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Aim: To describe and discuss clinical strategies for nurses working in partnership with substitute decision‐makers for people living with advanced dementia. Background: By providing person‐centred care to patients living with advanced dementia, nurses are positioned to work in partnership with substitute decision‐makers who make healthcare decisions related to advanced care. Because the experience of being substitute decision‐makers is complex and stressful, nurses need skillsets for working in partnership with substitute decision‐makers. Design: In this discursive paper, an innovative framework for working in partnership with substitute decision‐makers is proposed. Method: Evidence‐based findings from a systematic review provided five domain foci for the partnership framework. In each domain, two clinical strategies were discursively proposed. Clinical strategies were hypothesised from research findings and insights from the authors' nursing experiences. Then, topical literature was searched, and findings were used to support the discursively argued strategies. Discussion: To deal with complexities and reduce stress for substitute decision‐makers, an innovative Nurse–Substitute Decision‐Maker Partnership Framework for use in the context of advanced dementia is proposed and discussed. The partnership framework consists of five domains: Building trust, Exploring emotions, Translating quality of life, Encouraging proactivity and Negotiating families. Within these domains, ten strategies to support the practices of clinical nurses to work in partnership with substitute decision‐makers are discussed. Relevance to Clinical Practice: In the framework, the ten clinical nursing strategies are designed to provide targeted care to substitute decision‐makers in areas that are known to cause complexity and stress to them. The Nurse–Substitute Decision‐Maker Partnership Framework has been designed to improve nurse–substitute decision‐maker partnerships and reduce the stress experienced by substitute decision‐makers as they work through the complexities associated with advanced dementia. [ABSTRACT FROM AUTHOR]

Objectives: To explore the rate of NUPs and associated factors in the PED of the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain) using Andersen's Behavioural Model. Methods: We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain). Results: The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions: The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice: Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method: This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public: Participants, who voluntarily agreed to take part, contributed to the study by completing a paper‐based questionnaire containing all the study variables as prepared by the research team. [ABSTRACT FROM AUTHOR]

Background: Advance care planning is a process through which people communicate their goals and preferences for future medical care. Due to the complexity of the decision‐making process, decision aids can assist individuals in balancing potential benefits and risks of treatment options. Objective: While decision aids have the potential to better promote advance care planning, their characteristics, content and application effectiveness are unclear and lack systematic review. Therefore, we aimed to explore these three aspects and establish a foundation for future research. Design: Scoping review. Methods: This scoping review adheres to the framework proposed by Arksey and O'Malley and the PRISMA‐ScR list. Six English‐language databases were systematically searched from the time of construction until 1 December 2023. Two researchers conducted the article screening and data extraction, and the extracted data was presented in written tables and narrative summaries. Results: Of the 1479 titles and abstracts, 20 studies fulfilled the inclusion criteria. Types of decision aids were employed, mainly websites and videos. Decision aid's primary components center around 11 areas, such as furnishing information, exploring treatment and care preferences. The main manifestations were a significant increase in knowledge and improved recognition of patients' target value preferences. Among the aids, websites and videos for advance care planning have relatively high content acceptability and decision‐making process satisfaction, but their feasibility has yet to be tested. Conclusions: Decision aids were varied, with content focused on describing key information and exploring treatment and care preferences. Regarding application effects, the aids successfully facilitated the advance care planning process and improved the quality of participants' decisions. Overall, decision aids are efficient in improving the decision‐making process for implementing advance care planning in cancer and geriatric populations. In the future, personalised decision aids should be developed based on continuous optimization of tools' quality and promoted for clinical application. Reporting Method: The paper has adhered to the EQUATOR guidelines and referenced the PRISMAg‐ScR checklist. No Patient or Public Contribution: This is a review without patient and public contribution. Registration: https://doi.org/10.17605/OSF.IO/YPHKF, Open Science DOI: 10.17605/OSF.IO/YPHKF. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This paper aims to inform nursing and other healthcare disciplines by clearly defining patient competence and the skills required to improve self‐care behaviours. Background: Competence has been defined in education and leadership. However, competence in persons with chronic disease has not been expanded upon since one publication in 1983. Patient competence needs to be developed and defined so that healthcare disciplines can understand the attributes necessary for a patient to be deemed competent to promote self‐care behaviours. Design: A concept derivation. Methods: Walker and Avant's approach to concept derivation was used to identify a base concept (competence) that is well‐defined in another field, define the concepts associated with the parent field, and transpose that definition to a new field to formulate a redefined concept. PsycINFO, Scopus, Web of Science and Medline were searched, and 21 articles were included. Results: Patient competence is defined as the ability of a person with a chronic illness to reach skill mastery, achieve knowledge, maintain a positive attitude and develop trust in themselves and in healthcare providers that will facilitate active engagement to improve self‐care behaviours. Conclusions: Defining patient competence is important in assisting nurses and other healthcare providers in understanding the attributes needed to deem a patient competent, especially those living with chronic illnesses requiring lifelong self‐care behaviours. More research is needed to aid in the designing of a precise instrument for measuring this phenomenon. Relevance to Clinical Practice: Concept derivation of patient competence provides a framework for nurses and other members of the healthcare profession to understand the attributes needed to determine patient competence. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate the effectiveness of educational interventions for nurses caring for patients with chronic kidney disease in improving knowledge, nurse–patient interaction, performance, skills competence and clinical decision‐making. Design: Systematic review. Methods: Search of literature for randomised controlled trials, quasi‐experimental studies and pre‐experimental studies on chronic kidney disease‐related educational interventions for nurses was conducted across 10 databases. Two reviewers independently screened articles, appraised studies and extracted data. Data Sources: PubMed, Cochrane, Embase, CINAHL Complete, ERIC, Social Science Database, ASSIA, Scopus, Web of Science and ProQuest Thesis and Dissertations Global databases were searched from date of inception to 21 December 2022. Results: Three randomised controlled trials and eight pre‐experimental studies were included in this review. Synthesis without meta‐analysis was conducted due to high heterogeneity among studies. Interventions with teaching sessions, learning activities, self‐study modules, discussion and a web‐based training system were effective in improving nurses' knowledge, nurse–patient interaction, performance, skills competence and clinical decision‐making. Patients experienced an improvement in nurse–patient interaction and no significant decrease in overall quality of life. Conclusion: This review has shown the effectiveness of educational interventions for nurses caring for people with chronic kidney disease in improving outcomes for both nurses and patients, with sustained improvements up to a period of 1 year. Implications for the Profession and/or Patient Care: Study findings can guide the scope of future training for nurses caring for patients with chronic kidney disease. Impact: Nurses often lack in‐service training on how to improve care for patients with chronic kidney disease. This study found that training nurses on how to care for such patients can improve outcomes for nurses, which can translate to higher quality of patient care. Reporting Method: This paper adhered to the synthesis without meta‐analysis (SWiM) reporting guideline. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this study was to explore fathers' perceptions and experiences of support in the perinatal period. Change in society has seen the increased visibility of fathers being involved during pregnancy and engaging in their infants' lives and the expectation and benefits of men playing an equal and direct role in caring for their children. However, less is known about the nature of support that fathers require to facilitate this role transition. Design: A scoping review was conducted in accordance with Arksey and O'Malley's six‐step scoping review framework and the PRISMA‐ScR guidelines. Methods: A systematic search of CINAHL Plus, MEDLINE, the Cochrane Library, PsycARTICLES, PsycINFO, Psychology, Soc INDEX and Behavioural Sciences Collections databases for qualitative or mixed methods studies with qualitative data was undertaken. Qualitative data were extracted from original studies for coding and theme generation. Thematic synthesis was employed for the final stages of analysis. Results: Overall, 23 papers were included. Men desired to fulfil their rite of passage to be an involved father to their child. This transitional process commenced with men articulating their commitment to creating a role as an involved father and to be a role model for their children. Becoming a father is seen as having a significant status in society which contributes to their self‐efficacy as fathers. Conclusion: Fathers require support from all levels of the 'ecosystem' including policy, socio‐cultural and workplace changes as well as recognition and support from partners, family, peers and in particular from health service providers. Developing the parenting partnership requires a co‐production approach and commitment at macro, meso and micro levels. Relevance to clinical practice: Supporting men to be engaged fathers requires policy, socio‐cultural and workplace changes; however, maternity services and particularly midwives have an important role in this change. [ABSTRACT FROM AUTHOR]

Aims and objectives: This paper presents an exploratory account of an innovative methodology to record and evaluate fundamental care. Fundamental care is defined as the care required by everyone for survival, health and welfare. Background: Fundamental care has been informed by the development and testing of the Fundamentals of Care Framework, which describes how fundamental care is complex and multidimensional, and consists of three interrelated dimensions and 38 elements. This accords with a broader re‐examination of care provision as part of a complex adaptive system in which existing linear models of cause and effect are inadequate to describe the totality of activity. Design: Informed by graph theory and complexity science, this paper presents a novel methodological innovation. It uses the Fundamentals of Care Framework to create a Matrix to quantify the relationships between different elements within the Framework. Methods: We use a Matrix methodology to process care recipient narratives to generate three outputs: a heat map, a summary table and a network analysis. Conclusions: The three outputs serve to quantify and evaluate fundamental care in a multidimensional manner. They capture different perspectives (care recipients and their families, direct care providers and care managers) to improve care outcomes. The future aim is to advance this exploration into digitalising and operationalising the Matrix in a user‐friendly manner for it to become a real‐time mechanism to evaluate and potentially predict patterns of fundamental care. [ABSTRACT FROM AUTHOR]

Aim: To design a protocol based on the experiences of long‐term survivors to facilitate resilience for oesophageal cancer patients in rural China. Background: According to the latest Global Cancer Statistics Report, 604,000 new cases of oesophageal cancer were reported, of which over 60% of the disease burden is distributed in China. The incidence of oesophageal cancer in rural China (15.95/100,000) is twice as high as those in urban areas (7.59/100,000). To be sure, resilience can help patients better adapt to post‐cancer life. But universal interventions involving improving the resilience of oesophageal cancer patients have much less been explored, especially for rural patients. Methods: The two‐arm, parallel design, non‐blinded, randomised controlled trial will be implemented in 86 adults diagnosed with oesophageal cancer and will be randomly assigned to the control group or the intervention group via the blocked randomisation. The intervention group will undergo an intervention with one‐on‐one guidance from a nurse while viewing a CD of the experiences of long‐term survivors with oesophageal cancer in rural areas. Every 2 weeks, a theme session will be introduced, and the entire intervention will continue for 12 weeks. Psychosocial variables (resilience, self‐efficacy, coping mode and family support) will be surveyed at baseline, post‐intervention and 3 months after the intervention. The paper complies with the Standard Protocol Items: Recommendations for Intervention Trials 2013 and Consolidated Standards of Reporting Trials guidelines for study protocols adapted for designing and reporting parallel group randomised trials. Conclusion: The intervention programme transitions from hospitalisation to discharge, which includes one‐on‐one interventions by medical personnel and a portable CD describing the experiences of long‐term survivors with rural oesophageal cancer. Once the intervention's effectiveness is proven, this protocol will provide psychological support for massive oesophageal cancer patients. Relevance to clinical practice: The intervention programme may be used as an auxiliary therapy to promote patients' postoperative psychological rehabilitation. This programme has the advantages of being cost‐effective, flexible, accessible, and convenient and can be implemented without the limitation of time, place and clinical medical staff. Trial registration: The Chinese Clinical Trial Registration number is ChiCTR2100050047. Registered on 16 August 2021. [ABSTRACT FROM AUTHOR]

Aims and objectives: Investigate evidence available on the efficacy, safety and acceptability of devices for the management of female urinary incontinence, in which clinical settings and specific female populations they have been tested. Learn more about healthcare professionals' perspectives and experiences regarding female urinary incontinence devices. Background: Urinary incontinence is defined as the involuntary leakage of urine, estimated to affect 25%–45% of women. Urinary incontinence predisposes the skin to urinary incontinence dermatitis, it is one of the most common documented causes of inappropriate urinary catheterisation, favouring catheter‐associated infection. Several products for managing female urinary incontinence are available, no accurate and systematic data on usability, effectiveness and associated outcomes of these products are available. Design and Methods: A scoping review was conducted, using a methodological framework including the following five steps: identification of the research question; identification of relevant documents; selection of documents included in the review; tracking of information and data; synthesis and reporting of results. Twenty‐one articles were selected. PRISMA‐ScR Checklist was followed. Results: The devices explored in the studies were as follows: female external urinary catheter; disposable sanitary pads, diapers or sanitary pads used to manage urinary incontinence in women; mechanical devices; a new prototype of underwear that tracks where pads lose; reusable underwear for light incontinence; a new intelligent system pad. Conclusions: New smart pads, urine suction systems and female external catheters appear to be effective in preventing and reducing urinary incontinence dermatitis. The female external catheter reduces the days of indwelling catheterisation and could reduce the incidence of catheter associated urinary tract infection; therefore, it should be recommended. [ABSTRACT FROM AUTHOR]

Aim: To explain and understand leading care close to older persons in community home care from the perspective of registered nurses (RNs). Background: Leading care close to older persons in home care is an overlooked and not well‐described phenomenon. In home care, specific demands are placed on the registered nurse, as responsible for leading care guided by the older person's expectations and desires. Design: A reflective lifeworld hermeneutic approach grounded in the philosophy of phenomenology and hermeneutics. The study followed the COREQ checklist. Methods: Individual interviews were conducted with nine RNs working in community home care in a community in western Sweden. The data were analysed with a lifeworld hermeneutic approach. Results: The findings present four partially interpreted themes: leading with respect in a shared space, leadership that involves existential questions of life, balancing responsibility enables preservation of autonomy and challenges in maintaining a patient perspective. The partially interpreted themes conclude in a main interpretation: The patient perspective as an anchor when balancing responsibility for another person in an existential vulnerability of life. Conclusion: Leading care means being both close to the patient and at a distance when caring is performed through the hands of others. Ethical demands are placed on RNs as they encounter the vulnerability of the older person. Relevance to Clinical Practice: The findings can contribute to a greater understanding of the meaning of RNs as leaders and may have an impact for decision makers and policies to create conditions for leadership that contributes to dignified care for older persons in community home care. Patient of Public Contribution: Registered nurses working in community home care participated in data collection. [ABSTRACT FROM AUTHOR]

Background: While there exists an ample body of research in international contexts focused on the characterization and quantification of infertility psychological distress, the level of scholarly scrutiny directed towards this phenomenon within the context of China remains scant. Aims and Objectives: To investigate the formation and developmental processes of psychological distress associated with infertility and infertility treatment among women within the Chinese cultural context and to construct a theoretical framework that elucidates this phenomenon. Design: Qualitative approach with grounded theory methodology. Methods: This study was conducted within the reproductive medicine department of a tertiary‐level hospital located in central China from May to August 2023. Twenty‐seven women who experienced infertility and underwent assisted reproductive treatment (ART) were interviewed. The interview sessions spanned durations ranging from 20 min to 1 h and 35 min. Data analysis included open coding, axial coding and selective coding. The study is reported using the COREQ checklist. Results: The infertility psychological distress experienced by women undergoing ART is a socially constructed phenomenon influenced by a dynamic interplay of forces that construct and conciliate it. The formation and progression of infertility psychological distress are rooted in the process of self‐construction. A Middle‐Ranged Theory titled 'self‐reconstruction under the dome of infertility and infertility treatment' (SUDIT theory) was developed to explain this phenomenon. Within this framework, infertility psychological distress manifests across three distinct phases under the gambling of the constructive force and conciliative force: (1) distress of disrupting the former self; (2) distress linked to the struggling present self; and (3) the renewed‐self harmonized with distress. Conclusions: It is imperative for healthcare professionals and policymakers to acknowledge the socially constructed nature of infertility psychological distress, and proactively implement measures aimed at ameliorating it. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To evaluate the effectiveness of positive psychological interventions on quality of life, positive psychological outcomes and negative psychological outcomes in patients with cancer. Background: Patients with cancer often suffer from various psychological problems and have a poor quality of life. Positive psychological interventions have been increasingly applied to patients with cancer, but the results of these studies have not been synthesized. Design: A systematic review and meta‐analysis of randomized controlled trials according to PRISMA. Methods: Six English databases and four Chinese databases were searched from the inception to December 2022. Two reviewers independently assessed the risk of bias using the Cochrane Risk of Bias tool. RevMan was used for meta‐analysis. Results: Twenty‐nine randomized controlled trials examined the effects of positive psychological interventions including meaning therapy, dignity therapy, positive psychotherapy, mindfulness‐ based intervention, life review, expressive writing intervention, acceptance and commitment psychotherapy, attention and interpretation therapy, compassion training and spiritual therapy on patients with cancer. Positive psychological interventions significantly improved the quality of life, enhanced positive psychological outcomes including well‐being, meaning of life, self‐esteem, optimism, resilience and self‐efficacy and alleviated negative psychological outcomes including depression, anxiety and hopelessness. However, the heterogeneity of some outcomes was rather high, due to the wide diversity of the interventions included. Conclusion: Positive psychological interventions have potentially positive effects on improving quality of life, enhancing positive psychological outcomes and alleviating negative psychological outcomes in patients with cancer. However, due to the heterogeneity and the lack of follow‐up studies, more high‐quality studies are needed to confirm the results of our review and to clarify the long‐term effects of positive psychological interventions. Relevance to clinical practice: As feasible psychological interventions, healthcare professionals can consider applying appropriate positive psychological interventions according to the condition of cancer patients. Patient or public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To describe the development of a shared decision making intervention for planning end‐of‐life care for patients with kidney failure, their relatives and health professionals in kidney services. Background: End‐of‐life care conversations within standard disease management consultations are challenging for patients with kidney failure, their relatives and health professionals. End‐of‐life care planning is about making difficult decisions in advance, which is why health professionals need shared decision making skills to be able to initiate end‐of‐life conversations. Health professionals report needing more skills to raise the issue of end‐of‐life care options within consultations and patients want to be able to discuss issues important to them about future care plans. Methods: The development design was guided by the UK Medical Research Council's framework and a user‐centred approach was applied. Four workshops were conducted with end users. The Template for Intervention Description and Replication for Population Health and Policy interventions was used to shape which questions needed to be answered through the workshops and to present the intervention. The International Patient Decision Aid Standards (IPDAS) criteria set the standards to be achieved. Results: Areas considered significant to a shared decision making intervention were training of health professionals, conversations about end‐of‐life care, planning and evaluation of the decisions, reporting decisions in health records and repetition of consultation. The development process went through 14 iterations. Conclusion: An intervention named DESIRE was developed that comprises: (1) a training programme for health professionals; (2) shared decision making conversations; and (3) a patient decision aid. The intervention met 30 out of 33 IPDAS criteria. Implications for practice: DESIRE is intended to support shared decision making about planning end‐of‐life care among patients with kidney failure, their relatives and health professionals. The study provides important tools for the stakeholders engaged that can be used within different models of care. Impact: What problem did the study address?: International guidelines recommend health professionals involve patients with kidney failure in making decisions about end‐of‐life care, but there is variation in how this is implemented within and across kidney services. Furthermore, patients, relatives and health professionals find it challenging to initiate conversations about end‐of‐life care. What were the main findings?: The study resulted in the development of a complex intervention, called DESIRE, about shared decision making and planning end‐of‐life care for patients with kidney failure, their relatives and health professionals in kidney services, including a training programme for health professionals, shared decision making conversations and a patient decision aid. Where and on whom will the research have an impact?: The research contributes a shared decision making intervention to patients in the later stage of kidney failure, their relatives and health professionals. We believe that the DESIRE intervention could be introduced during consultations with health professionals at an earlier stage of the patient's illness trajectory, as well as being applied to other chronic diseases. Reporting Method: This intervention development research is reported according to the GUIDance for the rEporting of intervention Development (GUIDED) checklist and the DEVELOPTOOLS Reporting Checklist. Patient or Public Contribution: Patients, relatives and health professionals have been involved throughout the research process as part of the research team and advisory board. For this study, the advisory board has particularly contributed to the development process of the DESIRE intervention by actively participating in the four workshops, in the iterations between the workshops and in the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Aim: To explore relatives' needs in terms of bereavement care during euthanasia processes, how healthcare providers respond to these needs, and the degree of commonality between relatives' and healthcare providers' reports. Design: A phenomenological design was employed, utilising reflexive thematic analysis to examine interviews conducted with relatives (N = 19) and healthcare providers (N = 47). Results: Relatives' needs throughout euthanasia processes are presented in five main themes and several subthemes, with similar findings between both sets of participants. Although relatives infrequently communicated their needs explicitly to healthcare providers, they appreciated it when staff proactively met their needs. Healthcare providers aimed to assist with the relatives' grief process by tending to their specific needs. However, aftercare was not consistently offered, but relatives did not have high expectations for professional follow‐up care. Conclusion: Our research offers important directions for healthcare professionals, empowering them to provide needs‐based bereavement care during euthanasia processes. Moreover, it emphasises the importance of recognising the unique needs of relatives and proactively addressing them in the period before the loss to positively contribute to relatives' grief process. Implications for the profession and/or patient care: Insights into relatives' needs in the context of euthanasia. Good practices on how healthcare providers can attend to relatives' needs before, during and after the loss Impact: Current literature and guidelines on needs‐based bereavement care in the context of euthanasia and, more generally, assisted dying, are limited. These findings provide concrete directions for practice in supporting (nearly) bereaved relatives in the context of euthanasia, potentially mitigating adverse health outcomes. Reporting method: Standards for Reporting Qualitative Research (SRQR checklist). Patient or Public contribution: Relatives of deceased cancer patients were involved in the conduct of the study. [ABSTRACT FROM AUTHOR]

Aim: This study examines the intricate language and communication patterns of nurse‐to‐nurse handoffs across three units with varying patient acuity levels and nurse–patient ratios, seeking to identify linguistic factors that may affect the quality of information transfer and patient outcomes. Design: A mixed‐methods cross‐sectional design. Methods: This study used the Nurse‐to‐Nurse Transition of Care Communication Model to explore the content and meaning of language in nursing handoffs within a large academic medical centre. Data were collected on three units through digital audio recordings of 20 handoffs between June and September 2022, which were transcribed and analysed using the Linguistic Inquiry Word Count programme. Trustworthiness was established by adhering to COREQ and STROBE guidelines for qualitative and quantitative research, respectively. Results: Analysis revealed a preference for casual, narrative language across all units, with ICU nurses demonstrating a higher confidence and leadership in communication. Cognitive processes such as insight and causation were found to be underrepresented, indicating a potential area for miscommunication. Communication motives driven by affiliation were more pronounced in ICU settings, suggesting a strong collaborative nature. No significant differences were observed among the units post multiple testing adjustments. Speech dysfluencies were most pronounced in ICU handoffs, reflecting possible stress and cognitive overload. Conclusion: The study highlights the need for improved communication strategies such as interventions to enhance language clarity and incorporating technological tools into handoff processes to mitigate potential miscommunications and errors. The findings advance nursing science by highlighting the critical role of nuanced language in varied‐acuity hospital settings and the necessity for structured nurse education in handoff communication and standardized handoff procedures. Implications for the profession and patient care: This study underscores the critical role of language in nurse‐to‐nurse handoffs. It calls for enhanced communication strategies, technology integration and training to reduce medical errors, improving patient outcomes in high‐acuity hospital settings. Patient or Public Contribution: Nurses only. [ABSTRACT FROM AUTHOR]

Background: While previous research has established that resilience is affected by various factors, these studies have primarily focussed on individual variables associated with resilience, without providing insights into how to influence the rate of change in resilience. Aim: To examine the trajectory of resilience and identify the factors associated with changes in resilience among spousal caregivers of patients with newly diagnosed advanced cancer receiving treatment during the first 6 months. Design: An observational longitudinal study. Methods: A total of 312 spousal caregivers of patients with newly diagnosed advanced cancer were recruited from January 2022 to December 2022 in Yancheng, China. Three data collection points were established, spanning from the first month to 6 months after initial cancer treatment. A latent growth model was employed to depict the resilience trajectory at various time points. A latent growth model with time‐invariant covariates was adopted to determine the factors influencing resilience trajectory. The study adhered to the STROBE checklist for proper reporting. Results: Throughout the follow‐up period, the participants experienced a significant increase in resilience. Gender, family income, the patient's health status, spirituality and belief in familism were significantly associated with the baseline resilience level. Moreover, family income, the patient's health status, spirituality, caregiver burden and belief in familism were significantly associated with the rate of resilience change over time. Conclusions: Spousal caregivers demonstrated a linear increase in resilience during the first 6 months after initial treatment. Meanwhile, changes in resilience were influenced by multiple factors during the early phase of cancer treatment. Thus, more attention should be paid to early identification and implementation of targeted interventions. Relevance to Clinical Practice: Healthcare professionals should understand the change in resilience among spousal caregivers and conduct timely mental health interventions to enhance the resilience of families affected by cancer. Patient or Public Contribution: The Guidance for Reporting Involvement of Patients and the Public‐Short Form reporting checklists were used to improve patient and public involvement. [ABSTRACT FROM AUTHOR]

Background: Evidence‐based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC. Aim: To identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors. Design: A systematic review. Data Sources: CINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar. Methods: Databases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis. Results: The review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies. Conclusion: The development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs. Implications for the Profession: We should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice. Registration, and Reporting Checklist: The review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist. Patient/Public Contribution: None. [ABSTRACT FROM AUTHOR]

Aim: To describe patients' experiences of the quality of counselling to develop new digital counselling solutions for patients with cerebrovascular disease. Design: A descriptive, qualitative approach. Methods: Semi‐structured in‐person interviews were conducted among 22 patients diagnosed with acute cerebrovascular disease and treated as inpatients at a single university hospital in Finland between September 2021 and February 2022. Data were analysed using deductive and inductive content analysis. Results: The identified facilitators, barriers and possible solutions for the development of new digital counselling solutions were deductively categorized into five main categories: (1) background factors, (2) resources, (3) implementation, (4) sufficiency, and (5) effects and 12 generic categories. Patients with cerebrovascular diseases worry about symptoms affecting their ability to receive information and valued a supportive atmosphere. Staff should have more time for counselling and use motivational digital counselling solutions in plain language, moderate length and with multimedia content. Patients desired reminders, easy search functions and possibilities for two‐way communication. Conclusion: New digital counselling solutions could be beneficial in supporting the patients' knowledge, emotions and adherence. For the success of such solutions, patients' special needs concerning different levels of cognitive impairment need to be considered. Impact: The results of this study may benefit healthcare organizations in the development of digital counselling solutions that meet the patients' needs. Reporting Method: We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. Patient or Public Contribution: Patients were involved as the study population. [ABSTRACT FROM AUTHOR]

Aims: To explore adverse event reporting in the surgical department through the nurses' experiences and perspectives. Design: An exploratory, descriptive qualitative study was conducted with a theoretical‐methodological orientation of phenomenology. Methods: In‐depth interviews were conducted with 15 nurses, followed by an inductive thematic analysis. Results: Themes include motives for reporting incidents, consequences, feelings and motivational factors. Key facilitators of adverse event reporting were effective communication, knowledge sharing, a non‐punitive culture and superior feedback. Conclusion: The study underscores the importance of supportive organisational culture for reporting, communication and feedback mechanisms, and highlights education and training in enhancing patient safety. Implications: It suggests the need for strategies that foster incident reporting, enhance patient safety and cultivate a supportive organisational culture. Impact: This study provides critical insights into adverse event reporting in surgical departments from nurses' lived experience, leading to two primary impacts: It offers specific solutions to improve adverse event reporting, which is crucial for surgical departments to develop more effective and tailored reporting strategies. The research underscores the importance of an open, supportive culture in healthcare, which is vital for transparent communication and effective reporting, ultimately advancing patient safety. Reporting Method: The study followed the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines. Patients or Public Contribution: No patients or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To summarize existing studies that focused on improving hospitalized patient safety through patient and family engagement interventions to identify priorities and gaps. Design: A scoping review. Methods: Eight databases and citations of important reviews were searched on 30 September 2022. Two researchers independently screened the records. Then, two researchers extracted the data and cross‐checked. The results were synthesized narratively, and a comparison was performed for studies from China and those from other countries. Results: Ninety‐eight studies were included. The results indicated that patient and family engagement interventions were applied to decrease the incidence of patient safety incidents, and to improve the healthcare providers' and patients' knowledge, attitude or practice of patient safety. Most studies only engaged patients and families at the direct care level, and the engagement strategies at the organization and health system levels were insufficient. For stakeholders, many studies failed to consider patients' perspectives in intervention design and report taking staff training as a supportive strategy. Healthcare providers, especially nurses, were the main implementers of current interventions. Certain differences were observed between studies from China and those from other countries in the above aspects. Conclusions: International interest in engaging patient and family for patient safety is growing. Future studies should enhance the patient and family engagement as a partner in various patient safety at the direct care level, and further explore the engagement at the organization and health system levels. Relevance to Clinical Practice: Nurses, as the main formal caregivers for patients, should promote patient and family engagement in patient safety, especially at direct care level. Nurse should also incorporate the perspectives of patients in the design and implementation of interventions. Reporting Method: PRISMA‐ScR Checklist. [ABSTRACT FROM AUTHOR]

Aims: To examine how perceived balance problems are associated with self‐reported falls in the past month after controlling for known correlates of falls among older adults. Background: Approximately 30% of adults age 65 and older fall each year. Most accidental falls are preventable, and older adults' engagement in fall prevention is imperative. Limited research suggest that older adults do not use the term 'fall risk' to describe their risk for falls. Instead, they commonly use the term 'balance problems'. Yet, commonly used fall risk assessment tools in both primary and acute care do not assess older adults' perceived balance. Design and Method: The Health Belief Model and the concept of perceived susceptibility served as the theoretical framework. A retrospective, cross‐sectional secondary analysis using data from the National Health and Aging Trends Study from year 2015 was conducted. The outcome variable was self‐reported falls in the last month. Results: A subsample of independently living participants (N = 7499) was selected, and 10.3% of the sample reported a fall. Multiple logistic regression analysis revealed that the odds of reporting a fall in the past month was 3.4 times (p <.001) greater for participants who self‐reported having a balance problem compared to those who did not. In contrast, fear of falling and perceived memory problems were not uniquely associated with falls. Using a mobility device, reporting pain, poor self‐rated health status, depression and anxiety scores were also associated with falling. Conclusion and Implications: Older adults' perceived balance problem is strongly associated with their fall risk. Perceived balance may be important to discuss with older adults to increase identification of fall risk. Older adults' perceived balance should be included in nursing fall risk assessments and fall prevention interventions. A focus on balance may increase older adults' engagement in fall prevention. [ABSTRACT FROM AUTHOR]

Aims: This study aims to investigate the current situation of needlestick injuries (NSIs) of clinical nurses and identify associated factors by using the theoretical framework of the human factors analysis and classification system (HFACS). Design: A nationwide cross‐sectional survey was conducted. Methods: Multi‐stage sampling was used to investigate 3336 nurses in 14 Chinese hospitals. Descriptive statistics and univariate and multivariate logistic regression were employed to reveal the rate of NSIs and their associated factors. Results: A total of 970 nurses (29.1%) reported having experienced at least one NSI in the past year. The multivariate logistic regression analysis showed that good hospital safety climate and clinical nurses in intensive care unit (ICU) and emergency department had protective effects against NSIs compared with nurses in internal medicine department. The nurse, senior nurse, and nurse in charge have significantly increased the risk for NSIs compared with the associate chief nurse or above. Patients with poor vision but wearing glasses and poor vision but not wearing glasses were more prone to have NSIs. Working in the operating room compared with internal medicine, average weekly working time of >45 h compared with ≤40 h and poor general health led to increased risk of NSIs. Conclusion: The rate of NSIs in clinical nurses was high in China. Individual factors including professional title, department, visual acuity and general mental health and organisational factors including weekly working hours and hospital safety atmosphere were significantly correlated with the occurrence of NSIs. Relevance to Clinical Practice: Nursing managers should focused on physical and psychological conditions of clinical nurses, and organisational support is required to enhance the hospital safety atmosphere. No Patient or Public Contribution: Contributions from patients or the public are irrelevant because this study aims to explore current situation and factors associated with NSIs in clinical nurses. [ABSTRACT FROM AUTHOR]

Introduction: In 2015, the term 'intrinsic capacity' (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain. Aim: We aim to synthesise the factors connected with IC. Methods: This scoping review followed the five‐stage framework of Arksey and O'Malley and was reported using PRISMA‐ScR guidelines. Results: In all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults. Conclusions: This review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults. Relevance to Clinical Practice: The influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well‐being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline. No Patient or Public Contribution: As this is a scoping review, no patient or public contributions are required. [ABSTRACT FROM AUTHOR]

Aim: To establish a supportive care framework for addressing unmet needs among breast cancer survivors, providing practical guidance for healthcare providers to assess and manage these needs, ultimately enhancing the health outcomes and quality of life of breast cancer survivors. Design: We conducted a two‐round Delphi survey to gather expert opinions regarding the unmet needs supportive care framework for breast cancer survivors. Methods: Initial framework identification and inquiry questionnaire creation was achieved via literature search and expert group discussions, which included 15 experts from nursing practice, clinical medicine, nursing management and nursing education was conducted using a Delphi survey. To establish consensus, a two‐round Delphi poll was done, using criteria based on the mean (≥4.0), coefficient of variation (CV < 0.25) and percentage for entire score (≥20%). Results: Experts reached a consensus, leading to six care modules, and 28 care entries: Tumour Detection Support (three care entries), Management of Complications of Antitumor Therapy (seven care entries), Healthy Lifestyle Management (five care entries), Sexual and Fertility Support (four care entries), Psychosocial Support (four care entries) and Resource and Linkage Support (five care entries). Conclusion: To address breast cancer survivors' unmet needs, a supportive framework was developed to actively enhance their health outcomes. However, further refinement and feasibility testing using mobile devices or artificial intelligence are required. Implications for the Profession and Patient Care: This pioneering framework prioritises addressing unmet needs and equips healthcare providers to assess and manage these needs effectively, facilitating the implementation of programs aimed at improving the well‐being of breast cancer survivors. Reporting Method: This study was guided by a modified guideline for the Conducting and Reporting of Delphi Studies (CREDES) (Palliative Medicine, 31(8), 684, 2017). Patient or Public Contribution: No Patient or Public Contribution. Trial and protocol registration: The Delphi study methodology does not require registration. [ABSTRACT FROM AUTHOR]

Aim: To gain an understanding of children's experiences of expressing their views and having them heard in Australian healthcare settings. Design: Child‐centred qualitative research. A deductive qualitative content analysis was undertaken. Methods: Data were collected from 20 Australian children and young people between the ages of 7 and 18 years old using the 'draw, write and tell' method. Results: Children's experiences of 'space' and 'voice', and therefore the opportunity to express their views in health care were, in the main, positive. At the same time, their experiences of 'audience' and 'influence', the situations in which those views are given due weight, were overwhelmingly described as negative. Conclusion: Australian paediatric health services appear to have responded to calls to provide children with the opportunity to express their views and thus are delivering on the elements of 'space' and 'voice', whereas the realisation of 'audience' and 'influence' has some way to go. Due weight is not always given to children's views. Implications for the Profession and/or Patient Care: The Lundy model can be used to facilitate a better understanding of the concept of voice, and the responsibility of health organisations in implementing the rights of children and young people, as articulated in Article 12. Impact: Children and young people have a right to express their views and have them heard in health care, but their experiences in Australian health care are unknown.While children's experiences of expressing their views in health care were mostly positive, their views are not always taken seriously or given due weight.This research impacts child health professionals in Australia and internationally. Reporting Method: The study is reported using the Standards for Reporting Qualitative Research (SRQR). Patient or Public Contribution: Members of the Youth Advisory Council of two tertiary children's hospitals were consulted and invited to become members of the research team. [ABSTRACT FROM AUTHOR]

Aims: To identify postoperative interventions and quality improvement initiatives used to prevent wound complications in patients undergoing colorectal surgeries, the types of activities nurses undertake in these interventions/initiatives and how these activities align with nurses' scope of practice. Design: A scoping review. Data Sources: Three health databases were searched, and backward and forward citation searching occurred in April 2022. Research and quality improvement initiatives included focussed on adult patients undergoing colorectal surgery, from 2010 onwards. Data were extracted about study characteristics, nursing activities and outcomes. The 'Dimensions of the scope of nursing practice' framework was used to classify nursing activities and then the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework was used to synthesise the review findings. Results: Thirty‐seven studies were included. These studies often reported negative wound pressure therapy and surgical site infection bundle interventions/initiatives. Nurses' scope of practice was most frequently 'Technical procedure and delegated medical care' meaning nurses frequently acted under doctors' orders, with the most common delegated activity being dressing removal. Conclusion: The full extent of possible interventions nurses could undertake independently in the postoperative period requires further exploration to improve wound outcomes and capitalise on nurses' professional role. Impact Statement: Nurses' role in preventing postoperative wound complications is unclear, which may inhibit their ability to influence postoperative outcomes.In the postoperative period, nurses undertake technical activities, under doctors' orders to prevent wound infections.For practice, nurses need to upkeep and audit their technical skills. New avenues for researchers include exploration of independent activities for postoperative nurses and the outcomes of these activities. Implications for the Profession and/or Patient Care: There may be opportunities to broaden nurses' scope of practice to act more autonomously to prevent wound complication. Reporting Method: Scoping Reviews (PRISMA‐ScR) checklist. Patient or Public Contribution: A health consumer interpreted the data and prepared the manuscript. [ABSTRACT FROM AUTHOR]

Aim: To generate, test and refine programme theories that emerged from a rapid realist review investigating practising UK Nurses' and Midwives' experiences of effective leadership strategies during the COVID‐19 pandemic. Background: The realist review of literature generated six tentative theories of healthful leadership practices reflecting, working with people's beliefs and values; being facilitative; multiple means of communication and; practical support. The review yielded little insight into the actual impact of the leadership approaches advocated. Methods: A realist study, informed by person‐centredness using mixed‐methods. Online survey (n = 328) and semi‐structured interviews (n = 14) of nurses and midwives across the UK in different career positions/specialities. Quantitative data analysed using descriptive statistics and exploratory factor analysis. Framework analysis for qualitative data using context (C), mechanism (M), outcome (O) configurations of the tentative theories. Results: Three refined theories were identified concerning: Visibility and availability; embodying values and; knowing self. Healthful leadership practices are only achievable within organisational cultures that privilege well‐being. Conclusions: Leaders should intentionally adopt practices that promote well‐being. 'Knowing self' as a leader, coaching and mentoring practice development is important for leadership development. Implications for Clinical Practice: Nurses who feel valued, heard, cared for and safe are more likely to remain in clinical practice. Job satisfaction and being motivated to practice with confidence and competence will impact positively on patient outcomes. Impact: The study addresses the role of leadership in developing healthful workplace cultures. The main findings were six leadership practices that promote healthful cultures. The research will have an impact on strategic and clinical leaders, nurses and midwives. Reporting Method: This study used EQUATOR checklist, RAMASES II as reporting standards for realist evaluations. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To explore registered nurses' thinking strategies during the drug administration process in nursing homes. Design: An exploratory qualitative design. Methods: Eight registered nurses, one male and seven female, in five nursing home wards in Mid‐Norway were observed during 15 drug dispensing rounds (175 drug dispensing episodes). Think Aloud sessions with follow‐up individual interviews were conducted. The Think Aloud data were analysed using deductive qualitative content analysis based on Marsha Fonteyn's description of 17 thinking strategies. Interview data were used to clarify missing information and validate the content of Think Aloud data. Results: The registered nurses used all 17 thinking strategies described by Fonteyn, including several variants of each strategy. The three most frequent were 'providing explanations', 'setting priorities' and 'drawing conclusions'. In addition, we found two novel thinking strategies that did not fit into Fonteyn's template, which were labelled 'controlling' and 'interacting'. Among all strategies, 'controlling' was by far the most used, serving as a means for the registered nurses to stay on track and navigate through various interruptions, while also minimising errors during drug dispensing. Conclusion: The study highlights the diverse thinking strategies employed by registered nurses in nursing homes during medication administration. The findings emphasise the multifaceted nature of medication administration and underscore the importance of skilled personnel in ensuring medication safety. Recognising the significance of these findings is crucial for maintaining patient well‐being and upholding medication safety standards in healthcare settings. Relevance to Clinical Practice: Understanding the thinking strategies employed by registered nurses can inform training programmes and enhance the clinical judgements of health care professionals involved in medication administration, ultimately leading to improved patient outcomes and reduced medication errors in practice. Patient or Public Contribution: Patients were involved in this study as recipients of drugs which the nurses distributed during the observations. The patients were involved as a third party and consent to the observations was either given by the patients themselves or relatives in cases where the patient was not competent to consent. No personal information was collected about the patients. Reporting Method: The reporting of this study adhered to the COREQ checklist. [ABSTRACT FROM AUTHOR]

Aim: This scoping review aims to provide an overview of patients and caregivers perceptions of hospital‐at‐home (HaH) services. Background: HaH services provide patients with hospital‐level care at home and are central to integrated healthcare systems. Despite favourable data from individual studies in the literature, in‐depth analysis from patient and caregivers perspectives is lacking. This understanding is essential for the dissemination and scaling of HaH services. Design: The scoping review was performed using the PRISMA‐ScR checklist and PAGER framework for the findings report and research recommendations. Method: Literature from PubMed, Web of Science, Ovid, CINAHL, Cochrane and Mednar databases were searched. Relevant studies published between 1st January 2005 and 31st December 2022 were identified. The conceptual model of the development of patient perceptions of quality was used for data extraction and tabulation. Results: The review included 24 articles. Expectation attributions were identified as needs, types of service, hospitalisation experiences, family care preferences, social‐demographics and coping skills. From patient's and caregiver's perspectives, HaH was safe, effective and viewed positively. Perceived concerns/barriers and enablers/facilitators were associated with individual, caregiver and system factors, but demonstrated an overall satisfaction in the HaH service. Conclusion: HaH provides an excellent service according to patients' and caregivers' perceptions. However, gaps in care were identified such as prioritising patient‐centred care, along with improved multidisciplinary continuity of care and future studies should incorporate these into their research of HaH. Relevance to Clinical Practice: Patients' and caregivers' HaH needs should be embedded in the design, development and implementation of HaH services. Patient and Public Contribution: Not applicable for the study design of this scoping review. [ABSTRACT FROM AUTHOR]

Background: Suicide is a leading cause of death in the United States. Worldwide, over 700,000 people die by suicide each year. Healthcare workers are more vulnerable to suicide risk factors than the general population. The global COVID‐19 pandemic presents additional workplace and health concerns that relate to suicide risk factors in healthcare workers. It is important to recognise suicide risk factors in healthcare workers and to implement strategies to reduce these risk factors. Objectives: This study describes the impact of the global COVID‐19 pandemic on risk factors for suicide in healthcare workers and identifies evidence‐based strategies and resources to reduce suicide risk factors in healthcare workers. Design: The authors conducted a thematic analysis and narrative review of the literature. Methods: Using health science databases, the authors searched the literature, selected and analyzed studies, identified themes, synthesised findings and created a narrative review. The STROBE checklist was used in this study. Results: Two themes were identified (1) The impact of the COVID‐19 pandemic on work‐related suicide risk factors in healthcare workers; (2) The impact of the COVID‐19 pandemic on mental health‐related suicide risk factors in healthcare workers. The pandemic has affected suicide risk factors in healthcare workers. Many studies discussed evidence‐based strategies and resources that can be used to reduce suicide risk factors. Conclusion: The global COVID‐19 pandemic has negatively impacted suicide risk factors in healthcare workers. It is time for individuals and healthcare delivery systems to implement suicide risk prevention strategies to protect healthcare workers now and in the future. Relevance to Clinical Practice: This review increases awareness of the pandemic's impact on healthcare workers' risk factors for suicide and identifies evidence‐based suicide risk prevention strategies and resources for healthcare workers. Patient or Public Contribution: Library services supported this research by generating search strategies and providing resources and tools. [ABSTRACT FROM AUTHOR]

Background: Nurses play an essential role in responding to severe viral disease which bring considerable challenges to their personal and professional well‐being. This subsequently can affect the delivery of care and healthcare systems' organisational capacity to respond. Understanding nurses' experiences of these challenges will help inform healthcare policies. Aim: To explore the experiences and coping strategies of nurses caring for patients during severe viral disease pandemics. Design: A mixed‐methods systematic review informed by the Joanna Briggs Institute (JBI) methodology. Methods: A mixed‐methods systematic review. Five electronic databases Medline, CINAHL, PsychInfo, ASSIA and Scopus were searched on 4th April 2021. Results were reported in accordance with PRISMA. The findings were analysed and reported in the context of the Self‐Regulatory Common‐Sense Model. Results: In total, 71 peer‐review primary research articles describing nurses' experiences of caring for patients during SARS, MERS, Swine flu H1N1, Avian influenza or SARS‐CoV‐2 / COVID‐19 published in English from 2003 to 2021 were included. We found links between nurses' perception of the health threats, their emotional reactions, and coping strategies. Perceived health threats were influenced by organisational factors including frequent changes in clinical guidelines and workplace protocols, onerous workloads and working hours, unavailability of PPE, and lack of knowledge and training in pandemic management. These impacted nurses' physical, psychological and social well‐being. Nurses also reported helpful and unhelpful coping strategies to manage the health threats. Conclusions: It is vital for stakeholders, policymakers, government and healthcare institutions to recognise and monitor the wider impact on healthcare workers from health emergencies. In addition, support to develop and implement effective systems and individual mechanisms to offset the anticipated impact pre and post pandemics/epidemics is needed. Our findings can inform those strategies for similar future health emergencies. Relevance to Clinical Practice: Nurses are often the first point of contact in providing direct care to patients, hence they are at high risk of being infected. The findings from this review can help managers and policymakers in developing programmes to enhance resilience in the nursing workforce. No Patient or Public Contribution: This was a literature review study. [ABSTRACT FROM AUTHOR]

Aim and Objective: The purpose of this study was to generate a conceptual definition and theory of grief for nurses working on the frontlines during the COVID‐19 pandemic using grounded theory methodology. Background: The COVID‐19 pandemic has had a negative impact on nurses working on the frontlines. The increasing flow of diagnosed COVID‐19 cases, diverse unknowns and demands in the treatment of patients with COVID‐19, and depression related to countless deaths can trigger grief experiences. Design: A mixed methods approach, including the qualitative method of grounded theory and a quantitative 30‐question survey, was used in this study. Methods: Eight focus group sessions were conducted with registered nurses working on the frontlines during the pandemic. Sessions were audio recorded and analysed using constant comparative data analysis. Following the interviews, a survey including demographics and self‐report inventories was completed by participants. The COREQ checklist was used to assess study quality. Results: Major concepts that emerged include 'facing a new reality', 'frustrations', 'stress' and 'coping'. Core concepts were combined into a conceptual definition of grief and a grounded theory of the experience of nurses working on the frontlines during the pandemic. Cross comparisons of qualitative and quantitative findings were made and compared with the literature. Conclusions: This study provides a better understanding of the grief experience of nurses working on the frontlines during the COVID‐19 pandemic. It is necessary to recognise professional grief and develop intervention strategies that lead to grief reconciliation. Relevance to Clinical Practice: Findings provide useful insights for healthcare administrators to provide support and develop interventions to reduce frustrations and stress of frontline registered nurses. Patient or Public Contribution: This study design involved registered nurses participating in focus group sessions. Participants detailed their experience working on the frontlines of the COVID‐19 pandemic with patients, family and hospital administration. [ABSTRACT FROM AUTHOR]

Aim: To explore nurses' perceptions of using point‐of‐care ultrasound for assessment and guided cannulation in the haemodialysis setting. Background: Cannulation of arteriovenous fistulae is necessary to perform haemodialysis. Damage to the arteriovenous fistula is a frequent complication, resulting in poor patient outcomes and increased healthcare costs. Point‐of‐care ultrasound‐guided cannulation can reduce the risk of such damage and mitigate further vessel deterioration. Understanding nurses' perceptions of using this adjunct tool will inform its future implementation into haemodialysis practice. Design: Descriptive qualitative study. Methods: Registered nurses were recruited from one 16‐chair regional Australian haemodialysis clinic. Eligible nurses were drawn from a larger study investigating the feasibility of implementing point‐of‐care ultrasound in haemodialysis. Participants attended a semistructured one‐on‐one interview where they were asked about their experiences with, and perceptions of, point‐of‐care ultrasound use in haemodialysis cannulation. Audio‐recorded data were transcribed and inductively analysed. Findings: Seven of nine nurses who completed the larger study participated in a semistructured interview. All participants were female with a median age of 54 years (and had postgraduate renal qualifications. Themes identified were as follows: (1) barriers to use of ultrasound; (2) deficit and benefit recognition; (3) cognitive and psychomotor development; and (4) practice makes perfect. Information identified within these themes were that nurses perceived that their experience with point‐of‐care ultrasound was beneficial but recommended against its use for every cannulation. The more practice nurses had with point‐of‐care ultrasound, the more their confidence, dexterity and time management improved. Conclusions: Nurses perceived that using point‐of‐care ultrasound was a positive adjunct to their cannulation practice and provided beneficial outcomes for patients. Implications for the Profession and/or Patient Care: Haemodialysis clinics seeking to implement point‐of‐care ultrasound to help improve cannulation outcomes may draw on these findings when embarking on this practice change. Reporting Method: This study is reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ). Patient or Public Contribution: Patients were not directly involved in this part of the study; however, they were involved in the implementation study. Trial and Protocol Registration: The larger study was registered with Australian New Zealand Clinical Trials Registry: ACTRN12617001569392 (21/11/2017) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373963&isReview=true [ABSTRACT FROM AUTHOR]

Aim: To develop an advance care planning intervention based on the needs of patients with chronic kidney disease, families and healthcare professionals. Background: Patients with chronic kidney disease and their families request early advance care planning that continues throughout their illness trajectory. Healthcare professionals experience barriers to initiating advance care planning. Involvement of stakeholders in development of health interventions is important, to identify priorities, understand the problem and find solutions. Method: The development was inspired by the Medical Research Council's framework, and codesign was applied. One future workshop and one design workshop were conducted with the consumers. The process was iterative, and data were analysed using the action research spiral. The Guidance for reporting intervention development studies in healthcare (GUIDED) was used. Results: Five areas were considered significant to an advance care planning intervention; a biopsychosocial approach, early palliative care, a family‐focused approach, early and continuous advance care planning and a consumer‐centred approach. Based on these, a conversation process with healthcare professionals was designed to give patients and families the opportunity to share values, preferences and wishes for treatment and their family and everyday life. Conclusion: Codesign facilitated a collaborative process that allowed the consumers to have a significant impact on the design of an advance care planning intervention. A conversation process concerning everyday life, illness and treatment was designed for patients and families. The intervention included an advance care planning tool to guide the healthcare professionals. Practice Implications: The intervention has the intention to improve the communication between healthcare professionals, patients and families. The study provides important knowledge about the significance of giving the patients and their families support in sharing their values, preferences and wishes for treatment and everyday life, thus, to improve care and treatment in their illness trajectory. Impact: What problem did the study addressPatients with chronic kidney disease and their families strongly request early initiation of advance care planning that continues throughout the illness trajectory. Healthcare professionals experience barriers to the initiation of the advance care planning and request a more systematic approach.What were the main findingsDevelopment of a conversation process about everyday life, illness and treatment for patients diagnosed with chronic kidney disease and families, including an advance care planning tool to guide the healthcare professionals.Where and on whom will the research have an impactThe study contributes an advance care planning intervention to patients in the early stages of chronic kidney disease and their families. We believe that the intervention could be included during consultations with healthcare professionals in other stages of chronic kidney disease as well as other chronic disease. Reporting Method: To strengthen the reporting of the development of the advance care planning intervention, we used the Guidance for reporting intervention development studies in healthcare (GUIDED). Patient or Public Contribution: The development of the intervention in this study was a collaborative process between patients, families, healthcare professionals and representatives from the Danish Kidney Association, the department's user council and the research team. [ABSTRACT FROM AUTHOR]

Aim: To explore how patients with Inflammatory bowel disease experienced encounters with healthcare professionals in two gastrointestinal outpatient clinics to demonstrate what matters in the communication between patients and healthcare professionals. Design: This fieldwork study is part of a larger study developing an application for patients with inflammatory bowel disease in a framework inspired by Participatory Design. Participatory design consists of three phases and this study focused on the first phase, needs assessment. A phenomenological hermeneutic approach and qualitative methods were applied to obtain an understanding of patients' needs. Methods: Three weeks of participant observations and three focus groups with 14 subjects were conducted at two university hospitals in Denmark. Field notes and interview transcripts were analysed using condensation of meaning and interpreted based on interactional nursing practice theory. The reporting method adhered to the EQUATOR guideline: COREQ. Results: Four themes emerged: Easy and dependable access to healthcare professionals. Predictability of follow‐up appointments. Importance of privacy during patient exams and Quality of time spent with healthcare professionals. Conclusion: Easy, dependable access, privacy, presence and predictability of follow‐up appointments were important to patients with Inflammatory Bowel Disease. Implications for the profession and patient care: In communication with patients with inflammatory bowel disease, healthcare professionals must be aware of privacy and the importance of predictable follow‐up agreements. They must be aware that presence and easy, reliable access positively affect patients' self‐care skills. Patient contribution: This study is part of a larger project based on Participatory design involving patients and healthcare professionals in the development of technology to support communication. [ABSTRACT FROM AUTHOR]

Aim: To investigate the self‐reported levels of social support from friends and family and from nurses as mediators of the relationship between self‐rated physical and psychological condition in hospitalised patients. Design: Cross‐sectional study of adult inpatients at a large tertiary‐care hospital in the northeast United States. Methods: Multiple mediation analysis of survey data. Results: In surveys received from 324 inpatients, one fourth of the variation in patients' self‐rated psychological condition was explained by self‐rated physical condition. Social support from family and friends mediated a significant proportion (11.0%) of the relationship between self‐rated physical and psychological condition, however social support from nurses did not. Conclusion: Social support from family and friends can positively influence the psychological health of inpatients, but nurses are not an adequate replacement for the social support provided by family and friends. Implications for Nursing: Although nurses cannot replace the social support provided by family and friends, the assessment of social isolation and care planning of interventions to support patients is a fundamental nursing role. Technology to connect patients with friends and family should be used to mitigate isolation for hospitalised patients unable to receive in‐person visits from loved ones. Impact: The influence of social support from family and friends and nurses was addressed. The study found social support from family and friends, but not nurses, to influence the relationship between physical and psychological ratings. This finding has implications for the role of nurses in the hospital setting. Reporting Method: Strengthening the Reporting of Observational Studies in Epidemiology guidelines were followed. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To conduct an in‐depth exploration of oral hydration care provided to people living with dementia in acute hospital wards, using a person‐centred care framework. Background: Oral hydration care is an important, yet rarely explored aspect of fundamental care for people with dementia admitted to acute hospitals. Using person‐centred care as a conceptual framework we investigated how oral hydration care is delivered for people living with dementia in acute hospital wards. Design: A qualitative, multiple‐case study. The cases were three acute wards in one hospital. Methods: Direct observation of care for 13 people with dementia (132 h), semistructured interviews with ward staff (n = 28), ward leaders (n = 4), organisational leaders (n = 5), people with dementia (n = 6), their relatives (n = 5), documentary analysis of clinical inpatient records (n = 26) and relevant hospital policies. Data were analysed using framework analysis. Results: Four themes were identified: (1) The acute hospital: oral hydration is obscured and not prioritised (2) Overshadowing of oral hydration at ward level (3) Siloed nature of hydration roles (4) Strategies for, and barriers to, delivering person‐centred oral hydration care. Conclusions: This study combines the concept of person‐centred care and oral hydration care for people living with dementia admitted to acute hospital wards, demonstrating that person‐centred hydration care was complex and not prioritised. Relevance to Clinical Practice: Nurses should consider means of improving prioritisation and cohesive delivery of person‐centred hydration care in acute hospital wards. [ABSTRACT FROM AUTHOR]

Aims: To systematically identify and summarize the needs of chronically ill people concerning their sexual well‐being in peer‐reviewed published literature, to enable healthcare professionals to provide support in self‐management satisfying the needs. Design: A scoping review was performed according to the framework of (JBI Manual for Evidence Synthesis. JBI Global Wiki, 2020). Findings are reported in line with the PRISMA extension for scoping reviews. Review Methods: A literature search and thematic analysis were conducted. Data Sources: Full research was carried out in 2022 in the search engine BASE and the following databases: Scopus, MEDLINE, Science Citation Index Expanded, Social Sciences Citation Index and CINAHL. Peer‐reviewed articles published after 2011 were included. Results: Fifty articles could be found. Seven categories of needs could be identified. People with chronic diseases want their providers to initiate discussions about sexual concerns and treat them trustfully and respectfully. Most of the patients would like the issue of sexuality to be included in routine care. They perceive their medical specialists and psychologists as preferred providers to talk to about this issue. Nurses are seen as primary contact persons but in a smaller number of studies. Conclusion: Although the scoping review included different types of chronic diseases, the needs of chronically ill patients concerning their sexual well‐being are not very different. Healthcare professionals, especially nurses, who are often the first point of contact for people with chronic illnesses, should take the initiative for open discussions about sexual issues. That requires a new understanding of the role of nurses, training and further education. Implications for the Profession and/or Patient Care: Providing patient education and facilitating an open discussion about sexuality require further training in the new understanding of the role of the nurse and the concept of sexual well‐being. Impact: What problem did the study address? Chronic diseases have an impact on patients' sexuality. Patients want to be informed about sexual issues, but providers often do not address them. What were the main findings? Patients with a chronic condition expect providers to initiate discussions about sexual well‐being, regardless of the type of chronic disease. Where and on whom will the research have an impact? The research will impact healthcare professionals', especially nurses', future educational standards and ultimately patients. Reporting Method: PRISMA extension for scoping reviews. No patient or public contribution: Not required as it was a literary work (scoping review). [ABSTRACT FROM AUTHOR]

Aims: To test a model for person‐centred pain management using qualitative evidence in the literature and refine it based on the results. Design: A qualitative systematic review with thematic synthesis using the Fundamentals of Care framework. Methods and Data Sources: A literature search in February 2021 in six scientific databases: CINAHL, PsycInfo, Pubmed, Scopus, Social Science Premium Collection and Web of Science, reported using ENTREQ and PRISMA. Quality assessment was performed for the individual studies. Thematic analysis and the GRADE‐CERQual approach were used in the synthesis including the assessment of confidence in the evidence. Results: The model was tested against the evidence in 15 studies appraised with moderate or high quality and found represented in the literature but needed to be expanded. A refined model with a moderate/high confidence level of evidence presents elements to be used in a holistic care process; The nurse is guided to establish a trusting relationship with the patient and enable communication to identify and meet pain management needs using pharmacological and non‐pharmacological management. Nurse leaders are guided to support this process by providing the right contextual conditions. Conclusions: The strengths of the confidence level in the refined model, and that it is represented from the nurse and patient perspectives in nursing research across countries and cultures, support our recommendation for empirical evaluation. Implications for the Profession and/or Patient Care: The model links the knowledge of pain management elements from individual studies together into actions to be performed in clinical practice. It also outlines the organizational support needed to make this happen. Nurses and nursing leaders are suggested to test the model to implement person‐centred pain management in clinical practice. Patient or Public Contribution: No patient or public contribution. Impact: What Problem Did the Study Address? There is a need to transfer available evidence of person‐centred pain management into practice to relieve the patient from pain. What Were the Main Findings? Person‐centred pain management is of high priority for patients and nurses around the world and can be performed in a holistic care process including patient–nurse trust and communication, supported by contextual conditions to deliver timely pharmacological and non‐pharmacological pain management addressing the patient's physical, psychosocial and relational care needs. Where and on Whom will the Research Have an Impact? The model is to be tested and evaluated in clinical practice to guide the providers to relieve the patient from pain. Reporting Method: Relevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Statement. [ABSTRACT FROM AUTHOR]

Aims and Objective: To understand the frequent attendance phenomenon from the perspective of patients and healthcare professionals and how it can be reduced. Background: Frequent attenders (FAs) are characterised by the consumption of a disproportionate number of medical consultations and a high number of visits per year to primary care physicians (PCP). Although FAs constitute about 10% of all primary clinic attendees, they are responsible for ~40–50% of clinic visits, affecting the efficiency, accessibility and quality of health services provided to other patients. Design: Mixed methods (STROBE Statement: Data S1; COREQ checklist: Data S2). Methods: Eighteen FAs were interviewed in a qualitative approach. PCPs and nurses (n = 184) completed a cross‐sectional survey. Results: FAs are driven by their personal, emotional and mental state. FAs viewed clinics as a source for information and resolving medical problems. They perceived PCPs as authoritative and knowledgeable, and nurses as treatment managers and mediators between PCPs and patients. In contrast, FAs evoked more negative emotions than positive ones among medical staff. PCPs and nurses attributed frequent visits to FAs' personal and emotional states. A model based on the findings was constructed to provide a framework for grasping frequent attendance from a sociological perspective and for planning and managing it. Conclusions: The accessibility and availability of health services at primary clinics, and collaboration and trust in medical staff facilitate the frequent attendance phenomenon. Relevance to Clinical Practice: The frequent attendance phenomenon should be proactively prevented, even before patients become FA, using the model constructed, which serves as a foundation for introducing an intervention program to identify and prevent frequent attendance. PCPs and nurses working in primary care clinics should be made aware of the FA phenomenon and should be educated and given tools to deal with it within the clinic. The process should be facilitated by organisational support. Patient or Public Contribution: There was no patient or public contribution to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Aim and objectives: To explore the family's experience being offered memory making during end‐of‐life care in the adult intensive care unit and its use in early bereavement. Background: Family members of individuals who develop a critical illness requiring emergency hospitalisation are unlikely to be prepared for a possible death. This places them at increased risk of poorer bereavement experiences. One potential intervention is memory making, which is an act that provides tangible objects such as a handprint, footprint, lock of hair, or teddy bear, that allows connections with and provides meaningful memories about a person. Families in the adult acute population reportedly have positive reactions regarding the objects, but it is unknown the object's effects on early bereavement experiences. Design: Descriptive qualitative study utilising inductive reflexive thematic analysis. Reporting adheres to the COREQ checklist. Methods: Between May 2019‐December 2020, a purposeful, convenience sample of 21 participants from a tertiary referral, adult intensive care unit in Australia were recruited to explore their experiences being offered memory making during end‐of‐life care and the objects use in early bereavement. Interviews were conducted using a semi‐structured format and occurred at the participants' location of choice. Results: Data analysis generated three themes: guidance during end of life by healthcare professionals that recognises the autonomy of the family; object used as a trigger to access memories; and storage and preservation of the object as an indication of its sentimental value and use in early bereavement Conclusion: Memory making objects such as handprints, locks of hair, or teddy bears received in the adult intensive care unit were valued and utilised during early bereavement by most recipients. Relevance to clinical practice: Findings inform practice evidence gaps regarding the family's experiences of memory making received as a bereavement intervention in the adult acute population. Patient or public contribution: Participants contributed through sharing their first‐hand experiences of receiving memory making in the adult intensive care unit. [ABSTRACT FROM AUTHOR]

Aim: To explore the moral emotions that frontline nurses navigated in endeavouring to ensure a 'good death' for hospital patients and care home residents during the first wave of the COVID‐19 pandemic. Background: Under normal circumstances, frontline staff are focused on clinical ethics, which foreground what is best for individuals and families. Public health crises such as a pandemic require staff to adapt rapidly to focus on what benefits communities, at times compromising individual well‐being and autonomy. Visitor restrictions when people were dying provided vivid exemplars of this ethical shift and the moral emotions nurses encountered with the requirement to implement this change. Methods: Twenty‐nine interviews were conducted with nurses in direct clinical care roles. Data were analysed thematically informed by the theoretical concepts of a good death and moral emotions. Results: The data set highlighted that moral emotions such as sympathy, empathy, distress and guilt were integral to the decisions participants described in striving for a good palliative experience. Four themes were identified in the data analysis: nurses as gatekeepers; ethical tensions and rule bending; nurses as proxy family members; separation and sacrifice. Conclusions: Participants reflected on morally compromising situations and highlighted agency through emotionally satisfying workarounds and collegial deliberations that enabled them to believe that they were party to painful but morally justifiable decisions. Implications for the profession and patient care: Nurses are required to implement national policy changes that may disrupt notions of best practice and therefore be experienced as a moral wrong. In navigating the moral emotions accompanying this shift, nurses benefit from compassionate leadership and ethics education to support team cohesion enabling nurses to prevail. Public contribution: Twenty‐nine frontline registered nurses participated in the qualitative interviews that inform this study. Reporting method: The study adhered to the Consolidated Criteria for Reporting Qualitative Research checklist. [ABSTRACT FROM AUTHOR]

Aim: To develop a conceptual framework describing nursing care from the anaesthesia nurse's perspective in the perioperative context. Background: Surgical patients find themselves in a vulnerable situation in need of advanced treatment and care. Nurse anaesthetists have a central role in reducing harm and enhance patient safety, in which person‐centred care has been identified as a key component. However, they are challenged by productivity and efficiency demands leading to a potential risk to patient safety. Design: Noblit and Hare's interpretative meta‐ethnography, directed by the eMERGe reporting guidance. Methods: A comprehensive systematic search of nine databases without year limitation. Fifteen studies published between 2002 and 2021 were found eligible for inclusion. Quality appraisal was performed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Results: Four themes were identified: being vigilant to keep safe from harm, strengthening patients' confidence, expressing courage to act and speak up, and endorsing team collaboration to achieve best practice. The themes were synthesised into the metaphor, 'Continuously assessing and acting according to the patients' needs in a holistic perspective'. A conceptual framework was developed, illustrating the interconnection between the different nursing expressions, as the nurse anaesthetists seek to care for the patient as a whole person. Conclusions: Nurse anaesthetists aim to deliver holistic nursing care. Nursing care is expressed at two levels, foregrounding and backgrounding anaesthetic nursing, in line with the philosophy of person‐centred care. Nursing care in anaesthesia is a matter of how and why it is performed, expressed in attitudes toward the recipients of care. Relevance to clinical practice: The framework may be used to inform educational programs and clinical practice in nurse anaesthesia and to promote person‐centred care as a shared value across all levels involved in perioperative patient care. No patient or public contribution: Data were retrieved from already published literature. [ABSTRACT FROM AUTHOR]

Aim: To systematically review relevant literature to identify how Nurse Managers support graduate nurse work readiness. Background: Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment. Design: A five‐step, systematic integrative review reported in accordance with the PRISMA 2020 Checklist. Methods: The steps of the review method included (1) problem identification, (2) literature search, (3) data evaluation and quality appraisal, (4) data extraction and analysis and (5) presentation. Analysis used the Framework method and was guided by theory of graduate nurse work readiness and the Theoretical Domains Framework. Data Sources: MEDLINE COMPLETE, Cumulative Index to Nursing and Allied Health (CINAHL) Complete, ERIC and PSYCINFO searched in December 2020. Results: Studies eligible for inclusion (N = 40) represented research from 15 countries; most (67.5%, n = 27) used a qualitative design, 22.5% (n = 9) were quantitative and 10% (n = 4) used mixed methods. Three themes related to the social constructs and local area work environments influenced by nurse managers emerged: supporting people, supportive environment and supporting learning. Conclusion: The review identified a lack of robust evidence about the effectiveness of specific nurse manager‐led strategies to support development of graduate work readiness. However, the findings provide a framework to guide nurse managers in supporting graduate nurses and provide a foundation for further research about nurse manager roles in developing graduate work readiness. Implications for the profession or Patient Care: Previous research has described poor transition of graduate nurses as responsible for increased workplace errors, decreased job satisfaction and high rates of attrition. Exploring the role of nurse managers in graduate nurse transition is essential to ensure quality patient care and a sustainable workforce. Impact: What Problem Did the Study Address? Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment. What Were the Main Findings? High rates of attrition are attributed to poor support during the initial transition phase of graduate nurses. Nurse managers can impact transition by providing a supportive environment, support learning and by providing a team of supportive people. Where and on whom will the research have an impact? The research will have an impact on graduate nurses and nurse managers. Patient or Public Contribution: No patient or public contribution (integrative review exploring existing literature). This integrative review was registered with PROSPERO (CRD42021213142). [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to critically evaluate implementation frameworks, strategies and/or outcomes used to optimise peripheral intravenous catheter (PIVC) care and/or promote guideline adherence. Background: Although a considerable volume of research has investigated the effectiveness of PIVC interventions and treatments to promote performance and prevent harm, how to best implement this evidence into dynamic clinical settings and populations is not well understood. Implementation science is central to translating evidence‐based knowledge to the bedside; however, there is a gap in identifying the best implementation framework, strategies and/or outcomes to optimise PIVC care and/or guideline adherence. Design: A systematic review. Method: The review was conducted using innovative automation tools. Five databases and clinical trial registries were searched on 14 October 2021. Qualitative and quantitative PIVC intervention studies reporting implementation strategies were included in the review. Data were extracted independently by experienced researchers in pairs. The Mixed Method Appraisal tool was used to assess the quality of individual studies. Narrative synthesis was used to present the findings. The systematic review was reported following the PRISMA checklist. Results: Of 2189 references identified, 27 studies were included in the review. Implementation frameworks were used in 30% (n = 8) of studies, with most used during the preparation (n = 7, 26%) and delivery phase (n = 7, 26%) and then evaluation phase (n = 4, 15%). Multifaceted strategies were commonly adopted (n = 24, 89%) to promote PIVC care or study interventions which were clinician (n = 25, 93%) and patient‐targeted (n = 15, 56%). The most commonly reported implementation outcomes were fidelity (n = 13, 48%) and adoption (n = 6, 22%). Most studies were scored as low quality (n = 18, 67%). Conclusion: We call for researchers and clinicians to work together and use implementation science frameworks to guide study design, implementation and evaluation in future PIVC studies, to improve evidence translation and thereby improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore the notion of Being‐with and authentic discourse for people making decisions about major amputation. Background: Chronic limb‐threatening ischaemia is a devastating disease with a high burden of pain and complex wounds. Patients may deteriorate suddenly after multiple revascularisation procedures and, amputation is offered when further reperfusion is considered futile. Delayed decisions about amputation have negative consequences for patients, families and health systems, yet little attention is given to training clinicians for the sophisticated communication required. Clinicians need to engage in authentic discourse about amputation to create shared meaning and facilitate decision‐making. Design: Qualitative study using hermeneutic Heideggerian phenomenology. Methods: Twelve patients offered major amputation, and 13 family participants from three vascular units in Australia engaged in 42 semi‐structured interviews, representing 19 cases of chronic limb‐threatening ischaemia. Hermeneutic phenomenology using the Heideggerian tenet of Being‐with as an analytic framework, a philosophically based understanding of Being‐with and Discourse related to treatment discussions and decisions was derived. The research was reported in accordance with the COREQ checklist. Findings Effective discourse between the person and family was hampered by changed circumstances of Being‐with, characterised by guilt, and a retreat from discourse through deficient discourse and filtering information. Clinician Being‐with was hampered by discourse that was deficient, poorly delivered, discordant and disconnected through a lack of empathetic listening. There were also examples of enhanced clinician Being‐with that made room for more constructive discourse and more timely decisions about amputation. Conclusions: Heidegger's construct of Being‐with provides a useful framework to reveal the role of authentic discourse in improving patient and family experience and decisions about treatment. No Patient or Public Contribution: This study did not engage consumers other than as patient and carer participants. Relevance to Clinical Practice: Decisions about amputation are often difficult for patients or family members who may be substitute decision‐makers. A better understanding of the experience may assist clinicians in their interactions with patients and families. [ABSTRACT FROM AUTHOR]

Aims: To identify the barriers and enablers perceived by hospital‐based clinicians to providing evidence‐based continence care to inpatients. Design: This was a cross‐sectional study of inpatient clinicians using a questionnaire. Methods: Acute care and rehabilitation clinicians from 15 wards that admit patients after stroke at 12 hospitals (NSW = 11, Queensland =1, metropolitan = 4, regional = 8) were invited to complete an online questionnaire. The 58 questions (answered on a 5‐point Likert scale) were aligned to 13 of the 14 domains of the Theoretical Domains Framework. Results were dichotomized into 'strongly agree/agree' and 'unsure/disagree/strongly disagree' and proportions were calculated. Data collection occurred between January 2019 and March 2019. Results: The questionnaire was completed by 291 participants with 88% being nurses. Barriers were found in nine domains including knowledge; skills; memory attention and decision making; emotion; environmental context and resources; behavioural regulation; social professional role; intensions, social influences; and beliefs about capabilities. Enablers were found in seven domains including goals; social influences; knowledge; skills; social, professional role and identity; reinforcement and beliefs about consequences. Conclusion: This multi‐site, multi‐professional study that included predominantly nurses highlights the barriers and enablers to inpatient continence care. Future implementation studies in inpatient continence management should address these identified barriers and enablers to improve effectiveness of implementation of evidence‐based care. Implications for the profession: This study highlights that although there are many barriers to ward nurses providing evidence‐based continence care, there are also several enablers. Both should be addressed to improve practice. Reporting method: We adhered to the Checklist for Reporting Results of Internet E‐Surveys (CHERRIES) (Supplementary File 1). Relevance to clinical practice: Establishing barriers to practice gives a broader understanding of why practice does not occur and establishes areas where researchers and clinicians need to address in order to change behaviour. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To develop a conceptual framework that explores the process of building family resilience among Chinese families with children diagnosed with leukaemia. Background: The diagnosis of childhood leukaemia has a devastating effect on the family. Nonetheless, some families were able to positively respond to the crisis. The process through which Chinese families bounce back has received little attention. Design: Grounded theory. Methods: This study used purposive and theoretical sampling to select 16 parents who agreed to participate in semistructured interviews after children were diagnosed with leukaemia. Data collection and analysis occurred simultaneously. Data were analysed through a process of open, axial and selective coding. The COREQ checklist was followed for reporting. Results: A core category of 'finding family resilience in adversity' was generated. The core category was underpinned by a transition process between two fluid stages: (a) Disrupting the family system, informed by subcategories of negative emotional disturbances and challenges of the diagnosis and treatment journey; (b) Cultivating resilience in families, informed by subcategories of increasing positive attitudes; establishing new family routines; activating good support systems; and practising open family communication. Conclusions: The transition process from the disruption of the family system to the cultivation of family resilience is perceived as a complex family dynamic in response to childhood leukaemia. Our findings can form the basis for further research about resilience‐based family interventions that promote family well‐being during the early stages of a childhood leukaemia diagnosis. Relevance to Clinical Practice: It is necessary for healthcare professionals to provide essential support for families to face the challenges of diagnosis and treatment to facilitate the successful transition to family resilience. By understanding the dynamic process of developing family resilience, healthcare professionals are able to focus on these families to provide holistic care that satisfies the specific demands of family members. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore the rigour of nurse‐led quality improvement projects involving education, training or continuing professional development, and examine evaluation frameworks contained within. Background: Healthcare organisations invest significantly in quality improvement in the pursuit of cost‐effective, safe, evidence‐based and person‐centred care. Consequently, efforts to examine the success of investment in quality improvement activities are prominent, against a backdrop of rising healthcare expenditure, reforms, consumer expectations and feedback. Design: A qualitative document analysis of quality improvement projects located in a local health district repository was undertaken. Methods: N = 3004 projects were screened against inclusion criteria, with n = 160 projects remaining for analysis. Projects were mapped to an adapted version of the Standards for QUality Improvement Reporting Excellence (SQUIRE), specifically the education extension (SQUIRE‐EDU). Additionally, project evaluation frameworks were positioned within Kirkpatrick's four levels of training evaluation model. The SQUIRE checklist was also applied in line with EQUATOR guidelines. Results: Of n = 60 completed projects assessed against four broad SQUIRE‐EDU categories and relevant criteria, n = 36 were assessed not to have met any categories, n = 14 projects met one category, n = 8 projects met two categories, and n = 2 projects met three categories. None of the completed projects met all four SQUIRE‐EDU categories. There was insufficient documentation relating to evaluation frameworks in n = 133 projects to position within Kirkpatrick's four levels of training evaluation. Conclusions: Scientific rigour should underpin all quality improvement efforts. We recommend that SQUIRE international consensus guidelines (full or abridged) should guide both the design and reporting of all local quality improvement efforts. Relevance to Clinical Practice: To be of value to the expansion of evidence‐based practice, quality improvement platforms should be designed to reflect the structural logic, rigour and reporting recommendations being advocated in consensus reporting guidelines. This may require investment in training and development programs, and identification of governance and support systems. No Patient or Public Contribution, as the study was retrospective in nature and involved a health service repository of quality improvement projects accessible to health service staff only. [ABSTRACT FROM AUTHOR]

Aim and Objective: The aim of this study was to explore mothers' and public health nurses' (PHN) experiences with sleep problems in children aged 6 months to 3 years in Norway. Background: Sleep problems in children are common, affecting their health and development, and their mothers' well‐being. It is also the primary reason parents seek help in well‐child clinics (WCC). However, there is limited knowledge regarding the experiences of these mothers and the public health nurses who consult them. Design: Qualitative design. Methods: Four semi‐structured focus group interviews were conducted: two with mothers (n = 14) who had children with sleep problems and two with public health nurses (n = 14) from well‐child clinics. The Framework Method was used for analysing the interviews of mothers. Data from public health nurses were charted onto the analytical framework of maternal data to understand how or whether public health nurses addressed the issues raised by mothers. The study is reported according to the COREQ checklist. Result: The analysis resulted in two main themes: 'therapeutic alliance' (categories 'alliance ruptures' and 'demanding negotiation process') and 'reorganisation of identity' (categories 'unfulfilled expectations' and 'internal tension conflicts'). Conclusion: Young children's sleep problems present challenges to new mothers due to failed expectations, negatively affecting their feelings as mothers and towards their children, and consequently the reorganising of maternal identity. Most mothers experienced unsatisfactory therapeutic alliances while seeking help from public health nurses because advice was considered overly general, contradictory and unsafe for their children. Public health nurses were mostly aware of the parental consequences of children's sleep problems, but many appeared unable to help because of limited time and knowledge. Relevance to Clinical Practice: Public health nurses need to establish a therapeutic alliance and provide evidence‐based knowledge and guidance on sleep problems while also considering women's reorganisation of identity when becoming mothers. Clinical Trial Registration: Open Science Framework: osf‐registrations‐6ag38‐v1 (https://archive.org/details/osf‐registrations‐6ag38‐v1). [ABSTRACT FROM AUTHOR]