act sets the age of consent to sex at 16 years, and requires mandatory reporting of anyone younger. These contradictory obligations mean that nurses, doctors and counsellors are expected to provide care, and counsel teenagers about their choices, but also report and enforce the law. They must therefore make judgments about inherently moral issues: should teenagers be having sex, and what services should they receive? Based on in-depth interviews at 28 healthcare facilities conducted in 2012, and data from workshops on the 'conflicting laws' held in 2014, the paper uses the theoretical framework of street-level bureaucracy to understand barriers to nurses providing SRH care for teenagers in South Africa, and the implication that this has for adolescents' SRH. The paper argues that nurses' adaptation of the law is a response to significant structural constraints, moral discomfort, and poor understanding of the law e all taken against an ethical framework that emphasizes quality, responsive patient care. The result is uneven implementation that undermines SRH information, access to services, and ultimately increases risks for teens. [ABSTRACT FROM AUTHOR]