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Background: The purpose of this study is to examine and evaluate the existing clinical practice guidelines and consensus statements regarding tracheostomy care for non‐mechanically ventilated patients. Methods: A systematic search of databases, and professional organisations was conducted from inception to 19 March 2023. Two appraisers evaluated each guideline using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Text and Opinion Papers. Results: No specific clinical guidelines exist on airway management in non‐mechanically ventilated patients. Of 6318 articles identified, we included 12 clinical practice guidelines, and 9 consensus statements, which were from China, the US, the UK, South Korea, Australia, France and Belgium. The AGREE II scores in six domains are (1) the scope and purpose, 70.30%; (2) stakeholder involvement, 37.61%; (3) rigor of development, 33.97%; (4) clarity of presentation, 68.16%; (5) applicability, 44.23% and (6) editorial independence, 40.06%. The overall quality of evidence was level B. The summarised recommendations for clinical practice encompass the following six areas: airway humidification, management of the trach cuff, management of inner cannula, tracheostoma care, tracheostomy suctioning and management and prevention of common post‐operative complications. Conclusions: The overall quality of the clinical guidelines on non‐ventilated tracheostomy care was moderate, and further improvements are needed in domains of stakeholder involvement, applicability, clarity of presentation and editorial independence. Recommendations on non‐ventilated tracheostomy care are often embedded in the guidelines on ventilated tracheostomy. Specific clinical guidelines are needed to provide a standardised approach to tracheostomy care for non‐ventilated patients. Relevance to clinical practice: Patients with non‐ventilated tracheostomy need specialised airway management. Improving patient outcomes requires standardised protocols, patient involvement, quality evaluation, and interdisciplinary approaches. No patient or public contribution: The study reviewed clinical practice guidelines and consensus statements, therefore patient or public input was not needed. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aims to propose a self‐management clusters classification method to determine the self‐management ability of elderly patients with mild cognitive impairment (MCI) associated with diabetes mellitus (DM). Background: MCI associated with DM is a common chronic disease in old adults. Self‐management affects the disease progression of patients to a large extent. However, the comorbidity and patients' self‐management ability are heterogeneous. Design: A cross‐sectional study based on cluster analysis is designed in this paper. Method: The study included 235 participants. The diabetes self‐management scale is used to evaluate the self‐management ability of patients. SPSS 21.0 was used to analyse the data, including descriptive statistics, agglomerative hierarchical clustering with Ward's method before k‐means clustering, k‐means clustering analysis, analysis of variance and chi‐square test. Results: Three clusters of self‐management styles were classified as follows: Disease neglect type, life oriented type and medical dependence type. Among all participants, the percentages of the three clusters above are 9.78%, 32.77% and 57.45%, respectively. The difference between the six dimensions of each cluster is statistically significant. Conclusion(s): This study classified three groups of self‐management styles, and each group has its own self‐management characteristics. The characteristics of the three clusters may help to provide personalized self‐management strategies and delay the disease progression of MCI associated with DM patients. Relevance to clinical practice: Typological methods can be used to discover the characteristics of patient clusters and provide personalized care to improve the efficiency of patient self‐management to delay the progress of the disease. Patient or public contribution: In our study, we invited patients and members of the public to participate in the research survey and conducted data collection. [ABSTRACT FROM AUTHOR]

The purpose of our study was to describe the dissemination of research into the clinical nursing literature. The literature provides a means of transferring knowledge from a research study through citations of the work by other authors. This was a citation analysis study to explore the dissemination of research into the clinical nursing literature, beginning with the publication of an original research study and including all of the citations to that article through 2009. The authors searched five academic nursing research journal titles, using CINAHL, for original research reports that had clinical relevance and were published between 1990-1999. The search process yielded a final data set of 28 research articles. For each of the articles, the authors searched three databases, CINAHL, Web of Science and Google Scholar, to determine the citation patterns from the date of publication to August 2009. All of the research studies were cited in articles published in clinical journals although there was a wide range in the number of citations, from 3-80. The 28 research articles had a total of 759 citations; 717 (94·5%) of those citations were in articles published in clinical nursing journals. The median length of time between publication of the original study and the first citation was 1·5 years. Some of the studies were still being cited for 18 years after publication of the original work. All of the original research reports examined in this study were cited in articles in clinical journals, disseminating the research beyond the original work to reach clinicians. Clinical nursing journals keep readers up-to-date and informed about new practices in nursing and serve another important role: they disseminate research that is clinically relevant by publishing original studies and papers that cite research reports. [ABSTRACT FROM AUTHOR]

Aims and objectives: The purpose of this study was to examine the extent to which staffing adequacy predicts nursing teamwork, controlling for demographic and background variables. Background: Findings from former studies indicate that hospital, unit and staff characteristics may be related to nursing teamwork, such as type of hospital and unit, role, gender, age, work experience, type of shift worked, shift length, number of working hours per week, overtime and staffing adequacy. Teamwork as well as staffing is identified as significant contributors to patient and staff safety in hospitals. However, the contribution of staffing to the quality of nursing teamwork is scarcely studied. Design: This was a quantitative descriptive cross‐sectional study using the paper‐and‐pencil questionnaire Nursing Teamwork Survey‐Icelandic. Methods: The study was conducted in 27 inpatient units in eight hospitals in Iceland with a sample of 925 nursing staff members. Participants were 567 registered nurses, practical nurses, unit secretaries and nurse unit managers. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for this paper. Results: When controlling for unit type, role, experience on current unit and intent to leave, perceived adequacy of staffing alone explains up to 10% of overall teamwork. Unit type, role, years of experience on current unit and perceived staffing adequacy correlated significantly with overall teamwork. Conclusions: The findings of this study indicate that unit and staff characteristics, including perceived adequacy of staffing, are associated with and explain the variability in nursing teamwork on inpatient hospital units. The findings of this study provide important information for clinical nurses, nurse managers, policymakers and instructors in health care. Relevance to clinical practice: The findings underline the importance of adequate staffing for nursing teamwork in inpatient hospital units. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to explore the level of hope and symptom burden of breast cancer women undergoing chemotherapy, and predictive factors of hope were also investigated. Background: Chemotherapy brings physical and psychological stress to breast cancer patients. As an effective coping strategy, hope gives them the courage to overcome difficulties and improve prognosis and survival. Therefore, efforts are needed to raise hope. Design/Methods: A total of 450 women who were undergoing breast cancer chemotherapy participated in this cross‐sectional study. Sociodemographic data, disease characteristics, and measures of hope and symptom burden were collected using questionnaires. Hope was assessed using the validated Herth Hope Index, and the previously validated Memorial Symptom Assessment Scale was used to assess symptom burden. This paper adhered to the STROBE guidelines. Results: Chinese breast cancer chemotherapy women hope average scores of 30.15 ± 4.82 were in the medium range of the Hearth Hope Index as specified by Herth to be 24–35. Patients with age ≤45, religious beliefs and lighter symptom burden have a higher level of hope. These variables explained a total of 22.9% of the variation in hope. Conclusions: The level of hope for women undergoing breast cancer chemotherapy still needs to be further improved. Symptom burden can negatively predict hope. Relevance to clinical practice: If nurses can decrease breast cancer chemotherapy women symptom burden, there is an impact on increasing levels of hope. [ABSTRACT FROM AUTHOR]

Aims and objectives To determine presence of clinical complications related to dysphagia and to explore their operational outcomes. Background Dysphagia is a common complication of stroke. The management of poststroke dysphagia is multidisciplinary with nurses playing a key role in screening for dysphagia risk, monitoring tolerance of food and fluids and checking for the development of complications such as fever, dehydration and change in medical status. Dysphagia often results in further complications including aspiration pneumonia and the need for nasogastric feeding. Dysphagia-related complications have been shown to have a significant impact on morbidity and mortality, length of stay and cost of admission. Design Retrospective cohort study. Methods A total of 110 patients presenting with an ischaemic stroke were chart-audited. Results Aspiration pneumonia poststroke was found to be significantly associated with increased overall length of stay, poorer functional outcomes poststroke as well as being associated with a high risk of mortality. The presence of a nasogastric tube was also associated with reduced functional outcomes poststroke and increased risk of death. Conclusion High prevalence and cost of complications associated with stroke highlight the complexity of providing nursing and allied health care to this patient population. This provides a snapshot of dysphagia-related complications experienced by stroke patients. Relevance to clinical practice This paper highlights that poststroke complications can significantly impact on patient outcomes and operational factors such as cost of admission; therefore, poststroke care requires a multidisciplinary approach to management. Furthermore, preventing and managing complications poststroke is a key element of nursing care and has the potential to significantly reduce incidence of mortality, length of stay and cost of hospital admission. [ABSTRACT FROM AUTHOR]

Aims and objectives To discuss the issues and processes relating to the selection of the most appropriate statistical test. A review of the basic research concepts together with a number of clinical scenarios is used to illustrate this. Background Quantitative nursing research generally features the use of empirical data which necessitates the selection of both descriptive and statistical tests. Different types of research questions can be answered by different types of research designs, which in turn need to be matched to a specific statistical test(s). Design Discursive paper. Methods This paper discusses the issues relating to the selection of the most appropriate statistical test and makes some recommendations as to how these might be dealt with. Conclusion When conducting empirical quantitative studies, a number of key issues need to be considered. Considerations for selecting the most appropriate statistical tests are discussed and flow charts provided to facilitate this process. Relevance to clinical practice When nursing clinicians and researchers conduct quantitative research studies, it is crucial that the most appropriate statistical test is selected to enable valid conclusions to be made. [ABSTRACT FROM AUTHOR]

Aims and objectives. To examine the incidence of prescribing errors in a main public hospital in Pakistan and to assess the impact of introducing electronic prescribing system on the reduction of their incidence. Background. Medication errors are persistent in today's healthcare system. The impact of electronic prescribing on reducing errors has not been tested in developing world. Design. Prospective review of medication and discharge medication charts before and after the introduction of an electronic inpatient record and prescribing system. Methods. Inpatient records ( n = 3300) and 1100 discharge medication sheets were reviewed for prescribing errors before and after the installation of electronic prescribing system in 11 wards. Results. Medications (13,328 and 14,064) were prescribed for inpatients, among which 3008 and 1147 prescribing errors were identified, giving an overall error rate of 22·6% and 8·2% throughout paper-based and electronic prescribing, respectively. Medications (2480 and 2790) were prescribed for discharge patients, among which 418 and 123 errors were detected, giving an overall error rate of 16·9% and 4·4% during paper-based and electronic prescribing, respectively. Conclusion. Electronic prescribing has a significant effect on the reduction of prescribing errors. Relevance to clinical practice. Prescribing errors are commonplace in Pakistan public hospitals. The study evaluated the impact of introducing electronic inpatient records and electronic prescribing in the reduction of prescribing errors in a public hospital in Pakistan. [ABSTRACT FROM AUTHOR]

To examine the role of trained health and personal care assistants in supporting district nurses and family carers in providing palliative and end of life care in the community. In the UK, there is a policy directive to improve end of life care and to enable greater numbers of people to die at home. This places considerable demands on community nursing services and family carers. In response to this, the Complex and Palliative Continuing Care Service employing generic health and personal care assistants was developed as part of the Marie Curie Delivering Choice Programme in one city in the UK. This paper draws on findings from an independent evaluation of the scheme. The wider evaluation used a formative evaluation methodology. This paper draws on in-depth interviews with a range of stakeholders ( n = 17), in-depth interviews with bereaved carers ( n = 6) and an analysis of documentation. Stakeholders and bereaved carers perceived that the health and personal care assistants made a vital contribution to community palliative care. Careful recruitment, specific training, case management by district nursing with allocation of specific tasks and close ongoing communication were key features which stakeholders indentified. Family carers welcomed the way assistants developed relationships and became familiar and able to meet the care needs of patients. There were some problems reported which related to capacity, work flow and the need for extensive written care plans. Employing health care assistants under the supervision of district nurses appears to support patients and family at home during end of life care and contribute to good quality nursing care. The needs for community-based palliative and end of life care will increase rapidly over the course of the next 20 years, placing pressure on community nursing services and family carers. [ABSTRACT FROM AUTHOR]

Aim: To identify clinical observable items that can be used to identify dysphagia while observing a typical eating situation. Design: A three‐round e‐Delphi survey. Methods: An expert panel consisting of five nurses, eight speech language therapists and five physicians participated in this three‐round e‐Delphi survey from November 2022 to January 2023. Round 1 presented the results of a literature research conducted in September 2022 and an open question to the participants. The answers were analysed using the content analysis method. In the following rounds, the results were presented back to the participants with a request to rate them for usefulness. Means, standard deviations, ANOVA and Fisher's exact test were used to demonstrate the panel's opinion, level of agreement, demographic characteristics of the participants as well as differences between the professional groups in regard of the rating of the items. Methods and results are reported in accordance with the 'Guidance on Conducting and Reporting Delphi Studies' (CREDES). Results: The content analysis initially generated 36 items suggested by the expert panel. Seven additional items were incorporated from the literature review. In rounds 2 and 3, a 4‐point Likert scale was used to rate each item and to calculate the level of agreement. The predetermined level of agreement exceeded 70% for 23 items. Conclusion: Based on the expert opinions, it is possible for nurses to identify dysphagia in patients with dementia by using the determined 23 items while observing a typical eating situation. Patient or Public Contributions: The expert panel contributed to the creation of this study by participating in the Delphi rounds. Implications for the profession and/or patient care: The 23 items determined in this e‐Delphi study enable nurses to make dietary adjustments or consult other members of the multidisciplinary team based on available evidence, enabling complications to be avoided. Impact: What problem did the study address? This study provides evidence regarding the identification of dysphagia in patients with dementia by nurses. What were the main findings? Twenty‐three items were determined by an expert panel that can be used by nurses to identify dysphagia in patients with dementia while observing a typical eating situation. Where and on whom will the research have an impact? This research will have an impact on patients with dementia and the nurses caring for them. Reporting method: Methods and results are reported in accordance with the 'Guidance on Conducting and Reporting Delphi Studies' (CREDES) (Jünger et al., 2017), which promotes consistency and quality in conducting Delphi studies. [ABSTRACT FROM AUTHOR]

Aim: To examine the effects of spousal support and parent–nurse partnership on caregiver burden of parents of children with chronic disease. Background: With the trend of increasing the global number of children with chronic diseases, the parental caregiver burden has become increasingly prevalent. Design: Cross‐sectional study. Methods: The study participants included 115 parents of children diagnosed with chronic disease at a general hospital in South Korea. The study duration was 4 June 2021–30 April 2022. Self‐reported measures included the parent–nurse partnership scale, the Korean version of the Parenting Alliance Inventory and the family caregiver burden scale. T‐tests, ANOVA, Pearson's correlation coefficients and hierarchical linear multiple regression were conducted using IBM SPSS version 26.0. This study followed STROBE guideline. Results: Parental caregiver burden was significantly negatively associated with spousal support and parent–nurse partnership. Factors significantly influencing caregiver burden were parental alcohol consumption; child's inherited metabolic disease, cardiovascular disease, disease relating to haematological tumours or kidney disease diagnosis; child's health perceived as poor by parents; child's dependency perceived as high by parents; hospitalization recency; and low spousal support. These factors accounted for 65% of caregiver burden. Conclusion: Parental caregiver burden was related to spousal support and parent–nurse partnership, but the primary factor affecting caregiver burden was spousal support. Relevance to clinical practice: The results highlighted the role of healthcare professionals in educating parents of children with chronic diseases to facilitate spousal support and have implications for nursing and community‐based interventions to reduce parental caregiver burden. Furthermore, they underlined that policymakers and other stakeholders should pay attention to the parental caregiver burden through government‐based, family‐centered strategies. Patient or public contribution: Parents of children with chronic disease were recruited to perform the self‐administered survey in the phase of data collection. [ABSTRACT FROM AUTHOR]

Aims: To identify factors associated with health behaviours among stroke survivors, through a multi‐centre study. Design: A sequential mixed methods design. Methods: In the quantitative research phase, a total of 350 participants were recruited through multi‐stage sampling from December 2022 to June 2023. General information questionnaires, The Stroke Prevention Knowledge Questionnaire (SPKQ), Short Form Health Belief Model Scale (SF‐HBMS), Health Promoting Lifestyle Profile (HPLPII), and the WHOQOL‐BREF (World Health Organization Quality of Life Questionnaire, Brief Version) were distributed across five tertiary hospitals in Henan province, China. For the qualitative research component, semi‐structured interviews were conducted to explore the barriers and facilitators of health behaviour. This study adheres to the GRAMMS guidelines. Results: A total of 315 participants (90.0%) completed the survey. Identified barriers to health behaviour included residing in rural areas, higher scores on the Charlson Comorbidity Index (CCI) and mRS, as well as lower scores on SPKQ, SF‐HBMS and WHOQOL‐BREF. Twenty‐four individuals participated in qualitative interviews. Twenty‐eight themes were identified and categorised by frequency, covering areas such as knowledge, skills, intentions, social influences, social/professional role and identity, environmental context and resources, beliefs about capabilities, beliefs about consequences and behavioural regulation. Both quantitative and qualitative data suggested that health behaviour among stroke survivors is at a moderate level, and the identified barrier factors can be mapped into the COM‐B model (Capability, Opportunity, Motivation and Behaviour). Conclusion: The study indicates that key barriers to health behaviour among stroke survivors align with the COM‐B model. These identified factors should be carefully considered in the planning of future systematic interventions aimed at improving health behaviours among stroke survivors. Patient or Public Contribution: Patients were invited to completed questionnaires in the study and semi‐structured interviews. The investigators provided explanation of this study' content, purpose and addressed issues during the data collection. [ABSTRACT FROM AUTHOR]

Aims and objectives: To, on a sample of nurses and the general public, examine whether victim blame varies according to level of familiarly between victim and perpetrator. It also examines how Ambivalent Sexism and Rape Myth Acceptance impact on this. Background: Around one in five women will be victims of sexual assault during their lifetime. The majority are acquaintance rapes, and these victims are generally attributed more blame than victims of stranger rape. Research indicates that nurses hold similar attitudes on gender roles and victim blame as do the general public. Methods: Eighty‐one participants read a story depicting a sexual assault of a woman by either a stranger or an acquaintance and completed scales measuring victim blame, Ambivalent Sexism and Rape Myth Acceptance. Results: The results of this study indicated that victim–perpetrator relationship, Benevolent Sexism, Hostile Sexism and whether the participant was a nurse contributed to the variance in attributed victim blame. Hierarchical regressions revealed that whether or not the participant was a nurse contributed to the variance in victim blame in the acquaintance rape condition, and Hostile Sexism and Benevolent Sexism contributed to the variance in victim blame in the stranger rape condition. Conclusions: This paper gives a novel insight into attitudes involved in victim blame in rape cases and makes a unique comparison between nurses and the general public. Findings suggest that victim blame correlates primarily with aggressively sexist attitudes and that nurses generally attribute more blame to the victim of acquaintance rape. Relevance to clinical practice: This study has practical implications for the provision of medical services for victims of sexual assault, as it highlights problems in identifying and accessing rape victims, as well as recommending the sexual assault training of all practicing nurses. [ABSTRACT FROM AUTHOR]

Aims and Objective: To evaluate the attitudes of Indian nurses towards the importance of family involvement in nursing care and the association between nurse attitudes and sociodemographic characteristics. Background: Involving the family in the care process is crucial for delivering family‐ and patient‐centred care and ensuring the best possible patient outcomes. Nevertheless, published literature revealed that the nurses may lack clarity regarding the role of family members in the patient's care, which in turn hinders families' participation in care. Design: Cross‐sectional descriptive study. The STROBE checklist was used to report the present study. Methods: A total of 203 Nurses participated in a prospective cross‐sectional study between May 2022 and August 2022. They were recruited through convenience sampling from two tertiary care centres in India. A two‐part questionnaire was used to gather the data; the first section contained questions for gathering sociodemographic information, and the second part contained the standardized FINC‐NA scale. Results: The mean age of the nurses was (28.08 ± 4.722) years, and their median professional experience was 2.5 (1–5.5) years. Nurses' attitude regarding family's importance in patient care was found to be significantly associated (p ≤.05) with education level, marital status, religion and hometown region. Conclusion: In several items Indian nurses have positive attitudes towards family involvement in care but some of the lower scoring items can present opportunities for focused improvement. Continuing development programmes about family‐centered care can constitute important strategies to improve the positive attitudes of nurses towards families in practice. Patient and public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To identify latent profiles of competence and perceptions of spiritual care among clinical nurses and explore the possible influencing factors. Background: Understanding nurses' level of spiritual care competence and their perceptions and acceptance of such care is important, which could help devise nurse training programmes to address such competence in clinical nurses. However, research addressing interindividual variability in competence and perceptions among Chinese nurses is lacking. Design: Multicentre cross‐sectional study. Methods: Nurses working in departments with critically ill patients from 12 community, 5 secondary and 10 tertiary hospitals in Shanghai completed a demographic information questionnaire and the Chinese versions of the Spiritual Care Competence Scale, Spiritual Care‐Giving Scale and Spiritual Perspectives Scale. The data were analysed using IBM SPSS v26.0 and Mplus version 8.3. Latent profile analysis identified subgroups with different levels of spiritual care competence. Results: In total, 1277 Chinese nurses were recruited. Four profiles of competence and perceptions of spiritual care were revealed: Low ability (23.8%), High ability (6.4%), High acceptance (34.9%) and Moderate (34.9%). The level of job position, spiritual care‐related education, hospital grade and nurses' perceptions and perspectives of spiritual care predicted the probability of profile memberships in their competence. Conclusions: There was heterogeneity in the characteristics of spiritual care competence. Nursing managers can implement individualised interventions, including relevant training, according to the influencing factors of different competence profiles to improve the level of such competence among nurses. Relevance to Clinical Practice: The results provide a new and expanded view of improving nurses' spiritual care competence. Interprofessional collaboration with clinicians, administrators, educators and spiritual leaders can contribute to the development of related education and training. Reporting Method: EQUATOR guidelines, STROBE checklist: cross‐sectional studies. Patient or Public Contribution: All participants were clinical nurses. Participants were informed they could withdraw from the study at any time. [ABSTRACT FROM AUTHOR]

The study reported in this paper aimed at exploring the views of staff and patients of a potential emergency nurse practitioner service in an acute trust in the UK. The role of the nurse in emergency care has changed considerably in recent years, and the evolution of the emergency nurse practitioner role has changed emergency service provision dramatically. The emergency nurse practitioner role is not uniformly defined across emergency care in the UK, and the resulting blurring of the role of emergency nurse practitioners with that of emergency department medical staff is not helpful to hospital staff or patients. A quantitative and qualitative mixed method design was used that enabled exploration of an individual's viewpoint within their own practice or natural surroundings. Self-completed questionnaires were used to determine health professionals' opinions, and semi-structured interviews were employed to explore patients' views. A total of 144 health professionals responded to the questionnaire survey giving a response rate of 28·5%, and 10 patients participated in qualitative interviews. Health professionals and patients alike were generally supportive of an emergency nurse practitioner service, but there were some concerns in relation to the role and functions of the emergency nurse practitioner and associated accountability issues. This paper contributes further data that demonstrate the inter-professional and patient support of the advanced role of the emergency nurse practitioner and highlights potential conflictual issues and barriers to implementation that can and must be resolved successfully through proper consultation prior to the service being introduced. This paper provides important information to health professionals and service providers that should help to facilitate the introduction and maintenance of a successful and effective emergency nurse practitioner service in any trust. [ABSTRACT FROM AUTHOR]

Aims and objectives. To identify the effect of early rehabilitation of patients with post-traumatic amnesia in patients with traumatic brain injury, to review and critically assess evidence related to the timing of intervention and to identify the effect on outcome of a specific neurological rehabilitation in acute care. Background. Up to 70% of patients with traumatic brain injury will experience post-traumatic amnesia. Although duration of post-traumatic amnesia is correlated negatively with outcome for patients with traumatic brain injury, there is limited evidence relating to what influence timing and effect may have on enhancing early rehabilitation patient outcomes. Design. A critical literature review. Methods. Searches for systematic reviews were undertaken in Medline, CINAHL, Cochrane, PSYC INFO and Neurotraume databases. The efficacy of intervention and timing was classified based on a hierarchy of study designs for questions about health care interventions based on soundness of design. Results. Six reviews and 11 original studies were included and comprised the review. Many studies used weak designs and small sample size, thus limiting their ability to control confusing variables and outcomes. Few studies included papers with the information about timing and effect of early post-traumatic amnesia intervention. Only one study showed an effect of a reality orientation programme in acute care. Although there was no significant detail reported on the possibility of reducing the post-traumatic amnesia period, the study showed clinical relevance. Conclusion. This review highlights the limited evidence of the effect of early rehabilitation of patients with post-traumatic amnesia. Future research should be conducted to identify the effectiveness of early intervention. Relevance to clinical practice. Although nurses are treating patients with post-traumatic amnesia without systematic assessment, the limited evidence available does little to direct nurses as to the best approach to start early rehabilitation of post-traumatic amnesia to promote good outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives. To evaluate and improve patient assessment practices, care practices, recognition of patient deterioration and communication in the acute ward environment. Background. A growing recognition of patient safety-related concerns in acute hospitals, a nursing shortage and a reduction in availability of skill and experience levels at the bedside led a group of clinicians to explore the issues that impacted on patient care at a ward level within their organisation. Design. Multimethod practice development study. This paper reports phase one of concept development. Method. A practice review was conducted using clinical audit processes that examined practice and documentation in relation to patient assessment parameters and care planning, specifically identifying whether changes in clinical parameters were identified and acted on. Results. Results highlighted a clear discrepancy between the care that was identified on the nursing care plan and the care the patient was receiving. Actions as a result of the disappointing audit results included changes to education programmes, strategies to improve critical discussion regarding clinical practices and the development of assessable domains of nursing care that were relevant and realistic to ward-based nurses. Conclusion. The results enabled the identification of eight domains of care and associated care outcomes that target strategies for care improvement. Emancipatory practice development methodology will be used to further progress this work and ensure successful implementation into clinical units. Relevance to clinical practice. This paper examines the critical discussions, audit processes and actions that took place, leading to the development of care outcomes for nurses. [ABSTRACT FROM AUTHOR]

Aim and Objectives: To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID‐19 among Spanish nurses by comparing two assessment points: before and after the COVID‐19 vaccination campaign. Background: The COVID‐19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID‐19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential. Design: A repeated cross‐sectional design was carried out with a time‐lapse of 12 months. Methods: A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID‐19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies. Results: The fear of COVID‐19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID‐19 and BO (r =.44, p ≤.001; r =.41, p ≤.001) and also between fear of COVID and CF (r =.57, p ≤.001; r =.50, p ≤.001). Negative correlations between fear and CS were also found (r = −.16, p =.001; r = −.22, p ≤.001). Relevance to Clinical Practice: Programmes to reduce fear of COVID‐19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care. Patient or Public Contribution: The nurses collaborated by participating in the present study anonymously and disinterestedly. [ABSTRACT FROM AUTHOR]

Aim: Mental distress, non‐specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut‐off points for identifying highly distressed patients are lacking, entailing a gap in CPP management. Design: This instrumental cross‐sectional study identified a statistically derived cut‐off score for the Depression Anxiety Stress Scale‐8 (DASS‐8) among 214 Australian women with CPP (mean age = 33.3, SD = 12.4, range = 13–71 years). Methods: Receiver operator characteristic curve, decision trees and K‐means clustering techniques were used to examine the predictive capacity of the DASS‐8 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist. Results: Cut‐off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut‐off score for predicting key outcomes. Women with DASS‐8 scores below 15.5 had higher analgesic intake. Conclusion: CPP women with a DASS‐8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co‐morbidities. Implications for patient care: At a cut‐off point of 13.0, the DASS‐8 may be a practical instrument for recommending a thorough clinician‐based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations/countries are warranted. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this empirical study was to explore the current status and associated factors of lymphedema self‐management behaviours among Chinese breast cancer survivors. Background: Breast cancer‐related lymphedema is a lifetime concern for survivors and is currently incurable. Lifetime lymphedema self‐management takes a significant role in preventing development and progression of lymphedema. Understanding influencing factors of lymphedema self‐management behaviours can help to develop targeted intervention programs. Design: A multicentre cross‐sectional study. Methods: From December 2021 to April 2022, a convenience sample of 586 participants were recruited at four tertiary hospitals in four cities in China. Self‐reported questionnaires were used to measure socio‐demographic characteristics, disease‐and treatment‐related characteristics, lymphedema self‐management behaviours, lymphedema knowledge, illness perception, self‐efficacy, self‐regulation and social support. Descriptive analysis, bivariate analysis and hierarchical multiple regression were conducted. This study was registered at Chinese Clinical Trial Registry (ChiCTR2200057084), and was reported followed the STROBE checklist. Results: Breast cancer survivors reported moderate level of lymphedema self‐management behaviours. Promotion of lymph reflux management was ranked the least performed self‐management behaviours, while the affected limb protection management ranked the most. 36.2% of self‐management behaviours was explained by exercise regularly, level of attention on lymphedema prevention, unclear about the tumour stage (vs. stage I), knowledge, self‐efficacy, emotional illness representation and social support. Conclusions: Lymphedema self‐management behaviours of breast cancer survivors was insufficient. Performance of lymphedema self‐management varied with different socio‐demographic characteristics, along with different levels of knowledge, self‐efficacy, perception and social support. All these identified predictors should be reckoned in assessment and intervention of lymphedema self‐management behaviours. Relevance To Clinical Practice: This study addressed that breast cancer survivors' lymphedema self‐management behaviours should be promoted. Focusing on identified predictors, further lymphedema surveillance, knowledge education or social facilitation programs are recommended to enhance their self‐management performance and adherence. [ABSTRACT FROM AUTHOR]

Aims: To examine the association between nursing unit safety culture, quality of care, missed care and nurse staffing levels, and inpatient falls using two data sources: incidence of falls and nurses' perceptions of fall frequency in their units. The study explores the association between the two sources of patient falls and identifies if nurses' perceptions of patient fall frequency reflect the actual patient falls recorded in the incident management system. Background: Inpatient falls are associated with severe complications that result in extended hospitalisation and increased financial consequences for patients and healthcare services. Design: A multi‐source cross‐sectional study guided by the STROBE guidelines. Methods: A purposive sample of 33 nursing units (619 nurses) from five hospitals completed an online survey from August to November 2021. The survey measured safety culture, quality of care, missed care, nurse staffing levels and nurses' perceptions of patient fall frequency. In addition, secondary data on falls from participating units between 2018 and 2021 were also collected. Generalised linear models were fitted to examine the association between study variables. Results: Nursing units with strong safety climate and working conditions and lower missed care were associated with lower rates of falls using both data sources. Nurses' perceptions of the frequency of falls in their units were reflective of the actual incidence rate of falls, but the association was not statistically significant. Conclusion: Nursing units with a strong safety climate and better collaborations between nurses and other professionals, including physicians and pharmacists, were associated with lower incidents of patient falls. Relevance to Clinical Practice: This study provided evidence for healthcare services and hospital managers to minimise patient falls. Patient or Public Contribution: Patients who had experienced a fall, which was reported in the incident management system, from the included units in the five hospitals were part of this study. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to investigate the role of the family in supporting diabetes self‐management and explore the possible mechanisms between family and diabetes self‐management among rural patients in China. Background: The prevalence of Type 2 diabetes mellitus (T2DM) is growing rapidly in rural areas of China, where healthcare resources remain relatively poor and family members play an important role in chronic disease self‐management. Design: This was a multicentre cross‐sectional study. Methods: A total of 276 adults with T2DM were recruited from nine county hospitals in China. Diabetes self‐management, family support, family function, and family self‐efficacy were evaluated using the mature scales. A theoretical model was built based on the social learning family model and previous studies and then verified using a structural equation model. The STROBE statement was used to standardise the study procedure. Results: Family support and general family factors, including family function and self‐efficacy, were positively correlated with diabetes self‐management. Family support fully mediates the relationship between family function and diabetes self‐management and partially mediates the relationship between family self‐efficacy and diabetes self‐management. The model explained 41% of the variability in diabetes self‐management and had a good model fit. Conclusion: General family factors can explain nearly half of the change in diabetes self‐management in rural areas of China, while family support is a mediator between general family factors and diabetes self‐management. Family self‐efficacy, a potential intervention point of family based diabetes self‐management education, can be improved by building special lessons for family members. Relevance to Clinical Practice: This study emphasises the role of family in diabetes self‐management and proposes suggestions for diabetes self‐management intervention among patients with T2DM in rural areas of China. Patient or Public Contribution: Patients and their family members completed the questionnaire which was used for data collection. [ABSTRACT FROM AUTHOR]

Aim: To describe positive and negative spiritual responses to providing COVID‐related nursing care among nurses working in hospitals. Background: The COVID pandemic has intensified and publicised the threats to nurse well‐being. Absent from the recommendations for promoting nurse well‐being is recognition of how nurses' spirituality and/or religiosity is affected by the strain of COVID caring or how it may be affecting their well‐being. Design: Cross‐sectional, descriptive observational, mixed methods study. Methods: Data were collected from 523 registered nurses employed in three Southern California hospitals during March–May, 2022 when these hospitals' COVID case counts were <15%. Using Online survey methods, data were obtained using the Religious/Spiritual Struggles Scale–Short Form, Moral Injury Symptom Scale–Healthcare Professionals, Post‐traumatic Growth Inventory and demographic and work‐related items. STROBE guidelines for cross‐sectional observational studies were observed. Results: The mean for religious/spiritual struggles was 1.98 (range of 1–5, comparable to a little bit). Although roughly half of the sample reported the struggles were not experienced/did not apply, 23%–36.5% reported experiencing these struggles at least somewhat. The most frequent struggle was to find ultimate meaning. The mean observed for moral injury was 6.5 (range of 1–10); applying established criteria indicated it was troubling for at least 50%. The mean for post‐traumatic growth was 4 (on a scale of 0–6); using established criteria, 41% experienced PTG. Quantitative findings were illustrated by the qualitative responses that occasionally expressed spiritual tragedy and transformation concurrently. Conclusion: The professional work of nursing impacts nurses in invisible, spiritual ways that can be tragic and/or transformative. Relevance to Clinical Practice: Interventions to address nurses' mental health challenges must include attention to these invisible struggles. Nurses' mental health challenges must be met in part by addressing how they can surmount spiritual tragedy—and allow spiritual transformation. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper is a report of a study conducted to investigate differences between nurse practitioners' perceptions of the importance of required competencies and their self-evaluated existing competencies, and the main factors influencing these differences. Background. The difference between nurse practitioners' perceptions of required competencies and their existing competencies has never been investigated. Therefore, it is still uncertain whether these two competencies differ. Design. A nationwide survey study was authorised by the Department of Health (DOH) in Taiwan. Methods. For this nationwide survey study, the Questionnaire of Competencies in the Nurse Practitioner's Role was mailed to all nurse practitioners who qualified for the first annual national NP licence exam in Taiwan. Of 582 questionnaires distributed, 374 valid questionnaires were returned for a response rate of 64·2%. Results. The scores for required competencies were all higher than existing competencies. The competencies with largest differences were (in increasing order) clinical research, direct care, and leadership and reform. The competencies with smallest differences were (in ascending order) medical assistance, communication and coordination, and ethical decision-making. Differences in the total score between required and existing competencies were significantly influenced by nurse practitioners' age, seniority as nurse practitioner, whether the nurse practitioners' institution had a nurse practitioner advancement system, and the number of patients under their care. Conclusions. Nurse practitioners' perceptions of the importance of their expected role competencies were significantly greater in most cases than their actual competencies. Relevance to clinical practice. These findings could serve as a reference to improve cultivation of the NP system in Taiwan, to strengthen professional competencies in NP training programs. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this study was to establish pressure ulcer prevalence and prevention in the long-term care setting. Background. There is no information on pressure ulcers prevalence in care of the older person in Ireland; therefore, a prevalence study was undertaken to investigate key aspects related to current practices in pressure ulcer prevention. Design. A cross-sectional survey design was employed. Method. Ethical approval was received. Participants included 1100 older individuals residing in 12 long-term care settings. Data were collected using the Braden scale, the European Pressure Ulcer Advisory Panel minimum data set and pressure ulcer grading system. Results. All participants were Irish and white, 70% were women, and 75% were aged 80 years or older. Prevalence was 9%, with 28% of pressure ulcers grade 1, 33% grade 2, 15% grade 3 and 24% grade 4, mainly located on the sacrum (58%) and the heel (25%). Seventy-seven per cent scored Braden low risk or not at risk; however, 53% were completely immobile/very limited mobility and 58% were chair/bedfast. There was a significant association between activity and mobility and pressure ulcer development ( χ2 = 45·50, p < 0·001 and χ2 = 46·91, p = 0·0001, respectively). Fifty per cent had a pressure redistribution device in bed, and 48% had one in use on the chair; however, 9% had a repositioning regime planned for when in bed and 5% planned for when seated in the chair. Conclusions. This paper reports on the first ever pressure ulcer prevalence survey conducted in long-term care in Ireland, and results provide significant insights into decision-making and use of resources in the prevention of pressure ulcers. Relevance to clinical practice. Pressure ulcers are common, costly and impact negatively on individuals. Current practices in prevention show several areas for improvement, namely, risk assessment, care planning and documentation. [ABSTRACT FROM AUTHOR]

Aims and objective. The goal of this paper was to evaluate the reliability and validity of the Nursing Work Index-Revised - Brazilian version (B-NWI-R). Background. Some instruments evaluate the presence of certain characteristics in the professional practice environment of nurses. Among them, the B-NWI-R, often cited in the literature and which is examined in the present study. This instrument is composed of 57 items and four subscales: autonomy, control over the work environment, nurse-physician relationships and organisational support. Design. A cross-sectional research design was carried out in three public university hospitals in the State of São Paulo, Brazil. Methods. The sample was composed of 278 nurses. The reliability of the instrument was evaluated through its homogeneity, using the Cronbach's alpha coefficient. The validity of the subscales of the B-NWI-R was evaluated through divergent construct validity and criterion-related validity. For the divergent construct validity, the Brazilian version of the Maslach Burnout Inventory (MBI) was employed, while for the criterion-related validity, variables such as 'satisfaction at work', 'perception of quality of care' and 'nurses' intention to leave work in the following year' were considered. Results. The results showed satisfactory consistency for the total of the items ( α = 0·95) and for the subscales of the B-NWI-R: 'control over practice settings' ( α = 0·75); 'nurse-physician relationships' ( α = 0·75); 'organisational support' ( α = 0·75) and 'autonomy' ( α = 0·63). The divergent validity resulted in significant correlation between the adapted instrument subscales and those of the MBI. In addition, a significant correlation was obtained between the subscales of the B-NWI-R and the variables 'perception of quality of care', 'satisfaction at work' and 'intention to leave work in the following year'. Conclusion. The reliability and validity of the B-NWI-R have been established. Relevance to clinical practice. The B-NWI-R subscales can be used to assess the nurses' perceptions of the work environment. [ABSTRACT FROM AUTHOR]

Aims and objectives. To examine how the role of the Emergency Nurse Practitioner has evolved in Scotland. Background. In 2001, Cooper and colleagues published a report on their survey (carried out in 1998) which described the extent and nature of Emergency Nurse Practitioner services in Scotland. They described a nascent nursing role and service that existed in almost half of Emergency Departments and that concentrated its activity on the management of minor distal limb trauma and wound management. Since that date, several relevant and important political, professional and local issues have combined to accelerate the development of this role. Design. Longitudinal survey of Scottish Emergency Departments ( n = 97 in 1998, n = 93 in 2009). Method. Census survey of all Scottish Emergency Departments identified by NHS National Services Scotland's Information and Statistics Division Accident and Emergency Waiting Times dataset 2006-07. Results. Emergency Nurse Practitioners are now practising in the majority (89%) of Emergency Departments and Minor Injury Units compared with 47% in 1998. Most departments (78%) use Emergency Nurse Practitioners in dual roles, and most departments (67%) differentiate their Emergency Nurse Practitioners from other nursing staff by use of a title. Wide variations in pay, role and scope of practice still exist. Conclusions. The role of the Emergency Nurse Practitioner has increasingly become part of mainstream health care delivery in Emergency Departments across Scotland and can now be considered to be common place. This study demonstrates that 'Advanced Nursing Practitioners' and 'Nurse Practitioners' cannot necessarily be considered to be synonymous, and nursing roles that are allowed to evolve naturally adopt a non-uniform level of practice. Relevance to clinical practice. This paper is of interest to Nurse Practitioners and workforce planners. [ABSTRACT FROM AUTHOR]

This paper investigated the possible predictive and mediating determinates of quality of life in this often forgotten population, focusing specifically on the role of sociodemographics, mental impairments, coping mechanisms, resilience and hope on subjective quality of life. The family members of survivors of man-made trauma are sometimes severely traumatised themselves and may suffer from post-traumatic stress disorder, depression and poor quality of life. Most studies focus on the victims and ignore the effect of the incidents on the victim's family members. Data were collected between October 2007-March 2008, a self-report questionnaire incorporating seven scales was administrated to 175 family members of victims of man-made trauma. One-way was performed to compare the variance in the reported quality of life. The structural equation models of path analysis was used to evaluate the main effects and interactions and interrelations among variables. Of the psychosocial factors, having a personal previous traumatic experience was found to significantly affect post-traumatic stress disorder, depression and physical health. Post-traumatic stress disorder and depression were found to directly and indirectly affect quality of life. Coping mechanism, resilience and a hope state mediated the effect of post-traumatic stress disorder and depression making the three significant predictors of subjective quality of life. Based on these findings and the scores of the different scales, clinicians may be able to design treatment plans that encourage the poorly adapting family members of victims of trauma, especially those with symptoms of post-traumatic stress disorder or depression, to accept changes as a part of life, nurture a positive view of the self, make connections for better social support and maintain or re-create a hopeful outlook towards life goals. Knowledge of the psychosocial factors associated with resistance to severe trauma can also help in the prevention and treatment of individuals at high risk for developing post-traumatic stress disorder or depression. [ABSTRACT FROM AUTHOR]

This paper presents the preliminary descriptive findings from an online survey commissioned by the Royal College of Nursing to ascertain members' perceptions of spirituality and spiritual care. There is a professional requirement for nurses to achieve competence in the delivery of spiritual care and to assess and meet the spiritual needs of their patients. Recently, the area of spirituality has come under criticism bringing into question the role of the nurse with regard to the provision of spiritual care. A descriptive online survey was conducted with all Royal College of Nursing members to obtain their perceptions of spirituality and spiritual care in an attempt to identify what action they feel is required with regard to this aspect of nursing practice. An online survey consisting of a five-part questionnaire was developed incorporating the Spirituality and Spiritual Care Rating Scale. Members were asked to complete the survey during a three-week period in March 2010. Overall, 4054 Royal College of Nursing members responded, making this probably the largest UK survey ascertaining nurses' perceptions of spirituality and spiritual care. Descriptive statistics, frequencies and percentages were used to identify key findings. A Cronbach's alpha of 0·80 was obtained for the Spirituality and Spiritual Care Rating Scale. The preliminary analysis confirms that nurses across the full health economy in the United Kingdom consider spirituality to be a fundamental aspect of nursing. The findings indicate that nurses recognise that attending to the spiritual needs of patients enhances the overall quality of nursing care. However, despite all the attention given to the spiritual dimension, the majority of nurses still feel that they require more guidance and support from governing bodies to enable them to support and effectively meet their patients' spiritual needs. [ABSTRACT FROM AUTHOR]

The aims of this paper were to determine the level of knowledge and attitude of contraception and their relationships among Chinese migrant woman workers. Studies on psychosocial variables that lead to reproductive health behaviours among Chinese migrant woman workers in China remain limited. A cross-sectional, descriptive and correlational design. One hundred and ninety young woman workers of a factory in Guangdong, a representative city of factory base in mainland China, voluntarily participated in the study with a response rate of 63%. Data were collected through self-administered questionnaires consisting of a socio-demographic sheet, the Contraceptive Knowledge Scale and the Contraceptive Attitude Scale. Pearson product moment correlation coefficient test was employed to examine the relationships between the contraceptive knowledge and attitude, with level of significance set at p < 0·05. The Chinese migrant woman workers demonstrated lower contraceptive knowledge and less favourable contraceptive attitude compared with previous studies of adolescents in Taiwan and women seeking abortion in Hong Kong. Although it was a weak correlation, contraceptive knowledge was statistically associated with contraceptive attitudes among the respondents ( r = 0·276, p < 0·001). Respondents' age, education level and working experience were significantly positively correlated with the contraceptive knowledge. Young Chinese migrant workers reported in the current study are found to be at higher sexual risk, when compared to the adolescents in Taiwan and Hong Kong women seeking abortion. Early educational intervention for reproductive health in particular contraception and its usage to these young women is indicated. Migrant woman workers in mainland demonstrated poor knowledge and unfavourable attitudes towards contraception, especially for the younger, single and less educated group. Greater effort is necessary to promote young migrant women's knowledge and attitude towards contraception and sexual health. [ABSTRACT FROM AUTHOR]

To explore why innovations in service and delivery are adopted and how they are then successfully implemented and eventually assimilated into routine nursing practice. The 'Productive Ward' is a national quality improvement programme that aims to engage nursing staff in the implementation of change at ward level. Mixed methods (analysis of routine data, online survey, interviews) to apply an evidence-based diffusion of innovations framework. (1) Broad and narrow indicators of the timing of 'decisions to adopt' the Productive Ward were applied. (2) An online survey explored the perceptions of 150 respondents involved with local implementation. (3) Fifty-eight interviews in five organisational case studies to explore the process of assimilation in each context. Since the launch of the programme in May 2008 staff in approximately 85% of NHS acute hospitals had either downloaded Productive Ward materials or formally purchased a support package (as of March 2009). On a narrower measure, 40% (140) of all NHS hospitals had adopted the programme (i.e. purchased a support package) with large variation between geographical regions. Four key interactions in the diffusion of innovations framework appeared central to the rapid adoption of the programme. Despite widespread perception of significant benefits, frontline nursing staff report that more needs to be carried out to ensure that impact can be demonstrated in quantifiable terms and include patient perspectives. The programme has been rapidly adopted by NHS hospitals in England. A variety of implementation approaches are being employed, which are likely to have implications for the successful assimilation of the programme into routine nursing practice. This paper summarises the perceived benefits of the Productive Ward programme and highlights important lessons for nurse leaders who are designing (or adapting) and then implementing quality improvement programmes locally, particularly in terms of how to frame such initiatives - and provide support to - ward-level staff. [ABSTRACT FROM AUTHOR]

The primary objective of the study was to determine which professional, situational and patient characteristics predict nurses' judgements of patient acuity and likelihood of referral for further review. A secondary aim was to test the feasibility of the factorial survey method in an acute area. There is increasing recognition that indicators of deterioration in acutely unwell adults are being missed and referrals delayed. The reasons for this are unclear and require exploration. Assessing nurses' clinical decision-making or judgements in a 'real-world' situation is problematic. The study used a factorial survey design where participants completed randomly generated paper-based vignettes on one occasion. The dependent variables were assessment of patient acuity and likelihood of referral. Independent variables consisted of a number of patient characteristics, i.e. heart rate, blood pressure, nurse characteristics, i.e. clinical experience, and situational characteristics i.e. staffing. Participants were registered nurses working in acute areas excluding intensive care and theatre. Ninety-nine participants responded resulting in 1940 completed vignettes. An early warning score was the single most significant predictor of referral behaviour accounting for 9·6% of the variance. When this was not included in the vignette, nurses used physiological characteristics e.g. respiratory rate, urine output, neurological status. These explained 12% of the variance in the model predicting assessment of patient acuity and 9·4% or the variance predicting likelihood of referral. When given a series of vignettes, nurses appear to use appropriate physiological parameters to make decisions about patient acuity and need for referral. Our results support the use of early warning scoring systems. Education and professional development should focus more on developing and maximising clinical experience and expertise rather than knowledge acquisition alone. A factorial survey method is feasible to explore decision-making in this area. This study has several implications for practice. The emergence of an early warning scoring system as a significant individual predictor supports the use of such systems. However, the small amount of explained variance suggests that there are other influences on nurses' assessment of patient acuity and referral decisions that were not measured by the factorial survey approach. Educational provision might focus not just on knowledge acquisition but include educational delivery methods that incorporate or mimic real-ward settings. [ABSTRACT FROM AUTHOR]

This article provides insight into the potential economic viability of nurse practitioner employment in Dutch general practices. General practitioners face the challenging task of finding the most efficient and effective mix of professionals in general practice to accommodate future care demands within scarce health care budgets. To enable informed decision-making about skill mix issues, economic information is needed. Discursive paper. A descriptive and explorative design was chosen to study the economic viability of nurse practitioner employment in general practice. The conditions under which the nurse practitioner is able to earn back his/her own cost of employment were identified. Preferences and expectations of general practitioners and health insurers about nurse practitioner reimbursement were made transparent. Although general practitioners and health insurers acknowledge the importance of the nurse practitioner in accommodating primary care demands, they have polarised views about reimbursement. The employment of nurse practitioners is seldom economically viable in current practices. It requires a reallocation of (80% of) the general practitioner's freed up time towards practice growth (12% number of patients). The economic viability of the nurse practitioner has proven difficult to achieve in every day health care practice. This study provided insight into the complex interaction of the (cost) parameters that result in economic viability and feeds a further discussion about the content of the nurse practitioner role in general practice based on optimal quality of care vs. efficiency. Effective and efficient health care can only be provided if the actual care needs of a population provide the basis for deciding which mix of professionals is best equipped to deal with the changing and increasing demand of care. A macro-level intervention is needed to help a broad-scale introduction of the nurse practitioner in general practice. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to describe an assessment of a major retention initiative implemented at The Queen's Medical Center in Honolulu, Hawaii, in response to the nursing workforce shortage in the state. After tracking the situation for several years, nursing leadership at the medical centre critically analysed their registered nurse retention data. The retention rate among new nurses in their first year of employment was only 55·97%. A training programme was initiated to improve registered nurse retention and patient care outcomes with external funding from the US Health Resources and Services Administration. New nurses were supported via additional training and clinical coaches beyond the basic orientation period. Leadership skills of nurse managers were expanded to strengthen their role in retention of new nurses. Four inpatient nursing units became Magnet Pilot Units to demonstrate progress towards achievement of Magnet standards and improvement of patient outcomes. From 2005-2009, first-year-registered nurse retention improved from 55·97-68·20%; registered nurse vacancy rate decreased from 11·26-2·19%; patient satisfaction increased from 84·6-87·8%; registered nurse satisfaction-autonomy improved from 43·55-49·29; registered nurse satisfaction-decision-making went from 41·13-47·97%; and nosocomial decubitus ulcer rate decreased from 15·3-6·7% in the intensive care units. Dedicated resources and targeted activities can make a difference in outcomes for both nurses and patients. Keys to success included engaging staff, having high expectations coupled with high support, providing data to unit-level staff to measure improvements emphasising renewed accountability and maintaining the focus on quality patient care. When the goal is to provide the highest level of quality patient care, professional development of staff and managers is important to meet performance expectations and achieve target clinical goals. Improving registered nurse retention and vacancy rates while also improving patient outcomes had significant human resource and financial benefits for the organisation and contributed to achieving Magnet Recognition. [ABSTRACT FROM AUTHOR]

The increasing status and regard of indigenous minority languages across Europe, means the advantages of bilingualism for individuals and communities are now well established. We set out to elicit parents' and health professionals' views of the role of health visitors and midwives in promoting bilingualism in the family and to consider whether health professionals acknowledge the contribution that bilingualism makes to public health. A three-year study was completed to measure the impact of a language transmission initiative which depends on the input of midwives and health visitors with new parents and how its effect could be improved. This paper reports on one element of that study. A qualitative approach was used. Six focus group interviews were conducted with health visitors and midwives and 33 postnatal interviews were completed with parents across four counties in Wales. Thematic content analysis was undertaken by two researchers, a third trailed decision processes and scrutinised categories and themes. Findings suggest that health visitors and midwives perceive their roles relating to the promotion of bilingualism differently. Influences on their involvement include their language profile, contact with parents, personal experience, timing of the interaction and time in their workload. The relationship between promoting bilingualism and public health was accepted by some and denied by others. Data from the interviews with parents suggested that few health professionals discuss issues of language transmission with new parents. Some individual health visitors and midwives are willing to promote bilingualism with parents. However, there are challenges in enlisting the support of health visitors and midwives to discuss language transmission and bilingualism with parents. These findings challenge practitioners to consider their role in promoting bilingualism and its effect on public health and suggest the need for more defined responsibilities. [ABSTRACT FROM AUTHOR]

This paper examined the impact of leadership characteristics of nursing unit managers, as perceived by staff nurses, on staff satisfaction and retention. A positive work environment will increase levels of job satisfaction and staff retention. Nurse leaders play a critical role in creating a positive work environment. Important leadership characteristics of the front-line nurse manager include visibility, accessibility, consultation, recognition and support. Secondary analysis of data collected on 94 randomly selected wards in 21 public hospitals across two Australian states between 2004-2006. All nurses ( n = 2488, 80·3% response rate) on the selected wards were asked to complete a survey that included the 49-item Nursing Work Index-Revised [NWI-R] together with measures of job satisfaction, satisfaction with nursing and intention to leave. Subscales of the NWI-R were calculated. Leadership, the domain of interest, consisted of 12 items. Wards were divided into those reporting either positive or negative leadership. Data were analysed at the nurse level using version 16. A nursing manager who was perceived to be a good leader, was visible, consulted with staff, provided praise and recognition and where flexible work schedules were available was found to distinguish the positive and negative wards. However, for a ward to be rated as positive overall, nurse leaders need to perform well on all the leadership items. An effective nursing unit manager who consults with staff and provides positive feedback and who is rated highly on a broad range of leadership items is instrumental in increasing job satisfaction and satisfaction with nursing. Good nurse managers play an important role in staff retention and satisfaction. Improved retention will lead to savings for the organisation, which may be allocated to activities such as training and mentorship to assist nurse leaders in developing these critical leadership skills. Strategies also need to be put in place to ensure that nurse leaders receive adequate organisational support from nursing executives. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper describes a study that aimed to identify research priorities for the care of infants, children and adolescents at the sole tertiary referral hospital for children in Western Australia. The secondary aim was to stimulate nurses to explore clinical problems that would require further inquiry. Background. Planning for research is an essential stage of research development; involving clinicians in this exercise is likely to foster research partnerships that are pertinent to clinical practice. Nursing research priorities for the paediatric population have not previously been reported in Australia. Design. Delphi study. Method. Over 12 months in 2005–2006, a three-round questionnaire, using the Delphi technique, was sent to a randomly selected sample of registered nurses. This method was used to identify and prioritise nursing research topics relevant to the patient and the family. Content analysis was used to analyse Round I data and descriptive statistics for Round II and III data. Results. In Round I, 280 statements were identified and reduced to 37 research priorities. Analysis of data in subsequent rounds identified the top two priority research areas as (1) identification of strategies to reduce medication incidents (Mean = 6·47; SD 0·88) and (2) improvement in pain assessment and management (Mean = 6; SD 1·38). Additional comments indicated few nurses access the scientific literature or use research findings because of a lack of time or electronic access. Conclusions. Thirty-seven research priorities were identified. The identification of research priorities by nurses provided research direction for the health service and potentially other similar health institutions for children and adolescents in Australia and internationally. Relevance to clinical practice. The nurse participants showed concern about the safety of care and the well-being of children and their families. This study also enabled the identification of potential collaborative research and development of pain management improvement initiatives. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study to investigate the relationships among bone mineral density, demographics, knowledge of osteoporosis, beliefs concerning osteoporosis and preventive behaviours of at-risk females with family histories of osteoporosis. Background. Strong evidence demonstrates that genetics is a significant determinant of peak bone mass, with a heritability of 50–90%. However, few studies have examined the bone mineral density of at-risk females with family histories of osteoporosis, particularly in an Asian population. Design. Telephone survey. Methods. The study population ( n = 2890) was recruited from a radiology department at a national university medical centre in northern Taiwan during 2005–2006. In total, 886 females completed a questionnaire via the telephone; the participation rate was 30·7%. Results. The bone mineral density of at-risk females was close to osteopenia status (T score of −1 to −2·49). Most subjects were aware of osteoporosis-related information; however, few clearly understood osteoporosis. Furthermore, subjects reported difficult implementing strategies to improve bone mineral density. Variation in bone mineral density was correlated with self-rated health ( r = 0·56, p < 0·05), knowledge of osteoporosis ( r = 0·66, p < 0·05) and preventive behaviours ( r = 0·68, p < 0·05). Conclusions. This study is to examine risk factors associated with bone mineral density of females with family histories of osteoporosis. Early identification of risk factors for osteoporosis and development of prevention programmes are required to halt the increasing in the incidence of osteoporosis and improve the bone mineral density of at-risk females. Relevance to clinical practice. Nursing care professionals, who emphasise primary, secondary and tertiary prevention with individuals and families, should develop effective prevention strategies for women with family the history of osteoporosis to protect the health of these vulnerable populations at-risk for osteoporosis. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To determine the prevalence and levels of anxiety and depression symptoms among nursing students during the coronavirus lockdown, and to examine factors associated with higher levels of anxiety and depression on this population. Background: Nursing students deal with diverse stressors during their university lives. Confinement measures during COVID‐19 outbreak may have influenced students' mental health and well‐being. Anxiety and depression are common among nursing students due to different factors. Evidence relating to anxiety and depression in nursing student population during SARS‐CoV‐2 pandemic is limited. Design: A cross‐sectional descriptive co‐relational study during the lockdown due to the coronavirus outbreak in Spain was conducted. Methods: An online questionnaire was developed by using google forms. Sociodemographic characteristics form, and the Spanish version of the Hospital Anxiety and Depression Scale (HADS) were used. Spanish nursing students across the country were enrolled. Data collection was performed between 4 April 2020 and 21 April 2020. A multivariate analysis was performed to determine the association between sociodemographic variables, COVID‐19 and HADS scores. Results: 1319 participants were enrolled. The sample was formed by 87.1% female students with a mean age of 22 years (SD ± 5.677). We found a mean score of 8.47 ± 4.104 on Scale HADS‐Anxiety and 6.80 ± 2.988 on HADS‐Depression. 31.6% students presented abnormal scores of anxiety symptoms, and only 11.4% participants revealed abnormal scores on HADS‐Depression. Conclusions: The reported prevalence of anxiety and depression symptoms on nursing students during the COVID‐19 lockdown is 56.4% and 38.2%, respectively. 43.6% of the sample scored normal anxiety levels, and 61.8% obtained normal depression levels. Higher anxiety and depression levels were statistically associated with being a first‐year student, being a smoker, feeling fear, feeling stress and having any close family member infected. Relevance to clinical practice: These data should be valuable for detection and for further treatment decision of this disorders at the initial stage and could be important to prevent further damages to mental health and promote physical, psychological and well‐being among this population. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To examine knowledge, attitude, and practice regarding postoperative delirium and the relationships among cardiac surgery nurses in China. Background: Postoperative delirium is a prevalent and devastating complication following cardiac surgery. Nurses play a part in multi‐disciplinary collaboration for preventing and managing postoperative delirium, of whom knowledge, attitude, and practice are essential. Design: A cross‐sectional multi‐centre study. Methods: Nurses from cardiac surgery wards and intensive care units of five tertiary hospitals in Wuhan, Hubei Province, China were enrolled. Data were gathered online using a self‐administered questionnaire. Student's t‐test, or analysis of variance, or non‐parametric tests were performed to compare differences across groups. Bootstrapping mediation analysis was conducted to examine the relationship between knowledge, attitude, and practice. The STROBE checklist was used for the reporting of this study. Results: Of 429 nurses, a moderate level of knowledge and high levels of attitude and practice regarding postoperative delirium were revealed. Nurses with higher education, higher academic title, 5–10 years of practice in nursing and cardiac surgery nursing exhibited increased knowledge. With advanced age, practice in a specialised hospital, and training experience, nurses reported a better degree of practice. Attitude played a full mediating effect in the relationship between knowledge and practice, accounting for 81.82% of the total effects. Conclusions: Knowledge, attitude, and practice regarding postoperative delirium are promising among Chinese cardiac surgery nurses, with knowledge of screening tools and perioperative nonpharmacological interventions and practice of screening in need of enhancement. Attitudes act as an intermediary between knowledge and practice regarding postoperative delirium. Relevance to Clinical Practice: Innovative and stratified in‐service education is warranted to address knowledge enhancement. Meanwhile, organisations are suggested to make efforts to foster nurses' positive attitudes, particularly in creating a favourable culture and developing institutional protocols for postoperative delirium management to improve practice. No Patient or Public Contribution: This study is focused on cardiac surgery nurses' knowledge, attitude, and practice regarding postoperative delirium, and the research questions and design are from clinical nursing practice, literature review, and expert panel review, in which the patient or public is temporarily not involved. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To analyze stress levels, sleep quality, sleepiness and chronotypes on emergency room (ER) professionals before and during the COVID‐19. Background: ER healthcare professionals are exposed to high stress levels, and they often present with poor sleep quality. Design: Observational study conducted into two different phases (before the COVID‐19 and during the first wave of the COVID‐19). Method: Physicians, nurses and nursing assistants working in the ER were included. Stress, sleep quality, daytime sleepiness and chronotypes were assessed by the Stress Factors and Manifestations Scale (SFMS), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Horne and Österberg Morningness‐Eveningness questionnaire, respectively. The first phase of the study was performed between December 2019 and February 2020, and the second between April and June 2020. The STROBE checklist was used to report the present study. Results: In total, 189 ER professionals in the pre‐COVID‐19 phase and 171 (of the initial 189) during COVID‐19 were included. The proportion of workers with a morning circadian rhythm increased during the COVID‐19, and stress levels were significantly higher during COVID‐19 compared to the previous phase (38.34 ± 10.74 vs. 49.97 ± 15.81). ER professionals with poor sleep quality presented higher stress in the pre‐COVID‐19 phase (40.60 ± 10.71 vs. 32.22 ± 8.19) and during COVID‐19 (55.27 ± 15.75 vs. 39.66 ± 9.75). Similarly, workers with excessive sleepiness had higher stress in the pre‐COVID‐19 phase (42.06 ± 10.95 vs. 36.64 ± 10.24) and during COVID‐19 (54.67 ± 18.10 vs. 48.44 ± 14.75). Positive associations were also found between the SFMS and the PSQI, as well as with the ESS in both phases of the study. Conclusions: Emergency room professionals had increased stress levels during the COVID‐19 pandemic. Stress was particularly higher in those with poor sleep quality or with excessive daytime sleepiness. Relevance to Clinical Practice: These results should aim to impulse the implementation of measures to improve the working conditions of ER professionals. [ABSTRACT FROM AUTHOR]

Aims: To assess the incidence density of local complications of peripheral venous catheters in patients aged 70 years and older, to identify risk factors for local complications of peripheral venous catheters, to describe microbiological epidemiology and to assess the impact of complications on patient outcomes. Design: Prospective, observational, single‐centre study. Methods: Patients 70 years and older admitted to the geriatric department of a teaching hospital in France between December 2019 and May 2020 were considered for inclusion if they had a peripheral venous catheter during their stay. Nurses checked the catheter insertion site three times a day for local complications; physicians ensured the follow‐up of complications. The STROBE checklist was used in this prospective observational study. Results: A total of 322 patients were included, with 849 peripheral venous catheters; the median age was 88 years and 182 (56.5%) were women. The incidence density of local complications was 50.5/1000 peripheral venous catheter‐days. Risk factors for local complications on multivariate analysis were dressing replacement (OR 1.18), furosemide (OR 1.11) and vancomycin (OR 1.60) infusion, urinary continence (OR 1.09) and hematoma at the catheter insertion site (OR 1.15). Thirteen cellulitis and three abscesses were diagnosed. Occurrence of a local complication was associated with a 3‐day increased duration of hospital stay (17 vs. 14 days). Conclusion: Risk factors for peripheral venous catheter local complications include urinary continence, furosemide or vancomycin infusion, hematoma at the peripheral venous catheter insertion site or dressing replacement. Implication for the Patient Care: Closer clinical monitoring may help reduce the occurrence of local peripheral venous catheters complication in patients 70 years and older. Relevance to Clinical Practice: Patients at greater risk of peripheral venous catheter local complications deserve closer clinical monitoring or improved preventive measures, which may be beneficial to reduce the length of hospital stay. No Patient or Public Contribution: The study was designed to describe risk factors for local complications of peripheral venous catheters in order to reinforce surveillance in this specific population by nurses and medical staffs. Patients had their peripheral venous catheter insertion site checked thrice a day by the nurse in charge as part of usual care. They, as service users, caregivers or members of the public, were not solicited for data collection, analysis, interpretation or preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore the acceptances and associated influences of organ donation in mainland China. Background: The shortage of organ donors has limited the development of organ transplantation in China. It is important to recognise the target population who has high intention to donate their organs may change the status. Design: We conducted a cross‐sectional, multi‐stage sampling study collected demographic data and individuals' willingness to accept organ donation. Methods: A stepwise linear regression analysis was adopted to evaluate the factors related to the attitudes toward organ donation. Results: We collected 11,031 valid samples for the survey. The willingness to donate organs among Chinese residents averaged 56.93 points. To be specific, males (β = −.03), religious believers (β = −.01) and parents with a different number of children (all: β = −.04) are less willing to donate their organs. Respondents who live in an urban area (β =.03), have higher education level (High school or junior college β =.04, Bachelor degree or above β =.09), feel anxious (mild, moderate β =.02), feel pressured (moderate, severe β =.08), have higher scores of the Short‐Form Health Literacy Instrument (HLS‐SF12) (β =.31), The Self‐Management Scale (SHMS) (β =.16), EuroQol Five Dimensions Questionnaire (EQ‐5D) (β =.04) and EuroQol Visual Analogue Scale (EQ‐VAS) (β =.24), are more positive to donate. Conclusions: This study firstly discusses the public acceptance of organ donation through a nationwide sample around China. In this study, we discovered that Chinese residents' acceptance level of organ donation and that gender, house, anxiety, pressure, social support and health literacy were the main influencing factors on residents' attitudes. Relevance to Clinical Practice: To figure out the Chinese public acceptance and its influencing factors of organ donation can help nurse transplant coordinators to recognise the target population and the obstacles of organ donation. Patient or Public Contribution: At the phase of collecting data, participants were recruited to fill the questionnaires. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of this study was to examine the relationship between professional attitude and compassion among nurses. Material and Methods: The sample of the crossectional study recruited 202 nurses who accepted participation and working in a state hospital. Data were collected between 20 June 2019 and 2 August 2019 with a questionnaire form, Inventory of Professional Attitude at Occupation (IPA) and Compassion Scale. Data were collected via face‐to‐face method. Form and scales were completed by the participants. The study was reported according to the STROBE. Results: The mean IPA was 134.57 ± 15.43. The mean score of the Compassion Scale was 73.89 ± 11.54. The mean scores of the Compassion Scale's sub‐dimensions were 16.17 ± 3.22 for kindness, 8.62 ± 3.44 for indifference, 15.45 ± 3.17 for common humanity, 9.02 ± 3.46 for separation, 15.95 ± 3.00 for mindfulness, 8.67 ± 3.44 for disengagement. There were positive correlations between kindness (r =.356), common humanity (r =.214), mindfulness (r =.297) subscales and there were negative correlations between indifference (r = −.441), separation (r = −.411) and disengagement (r = −.415) subscales and the Inventory of IPA. There was a negative correlation between IPA and total Compassion Scale scores (r = −.140). IPA scores were significantly different according to sex, age, working duration, weekly working time, satisfied with colleague relationships. Compassion scores were significantly different for weekly working time, satisfaction with colleague relationships, suitability of the nursing profession and working in emergency and outpatient clinics (p <.05). Conclusion: As nurses' professional attitude scores increased, kindness, common humanity and mindfulness subscales scores increased, while indifference, separation and disengagement subscales scores of the compassion scale decreased. Relevance to clinical practice: Increasing the awareness about professional attitude and compassion in nursing should start with undergraduate education of nurses, and it is recommended to organise in‐service training to develop professional attitudes and compassion in occupational life and to research patient perspectives about compassion. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this study was to explore caller satisfaction with interaction, and the association to overall satisfaction with calls. Background: In the era of expanding healthcare at distance, the telephone remains a common tool for the provision of nursing care. Interaction between telenurse and caller in telenursing is vital for safety, satisfaction and adherence reasons. Few studies have quantitatively explored interaction in calls and how it relates to overall satisfaction with calls. Design: Cross‐sectional survey study with a deductive approach. Methods: A total of 466 callers to the Swedish Medical Advisory Service completed the Telenursing Interaction and Satisfaction Questionnaire. Satisfaction with four theoretically defined components of interaction were compared using repeated measures ANOVA. Associations between satisfaction with interaction and overall satisfaction with calls were evaluated with ordinal logistic regression models with and without adjustment for age, sex, health status, waiting time, time for call, main result of the call and expectations. The study followed the STROBE checklist. Results: Callers were most satisfied with affective support, followed by professional‐technical competence, health information and decisional control—in that order. A summated score of satisfaction with interaction was positively and significantly associated with overall satisfaction with calls before and after adjustment for waiting time, main result of call and variables related to the individual caller. Conclusions: Caller satisfaction with interaction is generally high but can be improved, especially regarding decisional control. Satisfaction with interaction is important for overall satisfaction with calls. Relevance to clinical practice: This study provides support for professionals at all levels in telenursing organisations to pay attention to interactional matters. The development of best practice for telenurses needs to consider all four components of interaction to enhance satisfaction with calls. [ABSTRACT FROM AUTHOR]

Background: Fatigue is associated with multidimensional factors in heart failure patients. Investigating longitudinal changes in fatigue and its association in patients undergoing cardiac surgery is needed to create interventions for improving fatigue during recovery. Aims: This study examined the trajectory of fatigue and its associated factors over time in patients undergoing cardiac surgery. Methods: This longitudinal study enrolled 125 patients undergoing cardiac surgery in northern Taiwan. Patients completed questionnaires before surgery, at discharge, and at 1, 3 and 6 months post‐discharge. Fatigue was measured using the General Fatigue Scale. Generalised estimating equation models were fitted to identify variables associated with fatigue over time. This study complied with the STROBE checklist. Results: The sample (mean age = 60.70 ± 10.42) was mostly male (68%). High fatigue was found in 73.6% of patients before cardiac surgery and significantly decreased over the six months after discharge. NYHA III/IV, lower haemoglobin level, more symptom distress, poor sleep quality, higher anxiety and depression and lower social and family support were significantly associated with an increase in fatigue levels over time. Compared with before discharge, decreases in sleep quality at 1, 3 and 6 months were significantly associated with an increase in fatigue levels (p <.001). The increases in social support (B = 0.20, p =.016) and family support (B = 0.37, p =.002) at 6 months were significantly associated with an increase in the fatigue scores. Conclusion: Fatigue was common and associated with symptoms, sleep quality, emotion and social support in patients undergoing cardiac surgery. In addition to symptom management, improving sleep quality and social support are important to manage fatigue for the long‐term care of patients undergoing cardiac surgery. Relevance to clinical practice: Patient education on symptom management, sleep hygiene and family support is suggested to improve fatigue in patients recovering from cardiac surgery. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To evaluate the impact of the professional transition of new graduate nurses during the COVID‐19 pandemic. Background: The transition from the role of student to the professional role can be challenging for new graduate nurses for the acquisition of higher autonomy and responsibility. The COVID‐19 pandemic impacted the quality of the professional transition. Design: This was a cross‐sectional observational study following the Strengthening and Reporting of Observational Studies in Epidemiology checklist. Methods: One hundred and two nurses who graduated in three consecutive sessions (November 2019—pre‐pandemic, March 2020—pandemic outbreak, and November 2020—2nd wave) in a north Italian university located in the most affected Italian region by the COVID‐19 pandemic, completed an online survey assessing well‐being, risk of burnout, resilience, perceived stigma, strengths and limitations and quality of the professional transition. The study was performed between March and May 2021. Results: 81.4% of participants described the professional transition as worse than expected, and new graduate nurses who worked in COVID‐19 settings reported a more difficult transition to professional life. No differences emerged in burnout, mental well‐being and perceived stigma between new graduate nurses who worked in COVID‐19 settings and those who did not. Similarly, no differences emerged amongst the three graduated cohort sessions. The most commonly mentioned challenges faced during the transition were organisational aspects, suddenly acquired autonomy and lack of suitable coaching. Conclusion: New graduate nurses reported a challenging academic‐professional transition, in particular, those who worked in COVID‐19 settings. The mid‐ and long‐term impact of experiencing an academic‐professional transition in COVID‐19 settings should be assessed and monitored. Relevance to clinical practice: The professional transition of new graduate students should be adequately planned and monitored, new graduates should be assisted to develop realistic expectations about the transition, and an adequate coaching period should be guaranteed all the more during health emergencies. [ABSTRACT FROM AUTHOR]

Purpose: This cross‐sectional, descriptive, correlational study aimed to measure burnout, quality of life (QOL) and perceptions of patient‐related adverse events among paediatric nurses amid the COVID‐19 pandemic and assess the relationships between these scores and participants' demographic and work‐related characteristics. Background: The mental health of most nurses may severely suffer due to the significant adversities that they struggle with while they care for their patients amid the COVID‐19 pandemic. Mental distress negatively affects nurses' relationships and work performance, which may adversely influence the quality of care and patient safety. Methods: A convenient sample of 225 Jordanian paediatric nurses completed a test batter comprising the Copenhagen Burnout Inventory, the Brief Version of the World Health Organisation's Quality of Life questionnaire and the nurse‐perceived patient adverse events' questionnaire. This study was prepared and is reported according to the STROBE checklist. Results: Paediatric nurses reported high levels of burnout, low QOL and high occurrence of hospital‐acquired infections. Participants' age and hospital/unit capacity were significantly associated with burnout and QOL. Conclusion: Personal traits, perceived salary insufficiency and hospital/unit capacity represent factors that aggravate burnout, lower quality of life and worsen perceived patient safety among paediatric nurses. Relevance to clinical practice: Policymakers should promote nurses' mental integrity and patient safety by addressing issues of workload and financial sufficiency and by provide interventions aimed to increase nurses' resilience. Patient or public contribution: Patients or public were not involved in setting the research question, the outcome measures, the design or implementation of the study. However, paediatric nurses responded to the research questionnaires. [ABSTRACT FROM AUTHOR]

Background: The importance of family resilience in the recovery of stroke patients has been demonstrated in numerous studies. However, little is known about post‐stroke family resilience. Aims: To investigate the family resilience of stroke patients from a patient–caregiver dyadic perspective during the first 6 months after stroke. Methods: A total of 288 dyads of patients diagnosed with a first‐episode stroke and their principal caregivers were recruited from neurology departments of 7 tertiary hospitals in Shanghai and Shangqiu, China. Family resilience and family function were assessed during hospitalisation and at 1, 3 and 6 months after stroke. K‐means cluster analysis was used to identify different clusters of family resilience based on family resilience of patients and caregivers during hospitalisation. The STROBE guidelines for observational studies were followed. Results: Three clusters of family resilience were identified with distinct trajectories: cluster of high resilience (HR), cluster of low resilience (LR) and cluster of discrepant resilience (DR). The level of family function was consistently highest in cluster HR and lowest in cluster with LR at four time points. Most (69.8%) families fell into the cluster with low resilience and low family function. Characteristics such as the Rankin scores and education level of patients, education level of caregivers, family monthly income and living district were different among the three clusters. Conclusions: We concluded that family resilience was linked to the family functioning of patients with a first‐episode stroke, however, the levels of resilience in most families were low. Factors, including the education level, family income and stroke severity of patients were revealed to influence the family resilience and its development. Relevance to clinical practice: A resilience‐focused approach to family‐related treatment is beneficial for families. Therefore, understanding family resilience among stroke survivors is needed to inform the development of interventions for enhancing the recovery of stroke families. [ABSTRACT FROM AUTHOR]