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Aim: To describe the activities nurses perceived to be delegable to other staff (delegable activities) in order to estimate the time nurses spend on delegable activities and explore nurses' reasons for not delegating these activities. Design: Mixed‐methods explanatory sequential. Methods: In total, 236 nurses from 27 medical and surgical wards of five hospitals in northern Italy completed a web‐based survey during a single shift between June and July 2022. Minutes spent on delegable activities, staff member to whom participants could have delegated and reason(s) for not delegating were reported. Chief nurses provided specific wards' characteristics using a paper‐and‐pencil questionnaire. Twenty semi‐structured interviews were conducted to explore delegable activities and reasons for not delegating. Quantitative and qualitative results were merged using joint displays. Results: Participants spent approximately one‐quarter of their time performing delegable activities, mainly delegable to nurse aides or nurse clerks, and performed due to a lack/shortage of staff or their concurrent participation in other activities. Participants recognized that activities requiring clinical assessment and decision‐making skills cannot be delegated, whereas technical activities and indirect care should be delegated. Organizational, structural and cultural factors, as well as patient characteristics, available staff and experience affected delegation, leading nurses to perform delegable activities to ensure patient care. Conclusion: Nurses spend a considerable part of their time on delegable activities due to a lack of staff or support services and suboptimal organization, which could be addressed by optimal staff management, but also to the complexity of the contexts, including individual and cultural factors that should be addressed through policy interventions. Impact: This study estimates the time nurses spend on delegable activities in acute care settings. Our findings highlighted the reasons that sustain the decision not to delegate that policymakers, healthcare managers, and nurse educators should consider to promote nurses' delegation skills. Reporting Methods: MMR checklist. Patient/Public Contribution: None. [ABSTRACT FROM AUTHOR]

Background: Poor medication adherence results in negative health outcomes and increased healthcare costs. Several healthcare professionals provide interventions to improve medication adherence, with the effectiveness of nurse-led interventions in people with chronic diseases remaining unclear. Objective: This study sought to evaluate the effectiveness of nurse-led interventions for improving medication adherence in adults with chronic conditions. Methods: Five databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, SCOPUS) were searched without applying a temporal limit. Studies evaluating the effects of nurse-led interventions on medication adherence in adults with one or multiple chronic conditions were included. Interventions only targeting a single acute disease were excluded. Results: A total of twenty-two studies with 5975 participants were included. Statistically significant improvements in adherence were reported in five out of seven studies involving face-to-face visits to patients with heart failure (n = 2), chronic myeloid leukemia (n = 1), hypertension (n = 1) and multimorbidity (n = 1) and in four out of nine studies adopting a mixed method involving face-to-face visits and telephone follow-up for patients with heart failure (n = 1), hypertension (n = 1), coronary disease (n = 1) and multimorbidity (n = 1). Remote interventions were effective in improving medication adherence in one out of six studies. No statistically significant differences were found between tablet computer-based patient education and nurse-led educational sessions. The motivational approach was found to be one of the most common strategies used to promote patient medication adherence. Conclusions: Nurse-led face-to-face visits may be effective in improving medication adherence in people with chronic diseases. However, further research is needed because current methods for measuring medication adherence may not accurately capture patient behaviour and medication consumption patterns. [ABSTRACT FROM AUTHOR]