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Balancing conflicting goals among different stakeholders is a challenging problem in various application domains. In this paper, we analyse it in the context of home healthcare. Fairness objective functions for nurses and patients are combined with system-level governance goals of the territorial centers in charge of the assistance service. From the solution of several multi-objective problems including one objective for each actor hierarchically ordered, the best goal for each stakeholder is identified and interesting managerial conclusions are drawn. To efficiently solve large-size instances, we introduce a parallel Adaptive Large Neighborhood Search algorithm with destroy and repair operators customised to solve multi-objective multi-actor problems. The algorithm proves to be highly efficient and effective when compared to a commercial Mixed Integer Programming solver, either in its plain form or enforced by a mild start and a primal heuristic. Additionally, we devise a metaheuristic method to generate the Pareto frontier of an instance. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Impact Public Contribution Reporting Method To investigate the perceptions of family members (FMs) of patients with traumatic brain injury (TBI) and nurses on empowering support and its implementation during the acute phase within Finnish neurosurgical and neurological care in hospital settings, focusing on identifying similarities and differences in their viewpoints.Participatory qualitative descriptive study.Data were collected from seven FMs and 11 nurses using the World Café method in November 2019. An abductive approach was employed for data analysis, combining deductive interpretation within the conceptual framework of empowering support and inductive content analysis.Four main themes were identified: (1) FMs' diverse information and guidance needs of TBI, treatment and its impact on family life, (2) support based on empowering FMs in participation, competence and decision‐making, (3) empowering FMs through collaborative nursing practices and interprofessional support, and (4) internal and external hospital support enhancing and promoting the empowerment of FMs.The perceptions of FMs and nurses regarding empowering support were largely consistent, yet diverged in its implementation in nursing practice. Nurses play a crucial role in fostering the empowerment of FMs; however, further research is needed to explore the impact of organisational and community factors on the implementation of empowering support.Our study contributes to advancing nursing practices by underscoring the necessity for a paradigm shift towards a family‐centred approach. Furthermore, it emphasises the urgency for standardising nursing practices to ensure equitable access to empowering support for FMs, applicable across various care settings for patients with TBI.This review is part of a larger research project in which FMs of patients with TBI and nurses were involved in designing the project.This study was reported using the Consolidated Criteria for Reporting Qualitative Checklist for qualitative studies. [ABSTRACT FROM AUTHOR]

Background: The relationship between a nurse and a patient is a key part of nursing that can impact how happy the patient is with the care they receive. It appears that the nurse's mental health can also affect this connection. However, there is little research on this topic. So, the aim of the present study was to determine the correlation of nurse's mental health with nurse–patient relational care and nursing care satisfaction. Methods: A total of 532 nurses and 532 patients from 13 Level-III hospitals of Hubei province (China) completed a China Mental Health Survey, general information questionnaire, the Nursing Care Satisfaction Scale, and Relational Care Scale. Results: Age, nurse working years, and night shift last month were correlated with mental health score (r = -0.142, r = -0.150, r = 0.164, p < 0.05). Nurse's mental health was correlated with relational care score and nursing care satisfaction score (r = -0.177, r = -0.325, p < 0.05). Also, relational care score, patients age and gender were correlated with nursing care satisfaction score (r = 0.584 and r = 0.143, x2 = 11.636, p < 0.05). Descriptive information of nurses had a direct impact on nurses' mental health (direct effect = 0.612, 0.419–0.713). Nurses' mental health had a direct effect on relational care score (direct effect = 0.493, 0.298–0.428) and an indirect effect on nursing care satisfaction score (indirect effect = 0.051, 0.032–0.074). Relational care score and patient's descriptive information had also a direct effect on nursing care satisfaction score (direct effect = 0.232, 0.057–0.172 and 0.057, 0.347–0.493). Conclusion: This study showed that the better the mental health of nurses, the more patients feel satisfied with nursing services. [ABSTRACT FROM AUTHOR]

Introduction Simulation-based medical training has been shown to be effective and is widely used in civilian hospitals; however, it is unclear how widely and how effectively simulation is utilized in the U.S. Military Health System (MHS). The current operational state of medical simulation in the MHS is unknown, and there remains a need for a system-wide assessment of whether and how the advances in simulation-based medical training are employed to meet the evolving needs of the present-day warfighter. Understanding the types of skills and methods used within simulation programs across the enterprise is important data for leaders as they plan for the future in terms of curriculum development and the investment of resources. The aim of the present study is to survey MHS simulation programs in order to determine the prevalence of skills taught, the types of learners served, and the most common methodologies employed in this worldwide health care system. Materials and Methods A cross-sectional survey of simulation activities was distributed to the medical directors of all 93 simulation programs in the MHS. The survey was developed by the authors based on lists of critical wartime skills published by the medical departments of the US Army, Navy, and Air Force. Respondents were asked to indicate the types of learners trained at their program, which of the 82 unique skills included in the survey are trained at their site, and for each skill the modalities of simulation used, i.e. mannequin, standardized patients, part task trainers, augmented/virtual reality tools, or cadaver/live tissue. Results Complete survey responses were obtained from 75 of the 93 (80%) MHS medical simulation training programs. Across all skills included in the survey, those most commonly taught belonged predominantly to the categories of medic skills and nursing skills. Across all sites, the most common category of learner was the medic/corpsman (95% of sites), followed by nurses (87%), physicians (83%), non-medical combat lifesavers (59%), and others (28%) that included on-base first responders, law enforcement, fire fighters, and civilians. The skills training offered by programs included most commonly the tasks associated with medics/corpsmen (97%) followed by nursing (81%), advanced provider (77%), and General Medical Officer (GMO) skills (47%). Conclusion The survey demonstrated that the most common skills taught were all related to point of injury combat casualty care and addressed the most common causes of death on the battlefield. The availability of training in medic skills, nursing skills, and advanced provider skills were similar in small, medium, and large programs. However, medium and small programs were less likely to deliver training for advanced providers and GMOs compared to larger programs. Overall, this study found that simulation-based medical training in the MHS is focused on medic and nursing skills, and that large programs are more likely to offer training for advanced providers and GMOs. Potential gaps in the availability of existing training are identified as over 50% of skills included in the nursing, advanced provider, and GMO skill categories are not covered by at least 80% of sites serving those learners. [ABSTRACT FROM AUTHOR]

Aim Background Method Results Conclusion This study aimed to systematically review empirical evidence on factors influencing nurses to report medication errors and near misses.There is underreporting of medication errors among nurses, in particular among novice and beginner nurses. To improve quality of care, factors influencing the reporting of medication errors and near misses should be documented.A systematic mixed methods review was conducted. CINAHL, Cochrane Collaboration, Embase, Medline, PsycINFO and Web of Science databases were explored and analysed from December 1990 to December 2023. Two reviewers independently selected and extracted data using a standardized data extraction grid. Data were analysed using thematic analysis based on the adapted theory of planned behaviour.Forty‐two studies met the eligibility criteria. Principal factors influencing the reporting of medication errors and near misses among nurses were associated with perceived behavioural control, subjective norm and attitude. Few studies examined factors influencing reporting medication errors and near misses among novice and beginner nurses, and sociodemographic and professional factors.To understand factors influencing reporting of medication errors and near misses, further studies should be conducted to investigate sociodemographic and professional factors. [ABSTRACT FROM AUTHOR]

Intensive Care Unit (ICU) nurses are burdened by excessive number of false and irrelevant alarms generated by patient monitoring systems. Nurses rely on these patient monitoring systems for timely and relevant medical information concerning patients. However, the systems currently in place are not sensitive to the perceptual and cognitive abilities of nurses and thus fail to communicate information efficiently. An efficient communication and an effective collaboration between patient monitoring systems and ICU nurses is only possible by designing systems sensitive to the abilities and preferences of nurses. In order to design these sensitive systems, we need to gain in-depth understanding of the user group through revealing their latent individual characteristics. To this end, we conducted a survey on individual characteristics involving nurses from two IC units. Our results shed light on the personality and other characteristics of ICU nurses. Subsequently, we performed hierarchical cluster analysis to develop data-driven nurse profiles. We suggest design recommendations tailored to four distinct user profiles to address their unique needs. By optimizing the system interactions to match the natural tendencies of nurses, we aspire to alleviate the cognitive burden induced by system use to ensure that healthcare providers receive relevant information, ultimately improving patient safety. [ABSTRACT FROM AUTHOR]

Modern demographic changes, which lead to increased migration and population diversity, impose the need for culturally sensitive care in health care, which requires training and education of nurses. Research highlights the importance of cultural competence and the development of skills to effectively interact with patients from diverse cultural backgrounds, which can improve the quality of care and reduce potential racial stereotyping and conflict. The aim of the research is to explore the role of the nurse in caring for patients from different cultural backgrounds. A direct, individual, anonymous survey was prepared and conducted through the Google Forms platform. The results of the study highlight the importance of cultural competence in nursing, with almost all participants acknowledging the need to understand the cultural characteristics of patients. Language barriers, different beliefs and stereotypes are major challenges for nurses in caring for culturally diverse patients. Most participants expressed a lack of confidence in their abilities and a desire for training in cultural competence, emphasizing the need for better training in this area. Nurses play a key role in caring for culturally diverse patients and must be trained and empathetic to provide the best care and treatment for each patient, regardless of their cultural background. [ABSTRACT FROM AUTHOR]

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]

Objective Method Findings Conclusions Implications for nursing practice To map nursing diagnoses related to cardiovascular function reported in studies involving patients in primary care.A scoping review follows JBI guidelines. Literature searches were conducted from March to May 2024. Studies included focused on nursing diagnoses for adults and older adult patients with cardiovascular conditions in primary care settings. Results were systematically presented in tables and narratively.Among the 12 included studies, the most prevalent diagnosis was “noncompliance” (00079), removed from NANDA‐I in 2017. Sixteen other diagnoses were identified, indicating a broader clinical profile of individuals with cardiovascular health issues in primary care. Most studies involved patients with hypertension in Brazil.Key nursing diagnoses for patients with cardiovascular conditions in primary care were identified. Ineffective health management emerged as a common characteristic among this population.Identifying prevalent diagnoses allows nurses to reinforce their commitment to managing cardiovascular conditions, improve care plans, and generate practice indicators for services, thus enhancing the quality of care provided. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions Liver transplant recipients are at a high risk of infection during the first month. Therefore, it is crucial to implement isolation measures correctly to prevent the spread of nosocomial infections. Evidence‐based practices and proper implementation of isolation measures can significantly reduce morbidity and mortality. The study aimed to investigate the impact of nurses' attitudes towards evidence‐based nursing on their compliance with isolation measures.This is a descriptive study conducted between October 2023 and January 2024, with the participation of 137 nurses working in the organ transplant clinics of a university hospital in Turkey. Data was collected using a participant introduction form, the attitudes towards evidence‐based nursing scale, and the compliance with isolation measures scale.The mean total score for the scale of attitudes towards evidence‐based nursing among nurses was 55.95 ± 10.43 (15–75). Similarly, the mean total score for the scale of compliance with isolation measures was 71.44 ± 13.53 (18–90). Both scores were above the middle level. The study found a moderately significant positive correlation between attitudes towards evidence‐based nursing and compliance with isolation measures (r: 0.670, p: 0.000). The regression model showed that the attitude towards evidence‐based nursing explained 44.9% of the positivity towards isolation measures (R2 = 0.449).The study found a positive correlation between nurses' positive attitudes towards evidence‐based nursing and their compliance with isolation precautions when caring for liver transplant patients. This highlights the significance of evidence‐based nursing in patient care and the importance of adhering to isolation measures to prevent nosocomial infections. [ABSTRACT FROM AUTHOR]

Aims Design Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To explore university nursing students and academic staff's perceptions of what increased gender diversity might bring to the nursing profession.An exploratory study with students and academic staff from two university nursing schools.Students and staff in two university nursing schools were invited to participate in an anonymous online survey (October–November 2022). The survey focused on gender diversity within nursing and patient care, asking respondents about existing barriers to gender diversity and inviting ideas on increasing gender diversity within nursing. The survey findings helped inform questions, which were used to further explore views and thoughts of gender diversity within nursing through semi‐structured one‐to‐one interviews (January–February 2023).Nearly, two‐thirds (64%, n = 69) of survey respondents strongly agreed/agreed that the lack of gender diversity in nursing negatively impacted delivering care to a gender‐diverse society. Most (84%, n = 90) strongly agreed/agreed that increased gender diversity within the nursing workforce would positively contribute to nursing. Three‐quarters (75%, n = 74) strongly agreed/agreed that working with a more gender‐diverse nursing workforce would enrich their experience as a nurse. Three themes emerged from the interview data: shared stereotypes; improved care through knowledge, better relations and the presence of a gender‐diverse workforce; a culture of welcome: suggested changes for the future.Most of those who participated in the study believe there are benefits to be gained from greater gender diversity within nursing. This study provides insight into the lack of gender diversity in the nursing environment, highlights how this might impact patient care and suggests actions to make nursing a more inclusive profession.Practical solutions were suggested, including the greater visibility of trans and non‐binary persons in advertisement and recruitment campaigns to ensure nursing is viewed as a career choice for “all”. Including a space for considered pronouns on university application forms, hospital documentation and name badges. Gender‐neutral titles and uniforms should be considered for all nursing staff, and more gender‐neutral toilets should be made available for staff and patients in university and hospital settings.This study addressed the lack of gender diversity in nursing and explored what an increase in gender diversity might bring to the nursing profession. The main findings were: (i) Less than a tenth (9%, n = 12) of respondents described their team of colleagues as being “extremely gender diverse”. (ii) Most (84%, n = 90) strongly agreed/agreed that increased gender diversity within the nursing workforce would be a positive attribute to nursing. (iii) Three‐quarters 75% (n = 74) strongly agreed/agreed that working with a more gender‐diverse nursing workforce would enrich their experience as a nurse. (iv) Many stereotypes still exist in nursing and tackling them is important to make the profession more inclusive. (v) A nurse's gender can impact the care they provide. (vi) A more gender‐diverse workforce would better reflect the population it serves. (vii) This research will have an impact on the nursing profession globally.The consolidated criteria for reporting qualitative studies (COREQ) was used as a guide throughout data collection and analysis.Every step of the study, including the survey and interview schedule, was co‐constructed using an iterative approach with service users, students and staff who had personal experience of gender diversity and were a core part of the study team. [ABSTRACT FROM AUTHOR]

Dyslexia is a specific learning difficulty impacting reading, writing and spelling. Practising nursing requires a unique set of skills that encompass effective communication, critical thinking, and organisational skills. This article focuses on the experiences of nurses with dyslexia, shedding light on the distinct challenges they encounter and the resilient strategies they employ to navigate their roles and excel in the health profession. [ABSTRACT FROM AUTHOR]

Background Aim Study Design Results Conclusions Relevance to Clinical Practice Delirium is an acute confusional state characterized by inattention, cognitive dysfunction and an altered level of consciousness. Delirium causes negative outcomes in patients, and patients with delirium increase the workload of nurses. Therefore, it is important to recognize the challenges and burdens experienced by nurses caring for patients with delirium.To determine the subjective burden experienced by intensive care nurses caring for patients who have undergone open‐heart surgery.A mixed‐method sequential explanatory design. A non‐probability purposive sampling method was used for the quantitative stage. Using OpenEpi, we employed the method of sample calculation with an unknown universe. The sample size of the quantitive study comprised 130 nurses. Quantitative data were collected with Google survey. For gathering qualitative data, online video interviews were conducted with 10 nurses, an interpretive phenomenological approach was used and content analysis was performed.In the quantitative phase, we found that the subjective burden was high. In the qualitative phase, five main themes emerged: difficulty in recognizing delirium, physical burden, emotional burden, burden in care management of patients with delirium and the effect of patients with delirium on other patients. The nurses experienced physical and emotional burden in delirium management and felt lonely while caring for patients with delirium.Because nurses play a key role in the care of patients with delirium, reducing the burden nurses experience when caring for patients with delirium should be considered important in ensuring that this patient population receives adequate care.Delirium patients create a care burden for intensive care nurses. To reduce this burden of care, in‐service training in patient management and bedside teaching support should be provided to nurses. Furthermore, the use of a valid scale to diagnose delirium should be integrated into health policies. Nurses should not be left alone in the management of delirium. Managing delirium patients with a team including physicians, nurses and professionals from other health disciplines will ensure that patients receive high‐quality care, thereby reducing the care burden of nurses. [ABSTRACT FROM AUTHOR]

Aims Background Design Methods Results Conclusion Relevance to Clinical Practice Public Contribution To investigate the relationship between medical narrative ability and humanistic care ability among Chinese clinical nurses, examining the potential mediating role of empathy.In the context of the bio‐psychosocial medical model and humanistic nursing care, understanding the core competencies of medical narrative ability, empathy and humanistic care in nursing is crucial. This study explored the mediating role of empathy between medical narrative ability and humanistic care ability.A cross‐sectional study.The study employed a descriptive, cross‐sectional survey design, involving 741 nurses from Wuxi People's Hospital. It assessed nurses' demographic characteristics, medical narrative ability, empathy, and humanistic care ability using an online questionnaire from December 2022 to February 2023. Pearson correlation analysis evaluated variable correlations, and PROCESS v3.3 model 4 was utilised for mediation analysis. The STROBE statement was chosen as the EQUATOR checklist.A positive correlation was found between nurses' medical narrative ability, humanistic care ability and empathy. Empathy partially mediated the relationship between medical narrative ability and humanistic care ability.Nurses' medical narrative ability directly and indirectly (via empathy) influences their humanistic care ability. Enhancing nurses' narrative and empathic skills can improve humanistic care, nursing quality and nurse–patient relationships.Managers should prioritise programmes to improve nurses' storytelling and empathy skills to enhance humanistic care, improving nursing quality and patient relationships.This study involves clinical nurses as participants and does not involve patients. This study collected data from clinical nurses using an online questionnaire platform in China. The questionnaire consisted of four sections, including demographic information and scales such as Narrative Competence Scale, Caring Ability Inventory and the Jefferson Scale of Empathy‐Health Professional. Clear instructions were given to participants on how to complete each scale, and measures were taken to prevent missing or duplicate responses. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusion There is well‐established data linking the adequacy of nurse staffing to patient outcomes. Evidence‐based standards for staffing are therefore critical to drive improvements in clinical care. One such evidence‐based approach is the use of patient acuity‐based tools. The objective of this study is to determine the performance of a neonatal acuity tool in an Australian tertiary neonatal health‐care setting, focusing on the classification of patient acuity and nursing:patient staffing ratios compared to current practice.Acuity data were collected in a neonatal intensive care unit (NICU) and special care baby unit (SCBU) over a 10‐week period in 2023. Patient data were scored in the 16 domains at two time points (prior to morning and evening nursing shift changeover) for all admitted newborns.For ventilated newborns nursed with a nurse:patient staffing ratio of 1:1, 78% of scores were within the L4‐high acuity (score ≥ 26) band, with the remaining scores within the L3‐high acuity (18–25) band. For newborns on non‐invasive respiratory support in NICU staffed 1:1, the proportion scoring within the L4 acuity band was higher in the nasal high‐flow group compared to the nasal continuous positive airway pressure group (P = 0.032), an effect not seen for those nursed 1:2 in NICU or for those on nasal high‐flow nursed in SCBU either 1:2 or 1:3.This study of how a neonatal acuity classification system compares with current nurse:patient staffing allocations in an Australian tertiary NICU, suggests refinements in staffing ratios for specific patient groups on respiratory support are possible. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusions Implications for patient care Impact To explore and describe acute care nurses’ decisions to recognise and respond to improvement in patients’ clinical states as they occurred in the real‐world clinical environment.A descriptive study.Nine medical and eleven surgical nurses in a large Australian metropolitan hospital were individually observed during nurse–patient interactions and followed up in interview to describe their reasoning and clinical judgements behind observed decisions. Verbal description of observations and interviews were recorded and transcribed. Reflexive thematic analysis was used to analyse the data.The three themes constructed from the data were as follows: nurses checking in; nurses reaching judgements about improvements; and nurses deciding on the best person to respond. Acute care nurses made targeted assessment decisions based on predicted safety risks related to improvement in clinical states. Subjective and objective cues were used to assess for and make judgements about patient improvement. Acute care nurses’ judgment of patient safety and a desire to promote patient centred care guided their decisions to select the appropriate person to manage improvement.The outcomes of this research have demonstrated that the proven safety benefits of acute care nurses’ decision making in response to deterioration extend to improvement in patients’ clinical states. In response to improvement, acute care nurses’ decisions protect patients from harm and promote recovery.Early recognition and response to improvement enable acute care nurses to protect patients from risks of unnecessary treatment and promote recovery.This study makes explicit nurses’ essential safety role in recognising and responding to improvement in patients’ clinical states. Healthcare policy and education must reflect the equal importance of assessment for and management of deterioration and improvement to ensure patients are protected and provided with safe care. [ABSTRACT FROM AUTHOR]

For successful human–robot collaboration, it is crucial to establish and sustain quality interaction between humans and robots, making it essential to facilitate human–robot interaction (HRI) effectively. The evolution of robot intelligence now enables robots to take a proactive role in initiating and sustaining HRI, thereby allowing humans to concentrate more on their primary tasks. In this paper, we introduce a system known as the Robot-Facilitated Interaction System (RFIS), where mobile robots are employed to perform identification, tracking, re-identification, and gesture recognition in an integrated framework to ensure anytime readiness for HRI. We implemented the RFIS on an autonomous mobile robot used for transporting a patient, to demonstrate proactive, real-time, and user-friendly interaction with a caretaker involved in monitoring and nursing the patient. In the implementation, we focused on the efficient and robust integration of various interaction facilitation modules within a real-time HRI system that operates in an edge computing environment. Experimental results show that the RFIS, as a comprehensive system integrating caretaker recognition, tracking, re-identification, and gesture recognition, can provide an overall high quality of interaction in HRI facilitation with average accuracies exceeding 90% during real-time operations at 5 FPS. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of basic nursing combined with psychological intervention on treatment compliance, self-care ability, clinical efficacy, lung function and nursing satisfaction of patients with Influenza-A(H1N1). Method: This was application research. Eighty patients with influenza-A (H1N1) admitted to The First Affiliated Hospital of Hebei North University from January 2020 to December 2022 were included as subjects and randomly divided into the observation group(n=40) and the control group(n=40). Patients in the control group were given routine basic nursing intervention, while those in the observation group were treated with combined psychological intervention in addition to basic nursing. The differences in treatment compliance, self-care ability, clinical efficacy, lung function and nursing satisfaction were compared between the two groups. Results: After the intervention, the treatment compliance score and the total self-care ability score of the observation group were higher than those of the control group, with statistically significant differences(P<0.05). After treatment, the clinical efficacy of the observation group was significantly higher than that of the control group(P<0.05). Before treatment, no significant difference was observed between the two groups in terms of various indexes of lung function, which were better in the observation group than in the control group after treatment(P<0.05). Conclusion: Basic nursing combined with psychological intervention results in a variety of benefits in the treatment of patients with Influenza-A(H1N1), such as improved treatment compliance and self-care ability, ameliorated lung function, as well as enhanced treatment outcomes and nursing satisfaction, which needs to be promoted in clinical practice. [ABSTRACT FROM AUTHOR]

Background Aim Study Design Results Conclusions Relevance to Clinical Practice Nurses accompany patients throughout the breaking bad news process.The aim of the research was to compare neonatal intensive care unit (NICU) nurses and well‐baby nursery (WBN) nurses on their role, barriers and experiences in breaking bad news to parents/relatives during hospitalization.A cross‐sectional comparative study.Two medical centres in Israel were employed. A 39‐item questionnaire was distributed with 140 nurses participating in the study. STROBE Checklist was used. A total of 140 nurses participated in this study. There was no significant overall difference (p ≤ .45) between NICU and WBN nurses in their perception of their role in breaking bad news. Differences were found in barriers to the role which included a lack of information, lack of time and communication issues. No differences were found in the nurses' experiences in breaking bad news. NICU and WBN nurses reported that they received no support (n = 40, 58.8%; n = 45, 64.3%, respectively). No breaking bad news specialty team existed in either unit (NICU: n = 64, 91.4%; n = 60, 87.0%).Nurses in the WBN and NICU are involved in breaking bad news. The role of the nurse has not been fully acknowledged making it difficult to perform. Nurses' experiences in breaking bad news were varied. Nurses facing challenges should be provided guidance and support. This needs to be implemented.The role played by nurses in breaking bad news has not been fully acknowledged making it difficult to perform. Nurses need to receive formal training and support in order to improve this practice. [ABSTRACT FROM AUTHOR]

Aim Design Data Sources Review Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To explore patients' and community nurses' perceptions and experiences of shared decision‐making in the home.Integrative review.CINAHL, British Nursing Index, Psycinfo, Medline and Social Services Abstracts were searched for qualitative, quantitative and mixed methods papers published between 1 December 2001 and 31 October 2023.A systematic search of electronic databases was undertaken using defined inclusion criteria. The included papers were appraised for quality using the Joanna Briggs Institute critical appraisal checklist for qualitative research. Relevant data were extracted and thematically analysed.Fourteen papers comprising 13 research studies were included. Patients attached great importance to their right to be involved in decision‐making and noted feeling valued as a unique individual. Communication and trust between the patient and nurse were perceived as fundamental. However, shared decision‐making does not always occur in practice. Nurses described tension in managing patients' involvement in decision‐making.The findings demonstrate that although patients and community nurses appreciate participating in shared decision‐making within the home, there are obstacles to achieving a collaborative process. This is especially relevant when there are fundamentally different perspectives on the decision being made. More research is needed to gain further understanding of how shared decision‐making plays out in practice and to understand the tensions that patients and nurses may experience.This paper argues that shared decision‐making is more than the development of a relationship where the patient can express their views (though of course, this is important). Shared decision‐making requires acknowledgement that the patient has the right to full information and should be empowered to choose between options. Nurses should not assume that shared decision‐making in community nursing is easy to facilitate and should recognize the tensions that might exist when true patient choice is enabled.This paper demonstrates how the idea of shared decision‐making needs to be explored in the light of everyday practice so that challenges and barriers can be overcome. In particular, the tensions that arise when patients and nurses do not share the same perspective. This paper speaks to the potential of a gap surrounding shared decision‐making in theory and how it plays out in practice.The reporting of this review was guided by the 2020 guidelines for the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (Page et al., 2021).This review was carried out as part of a wider study for which service users have been consulted. [ABSTRACT FROM AUTHOR]

Accessible summary What Is Known on the Subject What the Paper Adds to Existing Knowledge What Are the Implications for Practice Introduction Aim Methods Results Discussion Implication for Practice Missed, rationed or unfinished nursing care represents a global problem that jeopardizes the provision of quality and safe care. This phenomenon is frequently observed in adult, paediatric and child healthcare facilities and various care units. The findings of this review contribute valuable information to inform evidence‐based practices, foster organizational improvements and ultimately optimize the overall quality of care in psychiatric healthcare settings. In addition, the review illuminates the far‐reaching consequences of care on both patient and nurse outcomes, emphasizing the urgent need for tailored strategies to mitigate these effects. Based on the synthesis of the literature, a thorough and continuous assessment of patient care needs in the physical, psychological and social domains is needed, primarily utilizing standardized instruments designed for psychiatric settings to ensure a comprehensive understanding of unmet needs. Based on identified unmet needs, nurses should develop individualized care plans and tailor interventions to address them. In addition, nurse managers must adopt and implement regular monitoring mechanisms to track the prevalence of unmet care needs and at the same time establish reporting systems that capture the proportion of unmet needs, allowing timely interventions and adjustments to care delivery. Lastly, nurse managers must not only emphasize the importance of ethical care practices and dignity‐focused interventions but also educate healthcare providers, especially nurses, on the potential threats to patient dignity arising from unmet care needs. Despite frequent observations of unmet care needs in acute care adult settings, there are a limited number of studies that focus on investigating this phenomenon in the psychiatric setting.To synthesize the existing empirical research on unmet care needs in psychiatric healthcare settings.The search was carried out in August 2023 in four scientific databases, PubMed, ProQuest, Web of Science and OVID Nursing, based on their institutional availability. The search produced 1129 studies. The search and retrieval process reflected the recommendations of the Preferred Reporting Items for systematic reviews and meta‐analyses.This review included 14 studies investigating unmet care needs in the psychiatric healthcare setting. Unmet care needs included three domains: physical, psychological and social. The analysis of the factors revealed factors related to the characteristics of the organization, nurse and patient.The classification of unmet needs provides a comprehensive understanding of the various challenges facing people in psychiatric healthcare settings.Identified factors that influence the occurrence of unmet care needs will help prevent the occurrence of unmet care needs and timely assessment. The resolution of needs helps to achieve patient and nurse outcomes, increase the quality of care provided and patient satisfaction in a psychiatric healthcare setting. [ABSTRACT FROM AUTHOR]

Background Aim Study design Results Conclusions Relevance to Clinical Practice Implicit rationing of nursing care is defined as the withholding of necessary nursing measures for patients because of a lack of nursing resources. However, no studies have explored the experience of decision‐making about implicit rationing of nursing care in an intensive care unit (ICU).To explore the process of ICU nurses' decisions and judgement based on the conceptual framework of implicit rationing of nursing care.A qualitative study was undertaken between June 2020 and September 2020. The data collection methods were participative observation and interview. Eighteen ICU nurses participated in interviews. A thematic analysis was performed for the data analysis.The following five themes emerged: assessment of the condition and nature of nursing and time taken; strategies for setting personal priorities; plan implementation under mitigation strategy; existing nursing in reality; evaluation of the implementation of implicit rationing care. Nurses choose different strategies during plan implementation.In the absence of explicit guidelines on rationing nursing care, nurses often rely on intuitive and situational decision‐making processes for setting priorities. Given the vulnerability of ICU patients and the absence of family caregivers, nurses bear a heightened ethical responsibility to provide care. Establishing a positive nursing culture is essential. It is both reasonable and effective to organize work by accurately quantifying workload, improving staffing levels and optimizing scheduling methods. These themes align with the decision‐making process outlined in the conceptual framework and offer fresh perspectives.Nurses have a greater responsibility to provide care in an ethical manner and to increase awareness of the importance of holistic nursing care for the patient, that is to raise awareness of the importance of care that is often missed. Nurses actively adopt strategies to reduce implicit rationing of nursing care, including teamwork, organized nursing, working overtime and ignoring quality. The findings highlight the importance of creating a positive nursing culture that encourages nurses to adopt positive strategies. [ABSTRACT FROM AUTHOR]

Background: The wounded healer concept refers to healthcare providers who, in the past, have had similar experiences to those of their clients and now draw on these challenging experiences to assist their clients. This study explored the positive traits of nurses with chronic cardiovascular diseases who transitioned to wounded healers. Methods: A qualitative content analysis study was conducted within hospitals in Tehran, Iran, between November 2023 and March 2024. Sampling was conducted using a purposive sampling method in accordance with the study objectives and inclusion criteria. The data were collected through semi-structured face-to-face interviews. Twenty-three participants, comprising 16 females and 7 males, participated in the interviews. Data analysis was conducted by employing a qualitative content analysis approach, including creating codes, subcategories, generic categories, and main categories. MAXQDA v20 software was utilized to facilitate the analysis process. Results: The data analysis revealed one main category that aligned with the research question: the positive traits of a wounded healer nurse, consisting of three generic categories: (1) traits related to interpersonal and professional relationships; (2) traits related to the professional dimension; and (3) traits related to the personal dimension. wounded healer nurses demonstrate positive traits that enhance patient care. Conclusions: The findings of this study have important implications for nursing practice and education. By identifying the positive traits exhibited by nurses as wounded healers affected by chronic cardiovascular diseases, nursing programs can emphasize and strengthen these qualities to convert challenges into opportunities and bridge the theory-practice gap. [ABSTRACT FROM AUTHOR]

Aim(s) Background Design Methods Discussion/Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution The aim of this study is to understand factors that challenge retention and support nurses to stay in general practice.One in four general practice nurse positions in England expected to be left unfilled within the next 10 years. Cultural and structural issues associated with working in general practice have been linked with nurses leaving general practice, re‐evaluating their professional futures, adjusting work‐life balance and bringing forward retirement. This has implications for the future of the general practice nursing workforce and patient care more broadly.Exploratory qualitative interview study funded by the General Nursing Council Trust for England and Wales. University of York ethics approval (Ref: HSRGC/2023/586/A) was gained in September 2023. The study will be conducted between September 2023 and August 2024.Qualitative interviews will be conducted with a range of nurses working in, or who have worked in, general practice as well as nurse leaders associated with general practice across England and Wales. Recruitment will be via professional and social media networks and snowballing techniques. We aim to purposively recruit 30–40 participants for maximum variation. Cultural and structural influences which may contribute to retention decisions will be explored. Data will be analysed following framework analysis.This study will explore how underpinning cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention.By exploring factors that support or discourage nurses to remain in general practice, retention strategies can be better planned on order to address the general practice nursing workforce crisis.What problem did the study address? This study will address the retention crisis in nursing in general practice by exploring how cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention.Where and on whom will the research have an impact? From the study findings, recommendations will be developed to inform future policy and practice. Key factors to address attrition will be generated to support employers and policy makers in future primary care workforce planning, as well as supporting nurses, at an individual level, in negotiating their roles in practice.Standards for Reporting Qualitative Research (O'Brien et al., 2014).As this is a workforce study protocol, there is no patient or public contribution. [ABSTRACT FROM AUTHOR]

Background Optimal methods for deploying electronic patient-reported outcomes to manage symptoms in routine oncologic practice remain uncertain. The electronic symptom management (eSyM) program asks chemotherapy and surgery patients to self-report 12 common symptoms regularly. Feedback from nurses and patients led to changing the recall period from the past 7 days to the past 24 hours. Methods Using questionnaires submitted during the 16 weeks surrounding the recall period change, we assessed the likelihood of reporting severe or moderate and severe symptoms across 12 common symptoms and separately for the 5 most prevalent symptoms. Interrupted time-series analyses modeled the effects of the change using generalized linear mixed-effects models. Surgery and chemotherapy cohorts were analyzed separately. Study-wide effects were estimated using a meta-analysis method. Results In total, 1692 patients from 6 institutions submitted 7823 eSyM assessments during the 16 weeks surrounding the recall period change. Shortening the recall period was associated with lower odds of severe symptom reporting in the surgery cohort (odds ratio   =   0.65, 95% confidence interval   =   0.46 to 0.93; P  =  .02) and lower odds of moderate and severe symptom reporting in the chemotherapy cohort (odds ratio   =   0.83, 95% confidence interval   =   0.71 to 0.97; P  =  .02). Among the most prevalent symptoms, 24-hour recall was associated with a lower rate of reporting postoperative constipation but no differences in reporting rates for other symptoms. Conclusion A shorter recall period was associated with a reduction in the proportion of patients reporting moderate-severe symptoms. The optimal recall period may vary depending on whether electronic patient-reported outcomes are collected for active symptom management, as a clinical trial endpoint, or another purpose. ClinicalTrials.gov ID NCT03850912. [ABSTRACT FROM AUTHOR]

Purpose: Clinical benefits result from electronic patient-reported outcome (ePRO) systems that enable remote symptom monitoring. Although clinically useful, real-time alert notifications for severe or worsening symptoms can overburden nurses. Thus, we aimed to algorithmically identify likely non-urgent alerts that could be suppressed. Methods: We evaluated alerts from the PRO-TECT trial (Alliance AFT-39) in which oncology practices implemented remote symptom monitoring. Patients completed weekly at-home ePRO symptom surveys, and nurses received real-time alert notifications for severe or worsening symptoms. During parts of the trial, patients and nurses each indicated whether alerts were urgent or could wait until the next visit. We developed an algorithm for suppressing alerts based on patient assessment of urgency and model-based predictions of nurse assessment of urgency. Results: 593 patients participated (median age = 64 years, 61% female, 80% white, 10% reported never using computers/tablets/smartphones). Patients completed 91% of expected weekly surveys. 34% of surveys generated an alert, and 59% of alerts prompted immediate nurse actions. Patients considered 10% of alerts urgent. Of the remaining cases, nurses considered alerts urgent more often when patients reported any worsening symptom compared to the prior week (33% of alerts with versus 26% without any worsening symptom, p = 0.009). The algorithm identified 38% of alerts as likely non-urgent that could be suppressed with acceptable discrimination (sensitivity = 80%, 95% CI [76%, 84%]; specificity = 52%, 95% CI [49%, 55%]). Conclusion: An algorithm can identify remote symptom monitoring alerts likely to be considered non-urgent by nurses, and may assist in fostering nurse acceptance and implementation feasibility of ePRO systems. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions To analyze the accuracy of the defining characteristics of four respiratory nursing diagnoses (ND) in patients with COVID‐19 and on oxygen therapy.This is a cross‐sectional study conducted in four Brazilian public hospitals in two regions of the country. A total of 474 patients with COVID‐19 receiving oxygen therapy were assessed. Latent‐adjusted class analysis with random effects was used to establish the sensitivity (Se) and specificity (Sp) of the defining characteristics evaluated for each ND.Among the ND that constituted the study (impaired spontaneous ventilatory, impaired gas exchange, ineffective airway clearance, and dysfunctional ventilatory weaning response), the following defining characteristics had the highest simultaneous Se and Sp (>0.8): decrease in tidal volume, confusion, irritability, dyspnea, decreased breath sounds, orthopnea, impaired ability to cooperate and respond to coaching, and decrease in the level of consciousness.Recognizing the clinical signs that predict respiratory ND in patients affected by COVID‐19 can contribute to the nurse's accurate diagnostic inference and designate the appropriate nursing interventions to achieve the desired results and avoid complications. [ABSTRACT FROM AUTHOR]

Dysphoricmilk ejection reflex (D-MER) is characterized by a sudden onset of profoundly negative emotions that are temporally linked to milk letdown when breastfeeding or pumping breast milk. These affective experiences have no psychological precipitants and only last for minutes. D-MER is relatively underappreciated in the physician-oriented medical literature, although there are important clinical and public health consequences when a nursing parent experiences unwanted, negative emotions paired with breastfeeding. D-MER can undermine the parent's confidence and may affect bonding with their infant; it may also contribute to weaning earlier than planned. It is especially important for psychiatrists and other health care professionals who may be called upon to evaluate postpartum patients or nursing parents to be knowledgeable about D-MER. This perspective article aims to provide information about D-MER to the psychiatric and broader medical communities, and to underscore the need for additional research on this topic. Drawing on a literature search, the article first traces historical recognition of D-MER as a clinical entity, then summarizes the clinical characteristics of D-MER and recommends an assessment and management approach that emphasizes psychoeducation. The article also discusses factors that have contributed to the underappreciation of this condition, outlines gaps in our understanding, and suggests next steps for epidemiological and clinical research. D-MER is likely a neuroendocrine condition with psychiatric manifestations. Given that it is episodic but with predictable timing, this condition presents a unique opportunity for scientific investigation. [ABSTRACT FROM AUTHOR]

Objective: To describe the practices carried out by nurses in managing patients with diabetic ketoacidosis. Materials and Method: Integrative review, bringing up the following problem: What practices are carried out by nurses in managing patients with diabetic ketoacidosis. Results: The main nursing care identified in the studies for the management of diabetic ketoacidosis were: continuous monitoring of vital signs is crucial to detect any changes in the patient's clinical status. Changes in heart rate or blood pressure may indicate severe dehydration or shock. The patient's mental status should also be closely monitored, as changes may indicate increased metabolic acidosis or cerebral edema. Adequate fluid administration is critical in the treatment of diabetic ketoacidosis. Conclusions: In conclusion, nursing care is essential for the effective management of diabetic ketoacidosis. Nurses play a crucial role in continuously monitoring the patient's vital signs, administering adequate fluids and insulin, closely controlling fluid and electrolyte balance, and educating the patient about the appropriate management of diabetes. [ABSTRACT FROM AUTHOR]

The various specializations available to nurses represent an investment geared toward providing more qualified patient care. However, little is known about the attitudes of specialized nurses toward multidisciplinarity. The purpose of this study was to investigate nurses' perceptions of multidisciplinarity in the field of specialist nurses, as well as to determine how specialization is associated with improved patient care and nurses' age in a low-resource setting in Southeast Brazil. This cross-sectional study included 70 nurses aged ≥18 years with at least one nursing specialty working at the Regional Health Superintendence of Manhuaçu, Minas Gerais, Brazil. The study participants responded to questions about specialization and its importance in the field of health care. The majority of nurse specialists (84.3%) were between the ages of 20 and 40, and 31.4 percent worked in family health. Eighty percent of nurse specialists agreed that nursing specialization was important. More than 75% agreed that specialization promotes higher quality care and that multidisciplinarity is critical for improving patient care. Seventy percent of participants distrusted online health information. There is a relationship between the importance of having a specialty and better patient care (τb=0.293, p=0.002), and between being a specialist nurse and age (τb=-0.272, p=0.004). Nurses have embraced the concept of multidisciplinarity as a way to improve healthcare. However, they were concerned about the qualifications for nursing specialties. [ABSTRACT FROM AUTHOR]

BACKGROUND: Psychological factors are a risk factor for the incidence of breast cancer and have a significant impact on patient prognosis. OBJECTIVE: The present study aims to investigate the effects of personalised graded psychological intervention on negative emotion and quality of life in patients with breast cancer. METHODS: A total of 200 patients with breast cancer were randomly divided into two groups: an experimental group (n = 100) and control group (n = 100). Both groups received routine nursing care. The experimental group received personalised graded psychological intervention care, and the control group received routine nursing measures. After 2 months of standard treatment, the patients' quality of life and negative emotions were evaluated using the self-rating depression scale (SDS), self-rating anxiety scale (SAS), social support rating scale (SSRS) and quality of life measurement scale (FACT-B) scoring criteria. RESULTS: There were no significant differences in the general data between the two groups (p > 0.05). Furthermore, there were no significant differences in the SDS, SAS, SSRS and FACT-B scores between the two groups before personalised graded psychological intervention (p > 0.05). After the intervention, the experimental group exhibited an improved nursing effect compared with the control group. The SDS and SAS scores were lower in the experimental group than in the control group (p < 0.05); after the intervention, the SDS and SAS scores were significantly lower in the experimental group than in the control group (p < 0.05). The SSRS and FACT-B scores were higher in the experimental group than in the control group (p < 0.05), and the experimental group's post-intervention SSRS and FACT-B scores were significantly higher than before the intervention (p < 0.05). CONCLUSIONS: The use of personalised graded psychological intervention for the nursing of patients with breast cancer in clinical practice can significantly reduce patients' negative emotions as well as improve positive emotions and quality of life; thus, this method can be popularised in the nursing process. [ABSTRACT FROM AUTHOR]

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Background: The most common route of opioid delivery is nurse-administered pills. However, there are numerous challenges such as nursing burden, opioid diversion, medication delay, and patient dissatisfaction. In this study, we conducted two surveys, first to assess patients' and nurses' opinions on the current administration of opioids in pill form, followed by their attitudes towards an innovative concept of oral medication delivery based on a medical device currently undergoing research and development within the University, patient-controlled dispenser and deactivator (PCDD) that allows patients to self-administer liquid oral opioids on demand based on physician prescription. Methods: Questionnaires were developed, verified and deployed to assess nurse and post-surgical patient opinions on the current administration of opioids in pill form, as well as the proposed new concept of patient -controlled administration of oral liquid medication via an illustration of PCDD, from September 2022 through July 2023 at a major academic tertiary care center. Quantitative and qualitative data were collected from postoperative patients and nurses from surgical specialties including General Surgery, Surgical Oncology, Trauma Surgery, Orthopedics, and Neurosurgery. Results: Forty-three patients and 53 nurses were interviewed. Seventy percent of patients frequently called nurses for pain medication post-surgery 1– 4 times daily, and 32% of patients were told each day by nurses that they could not receive medication because they were not due yet. Medication delay caused 24% of patients to worry about nursing availability for medication delivery. Likewise, nurses reported that half of patients receive delayed medication (22 minutes median delay time) and half of nursing time was spent administering pain medication. Nurses expressed moderate satisfaction with their current delivery of medication (median satisfaction score 6.5 out of 10). When being introduced to the concept of PCDD via a product illustration, 15% of patients said that they prefer liquid medication and 51% said they prefer PCDD or were interested in trying it. Conclusion: Nurse-administered pills are a common but suboptimal method for postoperative pain management. Based on patient and nurse feedback, patient controlled self-administered liquid oral opioid delivery is conceptually innovative, practically viable and potentially a preferred alternative for timely and less nurse-exhaustive pain management. [ABSTRACT FROM AUTHOR]

Purpose Design and Methods Findings Conclusions Clinical Relevance This paper explores how frontline nurses experienced the onset of the coronavirus disease (COVID‐19) pandemic to provide appropriate care during a global health crisis.A qualitative descriptive phenomenological study. The sample consisted of 13 frontline nurses from Turkey, working in intensive care units, inpatient clinics and emergency unit. Data were collected online through face‐to‐face interviews based on a semi‐structured interview guide. Data were analysed using thematic analysis.Nurses experienced certain difficulties in the continuous use of protective personal equipment, communication both with patients and colleagues, administrative processes. Besides, they experienced exhaustion, reduced job satisfaction and certain physical complaints.Hospital administrators and health policy makers should effectively manage human and hospital resources effectively and solve nurses' problems in times of crisis, such as pandemics.Understanding the challenges faced by frontline nurses during the onset of the COVID‐19 pandemic may help healthcare practitioners and policy makers to implement targeted interventions, support mechanisms and resource allocation strategies that enhance the well‐being of frontline nurses and optimise patient care delivery during health crises. [ABSTRACT FROM AUTHOR]

Background Aim Study Design Results Conclusions Relevance to Clinical Practice Hospitals can improve how they learn from patient safety incidents. The Green Cross method, a proactive reporting and learning method, is one strategy to meet this challenge. In it, nurses play a key role. However, describing its impact on learning from the users' perspective is important.This study aimed to describe nurses' experiences of learning from patient safety incidents before and 3 months after implementing the Green Cross method in a postanaesthesia care unit.A qualitative study with an inductive descriptive design with focus group interviews was conducted before and 3 months after implementing the Green Cross method to assess its impact. The data were analysed using qualitative content analysis. The study was conducted in a postanaesthesia care unit in a Norwegian hospital trust.Before implementing the Green Cross method, participants indicated limited openness and learning, including the subcategories ‘Lack of openness hampers learning’, ‘Adverse events were taken seriously’ and ‘Insufficient visible improvements’. After implementing the Green Cross method, participants indicated the emergence of a learning environment, including the subcategories ‘Transparency increases learning’, ‘Increased patient safety awareness’ and ‘Committed to quality improvements’.Implementing the Green Cross method in a postanaesthesia care unit positively impacted openness and nurses' patient safety awareness, which is crucial for learning and improving quality.The Green Cross method could be useful for organizational learning and facilitating learning from patient safety incidents through transparency, discussion and involvement of nursing staff. [ABSTRACT FROM AUTHOR]

Purpose Data sources Data synthesis Conclusions Implications for nursing practice To analyze the diagnostic concept of “ineffective coping” (00069) proposed by NANDA‐I, using Walker and Avant's framework.The theoretical framework of Walker and Avant was used for the concept analysis. A search was performed in the Virtual Health Library portal using the keywords “ineffective coping” and “enfrentamento ineficaz.”According to the literature, ineffective coping is defined as an adoption of inadequate psychosocial and behavioral strategies in response to a set of contextual stressors that negatively affect well‐being and lifestyle.The concept created for ineffective coping has the potential to address the psychosocial elements associated with life experiences in the face of coping mechanisms.This analysis may contribute to the improvement of nursing care for patients experiencing difficult situations in their lives, as well as the challenges of nursing interventions that promote positive adaptation. [ABSTRACT FROM AUTHOR]

AbstractAims: We aimed to identify the unique challenges and opportunities faced by international student nurses in Türkiye when practicing patient care. This understanding is essential for educators, healthcare institutions, and policy makers to create more inclusive and supportive environments that enhance learning and professional development. Addressing these challenges can lead to better integration of foreign student nurses into the healthcare system, ultimately improving patient care quality. This research is important for all stakeholders in healthcare - educators, administrators, policymakers, and patients - because a diverse and well-supported nursing workforce is essential for the delivery of culturally competent and high-quality care. Methods: This study employed interpretative phenomenology. Data were collected from 12 foreign nursing students from Iraq, Egypt, Syria, Saudi Arabia, Iran, and the Netherlands. Data were collected between 01 and 20 May 2023 in the Nursing Department of the Faculty of Health Sciences of a state university in the province of Şanlıurfa, located in the southeastern region of Türkiye. Data were analyzed using Colaizzi’s method. Results: We identified four themes: “Metaphors describing patient care practices,” “Factors affecting care practices,” “Needs for education and support,” and “Opportunities during patient care practices.” Positively influencing factors included better education and living standards and economic benefits, while negatively influencing factors were traumatic events before studying abroad, racial discrimination, language and cultural differences, negative emotions, peer victimization, and lack of use of standards. Interviewees reported a need for training and support and that patient care practices provided opportunities for greater awareness, responsibility, and professional integration. Discussion: Positive and negative experiences of foreign student nurses were evident in the delivery of patient care practice. Interventions are needed to alleviate negatively influencing factors, provide training and support for students, and improve opportunities for foreign nationals. Identification of these factors can help medical educators to develop culturally sensitive and inclusive approaches, as well as individual/organisational facilitators that enhance existing opportunities and remove barriers. [ABSTRACT FROM AUTHOR]

Introduction: Robots present an opportunity to enhance healthcare delivery. Rather than targeting complete automation and nurse replacement, collaborative robots, or "cobots", might be designed to allow nurses to focus on high-value caregiving. While many institutions are now investing in these platforms, there is little publicly available data on how cobots are being developed, implemented, and evaluated to determine if and how they support nursing practice in the real world. Methods: This systematic review investigates the current state of cobotic technologies designed to assist nurses in hospital settings, their intended applications, and impacts on nurses and patient care. A comprehensive database search identified 28 relevant peer-reviewed articles published since 2018 which involve real studies with robotic platforms in simulated or actual clinical contexts. Results: Few cobots were explicitly designed to reduce nursing workload through administrative or logistical assistance. Most included studies were designed as patient-centered rather than nurse-centered, but included assistance for tasks like medication delivery, vital monitoring, and social interaction. Most applications emerged from India, with limited evidence from the United States despite commercial availability of nurse-assistive cobots. Robots ranged from proof-of-concept to commercially deployed systems. Discussion: This review highlights the need for further published studies on cobotic development and evaluation. A larger body of evidence is needed to recognize current limitations and pragmatic opportunities to assist nurses and patients using state-of-the-art robotics. Human-centered design can assist in discovering the right opportunities for cobotic assistance. Committed research-practice partnerships and human-centered design are needed to guide the technical development of nurse-centered cobotic solutions. [ABSTRACT FROM AUTHOR]

Nurses are at high risk of burnout and subsequent mental health concerns due to problems with overstaffing, immense workload volume, and personal health risks associated with the job. Effective mental health treatments are available but potential barriers to receiving care may prevent nurses from benefiting. The Emotional Health and Well-Being Clinic (EHWC) at Houston Methodist is an outpatient mental health clinic offering therapy and medication management services for employees and employee dependents of our institution. The EHWC is uniquely positioned to observe how nurses utilize mental health services and to address barriers to effective care for this vital group of healthcare professionals. This paper provides descriptive data on the utilization of mental health services by nurses in the EHWC and a discussion of possible challenges faced by this group when seeking care. Based on these data, we propose potential solutions to ensure that nurses can achieve maximum benefit from outpatient mental health services. [ABSTRACT FROM AUTHOR]

Cerebrovascular diseases (including strokes) are currently the second leading cause of death in the world [1,2]. In Poland, statistical data are quite diverse, depending on their source. Stroke patients are often at risk of chronic disability. A significant number of them are doomed to lose their independence and self-care for the rest of their lives. The aim of the study is to present selected nursing problems and ways to solve them in a patient after ischemic stroke who requires round-the-clock care in the field of nursing and care services as part of inpatient long-term care. The subject of the study is the process of nursing a patient diagnosed with ischemic stroke who requires round-the-clock care in the field of nursing and care services as part of long-term care. The study uses a research method - a case study, supported by individual observation, measurements, interview and analysis of medical records. Two scales were used to assess the patient's condition: Barthel and Norton. Conclusions: 1. The individual care plan takes into account the most important problems arising from the specificity of the disease entity, needs and individual situation of the patient. 2. The patient's care problems after a stroke are presented and proposed an effective solution to ensure the best possible care. 3. Nursing and care difficulties have been properly recognized, which has enabled appropriate nursing interventions. 4. Due to systematic prophylactic measures, the patient did not suffer from complications. 5. A detailed interview and careful observation made it possible to plan and implementation of interventions (not only nursing) to provide comprehensive care. 6. The urgent procedure of admitting the patient to the care and treatment facility contributed to the improvement of the quality and availability of health care services, which translated into an improvement in the patient's general condition. [ABSTRACT FROM AUTHOR]

Background: Self-management support improves asthma outcomes and is widely recommended in guidelines, yet it is poorly implemented in routine practice. There may be additional challenges in the context of ethnic minority groups, where making sense of culture may be necessary. This study aimed to explore the perspectives of healthcare professionals on supporting UK Bangladeshi and Pakistani patients to self-manage their asthma. Methods: One-to-one semi-structured interviews with professionals (primary and secondary care; medical and nursing) who routinely provide asthma care to Bangladeshi or Pakistani patients. Topics addressed included perceptions of professionals in supporting patients with asthma self-management and ideas for improving culturally competent care. Data were analysed thematically. Results: Nine professionals, from a range of ethnic backgrounds, with considerable experience of treating patients from these communities were interviewed. Despite organisational restrictions (language and time/resources) and expressed gaps in cultural knowledge and training, all interviewees reported attempting to tailor support according to culture. They used their perception of the patient's culture (e.g., big families and family involvement), integrated with their perception of patients' ability to self-manage (e.g., degree of responsibility taken for asthma), to formulate theories about how to culturally adapt their approach to supported self-management, e.g., supporting barriers in understanding asthma. There was consensus that gaps in cultural knowledge of professionals needed to be addressed through training or information. Interventions recommended for patients included basic education, group meetings, and culturally relevant action plans. Conclusion: In the absence of formal training and constrained by organisational limitations, self-management support was adapted based on personal and professional perception of culture. These ideas were based on experience and formulated a chain of reasoning. Professionals recognised the limitations of this approach and potential to overgeneralise their perceptions of culture and adaptations of supported self-management. Interventions were desired and need to address professional training in cultural competence and the provision of culturally relevant materials. [ABSTRACT FROM AUTHOR]

This review aims to analyze the current literature to identify articles related to the role of nurses and, in general, the nursing management of patients suffering from medication overuse headache (MOH), a globally spread disease. We specifically argue for non-pharmacological approaches to pain management, such as multidisciplinary team approaches, holistic treatment, cognitive behavioral therapy and exercise. For this review, we investigated international scientific databases, including PubMed, CINAHL, Scopus and Embase, in the period between 2000 and 2024. We observed a wealth of scientific articles related to MOH, but a poverty of articles relating to the nursing management of headache. The research included the presence of academic-level training for nurses, whereas there are few institutions that train competent professionals in both pharmacological and non-pharmacological management of MOH patients. Nursing assessment and assistance strategies are indicated to plan tailored treatment paths related to the specific needs of these patients. [ABSTRACT FROM AUTHOR]

Heart failure (HF) admissions are burdensome, and the mainstay of prevention is the timely detection of impending fluid retention, creating a window for medical treatment intensification. This study evaluated the accuracy and performance of a Triage-HF-guided carepath in real-world ambulatory HF patients in daily clinical practice. In this prospective, observational study, 92 adult HF patients (71 males (78%), with a median age of 69 [IQR 59–75] years) with the Triage-HF algorithm activated in their cardiac implantable electronic devices (CIEDs), were monitored. Following high-risk alerts, an HF nurse contacted patients to identify signs and symptoms of fluid retention. The sensitivity and specificity were 83% and 97%, respectively. The positive predictive value was 89%, and negative predictive value was 94%. The unexplained alert rate was 0.05 alerts/patient year, and the false negative rate was 0.11 alerts/patient year. Ambulatory diuretics were initiated or escalated in 77% of high-risk alert episodes. In 23% (n = 6), admission was ultimately required. The median alert handling time was 2 days. Fifty-eight percent (n = 18) of high-risk alerts were classified as true positives in the first week, followed by 29% in the second–third weeks (n = 9), and 13% (n = 4) in the fourth–sixth weeks. Common sensory triggers included an elevated night ventricular rate (84%), OptiVol (71%), and reduced patient activity (71%). The CIED-based Triage-HF algorithm-driven carepath enables the timely detection of impending fluid retention in a contemporary ambulatory setting, providing an opportunity for clinical action. [ABSTRACT FROM AUTHOR]

To assess the prevalence of mental health symptoms in nursing professionals during the COVID‐19 pandemic on the American continent. A systematic review and meta‐analysis of observational studies that estimated the prevalence of mental health symptoms in nursing professionals during the COVID‐19 pandemic was performed through bibliographic database searches. A three‐level meta‐analysis model was used with the inverse variance method, tau was estimated via restricted maximum likelihood and logistic transformation, and heterogeneity was presented as tau2 and I2. Of the 7467 studies obtained, 62 were included in the meta‐analysis, which involved 52 270 nursing professionals. The overall prevalence for at least one mental health symptom was 56.3% (50.4%, 62.1%; I2 = 98.6%, p < 0.001). Eight mental health symptoms were found; among them, the most prevalent were burnout (52.1%, 37.1%, 88.8%; I2 = 98.5%, p < 0.001) and fear (52.1%, 30.1%, 73.3%; I2 = 98.1%, p < 0.001). The prevalence of mental health symptoms in nursing professionals during the COVID‐19 pandemic on the American continent was high, and strategies should be developed and implemented by managers and government agencies to promote the well‐being, physical and mental health of nursing professionals. Studies like this one are necessary to highlight the need for efforts in the implementation of promotion and prevention actions to be developed by health organisations, managers and leaders with a view to improving the quality of life of nursing workers. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to examine the perception, willingness to engage, and demand of community residents regarding the 'internet + nursing service' in a designated pilot area, aiming to offer insights for the widespread adoption of the 'internet + nursing service' throughout China. Methods: A survey pertaining to the 'internet + nursing service' was conducted from March to April 2022. The study specifically targeted residents within two sub-districts of a city in the Jiangsu province. The sampling technique employed in this study was stratified random sampling. Results: Out of a total of 400 community residents selected from two sub-districts in this region, 378 provided valid responses, resulting in an effective rate of 94.5%. Within the study cohort, 80 participants (21.16%) demonstrated familiarity with the concept of 'internet + nursing service.' Additionally, 231 participants (61.11%) conveyed their willingness to adopt such services. Regarding service preferences, the primary demands were for health guidance, vital sign monitoring, and basic care. Challenges in implementing the service were attributed to concerns related to medical risks, personal safety for both nurses and patients, and potential breaches of privacy. Conclusions: Residents in the pilot area exhibited a moderate awareness of the 'internet + nursing service,' with a relatively high willingness to embrace the program. There is a need for further refinement of pertinent laws, widespread dissemination of policies, and enhancements in the quality of nursing services. These measures aim to ensure that a greater number of community residents can avail themselves of improved home-based nursing services. [ABSTRACT FROM AUTHOR]

Background: To ensure best possible patient outcomes, patient safety is a major component of healthcare delivery system that needs to be prioritized. Safety practices among nurses are essential to maintain patient safety, especially the practices of medication administration, handover, patient falls and unplanned extubations prevention. Purpose: To investigate the mediating effect of patient safety culture between the relationship of transformational leadership and safety practices among nurses. Methods: The data in this cross-sectional study were gathered from a survey targeted clinical nurses using a random sampling technique. The study was conducted in a medical city in Saudi Arabia, and two hundred nurses were surveyed. The Multifactor Leadership, Hospital Survey on Patient Safety Culture, and Nursing Safety Practice questionnaires were used in the study. Results: The results revealed significant positive associations between transformational leadership, patient safety culture, and nursing safety practices. Moreover, patient safety culture mediates the association between transformational leadership and safety practices among nurses. Conclusion: Enhancing transformational leadership capabilities among nurse managers should be considered in order to improve nursing safety practices. Additionally, patient safety culture should be measured and improved periodically to ensure better nursing safety practices. [ABSTRACT FROM AUTHOR]

A patient fall is one of the adverse events in an inpatient unit of a hospital that can lead to disability and/or mortality. The medical literature suggests that increased visibility of patients by unit nurses is essential to improve patient monitoring and, in turn, reduce falls. However, such research has been descriptive in nature and does not provide an understanding of the characteristics of an optimal inpatient unit layout from a visibility-standpoint. To fill this gap, we adopt an interdisciplinary approach that combines the human field of view with facility layout design approaches. Specifically, we propose a bi-objective optimization model that jointly determines the optimal (i) location of a nurse in a nursing station and (ii) orientation of a patient's bed in a room for a given layout. The two objectives are maximizing the total visibility of all patients across patient rooms and minimizing inequity in visibility among those patients. We consider three different layout types, L-shaped, I-shaped, and Radial; these shapes exhibit the section of an inpatient unit that a nurse oversees. To estimate visibility, we employ the ray casting algorithm to quantify the visible target in a room when viewed by the nurse from the nursing station. The algorithm considers nurses' horizontal visual field and their depth of vision. Owing to the difficulty in solving the bi-objective model, we also propose a Multi-Objective Particle Swarm Optimization (MOPSO) heuristic to find (near) optimal solutions. Our findings suggest that the Radial layout appears to outperform the other two layouts in terms of the visibility-based objectives. We found that with a Radial layout, there can be an improvement of up to 50% in equity measure compared to an I-shaped layout. Similar improvements were observed when compared to the L-shaped layout as well. Further, the position of the patient's bed plays a role in maximizing the visibility of the patient's room. Insights from our work will enable understanding and quantifying the relationship between a physical layout and the corresponding provider-to-patient visibility to reduce adverse events. [ABSTRACT FROM AUTHOR]

Faced by a severe shortage of nurses and increasing demand for care, hospitals need to optimally determine their staffing levels. Ideally, nurses should be staffed to those shifts where they generate the highest positive value for the quality of healthcare. This paper develops an approach that identifies the incremental benefit of staffing an additional nurse depending on the patient mix. Based on the reasoning that timely fulfillment of care demand is essential for the healthcare process and its quality in the critical care setting, we propose to measure the incremental benefit of staffing an additional nurse through reductions in time until care arrives (TUCA). We determine TUCA by relying on queuing theory and parametrize the model with real data collected through an observational study. The study indicates that using the TUCA concept and applying queuing theory at the care event level has the potential to improve quality of care for a given nurse capacity by efficiently trading situations of high versus low workload. [ABSTRACT FROM AUTHOR]

Objective: To explore the application effect of the direct reporting system of adverse nursing events and special continuous nursing quality improvement measures in the management of these adverse events. Methods: The implementation time of continuous nursing improvement based on the direct reporting system was the demarcation point. We retrospectively collected and analyzed nursing adverse event reports and hospitalization data from Xiangtan Central Hospital before implementation (2015–2018) and after implementation (2019–2022). The active reporting rate of adverse events, the composition of these events and the processing time were compared between the two groups. Results: The rate of active reporting of adverse events before the implementation was lower than that after the implementation (6.7% vs. 8.1%, X2 = 25.561, P < 0.001). After the implementation of the direct reporting system for nursing events and the continuous improvement of nursing quality, the reporting proportion of first-level and second-level events decreased significantly. Moreover, the reporting proportion of third-level events increased significantly. The proportion of falls and medication errors decreased, and the proportion of unplanned extubation, infusion xerostomia and improper operation increased. The processing time of the reported nursing adverse events was significantly reduced (31.87 ± 7.83 vs. 56.87 ± 8.21, t = 18.73, P < 0.001). Conclusion: The direct reporting system of adverse nursing events and the continuous improvement measures for nursing quality can effectively improve the active reporting rate of adverse events, change their composition and reduce their processing time, as well as help create a safe psychological environment for both patients and nursing staff. [ABSTRACT FROM AUTHOR]