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Purpose: The objective of this study was to analyze proposed Korean nursing legislation as depicted in newspaper articles, to highlight issues related to the legislative process for this potential law, and to better understand social awareness regarding this matter. Methods: The study focused on articles from 11 leading newspapers in Korea, published between February 2020 and August 2023, that pertained to nursing legislation. The articles were retrieved from the BigKinds database. Following text preprocessing, analytical methods including term frequency-inverse document frequency were employed, along with latent Dirichlet allocation (LDA), for word and topic modeling analysis. Additionally, LDA was applied across time periods to examine temporal changes in topics. Results: Following preprocessing, a total of 7,967 words were extracted from the 991 articles selected for analysis. The primary themes identified in newspaper articles concerning the nursing legislation were organized into three main topics: 1) the necessity and impact of enactment of the nursing law, 2) the political context surrounding enactment of the law, and 3) the conflicts between and actions of healthcare organizations related to enactment of the law. Conclusions: The findings confirmed that media coverage regarding the proposed nursing legislation primarily concentrated on the political and social conflicts associated with the law's passage, rather than its necessity and substance. More compelling evidence must be presented concerning the influence of the nursing workforce and the work environment of nurses on patient safety and health outcomes. Additionally, strategies should be devised to improve public comprehension of the nursing law's provisions. [ABSTRACT FROM AUTHOR]

Background: Nurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students. Methods: This is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics. Results: The mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (p<0.05). Conclusion: Palliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs. [ABSTRACT FROM AUTHOR]

Introduction: The World Health Organization (WHO) called for the expansion of all nursing roles, including advanced practice nurses (APNs), nurse practitioners (NPs) and clinical nurse specialists (CNSs). A clearer understanding of the impact of these roles will inform global priorities for advanced practice nursing education, research, and policy. Objective: To identify gaps in advanced practice nursing research globally. Materials and methods: A review of systematic reviews was conducted. We searched CINAHL, Embase, Global Health, Healthstar, PubMed, Medline, Cochrane Library, DARE, Joanna Briggs Institute EBP, and Web of Science from January 2011 onwards, with no restrictions on jurisdiction or language. Grey literature and hand searches of reference lists were undertaken. Review quality was assessed using the Critical Appraisal Skills Program (CASP). Study selection, data extraction and CASP assessments were done independently by two reviewers. We extracted study characteristics, country and outcome data. Data were summarized using narrative synthesis. Results: We screened 5840 articles and retained 117 systematic reviews, representing 38 countries. Most CASP criteria were met. However, study selection by two reviewers was done inconsistently and language and geographical restrictions were applied. We found highly consistent evidence that APN, NP and CNS care was equal or superior to the comparator (e.g., physicians) for 29 indicator categories across a wide range of clinical settings, patient populations and acuity levels. Mixed findings were noted for quality of life, consultations, costs, emergency room visits, and health care service delivery where some studies favoured the control groups. No indicator consistently favoured the control group. There is emerging research related to Artificial Intelligence (AI). Conclusion: There is a large body of advanced practice nursing research globally, but several WHO regions are underrepresented. Identified research gaps include AI, interprofessional team functioning, workload, and patients and families as partners in healthcare. PROSPERO registration number: CRD42021278532. [ABSTRACT FROM AUTHOR]

Background: Reducing the risk of infection transmission by getting emergency care for pediatric patients is a challenging task. Aim: The study aim was to assess emergency nurses' readiness to provide care for pediatric patients with infectious diseases. Method: Two hundred Jordanian emergency department nurses were surveyed using a descriptive design. Results: The study revealed that insufficient safety and infection control procedures were put into place, starting with family support to allow nurses to work 145 (78%), family care plans intended to assist caregivers 139 (74.7%), the availability of respiratory protection and a backup plan for standard precautions, training requirements, and equipment 131 (70.4%), create a unit pandemic safety strategy 124 (66.7%), have a plan for emergencies for at-risk staff 116 (62.4%), have a hospital pandemic safety plan 113 (60.8%), manage inventory 102 (54.8%), use reuse guidelines if there will be severe shortages 99 (53.2%), create a strategy for nurses' access to healthcare for themselves and their families 96 (51.6%), and end with any required system updates for new policies 88 (47.3%). Staff nurses made up a large proportion of participants (145; 78%; 115; 62.8%) who said they lacked experience with care for pediatric patients with infectious illnesses who were critically sick. A 62.8% of nurses reported they did not have training in infectious disease emergency prevention and control for pediatric patients. What nurses prioritize it was determined that the concept of crisis standards of care (34.9%) was the most important educational topic for training emergency room nurses to care for pediatric patients who are critically ill with infectious infections, while the clarity of communication pathways was ranked lowest. Conclusion: More training and support are needed for emergency room nurses to properly care for children's patients with infectious illnesses. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the effect of different teaching methods of geriatric nursing on the mastery of geriatric knowledge among nursing students and their attitude toward the elderly. Methods: Relevant randomized controlled trials (RCTs) and quasi-experimental studies on teaching methods to improve nursing students' knowledge and attitude were systematically retrieved in electronic databases. The time scale of retrieval spans from the database establishment to January 2024, and the database consists of PubMed, the Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure Database (CNKI), China Biological literature database (CBM), Wanfang Database and VIP Database. Network meta-analysis was performed by Stata 16.0 software. Results: Thirty-nine studies involving 5310 nursing students met our inclusion criteria, and a total of 6 teaching methods were analyzed. According to the surface under the cumulative ranking (SUCRA) ranking, problem-based learning (PBL) was most effective in enhancing the knowledge mastery of geriatric nursing, while simulation-based learning (SBL) demonstrated the best application effect in improving nursing students' attitude toward the elderly. When considering both knowledge acquisition and attitude improvement simultaneously, service learning combined with traditional teaching method (SL+TTM) was found to exhibit the most optimal effectiveness. Conclusion: Educators in geriatric nursing education should prioritize the adoption of PBL, SBL and SL + TTM to enhance nursing students' knowledge and attitude. Protocol registry: PROSPERO (CRD42023442001). [ABSTRACT FROM AUTHOR]

Introduction and aims: In the specialized nursing setting, nurses are susceptible to developing negative mental health issues. Such conditions among nurses can potentially result in unfavorable medical outcomes. Consequently, this study aims to explore the role of social support in regulating between sleep and mental health in nurses. Methods: A cross-sectional study was carried out in September 2022 on 1219 nurses in Quanzhou. The study comprised general demographic information and utilized various questionnaires, namely the Social Support Rate Scale (SSRS), Pittsburgh Sleep Quality Index Questionnaire (PSQI), Generalized Anxiety Disorder Questionnaire (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). The data analysis was performed using t-tests, ANOVAs, Pearsons correlations and hierarchical regression analyses in SPSS software. Results: Results show that significant associations of sleep quality and social support with anxiety and depression. Simple slope analysis shows that under low levels of social support, sleep quality has a positive impact on anxiety(β = 0.598) and depression(β = 0.851), and the impact is significant. Under high levels of social support, sleep quality also has a positive impact on anxiety(β = 0.462) and depression(β = 0.578), but the impact is smaller. This indicates that as the level of social support increases, the positive predictive effect of sleep quality on anxiety and depression gradually diminishes. Conclusions: Social support has the potential to alter the impact of sleep quality on anxiety and depression. Therefore, healthcare policymakers need to focus on enhancing the level of social support and mitigating the impact of poor sleep on anxiety and depression. [ABSTRACT FROM AUTHOR]

Physical inactivity is a growing societal concern with significant impact on public health. Identifying barriers to engaging in physical activity (PA) is a critical step to recognize populations who disproportionately experience these barriers. Understanding barriers to PA holds significant importance within patient-facing healthcare professions like nursing. While determinants of PA have been widely studied, connecting individual and social factors to barriers to PA remains an understudied area among nurses. The objectives of this study are to categorize and model factors related to barriers to PA using the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework. The study population includes nursing students at the study institution (N = 163). Methods include a scoring system to quantify the barriers to PA, and regularized regression models that predict this score. Key findings identify intrinsic motivation, social and emotional support, education, and the use of health technologies for tracking and decision-making purposes as significant predictors. Results can help identify future nursing workforce populations at risk of experiencing barriers to PA. Encouraging the development and employment of health-informatics solutions for monitoring, data sharing, and communication is critical to prevent barriers to PA before they become a powerful hindrance to engaging in PA. [ABSTRACT FROM AUTHOR]

Background: While research on meditative mindfulness in nursing is abundant, research on socio-cognitive mindfulness is in its early stages despite its potential advantages to nursing practice and nursing education. This study introduces the under-examined concept of socio-cognitive mindfulness to the nursing field. Objective: To identify what is known in the research field of socio-cognitive mindfulness in nursing. Specific aims were to identify the effects of socio-cognitive mindfulness on nurses and nursing students, and the application of socio-cognitive mindfulness interventions and their effectiveness in nursing. Design: A scoping review following the Arksey and O'Malley framework. Methods: An electronic search of PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, ERIC, and ProQuest databases was conducted. The search included full-text papers published in peer-reviewed journals in English. The included studies were independently examined by the two authors to ensure the thorough inclusion of relevant research by screening of titles and abstracts and screening of full-texts. The selected papers were categorized based on the specific objectives of the review. Results: Out of 5,798 papers, six quantitative studies and one mixed method study were included in the review. Among the seven studies, two studies investigated the effects of socio-cognitive mindfulness on nurses, four examined the effects of socio-cognitive mindfulness on nursing students, and one conducted an intervention study applying socio-cognitive mindfulness and identified its effects on nurses. The findings revealed several benefits of applying socio-cognitive mindfulness to nursing practice and nursing education. Specifically, socio-cognitive mindfulness enhanced nurses' and nursing students' positive emotions and effective emotion regulation, which would positively influence nurses' nursing performance as well as students' academic outcomes and quality of college life. Conclusions: This study raises researchers' awareness of the significance of socio-cognitive mindfulness in nursing, and strongly recommends applying socio-cognitive mindfulness to nursing practice and nursing education and evaluating its effects. [ABSTRACT FROM AUTHOR]

Introduction: The number of patients with chronic kidney disease is increasing worldwide; previous studies have suggested that advanced practice nurses, including nurse practitioners and clinical nurse specialists, with expert practice skills can provide high-quality care and solve complex healthcare problems. In general, nurse practitioners are generalist nurses who work as autonomous clinicians with whole personal care. Clinical nurse specialists, in contrast, are nurses with advanced nursing knowledge and skills for individuals or specific populations. Their roles are independent and different; however, similarities exist in their role in potentially improving healthcare outcomes. Although two previous studies described the role of nephrology nurse practitioners, they were systematic reviews, and their outcomes were limited. To clarify the overall aspect of advanced practice nurses' role, it is necessary to extract the studies illustrating advanced practice nurses' practices for patients with chronic kidney disease. Objective: This study aims to map the literature describing the role of advanced practice nurses in improving healthcare outcomes for patients with chronic kidney disease. Materials and methods: This scoping review will be conducted using the Joanna Briggs Institute methodology for scoping review. Online databases will be searched across MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Web of Science. Only studies published in English will be included, and no date limit will be set. Chronic kidney disease, renal replacement therapy, and advanced practice nurses as keywords and related search terms will be used. Two independent reviewers will screen the title and abstract/full-text; in case of discrepancy, a third reviewer will make the final decision. The results will be extracted and presented following the review question concerning the study characteristics, patients' characteristics, condition of chronic kidney disease, and role of advanced practice nurses. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic led to the closure of educational campuses and the suspension of conventional classroom teaching globally and locally, and many switched overnight to an online modality. The change was experienced differently by varied audiences, given the availability of resources. The study aimed to examine stakeholders' experiences of emergency remote instructions in the Post-RN Baccalaureate Nursing Program during the COVID-19 pandemic. A qualitative descriptive exploratory design with a purposive sampling technique was used at a private nursing university in Karachi, Pakistan. Focus group discussions with students and faculty were conducted separately, while in-depth interviews with key informants were held using semi-structured interview guides. The focus group discussions and in-depth interviews were recorded electronically and transcribed and translated, coded, and analysed manually. Findings uncovered two major themes. (a) Remote teaching and learning—a paradigm shift; and (b) Remote learning ecosystem—a challenging team sport. The first theme denotes a major shift in pedagogical approach migrating from blended learning model to a complete online modality. Theme two uncovers the efforts and teamwork of the various stakeholders who assisted in mitigating the challenges collaboratively when migrating to virtual learning environment. Findings suggest that to continue to thrive in the post-COVID world, faculty, students, and key informants must collegially enhance the teaching, learning, and assessment strategies and student-teacher interaction, capitalising on evidence-based practices, trial and error, multi-level support mechanisms, and partnerships. The study recommends building resilience in instructional and administrative infrastructure to prepare for future events like pandemics and suggests development of evidence-informed blended and online nursing programmes in the region. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding brings about a positive impact on both child and maternal health in the short and long terms. However, adolescent mothers have a lower breastfeeding initiation rate and a shorter breastfeeding duration than adult mothers. Although mobile applications have been found to be the most widely used platform for breastfeeding support, there is still a lack of design specific for adolescents. Aim: To explore the experiences, perspectives and needs of adolescent mothers and professional nurses using smartphone applications for breastfeeding support and the influence of this technology on healthcare in Thailand. Methods: This formative qualitative research of the 'Development of smartphone application for promoting breastfeeding and learning of infant responsiveness for Thai teenage pregnant women' study intends to design a smartphone application and develop an implementation plan. A purposive sample was used to elicit experiences from adolescent mothers and nurses. Data were collected from 48 adolescent mothers through in-depth interviews with six focus group discussions and 12 nurses, following the data saturation principle. Thematic analysis was conducted, and potential factors and needs were mapped to the capability, opportunity, and motivation model of behaviour change (COM-B). Results: Most adolescent mothers perceived the usefulness of smartphone apps as breastfeeding support resources. The qualitative findings of adolescent mothers were grouped into the following three themes: a friendly breastfeeding tool; allows them to manage their breastfeeding activities; and enhances the accessibility and equality of breastfeeding support. The professional nurses perceived the benefits of using smartphone applications in their work, which included the following three themes: reducing workload and making their work easier; preparation is always better; and increasing the standards of breastfeeding support. Conclusion: Adolescent mothers and professional nurses showed favourable attitudes toward smartphone apps for breastfeeding support. These smartphone apps should be tailored to these groups to achieve optimal BF outcomes. [ABSTRACT FROM AUTHOR]

Nursing students are confronted with euthanasia during their internship and certainly during their later career but they feel inadequately prepared in dealing with a euthanasia request. This study presents a simulation module focused on euthanasia and evaluates nursing students' perceptions after they have completed the simulation practice. The 'euthanasia module' consisted of a preparatory online learning module, a good-practice video, an in-vivo simulation scenario, and a debriefing session. The module's content was validated by four experts in end-of-life care. The module was completed by three groups of students from two different University Colleges (n = 17 in total). The students were divided into three groups: one with no previous simulation education experience, one with all students having previous experience, and another with a mix of experiences. After completing the entire module, each group had a discussion regarding their perceptions and expectations concerning this simulation module. Thematic content analysis was conducted on audio-recorded group interviews using NVIVO® software, involving initial open coding, transformation into specific themes and subthemes through axial coding, and defining core themes through selective coding, with data analysis continuing until data saturation was reached. Students generally found the online learning module valuable for background information, had mixed perceptions of the good-practice video, and appreciated the well-crafted scenarios with the taboo of euthanasia emerging during simulations, while the debriefing process was seen as enhancing clinical reasoning abilities. Students considered the simulation module a valuable addition to their education and nursing careers, expressing their satisfaction with the comprehensive coverage of the sensitive topic presented without sensationalism or taboos. This subject holds significance for nations with established euthanasia laws and those lacking such legal frameworks. The findings of this study can aid teachers in developing and accessing euthanasia simulation training programs, contributing to broader education's emphasis on integrating euthanasia-related knowledge and skills. [ABSTRACT FROM AUTHOR]

Background: Health disparities, inconsistent outcomes, and underwhelming health services continue to be problems for all nurses and doctors. Studies from a variety of nations have found that doctors and nurses have little familiarity with evidence-based practice. There is a knowledge vacuum about the degree of evidence-based nursing practice and its contributing factors in Ethiopia as well as the current study region. Objective: The study's objective was to evaluate how healthcare professionals working in government hospitals in the Sidama regional state of 2022 are implementing evidence-based clinical practice and to identify associated factors. Methods: From October 1 to December 30/2022, a cross-sectional institution-based study with a mix of quantitative and qualitative methods was carried out. A total of 422 healthcare workers were randomly selected to participate in the current study from 6 randomly selected public hospitals in the region. This study included 25 key informant interviews. The Friedman test and Funk's BARRIER scale were adapted into a semi-structured questionnaire quantitative. Multivariable logistic regression was used to assess the significance of the association between the dependent and independent variables. A pretest was conducted on 22 healthcare workers from Shashmane Hospital. Result: This study found that more than half, 51.7%, of the participants had a total implementation of evidence-based practice score below the mean score (40.4). only Access to the internet [having smart phone] (Adjusted Odds Ratio (AOR) = 3.03: 95% Confidence Interval (CI): (1.75–5.26))., favorable Attitude toward EBP of participants. (Adjusted Odds Ratio (AOR) = 1.84Confidence Interval (1.12–2.70)), inadequate Self-efficacy of Evidence-based practice skills (Adjusted Odds Ratio (AOR) = 0.29 Confidence interval = 0.19–0.46), and Knowledge of evidence-based practice (Adjusted Odds Ratio (AOR) = 0.45 Confidence interval = 0.30–0.77)were factors significantly associated with EBP implementation. Conclusion: More than half of the participants,51.7%, do not implement evidence-based practice in the care of their clients, which is unacceptable. The use of EBP has been significantly associated with access to the internet (having a smartphone), participants' positive attitudes toward it, their level of skill efficacy in finding and accessing it, and their knowledge of it. Therefore, stakeholders ought to think about addressing these obstacles to the adoption of EBP. [ABSTRACT FROM AUTHOR]

Background: Nurses as the largest group of health workers have a very stressful job which can cause number of diseases specially increase cardiovascular risk factors. This study aims to investigate the overall epidemiology of cardiovascular disease (CVD) risk factors among nurses. Method: We searched all four main databases such as Scopus, PubMed, Embase and Web of Sciences from the beginning of 2000 to March 2022 with appropriate Mesh Terms. We also searched Google scholar. Then we applied inclusion and exclusion criteria and after selection the studies the Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of included studies. Comprehensive Meta-analysis and R software was used for analysis. Results: Finally, 22 articles with a total number of 117922 nurses were included. Among all risk factors, sedentary lifestyle and lack of regular physical activity with a prevalence of 46.3% (CI 95%, 26.6–67.2) was regarded as the main prevalent risk factor among nurses. The mean systolic blood pressure (SBP) measured in the study population was 121.31 (CI 95%, 114.73–127.90) and the mean diastolic blood pressure (DBP) was 78.08 (CI 95%, 74.90–81.25). Also family history of cardiovascular disease (41.9%; 95% IC: 29.8–55.1%), being overweight (33.3%; 95% IC: 24.7–43.2%), and alcohol consumption (24.6%; 95% IC: 16.4–35.2%) was found among the participants. Conclusion: Study results revealed that sedentary lifestyle was the main prevalent CVD risk factor among nurses followed by family history of cardiovascular disease, being overweight and alcohol consumption. Furthermore, among nurses with shift works almost all risk factors got higher score representing the worse condition in comparison with day workers' nurses. This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors. 1. What was already known?: In general, many studies have emphasized the impact of the nursing profession on the incidence of some cardiovascular patients. Also, different shifts of nurses can have a double effect. 2. What are the new findings?: In this study, the mean for sedentary lifestyle was reported to be 46.3% which represented the most prevalent risk factor for cardiovascular risk factors among study population. 3. What is their significance?: This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors. This information can comprise essential tools for health human resource management contributing to advance nursing. [ABSTRACT FROM AUTHOR]

Background: Effective nurse leadership enhances nurse welfare, improves patient care, and increases organisational success. A lack of adequate, supportive leadership significantly contributes to many nurses leaving the profession. Nurse managers need to prioritise engagement and retention as significant focus areas to address the nursing shortage in Saudi Arabia and accomplish the national program's objectives. Aim: To examine the correlation between the leadership styles of clinical nurse managers and staff engagement. Method: This study used a descriptive, cross-sectional, correlational design. The leadership styles of clinical nurse managers were evaluated using the Multifactor Leadership Questionnaire (MLQ-5X). Work engagement was assessed using the Utrecht Work Engagement Scale (UWES). Questionnaires were distributed to 450 nurses in four public hospitals in western Saudi Arabia. Non-probability convenience sampling was used to collect the data. Results: A total of 278 nurses from a range of clinical areas participated in the survey, which revealed that the leadership styles of clinical nurse managers positively or negatively impact nurse work engagement. Most clinical nurse managers exhibit transformational leadership, followed by transactional, then passive-avoidant styles. Respondents displayed a high level of work engagement, emphasising the positive impact of transformational and transactional leadership on work engagement outcomes. The findings showed significant differences in leadership styles and work engagement levels between Saudi and non-Saudi nurses across various dimensions. Conclusion: Understanding the effect of leadership styles employed by nurse managers on work engagement can positively impact staff retention rates and the quality of patient care. Nurse managers should participate in training programs to enhance their practical leadership skills to enhance the work engagement levels of nurses. Implication: Nurse work engagement can be improved by establishing training programs that promote effective leadership and highlight the significance of various leadership styles and their subsequent impact on nurse work engagement. Nursing students should receive education on leadership styles. Nursing leaders should be given access to mentoring programs and opportunities for career advancement to support the introduction of effective leadership styles. [ABSTRACT FROM AUTHOR]

COVID-19 has a range of complications, from no symptoms to severe pneumonia. It can also affect multiple organs including the nervous system. COVID-19 affects the brain, leading to neurological symptoms such as delirium. Delirium, a sudden change in consciousness, can increase the risk of death and prolong the hospital stay. However, research on delirium prediction in patients with COVID-19 is insufficient. This study aimed to identify new risk factors that could predict the onset of delirium in patients with COVID-19 using machine learning (ML) applied to nursing records. This retrospective cohort study used natural language processing and ML to develop a model for classifying the nursing records of patients with delirium. We extracted the features of each word from the model and grouped similar words. To evaluate the usefulness of word groups in predicting the occurrence of delirium in patients with COVID-19, we analyzed the temporal changes in the frequency of occurrence of these word groups before and after the onset of delirium. Moreover, the sensitivity, specificity, and odds ratios were calculated. We identified (1) elimination-related behaviors and conditions and (2) abnormal patient behavior and conditions as risk factors for delirium. Group 1 had the highest sensitivity (0.603), whereas group 2 had the highest specificity and odds ratio (0.938 and 6.903, respectively). These results suggest that these parameters may be useful in predicting delirium in these patients. The risk factors for COVID-19-associated delirium identified in this study were more specific but less sensitive than the ICDSC (Intensive Care Delirium Screening Checklist) and CAM-ICU (Confusion Assessment Method for the Intensive Care Unit). However, they are superior to the ICDSC and CAM-ICU because they can predict delirium without medical staff and at no cost. [ABSTRACT FROM AUTHOR]

Background: Obstetric-Gynecological Nursing is articulated as one of the specialities with the greatest responsibility in the field of health care, due to the involvement of being in care not only for the life of the pregnant woman, but also for the future neonate. Settling down as a profession with a high number of legal claims, there are not many studies in Spain on legal claims in the field of Nursing in general, and Obstetric-Gynecological Nursing in particular. Methods: Retrospective analysis of judgments against midwives in the period from 2010 to the present through the CENDOJ database, with the aim of searching for criminal, civil and contentious-administrative judgments. Quality was assessed using the STROBE critical appraisal tool for observational studies. Results: 19 judgments were selected from the 197 found that were related to the objective of the study. Fifty-three percent of the judgment analyzed resulted in acquittals, while the remaining 47% were upheld to varying degrees. Most of them were motivated damage to the newborn (79%), processed entirely through the contentious-administrative route. Conclusions: Most of the legal claims in the field of Obstetric-Gynecological Nursing are related to adverse events with fetal damage, most of them receiving higher monetary compensation as the contentious-administrative route is the jurisdiction with the highest number of claims filed, due to breaches of the lex artis ad hoc. [ABSTRACT FROM AUTHOR]

Understanding the factors influencing infection management behavior related to Emerging Respiratory Infectious Diseases (ERIDs) among nursing students is important because nursing students play a vital role in preventing the spread of ERIDs. This study aimed to determine factors influencing infection management behavior related to ERIDs among nursing students in Korea. In this cross-sectional survey study, data were collected from May 3 to June 30, 2022, using a questionnaire. Data collected from 481 nursing students were analyzed using descriptive statistics, an independent t-test, a one-way analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression using the SPSS program. The key factors influencing respondents' ERID-related infection management behavior were attitude (β = 0.554, p<0.001) and knowledge (β = 0.282, p<0.001). The explanatory power of this model was 40.2%, and the regression model was found to be statistically significant (F = 27.935, p<0.001). To improve nursing students' ERID-related infection management behavior, their knowledge of and attitudes toward ERIDs should be enhanced by repeatedly providing them with accurate professional information about ERIDs. Therefore, intensive efforts should be taken to develop a systematic educational program that can help nursing students better perform infection management. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this scoping review was to determine the underlying design of simulations that help undergraduate nursing students acquire evidence-based practice (EBP) experiences. Method: The JBI methodology was used for this review. The inclusion criteria were studies conducted in academic, clinical, or virtual settings that examined simulation programs designed to facilitate the acquisition of EBP by undergraduate nursing students. A comprehensive search was performed on Jan 3, 2022, using the Medical Literature Analysis and Retrieval System Online (MEDLINE; PubMed), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), and the Excerpta Medica database (EMBASE). Grey literature was not included. Publication year was limited to 2020 and later. There was no language restriction. Data were extracted using a tool developed by the reviewers and based on the National League for Nursing Jeffries Simulation Theory. Result: A total of 12,931 articles were found, and after duplicate articles and articles deemed ineligible based on the title and abstract (12,914 articles), 17 published papers were examined. The full texts of these studies were reviewed for eligibility, and one study was selected for the present scoping review. The selected study examined a mock trial designed to allow undergraduate nursing students to experience the ethical decision-making based on a diversity of evidence. The program reported in the study consisted of a prebriefing—simulation (mock)—debriefing structure with verified positive effects on EBP education. Conclusion: A mock trial is a useful educational strategy for allowing undergraduate nursing students to experience EBP, but a creative method should be found that can modify the mock trial for practical operation as the designing the program demands high levels of human and material resources. Registration: OSF Registries, https://osf.io/gdtyu, We updated OSF registry data for documenting important protocol amendments. [ABSTRACT FROM AUTHOR]

Background: The prevalence of violence in acute psychiatric wards is a critical concern. According to a meta-analysis investigating violence in psychiatric inpatient units, researchers estimated that approximately 17% of inpatients commit one or more acts of violence during their stay. Inpatient violence negatively affects health-care providers and patients and may contribute to high staff turnover. Therefore, predicting which psychiatric inpatients will commit violence is of considerable clinical significance. Objective: The present study aimed to estimate the violence rate for psychiatric inpatients and establish a predictive model for violence in psychiatric inpatients. Methods: We collected the structured and unstructured data from Chinese nursing electronic medical records (EMRs) for the violence prediction. The data was obtained from the psychiatry department of a regional hospital in southern Taiwan, covering the period between January 2008 and December 2018. Several text mining and machine learning techniques were employed to analyze the data. Results: The results demonstrated that the rate of violence in psychiatric inpatients is 19.7%. The patients with violence in psychiatric wards were generally younger, had a more violent history, and were more likely to be unmarried. Furthermore, our study supported the feasibility of predicting aggressive incidents in psychiatric wards by using nursing EMRs and the proposed method can be incorporated into routine clinical practice to enable early prediction of inpatient violence. Conclusions: Our findings may provide clinicians with a new basis for judgment of the risk of violence in psychiatric wards. [ABSTRACT FROM AUTHOR]

Introduction: In 2020, the World Health Organization called for the expansion and greater recognition of all nursing roles, including advanced practice nurses (APNs), to better meet patient care needs. As defined by the International Council of Nurses (ICN), the two most common APN roles include nurse practitioners (NPs) and clinical nurse specialists (CNSs). They help ensure care to communities as well as patients and families with acute, chronic or complex conditions. Moreover, APNs support providers to deliver high quality care and improve access to services. Currently, there is much variability in the use of advanced practice nursing roles globally. A clearer understanding of the roles that are in place across the globe, and how they are being used will support greater role harmonization, and inform global priorities for advanced practice nursing education, research, and policy reform. Objective: To identify current gaps in advanced practice nursing research globally. Materials and methods: This review of systematic reviews will provide a description of the current state of the research, including gaps, on advanced practice nursing globally. We will include reviews that examine APNs, NPs or CNSs using recognized role definitions. We will search the CINAHL, EMBASE, Global Health, HealthStar, PubMed, Medline, Cochrane Library Database of Systematic Reviews and Controlled Trials Register, Database of Abstracts of Reviews of Effects, Joanna Briggs Institute, and Web of Science electronic databases for reviews published from January 2011 onwards, with no restrictions on jurisdiction or language. We will search the grey literature and hand search the reference lists of all relevant reviews to identify additional studies. We will extract country, patient, provider, health system, educational, and policy/scope of practice data. We will assess the quality of each included review using the CASP criteria, and summarize their findings. This review of systematic reviews protocol was developed following the PRISMA-P recommendations. PROSPERO registration number: CRD42021278532. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic and governments' response lead to dramatical change in quality of life worldwide. However, the extent of this change in Vietnamese medical and nursing students has not been documented. Objectives: The study aims to describe the quality of life and changes in quality of life of medical and nursing students during the COVID-19 pandemic and examine the association of quality of life and changes in quality of life with fear of COVID-19 and other socio-economic and demographic factors. Methods: The study was a cross-sectional study on all students of Hanoi Medical University from 3 majors: General Medicine, Preventive Medicine, Nursing (3672 invited students); from 7th to 29th of April 2020; using an online questionnaire that included demographic and academic information, the Vietnamese version of the SF-36 Quality of Life questionnaire and the Fear of COVID-19 Scale (FCV-19S). Linear and modified Poisson regression was used to examine the association between quality of life, changes in quality of life and other factors. Results: The number of participants was 1583 (response rate 43%). Among 8 dimensions of the SF-36 (ranged 0–100), Vitality had the lowest score with a median score of 46. The median physical composite score (PCS) of the sample was 40.6 (IQR:20.8–53.2), 33.5% of the sample had an above-population average PCS score. The median mental composite score (MCS) of the sample was 20.3 (IQR:3.8–31.7), and 98.2% had an MCS score below average. 9.9% (95%CI:8.5%–11.4%) of the population reported a significant negative change in the quality of life. Fear of COVID-19 was not associated with significant changes in quality of life, nor MCS while having some association with PCS (Coef:-5.39;95%CI:-3to-7.8). Perceived reduction in quality of life was also associated with: being on clinical rotation COVID-19 (PR:1.5;95%CI:1.05–2.2), difficulties affording health services (PR:1.4;95%CI:1.02–1.95), obesity (PR:2.38;95%CI:1.08–5.25) and chronic disease (PR:1.92;95%CI:1.23–3), typical symptoms (PR:1.85; 95%CI:1.23–2.78) and atypical symptoms of COVID-19 (PR:2.32;95%CI:1.41–3.81). Conclusion: The majority of medical and nursing students had below average quality of life, with lower vitality and mental composite health score in the settings of COVID-19. Perceived decrease in quality of life was associated with clinical rotation, difficulties affording healthcare services and was not associated with Fear of COVID-19. [ABSTRACT FROM AUTHOR]

Background: During in-hospital cardiac arrest events, clinical nurses are often the first responders; therefore, nurses require sufficient advanced cardiac life support (ACLS) competency. This study aimed to verify the effects of a hybrid team-based ACLS simulation (HTAS) program (developed in this study) on nurses' ACLS performance, specifically ACLS knowledge, cardiopulmonary resuscitation (CPR) self-efficacy, and CPR-related stress. Methods: The developed HTAS comprised four lecture videos, one team-based skills training video, and a team-based ACLS simulation. A quasi-experimental pretest-posttest design with a comparison group (CG) was used to evaluate the effectiveness of the HTAS. Of the 226 general ward nurses with more than 6 months of clinical experience, 117 were allocated to the intervention group (IG), which attended the HTAS, and 109 to the CG, which attended only basic ACLS training. Results: The IG's ACLS performance significantly improved (t = 50.8, p < 0.001) after the training. Relative to the respective pretest conditions, posttest ACLS knowledge (t = 6.92, p < 0.001) and CPR self-efficacy (t = 6.97, p < 0.001) of the IG also significantly increased. However, when the mean difference values were compared, there was no significant difference between the two groups with respect to ACLS knowledge (t = 1.52, p = 0.130), CPR self-efficacy (t = -0.42, p = 0.673), and CPR stress (t = -0.88, p = 0.378). Conclusion: The HTAS for ward nurses was effective at enhancing the nurses' ACLS performance. It is necessary to develop effective training methods for team-based ACLS and verify the sustained effects of such training. [ABSTRACT FROM AUTHOR]

Game-based virtual reality phone applications can create a realistic environment to prepare for clinical applications and improve students' knowledge of and compliance with standard precautions. An experimental study was performed among 126 nursing students' from the third and fourth nursing levels to determine the effect of online education and game-based virtual reality phone applications related to standard precautions. Students were divided randomly into two groups; the experimental group used online education and game-based virtual reality phone applications, while the control group used traditional education. The study was performed between July and August 2019 to prevent clashes with lectures and midterm and final examinations. A tool package including knowledge, attitude, and compliance with standard precautions was used in pre-and post-tests among nursing students. The results showed that the knowledge of, attitudes towards, and compliance with standard precautions differed between the two groups. The performance of the experimental group of nursing students significantly improved with online instruction and game-based virtual reality phone applications. This study demonstrated the effectiveness of online education and game-based virtual reality phone application among nursing students. [ABSTRACT FROM AUTHOR]

Introduction: Several teaching methods have been used in clinical nursing teaching to increase quality and efficiency, but disagreements over their effects persist. This study will evaluate the effects of five teaching methods in clinical nursing on nursing students' knowledge, skill scores, learning satisfaction, and patients' satisfaction. Methods: We will conduct searches in PubMed, Embase, Web of Science, The Cochrane Library, China National Knowledge Infrastructure Database (CNKI), China Biological literature database (CBM), Wanfang Database, and China Science and Technology Journal Database (CSTJ) up to April 2022. Relevant randomized controlled trials meeting the eligibility criteria will be included. And the study selection and data extraction will be independently screened for eligibility by two authors. The quality of evidence will be evaluated using the Cochrane risk of bias tool. Pairwise meta-analysis and network meta-analysis (NMA) will be conducted using Rev Man, Stata, and R software. Statistical analyses including homogeneity tests, sensitivity analysis, transitivity tests, consistency tests, and publication bias will be completed. Ethics and dissemination: No formal research ethics approval is required. The results will be disseminated to a peer-reviewed journal for publication. Protocol registration number: INPLASY2021120040. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence (AI) has affected our day-to-day in a great extent. Healthcare industry is one of the mainstream fields among those and produced a noticeable change in treatment and education. Medical students must comprehend well why AI technologies mediate and frame their decisions on medical issues. Formalizing of instruction on AI concepts can facilitate learners to grasp AI outcomes in association with their sensory perceptions and thinking in the dynamic and ambiguous reality of daily medical practice. The purpose of this study is to provide consensus on the competencies required by medical graduates to be ready for artificial intelligence technologies and possible applications in medicine and reporting the results. Materials and methods: A three-round e-Delphi survey was conducted between February 2020 and November 2020. The Delphi panel accorporated experts from different backgrounds; (i) healthcare professionals/ academicians; (ii) computer and data science professionals/ academics; (iii) law and ethics professionals/ academics; and (iv) medical students. Round 1 in the Delphi survey began with exploratory open-ended questions. Responses received in the first round evaluated and refined to a 27-item questionnaire which then sent to the experts to be rated using a 7-point Likert type scale (1: Strongly Disagree—7: Strongly Agree). Similar to the second round, the participants repeated their assessments in the third round by using the second-round analysis. The agreement level and strength of the consensus was decided based on third phase results. Median scores was used to calculate the agreement level and the interquartile range (IQR) was used for determining the strength of the consensus. Results: Among 128 invitees, a total of 94 agreed to become members of the expert panel. Of them 75 (79.8%) completed the Round 1 questionnaire, 69/75 (92.0%) completed the Round 2 and 60/69 (87.0%) responded to the Round 3. There was a strong agreement on the 23 items and weak agreement on the 4 items. Conclusions: This study has provided a consensus list of the competencies required by the medical graduates to be ready for AI implications that would bring new perspectives to medical education curricula. The unique feature of the current research is providing a guiding role in integrating AI into curriculum processes, syllabus content and training of medical students. [ABSTRACT FROM AUTHOR]

Introduction: As the frequency of infectious diseases rises, it's more important than ever to pay attention to the competency level of front-line nurses as the primary force in front-line rescue, which has an impact on the quality of anti-epidemic response. This paper aims to construct the competency evaluation index system for front-line nurses during the outbreak of major infectious diseases. Materials and methods: This study combined literature review, critical incident technique interviews, and semi-structured in-depth interviews, as well as two rounds of Delphi expert correspondence, to construct a competence evaluation index system for front-line nurses during the outbreak of major infectious diseases. The study used purposive sampling to select 26 experts from 11 provinces and cities across China to conduct two rounds of Delphi expert consultation, and the indicators were selected based on the mean importance score > 3.5 and the coefficient of variation < 0.25, and the weights of the indicators were calculated by the Analytic Hierarchy Process. The effective recovery rates of the two rounds of correspondence questionnaires were 93.1% and 96%. Results: The effective recovery rates of the two rounds of correspondence questionnaires were 93.1% and 96%, the authority coefficients of experts were 0.96 and 0.98, the Kendall's coordination coefficients of the first, second, and third level indexes were 0.281, 0.132, and 0.285 (P < 0.001), 0.259, 0.158, and 0.415 (P < 0.001). The final index system includes 4 primary indicators (Knowledge System of Infectious Diseases, Nursing Skills for Infectious Diseases, Related Professional Abilities for Infectious Diseases, and Comprehensive Quality), 10 secondary indicators, and 64 tertiary indicators. Conclusion: The competency evaluation index system of front-line nurses during the outbreak of major infectious diseases is scientific, reasonable, and practical, which can provide a scientific basis for nursing managers to accurately understand, describe, analyze, and evaluate the competence level of nursing staff and scientifically implement the allocation of human resources in the future, as well as serve as a content framework for subsequent training programs. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis B infection remains a public health threat associated with undesirable statistics of morbidity and mortality. Good knowledge, attitude and practice (KAP) of hepatitis B infection (HBI) prevention are essential for HBI control. However, there is limited evidence concerning the KAP of HBI prevention among nursing students, who are significantly exposed to HBI. We assessed the KAP of HBI prevention and the factors associated with the practice of HBI prevention among nursing students in the Upper West Region of Ghana. Methods: We administered an online cross-sectional survey in November 2020 to a stratified random sample of 402 nursing students in two nursing training colleges in the Upper West Region. Using STATA version 13, we computed composite scores of KAP of HBI prevention with maximum scores of 18 for knowledge and 8 each for attitude and practice. A generalised ordered logistic regression model was run to assess the factors associated with the practice of HBI prevention. Results: The students had moderate median scores for knowledge (12.00; IQR = 10–13) and attitude (6.00; IQR = 5.00–7.00) but a poor median score (5.00; IQR = 4.00–6.00) for the practice of HBI prevention. High knowledge (aOR = 2.05; p = 0.06), good attitude, being a male, second year student and having parents with tertiary education were significantly associated with higher likelihoods (aOR >1; p < 0.05) of demonstrating good practice of HBI prevention. Students who had never married were significantly (aOR = 0.34; p = 0.010) less likely to exhibit good practice of HBI prevention. Conclusion: The KAP scores of HBI prevention among the students were sub-optimal. We recommend institution-based policies and regular education on HBI prevention, free/subsidised HBI prevention services, and the enforcement of proper professional ethics on HBI prevention in nursing training colleges. Such interventions should predominantly target female, non-married and first year nursing students. [ABSTRACT FROM AUTHOR]

Clinical expertise has since 1891 a Swedish counterpart in proven experience. This study aims to increase our understanding of clinicians' views of their professional expertise, both as a source or body of knowledge and as a skill or quality. We examine how Swedish healthcare personnel view their expertise as captured by the (legally and culturally relevant) Swedish concept of "proven experience," through a survey administered to a simple random sample of Swedish physicians and nurses (2018, n = 560). This study is the first empirical attempt to analyse the notion of proven experience as it is understood by Swedish physicians and nurses. Using statistical techniques for data dimensionality reduction (confirmatory factor analysis and multidimensional scaling), the study provides evidence that the proven experience concept is multidimensional and that a model consisting of three dimensions–for brevity referred to as "test/evidence", "practice", and "being an experienced/competent person"–describes the survey responses well. In addition, our results cannot corroborate the widely held assumption in evidence-based medicine that an important component of clinical expertise consists of experience of patients' preferences. [ABSTRACT FROM AUTHOR]

Assisting patients with upper gastrointestinal bleeding is a crucial role for nurses, and as future nurses, students should demonstrate sound clinical judgment. Well-structured, high-quality simulations are useful alternatives to prepare students for clinical practice. However, nursing simulation scenarios focused on enhancing clinical judgment in managing upper gastrointestinal bleeding are limited. This study aims to develop, apply, and evaluate an effective nursing simulation scenario for patients with upper gastrointestinal bleeding based on Tanner's clinical judgment model using a mixed methods study design. A high-fidelity patient simulation was conducted among 80 undergraduate nursing students divided into a simulated control group (n = 39) and an experimental group (n = 41). Subsequent student performance evaluations used questionnaires and video recordings. After scenario simulations, the students showed a statistically significant increase in theoretical knowledge (p = 0.001) and clinical performance skills (p < 0.001), but there was no significant increase in self-confidence (p = 0.291). According to the video analysis, the "noticing" clinical judgment phase was the most frequently observed phase, while "reflection" was the least frequently observed phase. Additionally, "education" was the most frequently observed nursing domain, and "anxiety" was the least frequently observed domain. Although further simulation repetitions are required to reinforce students' self-confidence when caring for patients with upper gastrointestinal bleeding, the scenario was deemed effective. Moreover, emphasis should be placed on developing various scenarios to strengthen students' clinical judgment skills, especially "reflecting" and "emotional care." [ABSTRACT FROM AUTHOR]

Background: There is growing evidence about the role of nurses in patient outcomes in several healthcare settings. However, there is still a lack of evidence about the transitional care setting. We aimed to assess the association between patient characteristics identified in a multidimensional nursing assessment and outcomes of mortality and acute hospitalization during community hospital stay. Methods: A retrospective observational study was performed on patients consecutively admitted to a community hospital (CH) in Loreto (Ancona, Italy) between January 1st, 2018 and May 31st, 2019. The nursing assessment included sociodemographic characteristics, functional status, risk of falls (Conley Score) and pressure damage (Norton scale), nursing diagnoses, presence of pressure sores, feeding tubes, urinary catheters or vascular access devices and comorbidities. Two logistic regression models were developed to assess the association between patient characteristics identified in a multidimensional nursing assessment and outcomes of mortality and acute hospitalization during CH stay. Results: We analyzed data from 298 patients. The mean age was 83 ± 9.9 years; 60.4% (n = 180) were female. The overall mean length of stay was 42.8 ± 36 days (32 ± 32 days for patients who died and 33.9 ± 35 days for patients who had an acute hospitalization, respectively). An acute hospitalization was reported for 13.4% (n = 40) of patients and 21.8% (n = 65) died. An increased risk of death was related to female sex (OR 2.25, 95% CI 1.10–4.62), higher Conley Score (OR 1.19; 95% CI 1.03–1.37) and having a vascular access device (OR 3.64, 95% CI 1.82–7.27). A higher Norton score was associated with a decreased risk of death (OR 0.71, 95% CI 0.62–0.81). The risk for acute hospitalization was correlated with younger age (OR 0.94, 95% CI 0.91–0.97), having a vascular access device (OR 2.33, 95% CI 1.02–5.36), impaired walking (OR 2.50, 95% CI 1.03–6.06) and it is inversely correlated with a higher Conley score (OR 0.84, 95% CI 0.77–0.98). Conclusion: Using a multidimensional nursing assessment enables identification of risk of nearness of end of life and acute hospitalization to target care and treatment. The present study adds further knowledge on this topic and confirms the importance of nursing assessment to evaluate the risk of patients' adverse outcome development. [ABSTRACT FROM AUTHOR]

Background: Today, physicians are at the front lines of a pandemic response. Military physicians are uniquely trained to excel in such large-scale emergency situations. Civilian physicians can harness military know-how, but it will require research into military healthcare responses—specifically, we need to learn lessons from military interprofessional healthcare teams (MIHTs). Methods: This research answers two questions: What are the characteristics of successful MIHTs? Why are those characteristics important to MIHT success in large-scale emergency situations? Using a Grounded Theory approach, 30 interviews were conducted soliciting perspectives from the broadest range of healthcare professionals who had experiences working in and leading MIHTs. Purposive sampling was used to recruit participants broadly across: contexts where MIHTs work; military branches; ranks; genders; and healthcare professions. Data were iteratively collected and analyzed. Results: 30 participants were interviewed (18 male (60%); 21 officers (70%); 9 enlisted (30%)) who held various healthcare occupations (medic/tech/corpsman (9); nurse (7); physician (7); dentist (2); occupational therapist (2); chaplain (1); physician's assistant (1); and psychiatrist (1)). Six characteristics of successful MIHTs that are directly applicable to large-scale emergency situations were identified thatthat clustered into two themes: own your purposes and responsibilities (through mission focus and ethical bearing) and get it done, safely (via situational awareness, adaptability, and leadership with followership). Conclusions: This study provides insights, informed by decades of military service and training, to help civilian physicians succeed in large-scale emergency situations. These experiences from the war front can support today's pandemic responses on the home front. [ABSTRACT FROM AUTHOR]

Background: Google Classroom (GC) is a free web-based instructional platform rarely used for nursing student education. The acceptance, intention to use, and learning outcomes of GC remain unclear in Taiwan. We sought to identify the technology acceptance level and factors affection the intention to use GC. We also explored how integrating GC into traditional teaching affects learning satisfaction and academic achievement among nursing students in Taiwan. Methods: In this randomized controlled study, based on a technology acceptance framework, 74 nursing students were randomly assigned in clusters to experimental (n = 39) and control (n = 35) groups during the spring semester of 2018. In Weeks 3–18, each member of the experimental group received one hour of traditional and GC teaching per week. The control group received two hours of traditional teaching per week. Both groups were asked to complete questionnaires to evaluate learning satisfaction and academic achievement during weeks 10 (mid-semester) and 18 (end-of-semester). The experimental group additionally completed technology acceptance questionnaires in both situations. Findings: In the experimental group, the overall end-of-semester technology acceptance score was high (141.8 out of 155); their perceived ease of use, intention to use, and technology acceptance scores increased significantly compared to mid-semester (p<0.05). At the end-of-semester, perceived playfulness and perceived usefulness explained 63.5% of the variance in intention to use. Regardless of whether the assessment was administered mid-semester or at the end-of-semester, the experimental group had higher learning satisfaction and academic achievement scores than the control group. However, the degree of progress on learning satisfaction and academic achievement demonstrated no significant between-group differences. Conclusions: The experimental group demonstrated high acceptance of GC. Playfulness and usefulness positively influenced nursing students' intention to use GC. Blended learning—in combination with GC and traditional methods—resulted in similar learning satisfaction and academic achievement when compared to traditional learning. More research is needed to explore the effectiveness of blended learning through the GC platform with different courses and ethnic groups. [ABSTRACT FROM AUTHOR]

Background: Influenza is a serious global healthcare issue that is associated with between 290,000 to 650,000 deaths annually. The aim of this study is to evaluate the effect of a 'serious game' about influenza, on nursing student attitude, knowledge and uptake of the influenza vaccination. Methods: 1306 undergraduate nursing students were invited, via email, to play an online game about influenza between September 2018 and March 2019. 430 nursing students accessed the game and completed an 8-item questionnaire measuring their attitudes to influenza between September 2018 and March 2019. In April 2019, 356 nursing students from this sample completed a follow-up 2-item questionnaire about their uptake of the influenza vaccination. A larger separate 40-item knowledge questionnaire was completed by a year one cohort of 124 nursing students in August 2018 prior to receiving access to the game and then after access to the game had ended, in April 2019. This sample was selected to determine the extent to which the game improved knowledge about influenza amongst a homogenous group. Results: In the year preceding this study, 36.7% of the sample received an influenza vaccination. This increased to 47.8% after accessing to the game. Nursing students reported perceived improvements in their knowledge, intention to get the vaccination and intention to recommend the vaccination to their patients after playing the game. Nursing students who completed the 40-item pre- and post-knowledge questionnaire scored an average of 68.6% before receiving access to the game and 85.2% after. Using Paired T-Tests statistical analysis, it was determined that this 16.6% increase was highly statistically significant (P < 0.001). Conclusions: The research highlights that the influenza game can improve knowledge and intention to become vaccinated. This study suggests that improvement in influenza knowledge is likely to encourage more nursing students to receive the influenza vaccination. [ABSTRACT FROM AUTHOR]

Background: Despite an increasing importance of home care, quality assurance in this healthcare sector in Switzerland is hardly established. In 2010, Swiss home care quality indicators (QIs) based on the Resident Assessment Instrument-Home Care (RAI-HC) were developed. However, these QIs have not been revised since, although internationally new RAI-HC QIs have emerged. The objective of this study was to assess the appropriateness of RAI-HC QIs to measure quality of home care in Switzerland from a public health and healthcare providers' perspective. Methods: First, the appropriateness of RAI-HC QIs, identified in a recent systematic review, was assessed by a multidisciplinary expert panel based on the RAND/UCLA Appropriateness Method taking into account indicators' public health relevance, potential of influence, and comprehensibility. Second, the QIs selected by the experts were afterwards rated regarding their relevance, potential of influence, and practicability from a healthcare providers' perspective in focus groups with home care nurses based on the Nominal-Group-Technique. Data were analyzed using median scores and the Disagreement Index. Results: 18 of 43 RAI-HC QIs were rated appropriate by the experts from a public health perspective. The 18 QIs cover clinical, psychosocial, functional and service use aspects. Seven of the 18 QIs were subsequently rated appropriate by home care nurses from a healthcare providers' perspective. The focus of these QIs is narrow, because three of seven QIs are pain-related. From both perspectives, the majority of RAI-HC QIs were rated inappropriate because of insufficient potential of influence, with healthcare providers rating them more critically. Conclusions: The study shows that the appropriateness of RAI-HC QIs differs according to the stakeholder perspective and the intended use of QIs. The findings of this study can guide policy-makers and home care organizations on selecting QIs and to critically reflect on their appropriate use. [ABSTRACT FROM AUTHOR]

Background: Adherence to the best standards of nursing practice is the fundamental principle to improve patient outcome and prevent nursing procedure related-infections. A peripheral venous catheter (PVC) is the most common invasive procedure performed in nursing care. Its poor performance could expose patients to bloodstream-related infections. The present study aimed to assess post-basic nursing students' knowledge of evidence-based guidelines on the management of peripheral venous catheters. Methods: A cross-sectional study design was conducted on May 01–03, 2019, using a convenient sample 239 among post-basic nursing students in Wollega University. Results: The study result showed that nursing students' had a low mean (4.1±1.52) of knowledge about PVC procedure management. Only 41% of the respondents have adhered to recommendations of CDC guidelines. Among the provided options of the items, none achieved 100% correct answers. The majority of nursing students (77%) responded that antiseptic handwashing is always performed before insertion of PVCs. Meanwhile, few students (5%) correctly answered that the infusion set is recommended to be removed after 96 hours when neither lipids nor blood products are administered. In multivariable regression analysis, nursing students who had received training (AOR = 2.9, 95% CI (1.6, 5.1)) and who were younger (AOR = 2.4, 95% CI (1.3, 4.3)) significantly associated with a higher score of knowledge. Conclusions: This study finding shows that an overall level of knowledge of post-basic nursing students is inadequate. Measurements such as an increase in the provision of adequate training by nurses educators based on evidence-based guidelines could improve the post-basic nursing students' knowledge. [ABSTRACT FROM AUTHOR]

Introduction: Chronic hepatitis C (HCV), considered by the World Health Organization as one of the greatest epidemiological health hazards, often with asymptomatic clinical course and one which, due to scanty knowledge, remains a crucial risk factor of serious chronic HCV infection complications. The purpose of this study is to validate the psychometric properties of the Polish version of the validated Brief Hepatitis C Knowledge Scale (BHCKS_PL), developed by Balfour in 2009. Methods: The study, conducted from May to July 2018, included 246 persons (68,69% females), divided into four subgroups: patients (n = 86), nursing students (n = 74), medical students (n = 28), healthcare workers (nurses and doctors; n = 58). The 19-items questionnaire contained questions designed to assess general knowledge regarding hepatitis C and the transmission risk factors. Results: An evaluation by means of multiple comparisons in pairs showed that there were significant differences in the knowledge level between the group of patients and the group of nursing students (Mdn: 14.0 vs 11.0, z = 7.713, P<0.001), and between students of medicine (Mdn: 16.0 vs 11.0, z = 0.339, P<0.001) and healthcare workers (17.0 vs 11.0, z = 11.447, P<0.001). Moreover, significant differences were observed between the groups of students of nursing and medicine (Mdn: 14.0 vs 16.0, z = 3.646, P = 0.002) and healthcare workers (Mdn: 14.0 vs 17.0, z = 4.117, P<0.001). No significant differences in the knowledge level between the students of medicine and healthcare workers were observed (z = 0.377, P = 1.000). Conclusions: The completed validation suggests good BHCKS_P psychometric characteristics with the internal consistency convergent and known-groups validity. The questionnaire can be used in educational practice. The obtained results of the measurement provide information about the studied person based on the total score. [ABSTRACT FROM AUTHOR]

Background: In nursing practice, flushing the catheters pre and post-drug administration is considered an important clinical procedure to prevent complications, and requires the use of several syringes to comply with international standards of care. We envisioned an innovative double-chamber syringe that enables the filling and administration of both solutions. Following current international recommendations, the development of new medical devices should integrate Health Technology Assessment. The Human-centred design is usually used for that assessment purposes, as a method that actively include end-users in the devices development process. Method: Application of the Human-Centred Design through the involvement of nurses in the initial stages of the device development in order to accomplish the initial stages of Technology Readiness Level. A multi-method approach was used, including literature/guidelines review, focus groups with end-users and expert panels. Results: The involvement of nurses enabled the definition of user requirements and contexts of use, as well as the evaluation of design solutions and prototypes in order to accomplish with usability and ergonomic features of the medical device. Conclusions: Significant contributions were made regarding the final design solution of this innovative double-chamber syringe. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the impact of the presence of a certified nurse specialist in critical care (CNS) as ICU head nurse in an open ICU on clinical outcomes. Methods: The presence of a CNS as ICU head nurse was implemented in practice in April 2017. To evaluate the impact on patient outcomes before and after the implementation, patients were divided into two groups: before (April 2014 to March 2017; 1988 patients) and after (April 2017 to March 2019; 1664 patients). Patients' demographic data were collected from the ICU database. Results: Multivariable logistic regression analysis revealed that the presence of a CNS as ICU head nurse was associated with lower ICU mortality (odds ratio (OR): 0.52, 95% CI: 0.36–0.73, p <.001) and fewer patients receiving mechanical ventilation in the ICU (OR: 0.20, 95% CI: 0.15–0.26, p <.001). Conclusion: CNSs are defined as one type of advanced practice nurses. Having a CNS as a head nurse in the ICU may have helped improve patient outcomes by leveraging these practical skills in nursing management. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals and students of medical faculties in Poland increasingly encounter culturally diverse patients. It is necessary to support the development of cultural intelligence in order to improve the medical care provided to patients from different cultural backgrounds. At present there are no standardized tools in Poland that can accurately and reliably assess cultural intelligence, which is defined by Ang et al. as "an individual's capability to function and manage effectively in culturally diverse settings". As argued in the present paper, this (cap)ability may be important for providing patient-centred care that is culturally adequate and competent. Purpose: The aim of the research was to show the multistage process of validation of the Polish version of The Cultural Intelligence Scale by Ang et al. and Van Dyne et. al. Methods: Across two studies we examined the psychometric properties of the Cultural Intelligence Scale, including reliability (i.e. internal consistency, test-retest reliability, factor structure) and validity (i.e. theoretical, criteria, convergent). In the first two-session study, 349 participants (98% were healthcare professionals, e.g. nurse, student nurse, medical student; mainly women, 89%) completed the Polish version of the Cultural Intelligence Scale twice with an interval of at least 22 days. In addition, across two study sessions participants completed questionnaires constructed to measure (a) cultural competence, (b) need for cognitive closure, (c) emphatic sensitiveness, (d) emotional intelligence, (e) self-esteem, (f) social desirability, (g) personality, and (h) positive/negative attitudes towards culturally divergent people. Finally, to additionally examine the theoretical validity, 36 professional cross-cultural competence trainers completed the Cultural Intelligence Scale during a one-session study. Results: The Cultural Intelligence Scale has been shown to have satisfactory psychometric properties. It has high reliability (Cronbach's alpha, respectively.94 and.95 in the first and second sessions) and the factor structure seems to approach the postulated one. Theoretical and criterion accuracy are well proven; convergence is less straightforward, but it correlates well with tools that examine variables such as cultural competence, cognitive closure, empathy/emphatic sensitiveness, emotional intelligence, self-esteem, personality, and social desirability. The results suggest that these factors contribute to the development of the cultural intelligence. Conclusion: The Cultural Intelligence Scale can be successfully used in empirical research of cultural intelligence of medical professionals and students of medical majors and their education in Polish conditions. [ABSTRACT FROM AUTHOR]

As a result of unhealthy lifestyles, reduced numbers of healthcare providers are having to deal with an increasing number of diabetes patients. In light of this shortage of physicians and nursing staff, new concepts of care are needed. The aim of this scoping review is to review the literature and examine the effects of task delegation to non-physician health professionals, with a further emphasis on inter-professional care. Systematic searches were performed using the PubMed, Embase and Google Scholar databases to retrieve papers published between January 1994 and December 2017. Randomised/non-randomised controlled trials and studies with a before/after design that described the delegation of tasks from physicians to non-physicians in diabetes care were included in the search. This review is a subgroup analysis that further assesses all the studies conducted using a team-based approach. A total of 45 studies with 12,092 patients met the inclusion criteria. Most of the interventions were performed in an outpatient setting with type-2 diabetes mellitus patients. The non-physician healthcare professionals involved in the team were nurses, pharmacists, community health workers and dietitians. Most studies showed significant improvements in glycaemic control and high patient satisfaction, while there were no indications that the task delegation affected quality of life scores. The findings of the review suggest that task delegation can provide equivalent glycaemic control and potentially lead to an improvement in the quality of care. However, this review revealed a lack of clinical endpoints, as well as an inconsistency between the biochemical outcome parameters and the patient-centred outcome parameters. Given the vast differences between the individual healthcare systems used around the world, further high-quality research with an emphasis on long-term outcome effects and the expertise of non-physicians is needed. [ABSTRACT FROM AUTHOR]

Background: Veteran patients with traumatic brain injury (TBI) and their family members regularly receive care from nurses. Understanding nurses’ training and beliefs can provide direction for intervention work aimed at ensuring the best possible care is delivered to this population. Aims: We examined Veterans Health Administration (VHA) nurses’ training and beliefs related to care of patients with moderate-to-severe TBI. Design and methods: We conducted an exploratory, cross-sectional survey with 211 VHA nurses and analyzed data using descriptive statistics. Results: The average years of nursing experience was 18 years, and 90% reported ever caring for a patient with TBI. Most nurses (70%) reported only seeing patients with TBI ≤1–2 times per year in their current role; 20% reported seeing these patients 1–2 times per month. Even with infrequent care, almost 50% reported previously receiving TBI-related training. Beliefs items with the highest accuracy indicated nurses agreed that they need specialized training to care for patients with TBI and that TBI recovery may continue for several years (96.39% accuracy respectively). The beliefs item with the lowest accuracy indicated focus on whether nurses agreed that TBI severity was important in developing care plans (27.84% accuracy). Nurses reported the need for clarity of the nursing role in caring for patients with TBI (77.32% agreement). Conclusion: VHA nurses do have accurate beliefs about caring for Veteran patients with moderate-to-severe TBI; however, there is the need for further role clarification regarding nursing care of patients with TBI. Impact: These findings have implications for development of education and training interventions for nurses who care for Veteran patients with TBI. [ABSTRACT FROM AUTHOR]

Catheter-associated asymptomatic bacteriuria (CAABU) is frequent in intensive care units (ICUs) and contributes to the routine use of antibiotics and to antibiotic-resistant infections. While nurses are responsible for the implementation of CAABU-prevention guidelines, variability in how individual nurses contribute to CAABU-free rates in ICUs has not been previously explored. This study’s objective was to examine the variability in CAABU-free outcomes of individual ICU nurses. This observational cross-sectional study used shift-level nurse-patient data from the electronic health records from two ICUs in a tertiary medical center in the US between July 2015 and June 2016. We included all adult (18+) catheterized patients with no prior CAABU during the hospital encounter and nurses who provided their care. The CAABU-free outcome was defined as a 0/1 indicator identifying shifts where a previously CAABU-free patient remained CAABU-free (absence of a confirmed urine sample) 24–48 hours following end of shift. The analytical approach used Value-Added Modeling and a split-sample design to estimate and validate nurse-level CAABU-free rates while adjusting for patient characteristics, shift, and ICU type. The sample included 94 nurses, 2,150 patients with 256 confirmed CAABU cases, and 21,729 patient shifts. Patients were 55% male, average age was 60 years. CAABU-free rates of individual nurses varied between 94 and 100 per 100 shifts (Wald test: 227.88, P<0.001) and were robust in cross-validation analyses (correlation coefficient: 0.66, P<0.001). Learning and disseminating effective CAABU-avoidance strategies from top-performers throughout the nursing teams could improve quality of care in ICUs. [ABSTRACT FROM AUTHOR]