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Aim: Standardized quality indicators for long-term care (QIs-LTC) were previously developed to ensure high-quality holistic nursing care for older adults. This research aimed to assess the feasibility and reliability of unfavorable health outcomes measured by the QIs-LTC and proposed strategies for improvement., Methods: Thirty-nine pairs of home care nurses assessed 53 clients. We evaluated 20 of the 21 items of feasibility to calculate scores for the "I do not know" answer and test the interrater reliability using bias-adjusted and prevalence-adjusted kappa (PABAK). We then conducted interviews with 16 home care nurses to collect feedback on the implementation of QIs-LTC. Based on this feedback, we developed the QIs-LTC assessment manual and reassessed the QIs-LTC when used with the manual., Results: The mean for the "I do not know" answer was 13.8%, and the mean PABAK was 0.75 (±0.28). Overall, the reliability was good for physical assessment but inadequate for social aspects. Using the assessment manual, the mean for the "I do not know" answers decreased to 10.4%. The mean PABAK was 0.77 (±0.32) and increased for 12 unfavorable health outcomes., Conclusions: The feasibility and reliability of most unfavorable health outcomes were ensured by using the newly developed assessment manual. Challenges in education and practice of social aspects were identified. QIs-LTC support individual and agency evaluations, nursing interventions and quality evaluations, which are a priority for long-term care in Japan. Geriatr Gerontol Int 2025; ••: ••-••., (© 2025 The Author(s). Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.)

Background: Highly cited papers in critical care nursing can offer valuable insights for all stakeholders engaged in the research process by highlighting key research trends, guiding resource allocation and shaping future research priorities., Aim: To gain insights from the top-cited papers in the top critical care nursing journals., Study Design: This was a bibliometric analysis of the top-cited papers in the top critical care nursing journals as reported by the Journal Citation Report 2023-released in June 2024. Data were tabulated and visualized using Microsoft Excel and the VOSviewer software., Results: Forty papers from the top four critical care nursing journals (Intensive and Critical Care Nursing [ICCN], Nursing in Critical Care [NICC], Australian Critical Care [ACC] and American Journal of Critical Care [AJCC]) were analysed. Half of the analysed papers were related to the COVID-19 pandemic, and mental health was the most addressed theme (n = 11 papers). Papers from the ICCN featured contributions from 17 countries, the highest among the journals analysed, followed by NICC, with contributions from 11 countries. Articles received more citations than reviews (median [interquartile range]: 18 [9-23] vs. 8 [8-11.5]), and open-access papers were cited about twice those published under a subscription model (19 [16-31] vs. 9 [8-15]). In ICCN, 9 of the 10 analysed papers were published open access compared with 3 in NICC and ACC and 2 in AJCC., Conclusions: The identified themes in this paper underscore the dynamic nature of the field of critical care nursing and the ongoing efforts to address key challenges in critical care nursing practice and health care delivery. Publishing open-access articles on trending topics and collaborating internationally seem to be effective approaches for gaining more citations., Relevance to Research: Understanding these prevalent themes has significant implications for guiding research priorities, informing clinical practice, shaping policy and improving patient outcomes. Academic journals need to encourage increasing the representation of researchers from the Global South in both journals' editorial boards and submissions to the journals., (© 2025 The Author(s). Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses.)

Background: Post-extubation dysphagia (PED) is a common post-extubation complication that may lead to serious problems, such as malnutrition and longer hospital and intensive care unit (ICU) stays., Aim: To explore factors associated with the readiness for oral intake in post-extubated critically ill adult patients., Study Design: This prospective observational study involved 125 extubated patients. Readiness for oral intake was assessed using the Gugging Swallowing Screen (GUSS), and regression analysis was used to determine its predictors., Results: The median age of the participants was 40.0 years, and 51.2% were female. The median GUSS score was 12.0 (possible range, 0-20), and 35.2% of the studied patients had severe dysphagia (scored 0-9). Bivariate regression analysis showed that older age, male, higher APACHE II score, body mass index (BMI) ≥30, smoking history, longer ICU stay, muscle relaxants use, large-bore endotracheal and orogastric tubes and frequent intubation attempts were associated with lower GUSS score (p-value <.05). Multivariate regression analysis showed that age, BMI and smoking history predicted 37.2% of the variability in the GUSS score (F = 23.865, p-value <.001). Adding the ICU length of stay, muscle relaxants use, size of the endotracheal tube, size of the orogastric tube and frequency of intubation attempts to the regression model raised the predictability to 86.0% (F = 88.809, p-value <.001)., Conclusions: More than one-third of extubated patients have severe PED with a high risk of aspiration. Several modifiable factors, such as muscle relaxant use and endotracheal and orogastric tube size, predict post-extubation readiness for oral intake., Relevance to Clinical Practice: Using endotracheal and orogastric tubes of appropriate sizes, careful assessment of patients with a high risk for difficult intubation, and minimal use of muscle relaxants may help increase patients' readiness for post-extubation oral intake., (© 2024 The Author(s). Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses.)

Background: Gamification and augmented reality (AR) are innovative teaching modalities. Research on the effects of combining these two strategies in nursing education is scarce., Objectives: To examine the effect of the combined use of gamification and AR in teaching mechanical ventilation (MV) on nurse students' knowledge, motivation, self-efficacy, and satisfaction., Design: Randomized controlled trial., Setting: A conveniently selected faculty of nursing in Egypt., Participants: A total of 410 nurse students., Methods: Participants were randomly assigned to the intervention or control group (205 in each). Kahoot games and AR were used in the intervention group, whereas a traditional lecture was applied in the control group. The outcomes included levels of students' knowledge, learning motivation, self-efficacy, and satisfaction., Results: Mixed design repeated-measures ANOVA test revealed a statistically significant difference in knowledge test scores within-subject over time (p-value [effect size]: <0.001 [0.515]), between-subject due to the main effect of interventions (<0.001 [0.146]), and within-between interaction effect of group and time (<0.001 [0.515]). After using Kahoot and AR, the total mean self-efficacy score was significantly higher in the intervention group than in the control group (<0.001 [0.662]). The total median motivation score was significantly higher for the Kahoot and the AR groups compared with the traditional lecture (<0.001 [0.558])., Conclusion: Kahoot games and AR significantly increased nurse students' knowledge, motivation, and self-efficacy compared with traditional MV learning classes. Nursing educators need to incorporate Kahoot and AR in their pedagogies to enhance nurse students' satisfaction and development., Competing Interests: Declaration of competing interest The authors declare that there are no apparent conflicts of financial or personal interests that could have impacted the outcomes of the research., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This international cross-sectional survey examined the potential role of organizational psychological support in mitigating the association between experiencing social discrimination against long-term care (LTC) facilities' healthcare professionals (HCPs) and their intention to stay in the current workplace during the COVID-19 pandemic. Participants included a convenience sample of 2,143 HCPs (nurses [21.5 %], nurse aids or residential care workers [40.1 %], social workers [12.1 %], and others [26.4 %]) working at 223 LTC facilities in 13 countries/regions. About 37.5 % of the participants reported experiencing social discrimination, and the percentage ranged from 15.3 % to 77.9 % across countries/regions. Controlling for socio-demographic and work-related variables, experiencing social discrimination was significantly associated with a lower intention to stay, whereas receiving psychological support showed a statistically significant positive association (p-value=0.015 and <0.001, respectively). The interaction term between social discrimination and psychological support showed a statistically significant positive association with the intention to stay, indicating a moderating role of the psychological support., Competing Interests: Declaration of competing interest None, (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Assessing the acceptance of vaccinations among vulnerable populations is essential to ensure proper coronavirus disease 2019 (COVID-19) control. This study used the Health Belief Model to examine the intention to vaccinate against COVID-19 among vulnerable populations in Thailand., Methods: This analytical cross-sectional study was conducted in Thailand between October and November 2021. Using multistage random sampling, 945 individuals from vulnerable populations (i.e., older adults, pregnant women, market or street vendors, and individuals with chronic diseases) were selected and invited to complete a self-reported questionnaire. The questionnaire assessed participants' socioeconomic characteristics, COVID-19 preventive measures, knowledge, preventative health beliefs, and vaccine intention. A generalized linear mixed model was used to identify factors associated with the intention to receive the vaccine., Results: The prevalence of intent to accept the COVID-19 vaccine was 75.03% (95% confidence interval [CI]: 72.16-77.68). The Health Belief Model factors associated with vaccine acceptance were cue to action (adjusted odds ratio [AOR] = 3.13; 95% CI: 2.07-4.71), perceived benefits (AOR = 2.04; 95% CI: 1.38-3.01), and perceived severity (AOR = 1.77; 95% CI: 1.18-2.65). Significant other covariates were wearing a face mask in the previous month (AOR = 2.62; 95% CI: 1.59-4.31), being 1-2 m away from other people (AOR = 1.58; 95% CI: 1.11-2.24), trust in government (AOR = 1.44; 95% CI: 1.03-2.02). Additionally, women were more likely to accept the COVID-19 vaccine compared to men (AOR = 1.43; 95% CI: 1.02-2.01)., Conclusions: Approximately one quarter of vulnerable individuals do not intend to be vaccinated. Health Belief Models can explain vaccine acceptance, and aid the Ministry of Public Health in planning future efforts to increase vaccine uptake. Healthcare professionals' advice, village health volunteers' information, and partnership collaborations are critical. Facilitating mobile community units, launching educational campaigns, maintaining a distance of 1-2 m from others, and wearing masks may increase COVID-19 vaccine acceptability. This research can help prepare for future pandemics., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Aims: To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions., Design: Cross-sectional survey., Methods: Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines., Results: The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work-life imbalance., Conclusions: Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks., Impact: This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks., Patient or Public Contribution: No Patient or Public Contribution., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Objectives: Coronavirus disease (COVID-19) has severely affected older residents in long-term care (LTC) settings. However, care workers' perceptions of their work environment and potential impact on their work outcomes during the pandemic is not well known. This study examined associations between care staff's perceived work environment, educational status, and facility staffing levels and work outcomes of care staff in LTC settings during the COVID-19 pandemic., Design: This study employed a cross-sectional, observational, correlational design., Setting and Participants: A total of 207 care staff were conveniently recruited from 30 LTC settings in South Korea., Methods: The perceived work environment, educational status of care staff, and facility staffing levels (ie, beds-to-registered nurse [RN] and beds-to-nursing assistant [NA] or care worker ratios), as well as their work outcomes (ie, general and COVID-19 specific outcomes) were collected using questionnaires. Multivariable binary logistic regressions were conducted, controlling for the characteristics of care staff (ie, age, sex, occupation, and career length) and facilities (ie, location, bed size, ownership, and residents' disease and care profiles)., Results: Approximately 45% of the participants were either NAs or care workers, and 38% were RNs. More than half (53.14%) perceived their work environment to be good. LTC staff who perceived their work environment to be poor were more likely to be dissatisfied with their work [odds ratio (OR) 20.88), experience high burnout (OR 8.63), intend to leave the facility within a year (OR 5.00), and experience increased overtime work (OR 3.58) and work-life imbalance (OR 1.93) due to COVID-19., Conclusions and Implications: LTC work environments should be improved and government-led initiatives for ensuring such improvements should be implemented to enable a better response to future public health crises and maintain the quality of care for and safety of residents in LTC settings., (Copyright © 2023 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: Care quality in Japan's long-term care (LTC) agencies, including home care, is the responsibility primarily of individual agencies, and the evaluation of service processes and outcomes is minimal., Objectives: To describe the development of quality indicators for LTC (QIs-LTC) in Japan., Methods: QIs-LTC were developed through literature review and expert panel discussions and then were piloted and used in a 2-year longitudinal survey. The survey (launched in September 2019) targeted older people receiving home care (n = 1450), their family members (n = 880), their professional home care providers (n = 577), and managers of home care agencies (n = 122)., Results: Across eight domains (maintaining dignity, minimizing symptoms and disease deterioration, maintaining nutritional status, maintaining bladder/bowel control, encouraging physical activities, experiencing sound sleep, maintaining serenity and contentedness, and maintaining family's well-being), 24 care quality objectives were set with 24 outcome QIs-LTC and 144 process QIs-LTC. In the survey, 84.8% of clients were using home care nursing, 26.3% were living alone, and 39.5% had dementia. In the month preceding the data collection, 13.9% of clients had a new disease or worsening of an existing disease, 8.8% were hospitalized at least once, and 47.9% did not participate in activities of interest. About 20% of clients' families were unable to spend time peacefully, and 52.8% were exhausted from the client's care., Conclusions: The QIs-LTC developed in the current study are generic and client- and family-centered. They encompass objective and subjective information and would facilitate standardized monitoring if adopted and comparison between LTC settings, including home care. In addition, future research directives are outlined. Geriatr Gerontol Int 2023; 23: 383-394., (© 2023 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.)

This umbrella review followed the JBI methodology and synthesized systematic reviews of the effectiveness of long-term home visit nursing for older people (≥ 60 years) on improving mortality, hospitalization, institutionalization, patient satisfaction, and quality of life. Eight bibliographic databases were searched, and 10 reviews with 22 distinct relevant trials (n = 10,765 participants) were included. Mortality was the most frequently examined outcome and satisfaction was the least examined (n = nine and one reviews, respectively). Home visit nursing had a favorable effect on reducing the number of admissions to hospital (n = 1,152 participants in two trials vs. 788 participants in three trials) and no effect on other outcomes. The evidence of the effectiveness of long-term home visit nursing for older people is minimal. Future research needs to be based on a theoretical foundation that explains how interventions are expected to work., Competing Interests: Declarations of Competing Interest None, (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction: Family-oriented interventions in long-term care (LTC) residential facilities are heterogenous in design, characteristics, and outcomes., Objectives: To synthesize characteristics (e.g., type, provider, and duration) and outcomes of family-oriented interventions in LTC residential facilities., Methods: We followed the JBI methodology and searched seven databases for quantitative, qualitative, and mixed method studies that reported family-oriented interventions in LTC residential settings for older people; defined in this review as ≥60 years. Interventions that included residents, resident families, health professionals, or any combinations of these three were included if the study reported post-intervention assessment of at least one family-related outcome., Results: Thirteen studies met the inclusion criteria. Interventions were found to be multifaceted, and education was the most common element. Nurses were the most common intervenors, and most interventions had more than one target (residents, resident families, or staff). Most outcomes were related to family involvement, satisfaction with care, quality of life, communication, symptom management, and shared decision making, and none of the studies reported a negative impact., Conclusions: Family-oriented interventions were associated with high care quality and better resident-staff-family partnership. Staff education and staff-family conversation are relatively cheap interventions to help family involvement, facilitate shared decision-making, and improve family satisfaction., (© 2022 Wiley Periodicals LLC.)

Aim: To examine the response of long-term care (LTC) residential facilities to the COVID-19 pandemic worldwide, and the antecedents and outcomes of this response., Design: A protocol of a cross-sectional survey., Methods: Two online questionnaires will be used to collect data from LTC residential facilities' managers and staff worldwide. Collected data include participants' socio-demographic characteristics, facility-related characteristics, facility response to the COVID-19 pandemic, and possible influences of the pandemic on staff, residents, and residents' families. Data collection has started in April 2021. Data analyses will be conducted on the pooled sample and stratified by the type of facility, participants, or country if required. Multi-level regression analysis will be considered to account for participants' data clustering in countries and facilities., Results: The data collection is ongoing. The findings would guide policy-makers and healthcare organizations to reform their protocols for the best interest of facilities, staff, residents, and residents' families., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Objective: The objective of this review is to synthesize systematic reviews on the effectiveness of home visit nursing for improving patient-related outcomes in older people., Introduction: Home care for older people covers a wide range of services and is provided by an array of health professionals. Reviews on the effectiveness of home care services differ in definition and scope, and the unique contribution of home visit nursing services for older people has not been clearly identified., Inclusion Criteria: This review will consider systematic reviews of quantitative studies assessing the effectiveness of home visit nursing for older people. Home visit nursing will include the provision of preventive, promotive, curative, or rehabilitative services in the home. This will be compared with usual care, alternative therapeutic interventions, or no intervention. The outcomes of interest are hospitalization, institutionalization, mortality, patient satisfaction, and quality of life. Systematic reviews with and without meta-analyses will be eligible for inclusion., Methods: This review will follow the JBI methodology. MEDLINE, CINAHL Plus with Full Text, PsycINFO, the Cochrane Database of Systematic Reviews, Epistemonikos, ProQuest Dissertations and Theses, PROSPERO, and Grey Literature Report will be searched. The authors will hand-search reference lists of the included reviews. There will be no restrictions on the publication date or country of origin of the review. Only systematic reviews with full text published in English will be considered. Screening of articles, assessment of methodological quality, and data extraction will be performed independently by two reviewers. Quality of evidence will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Data will be summarized in a narrative format with supporting tables., Scoping Review Registration: Open Science Framework (https://osf.io/3fexj)., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 JBI.)

Objective: The aim of the study was to explore the degree of agreement of intensive care unit nurses working on a set of medication error preventive strategies and to examine possible predictors of nurses' knowledge, attitude and behavior., Materials and Methods: Observational, international, and cross-sectional study. Iran, Malta, Spain, Pakistan, Nepal, Qatar, Ecuador, Australia, Finland, Italy, Egypt, and Jordan were the countries included in this survey. To collect data, the Knowledge, Attitude and Behavior in Medication Errors questionnaire was used. A descriptive statistical analysis was performed for the socio-demographic characteristics of the sample and three multiple logistic regressions were performed., Results: The international sample consists of 1383 nurses, of whom 478 (34.6%) were men and 900 (65.1%) were women and their mean age was 35.61 years with a range of 19-61. Descriptive statistics conducted on the international sample show a medium to high degree of agreement among participants concerning some preventive strategies of medication error. In addition, the results of the present study show a strong relationship between positive nurses' attitudes and correct behaviors and/or adequate knowledge, as well as between adequate knowledge and correct behaviors (p< 0.01)., Conclusions: Further studies are needed to explore the issue of medication error concerning nurses' cultural backgrounds, as well as to assess similarities and disparities among international nurses.

Background: To date, a comprehensive, psychometrically robust instrument to assess palliative and end-of-life (PEOL) care education, practice, and perceived competence among intensive care unit (ICU) nurses does not exist., Objective: To examine content validity and reliability of a proposed instrument to assess the PEOL care education-practice- competence triad among ICU nurses., Methods: An international modified e-Delphi and a cross-sectional pilot questionnaire survey. The Delphi involved 23 panelists from 11 countries. The pilot study involved 40 staff nurses and 3 nurse managers from 3 adult ICUs in a randomly selected hospital in Egypt. An instrument was developed and judged for content validity by international panelists, and then pretested in a pilot study, where data were collected at 2 time points using self-administered questionnaires, followed by cognitive interviews. Test-retest reliability was examined using intraclass correlation (ICC), standard error of measurement (SEM), and repeatability coefficient (RC)., Results: The panelists confirmed content validity of the proposed instrument, and staff nurses confirmed its comprehensibility. At the level of the instrument's total scores, the lowest ICC was .9 (95% confidence interval: .8-.9); and the highest SEM and RC were 4.8 and 13.3, respectively., Conclusions: The PEOL Care Index is a comprehensive, comprehensible, content valid, and reliable instrument to assess the PEOL care education-practice-competence triad among ICU nurses. Construct and criterion validities need to be confirmed in future studies. Applicability of the PEOL Care Index in different settings and cultures needs to be examined.

Background: Nursing students' and educators' experiences with e-learning during the Coronavirus disease 2019 (COVID-19) pandemic are unknown in most countries., Aim: To (1) describe and compare Egyptian nursing students' and educators' experiences with e-learning during the COVID-19 pandemic and (2) elicit participants' preferences for responding to online versus paper questionnaires., Methods: This is a cross-sectional online survey of nursing students (undergraduate and postgraduate; n =580) and nursing educators (n = 95) in one faculty of nursing in Egypt. The survey assessed participants'characteristics, preferences for online versus paper surveys, and 11 dimensionsrelated to the e-learning experience, such as perceived competency, satisfaction, cognitive presence, and the preferred platforms for e-learning., Results: About 91% of students and 80% of educators received either no or inadequate training on e-learning before the pandemic. Students' and educators' experiences significantly differed (p-value < 0.001) in most of the examined dimensions, with educators having better experiences. About 71% of the students and 76% of the educators preferred responding to online surveys. The Strengths, Weaknesses, Opportunities, and Threats (SWOT analysis) of e-learning were mapped., Conclusion: Students are in more need of training on e-learning than educators, and this training is a must before any attempt to undertake online exams. The online survey is a preferred methodology among Egyptian nursing educators and students. The provided SWOT analysis may help administrators best implement and support e-learning during infection outbreaks., (© 2021 Wiley Periodicals LLC.)

Objectives: To examine family members' satisfaction in adult intensive care units., Methodology: This is mixed-method research. Family members of critically ill patients responded to a structured questionnaire and then were interviewed using semi-structured interviews. Quantitative and qualitative data were analyzed separately and integrated during the discussion., Settings: Six adult intensive care units in university hospitals in Egypt., Main Outcome Measures: Family satisfaction was assessed using the Critical Care Family Satisfaction Survey and field notes of the interviews., Results: The mean total satisfaction score was 12.8 ± 3.5, and comfort has the lowest subscale mean score: 2.07 ± 0.96. Multivariate regression analysis showed that family members' satisfaction was positively associated with their ability to communicate with patients (B [95% confidence interval]: 2.1 [1.19 to 3.02]) and negatively with daily purchasing of medications and supplies (-2.41 [-3.23 to -1.59]), low economic status (-1.57 [-2.47 to -0.67]), and perceiving patient condition to be deteriorating (-0.99 [-1.93 to -0.04]). Content analysis of qualitative data revealed four themes: aspects of family care, aspects of patient care, organizational and administrative issues and environment., Conclusions: In Egyptian adult intensive care units, regular family meetings, flexible visiting hours, shared decision-making, increasing staff-to-patient ratio and ensuring comfortable waiting rooms are promising strategies to enhance family satisfaction., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: There are no data on the provision of palliative nursing care in Egyptian adult intensive care units (ICUs). The Palliative and End-Of-Life (PEOL) Care Index is reliable and content valid; however, its construct and criterion validities have not been examined., Aims and Objectives: First, to assess palliative care education, practice, and perceived competence among adult ICU nurses in Egypt. Second, to explore factors related to palliative care nursing practice and perceived competence. Third, to assess the construct and criterion validities of the PEOL Care Index., Design: A cross-sectional survey., Methods: Nurse managers and staff nurses in 33 adult ICUs completed self-administered questionnaires. The questionnaires assessed nurses' palliative care practice and perceived competence. A multilevel regression analysis was used to determine the best predictors of palliative care practice and perceived competence. Theory evidence construct validity and predictive criterion validity of the PEOL Care Index were examined., Results: Thirty-three nurse managers and 403 staff nurses participated in the study-response rate = 100% and 72.5%, respectively. On a 0-100 scale, the mean scores of undergraduate education, practice, and perceived competence were 54.0 ± 18.7, 49.7 ± 18.1, and 54.5 ± 17.0, respectively. Palliative care practice was significantly related to receiving in-service training on palliative care or end-of-life care (regression coefficients: 3.39), higher job satisfaction (0.97), and higher organizational support (1.85). Palliative care perceived competence was significantly related to older nurses' age (0.20), higher job satisfaction (0.97), and higher palliative care undergraduate education (0.63)., Conclusions: Palliative care education, practice, and perceived competence among adult ICU nurses in Egypt are inadequate, especially in terms of spiritual and cultural care. The PEOL Care Index is construct and criterion valid., Relevance to Clinical Practice: Palliative care education should begin in nursing schools and extend through clinical in-services. Guidelines should be developed to maximize staff collaboration and the utilization of chaplains in ICUs., (© 2020 British Association of Critical Care Nurses.)

Objectives: The objective of this review will be to identify the characteristics (eg, type, duration, and provider) of family-oriented interventions in long-term care residential settings. The authors will also identify which outcomes are reported in the literature when implementing family-oriented interventions., Introduction: An array of family-oriented interventions in long-term care residential settings exist. Given the heterogeneity of current literature, mapping characteristics and intended outcomes of family-oriented interventions is an essential step to inform how best to support families of patients in long-term care residential settings., Inclusion Criteria: This review will consider studies describing family-oriented interventions for families of elderly patients in long-term care residential settings, with no exclusion based on country, gender, or comorbidities. Interventions that address any family-related issue, such as quality of life, psychological burden, and family involvement in patient care, are eligible for inclusion. Studies will be excluded if the patients are cared for at their own homes or institutionalized care is provided on a temporary basis. Quantitative, qualitative, and mixed method study designs will be considered for inclusion., Methods: A scoping review will be conducted using the JBI methodological approach. Seven databases will be systematically searched: MEDLINE, CINAHL, Scopus, Evidence-Based Medicine Reviews including Cochrane Library, PsycINFO, OpenGrey, and the Grey Literature Report. Citations will be screened against the inclusion criteria by two reviewers independently. Relevant data will be extracted from the included studies, and will be synthesized, summarized, and reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Findings will be published in a peer-reviewed journal., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 JBI.)

Aims: To examine the relationship between homecare nurses' length of conversation with nurse managers and colleagues and intention to remain at the workplace., Background: Nurse turnover is an important issue. Previous studies focused on the perceived function of communication. However, we do not know the contribution of homecare nurses' actual conversations to nurse turnover prevention., Methods: We conducted a cross-sectional study in 330 homecare nurse organisations in Japan. We recruited 2,315 homecare nurses and analysed the data of 608 nurses. We used a questionnaire to investigate participants' intention to remain., Results: Nearly 68% had the intention to remain. The mean length of conversation was 34 min/day with the manager and 68 min/day with colleagues. Multilevel logistic regression analysis showed that long conversations with the nurse manager (20 min and more) and colleagues (40 min and more) were significantly related to the intention to remain., Conclusions: Ensuring the time of conversation with a manager and colleagues may contribute to preventing potentially avoidable nurse turnover., Implications for Nursing Management: Nurse managers should encourage homecare nurses to have daily conversations of 20 min or more with the nurse manager and 40 min or more with colleagues to continue working at their current workplace., (© 2020 John Wiley & Sons Ltd.)

Background: Worldwide, rather few studies have examined the association between burnout and care quality using objectively measured quality indicators, with most of the studies have relied on perceived quality outcomes. This study aimed to examine the association between staff nurses' burnout and selected objective quality metrics in long-term care wards in Japan., Methods: This is a secondary analysis of a cross-sectional survey. Nurse managers and staff nurses working at randomly selected hospitals with long-term care wards-the equivalent of skilled nursing homes in Western countries- completed self-administered, anonymous questionnaires. The questionnaires collected data regarding care quality indicators, staff nurses' burnout, and other confounders (e.g., ward size, participants' years of experience, and patients' conditions). All statistical analyses were conducted at the ward level. A multivariate regression analysis was used to examine associations between burnout and outcome indicators., Results: Data from 196 wards in 196 hospitals (196 nurse managers and 2473 staff nurses) across Japan were analyzed. Multivariate regression analysis showed that higher emotional exhaustion was associated with higher rates of pneumonia and pressure ulcers (p-value = .036 and .032, respectively), and that reduced personal accomplishment was associated with higher rates of tube feeding (p-value = .018). A larger ward size was also associated with low rates of pneumonia (regression coefficient = -.001, p-value = .019)., Conclusions: Staff nurses' burnout is a significant determinant of care quality in long-term care wards, implying that organizations that implement burnout reducing strategies may see greater benefits in patient outcomes. A large ward size was significantly associated with better care outcomes-specifically, low rates of pneumonia. Future research needs to determine feasible quality improvement measures in small-scale long-term care facilities, and to provide more comprehensive insights on ward-level variables that influence care quality in long-term care settings.

Background: In the Arab and Islamic world, data on palliative and end-of-life (PEOL) care education are minimal., Objectives: The current study's primary aim was to identify what PEOL care education is delivered to undergraduate nurses in Egypt and the teaching strategies used to deliver this education. A secondary aim was to assess the feasibility of using online surveys in nursing research in Egypt., Design: This is a cross-sectional survey., Settings: Ten randomly selected faculties of nursing across Egypt., Participants: Nursing educators who were working at three academic departments; Medical-Surgical Nursing, Critical Care Nursing, and Gerontological Nursing; in the participating faculties., Methods: After face-to-face recruitment of participants, data were collected using an online questionnaire with an adjunctive use of paper questionnaires. The questionnaire assessed participants' and courses' characteristics, the inclusion of the PEOL Care Index content in the surveyed courses, and teaching strategies used to deliver this content., Results: A total of 95 nursing educators were involved in the current study (response rate = 86.4%). All participants were female, and 87.4% responded via online questionnaires. The overall coverage of the PEOL care content ranged from 76% to 100%. End-of-life care and spiritual care were the least frequently reported PEOL care topics; on average, by 19.6% and 36% of the educators, respectively. Lecture was the most frequently used teaching strategy, followed by clinical field practice (mean percentages of utilization: 77.7% and 53.6%, respectively)., Conclusions: In Egypt, most PEOL care topics are covered in undergraduate nursing curricula. Yet, educating these topics is predominantly theoretical. End-of-life care and spiritual care are the least frequently covered PEOL care topics. Online surveys are feasible for multisite curricular assessment, and this feasibility may be augmented by face-to-face recruitment of participants and adjunctive use of paper questionnaires., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Dealing with an aging society is a global challenge, and more countries than ever before are now mobilizing their healthcare systems to provide high-quality long-term care (LTC) to older adults. This paper reviews the current situation pertaining to aging and the issues for measuring the LTC quality in Japan. It also introduces current efforts to develop quality indicators for measuring LTC quality. Assuring the quality of LTC and developing indicators to measure its quality is a challenge worldwide. Detailed systems for LTC quality measurement have been developed and managed, primarily in the US. In Japan, on the other hand, such systems do not exist; the public LTC system mostly depends on the evaluation of structural aspects, such as facility structure and staffing. Our research group has been developing quality indicators to measure LTC quality. In the future, we aim to evaluate care quality in various LTC settings using the proposed quality indicators, aiming to improve care quality across LTC settings in the community-based integrated care system., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

Background: The literature on the situation of palliative and end-of-life care in the Arab and Islamic world, including Egypt, is limited and does not present a clear picture of the cultural context. This report aims to portray the palliative and end-of-life care situation in Egypt, focusing on the nursing viewpoint. First, we describe health- and illness-related cultural, religious, and ethical issues. Second, we present an overview of the healthcare and nursing system in Egypt. Third, we discuss the situation of palliative and end-of-life care, highlighting the shortcomings of existing literature. Finally, we delineate country-specific recommendations to improve the palliative and end-of-life care situation at the level of policy, education, and research. Countries with similar healthcare, cultural, legal, religious, economic, or ethical contexts may benefit from the recommendations made in this study.

Aim: To elicit intensive care unit (ICU) nurses' recommendations to prevent nursing errors., Background: Errors are usually induced by faulty systems, and managers play a key role in building a safe health care system., Method: A qualitative research design was used. Semi-structured interviews with 112 Egyptian ICU nurses were conducted, and responses were analysed using qualitative content analysis., Results: Responses from 108 nurses were analysed. Six themes of recommendations were identified: improvement and better organisation of resources, policy modification, education and training, likeness minimization, use of technology and work environment changes., Conclusion: Nurses' recommendations reflect the poor-resource context in developing countries. Several recommendations, however, are relatively cheap to implement strategies., Implications for Nursing Management: All reported recommendations are organisational issues. Improvement and better organisation of human and non-human resources is a priority issue to prevent or minimize nursing errors. Policy modification, education and training, and likeness minimization are relatively cheap, easy-to-implement strategies to tackle the occurrence of nursing errors in developing countries. Staff nurses should be actively involved in policy reform. Patient safety education should be supported by adopting modern technology and work environment reform., (© 2020 John Wiley & Sons Ltd.)

Background: Errors tend to be multifactorial and so learning from nurses' experiences with them would be a powerful tool toward promoting patient safety., Aim: To identify the nature of nursing errors and their contributing factors in intensive care units (ICUs)., Methods: A semi-structured interview with 112 critical care nurses to elicit the reports about their encountered errors followed by a content analysis., Results: A total of 300 errors were reported. Most of them (94·3%) were classified in more than one error category, e.g. 'lack of intervention', 'lack of attentiveness' and 'documentation errors': these were the most frequently involved error categories. Approximately 40% of reported errors contributed to significant harm or death of the involved patients, with system-related factors being involved in 84·3% of them. More errors occur during the evening shift than the night and morning shifts (42·7% versus 28·7% and 16·7%, respectively). There is a statistically significant relation (p ≤ 0·001) between error disclosure to a nursing supervisor and its impact on the patient., Conclusions: Nurses are more likely to report their errors when they feel safe and when the reporting system is not burdensome, although an internationally standardized language to define and analyse nursing errors is needed. Improving the health care system, particularly the managerial and environmental aspects, might reduce nursing errors in ICUs in terms of their incidence and seriousness., Relevance to Clinical Practice: Targeting error-liable times in the ICU, such as mid-evening and mid-night shifts, along with improved supervision and adequate staff reallocation, might tackle the incidence and seriousness of nursing errors. Development of individualized nursing interventions for patients with low health literacy and patients in isolation might create more meaningful dialogue for ICU health care safety., (© 2018 British Association of Critical Care Nurses.)

Background: Keeping long-term care nurses employed is necessary to sustain the current and future demand for high-quality long-term care services. Understanding the factors relating to intention to stay among long-term care nurses is limited by the scarcity of studies in long-term care settings, lack of investigation of multiple factors, and the weakness of existing explanatory models., Objective: To identify the factors associated with long-term care nurses' intention to stay in their current workplace., Design: A cross-sectional questionnaire survey., Setting: Two hundred and fifty-seven hospitals with long-term care wards across Japan., Participants: A total of 3128 staff nurses and 257 nurse managers from the long-term care wards of the participating hospitals., Method: The questionnaire assessed nurses' intention to continue working in the current workplace as well as potential related factors, including individual factors (demographic data, reason for choosing current workplace, burnout, work engagement, somatic symptom burden) and unit factors (unit size, nurse-manager-related data, patients' medical acuity, average number of overtime hours, recreational activities, social support, perceived quality of care process, educational opportunities, feeling of loneliness, and ability to request days off). Multilevel logistic regression analysis was used to determine which variables best explained nurses' intention to stay in their workplace., Results: Only 40.1% of the respondents reported wanting to continue working at their current workplace. The regression analysis revealed that long-term care nurses' intention to stay was positively associated with nurses' age (odds ratio [95% confidence interval]: 1.02 [1.01-1.03]), work engagement (1.24 [1.14-1.35]), getting appropriate support from nurse managers (2.78 [1.60-4.82]), perceived quality of care process (1.04 [1.01-1.06]), educational opportunities (1.06 [1.0-1.13]), and various specific reasons for choosing their workplace (e.g., a good workplace atmosphere, being interested in gerontological nursing, and a high salary). By contrast, intention to stay was negatively associated with emotional exhaustion (0.93 [0.91-0.95]) and depersonalization (0.91 [0.89-0.93]). Intention to stay was associated with neither nurses' qualifications nor patient medical acuity., Conclusion: Reason for choosing the workplace, work engagement, getting support from the nurse manager, and perceived quality of care process are significant predictors of long-term care nurses' intention to stay in the workplace. Promoting such nurses' work engagement, provision of high-quality care, and access to educational opportunities might augment long-term care nurses' intention to stay., (Copyright © 2018 Elsevier Ltd. All rights reserved.)