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Today, one of the major ethical challenges facing the world's health care system, and in particular nurses in the intensive care unit, is euthanasia or death out of pity. The aim of this study was to investigate the attitude of Iranian nurses in the intensive care unit toward euthanasia. This was an analytical cross-sectional study using census sampling. The data collection tool was the Euthanasia Attitude Scale. A total of 206 nurses working in the intensive care unit in 4 hospitals in the Mazandaran province of Iran were included in this study. The mean of total Euthanasia Attitude Scale score in intensive care unit nurses was 2.96. The mean euthanasia dimensions were ethical consideration, practical considerations, treasuring life, and naturalistic beliefs, 3.03, 2.92, 2.98, and 2.99, respectively. There was significant but low negative correlation between age and total Euthanasia Attitude Scale score, ethical considerations, and practical considerations. Male nurses exhibited significantly higher Euthanasia Attitude Scale scores, specifically in regard to ethical and practical considerations compared with female nurses. The most Iranian nurses in the intensive care unit had a negative attitude toward euthanasia for patients in the later stages of the disease. However, this opposition was less than similar studies in Iran in the past. [ABSTRACT FROM AUTHOR]

Background: Worldwide disparities in surgical capacity are a significant contributor to health inequalities. Safe surgery and infection prevention and control depend on effective sterile processing (SP) of surgical instruments; however, little is known about SP in low- and middle-income countries (LMICs), where surgical site infection is a major cause of postoperative morbidity and mortality. Aim: To appraise and synthesise available evidence on SP in LMICs. Methods: An integrative review of research literature was conducted on SP in LMICs published between 2010 and 2020. Studies were appraised and synthesised to identify challenges and opportunities in practice and research. Results: Eighteen papers met the inclusion criteria for qualitative analysis. Challenges to advancing SP include limited available evidence, resource constraints and policy-practice gaps. Opportunities for advancing SP include tailored education and mentoring initiatives, emerging partnerships and networks that advance implementation guidelines and promote best practices, identifying innovative approaches to resource constraints, and designing and executing quality assurance and surveillance programmes. Discussion: Research investigating safe surgery, including SP, in LMICs is increasing. Further research and evidence are needed to confirm the generalisability of study findings and effectiveness of strategies to improve SP practice in LMICs. This review will help researchers and stakeholders identify opportunities to contribute. The burdens of unsafe surgery transcend geopolitical borders, and the global surgery and research communities are called upon to negotiate historical and present-day inequities to achieve safe surgery for all. [ABSTRACT FROM AUTHOR]

Aim: To develop a substantive theoretical explanation that makes sense of the decision‐making process that clinical instructors use to place students on a learning contract. Background: Clinical instructors are challenged with the task of objectively evaluating students using subjective tools such as anecdotal notes, diaries, unstructured observations and verbal feedback from other nurses. Clinical instructors' assessment decisions have a considerable impact on a variety of key stakeholders, not least of all students. Design: Grounded theory method and its heuristic tools including the logic of constant comparison, continuous memoing and theoretical sampling to serve conceptualisation were used in the process of data collection and analysis. Methods: Seventeen individual semi‐structured interviews with clinical instructors in one university in Western Canada were conducted between May 2016–May 2017. Data were analysed using open, axial and selective coding consistent with grounded theory methodology. The study was checked for the Standards for Reporting Qualitative Research (SRQR) criteria (See Appendix S1). Findings: Three subcategories, "brewing trouble," "unpacking thinking" and "benchmarking" led to the study's substantive theoretical explanation. "Gut feeling" demonstrates how clinical instructors reason in their decision‐making process to place a student on a learning contract. Conclusion: Placing a student on a learning contract is impacted by personal, professional and institutional variables that together shift the process of evaluation towards subjectivity, thus influencing students' competency. A system‐level approach, focusing on positive change through implementing innovative assessment strategies, such as using a smart phone application, is needed to provide some degree of consistency and objectivity. Relevance to clinical practice: Making visible the objective assessments currently being done by clinical instructors has the potential to change organisational standards, which in turn impact patient and clinical outcomes. [ABSTRACT FROM AUTHOR]

In this paper, we examine the practicalities of nurse managers’ work. We expose how managers’ commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers. We learned how nurse managers’ responsibility for staffing is accomplished within tightening budgets and a burgeoning suite of technologies that direct decisions about whether or not there are enough nurses. Our inquiry explicates how technologies organize nurse managers to put aside their professional knowledge. We describe professionally committed nurse leaders attempting to activate transformational leadership and show how their intentions are subsumed within information systems. Seen in light of our analysis, transformational leadership is an idealized concept within which managers’ responsibilities are shaped to conform to institutional purposes. [ABSTRACT FROM AUTHOR]