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Aim: This study was carried out to investigate the perception of the main competencies of disaster management in Iranian emergency department nurses in 2023 in hospitals affiliated with Kermanshah University of Medical Sciences. The present study was conducted to explore the perceived core disaster competencies in nurses of hospitals affiliated with Kermanshah University of Medical Sciences in 2023. Background: Due to the rise in natural disasters, their escalating severity and associated regulatory response necessitate a closer look at the preparedness and core competencies of nursing personnel. The main competencies of nurses are necessary to deal with disasters in unexpected events, and they are expected to use their professional expertise to provide the required nursing services to reduce the risks caused by disasters. Methodology: This descriptive‐analytical study was conducted cross‐sectionally between May and September 2023. In the study, a sample of 384 nurses working in the departments of four hospitals affiliated with Kermanshah University of Medical Sciences was selected through a random stratification. The data collection instrument was a 45‐item scale of nursesʼ perceived core competencies (NPDCC) in handling disasters. The data were analyzed using the Mann–Whitney U‐test, Kruskal–Wallis test, and independent samples t‐test. The significance level was set at 5%. Results: The mean total score of perceived core disaster competencies was 139.11 ± 37.65. The technical skills subscale got the highest score (51.81 ± 11.28) and critical thinking skills received the lowest (9.74 ± 3.92). Also, "technical skills" had the highest average and "critical thinking skills" had the lowest average in all three age groups. The results found a significant difference between the scores of nurses in perceived core disaster competencies in age groups, work environments, education degrees, marital statuses, and experiences of attending disaster workshops (p ≤ 0.05). Conclusions: The results showed that nurses had different levels of core disaster competencies in the department. There are gaps in the core disaster nursing competencies that need to be filled. Nursing managers should consistently evaluate the core nursing competencies to achieve efficacious disaster preparedness. To this aim, it is recommended that authorities implement training courses and programs to enhance the preparedness of nurses in responding to disasters. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Methods Data Sources Results Conclusions Impact Reporting Method Patient or Public Contribution What Does This Paper Contribute to the Wider Global Clinical Community To identify the evidence of gender disparities in frailty and explore the factors contributing to male–female differences.A longitudinal study.A total of 24,429 older adults (60+) were enrolled. Frailty was assessed by frailty index and frailty risk based on Rockwood's cumulative deficit frailty index. OLS and logistic regression models were conducted, with Oaxaca–Blinder and Fairlie decomposition methods to further analyse the factors contributing to gender disparities in frailty.The paper used four waves of the China Health and Retirement Longitudinal Study from 2011 to 2018, a nationwide survey organised by the National Development Institute of Peking University.Women had higher frailty status than men, with more pronounced increases. Among the factors, education has the most significant association with frailty gender disparities. The contribution of individual characteristics, particularly education, to gender disparities in frailty appeared to diminish over time, while the contribution of family and regional factors remained relatively stable, and the contribution of institutions was deemed inadequate.The frailty in Chinese older adults is generally on the rise with continuously expanded gender disparities. It is crucial to consider the contributing factors to frailty in older adults for effective prevention and intervention strategies. Additional gender‐specific geriatric care policies are needed in order to address gender inequality in health.The findings of this study highlight the prevalence of increasing gender disparities in frailty and identify that the level of education, per capita annual household income as well as marital status are the most significant factors contributing to the gender gap. Those findings provide policy implications for healthcare nursing service from a gender‐specific perspective in order to achieve health equity.This study has adhered to the STROBE guideline.No Patient or Public Contribution. This study provided implications on gender‐specific geriatric care nursing services. The study highlighted the importance of focusing on frailty and its gender disparities in geriatric clinical nursing. [ABSTRACT FROM AUTHOR]

Introduction Objective Methods Results Conclusions Implications for nursing practice The postpartum period is considered a phase of many physiological and hormonal changes that affect the individual. Fatigue is something present and can influence the postpartum woman in a negative way. In this way, the nurse has an essential role, and the nursing process can be used to establish an efficient care plan.To present the main nursing interventions and activities of the nursing diagnosis (ND) fatigue (00093) in individuals/people in the immediate postpartum period obtained through an integrative literature review and correlate with the proposed ND puerperal fatigue/excessive burden of fatigue in the postpartum period.Integrative literature review, carried out in the databases Cochrane, Scopus and Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science (WoS), Virtual Health Library (VHL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL), following rigorous methodological standards.Six articles were included that identified the main nursing interventions related to the proposed ND puerperal fatigue.The integrative review highlighted the main nursing interventions and activities, and this study will be the basis for the next stages of the validation process for the ND puerperal fatigue/excessive fatigue in the postpartum period.This work can help nurses in clinical practice establish an efficient care plan through the most accurate nursing interventions and thus improve the quality of nursing services. [ABSTRACT FROM AUTHOR]

This pilot randomized controlled trial (RCT) aimed to explore whether depression and anxiety could be reduced by psychiatric home nursing supporters offering brief cognitive behavioral therapy for psychosis (CBTp) at home, using a workbook for patients with schizophrenia. Eighteen patients with schizophrenia treated in a psychiatric home nursing service were randomly assigned to two groups: one group received CBTp in addition to usual care (TAU + CBTp group; n = 9) and the other received only usual care (TAU group; n = 9); two patients were excluded due to hospitalization or withdrawal of consent. Eight weekly CBTp sessions were conducted; anxiety/depression, quality of life, self-esteem, and overall functioning were assessed at baseline, week 9, and week 13. There was no significant difference in the primary and secondary evaluations. The effect size was 0.84 for primary evaluation indicating a large effect. This study showed that nurses and occupational therapists can provide CBTp in psychiatric home nursing for patients with schizophrenia to potentially alleviate anxiety and depression compared to standard psychiatric home nursing service alone. Therefore, larger RCTs with larger sample sizes are recommended. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Implications Impact Patient or Public Contribution To describe a knowledge translation capacity‐building initiative and illustrate the roles of nurses in practice change using an exemplar case study.The report uses observational methods and reflection.The Knowledge Translation Challenge program involves a multi‐component intervention across several sites. The advisory committee invited eligible teams to attend capacity‐building workshops. Implementation plans were developed, and successful teams receive funding for a 2 year period. Evaluation involved collecting data on program uptake and impact on practice change. Data has been collected from five cohorts. The exemplar case study employed an action‐research framework.Four nurse‐led teams have demonstrated successful implementation of their practice change. The case study on implementing a clinical toolkit for clozapine management further illustrates a thoughtful planning process, and implementation journey and learnings by a team of nurses.The Knowledge Translation Challenge program empowers nurses to use implementation science practices to enhance the quality and effectiveness of healthcare services. Success of this initiative serves as a model for addressing the persistent gap between knowledge and practice in clinical settings and the value of activating nurses to help close this gap.As the most trusted and numerous profession, it is vital that nurses contribute to efforts to translate research evidence into clinical practice. The Knowledge Translation Challenge program supports nurses to lead practice change.The Knowledge Translation Challenge program successfully equips nurses and other health care providers with the knowledge, skills and resources to implement practice improvements which enhance the quality and effectiveness of healthcare services and nursing practice.The Knowledge Translation Challenge advisory committee has three patient‐public partners that support teams to develop a patient‐oriented approach for their projects by providing feedback on the implementation plans. Each team was also supported to include patient‐public partners on their project. [ABSTRACT FROM AUTHOR]

This work addresses a home health care scheduling problem faced by home care agencies. In home health care scheduling, there is a desire to retain consistency with respect to the home health aide servicing each patient; this consistency is referred to as continuity of care. To address this preference for continuity of care, we propose a rolling horizon approach to the scheduling problem and introduce the consistent home health care scheduling problem (Con-HHCSP). The goal is to be able to quantify and control the deviation of the new schedule suggested each day from the existing schedule in place, so that some of the existing assignments may be retained in the new schedule that is produced. We present two different methods to solve Con-HHCSP on a daily basis: an integer programming-based method with approximations and a variant of a petal heuristic. We discuss the performance and computational efficiency of these methods. [ABSTRACT FROM AUTHOR]

This research letter examines the provision of physiotherapy services for nursing home residents with dementia in the Netherlands. The study surveyed physiotherapists and found variation in the availability of services and the use of assessment tools. Multidisciplinary collaboration was common, and physiotherapists also provided advice to nursing home staff and families. The study suggests the need for standardized guidelines and further research to identify effective practices. [Extracted from the article]

Background: The demographic changes affecting Switzerland and other European countries, including population ageing, will continue to challenge policymakers in building accessible, affordable, comprehensive and high-quality long-term care (LTC) systems. The purpose of this paper is to investigate how Switzerland's LTC system compares to other European countries, in order to inform how to respond to the increasing need for LTC. We carried out a descriptive study using secondary data from key national and international organizations. Methods: By comparing the financing, workforce, service delivery and need for LTC in Switzerland, Germany, Italy, Norway and the United Kingdom, we described similarities and differences in these five European countries between 2005-2019. Thirty-three indicators within five domains were analysed: (1) Population statistics and health expenditure, (2) Need for LTC, (3) LTC financing, (4) LTC service delivery, and (5) LTC workforce. Results: Switzerland has the highest life expectancy in comparison to the other four high-income countries. However, similarly to other countries, the years lived with disability are increasing in Switzerland. Switzerland's public expenditure on LTC as a share of GDP is lower than that of Norway and Germany, yet out-of-pocket expenditure on LTC is highest in Switzerland. Switzerland has the highest proportion of persons receiving formal LTC both in institutions and at home. Switzerland has had the most pronounced increase in the proportion of over 65-year-olds receiving LTC at home. Even though more than fourfold more persons receive care at home, Switzerland still has more workforce in LTC institutions than in home-care. In comparison to Germany and the UK, Switzerland has a lower number of informal carers as a proportion of 50-year-olds and over, as well as fewer nationally available services for informal carers compared to Germany, Italy, Norway and the UK. Conclusions: Our comparative study corroborates the importance of improving the affordability of LTC, continuing to support the movement towards home care services, improving the support given to both the professional workforce and informal carers, and improving the amount and quality of LTC data. It also provides a valuable contrast to other European countries to support evidence-informed policymaking. [ABSTRACT FROM AUTHOR]

Background: There are many studies of medical costs in late life in general, but nursing home residents' needs and the costs of external medical services and interventions outside of nursing home services are less well described. Methods: We examined the direct medical costs of nursing home residents in their last year of life, as well as limited to the period of stay in the nursing home, adjusted for age, sex, Hospital Frailty Risk Score (HFRS), and diagnosis of dementia or advanced cancer. This was an observational retrospective study of registry data from all diseased nursing home residents during the years 2015–2021 using healthcare consumption data from the Stockholm Regional Council, Sweden. T tests, Wilcoxon rank sum tests and chi-square tests were used for comparisons of groups, and generalized linear models (GLMs) were constructed for univariable and multivariable linear regressions of health cost expenditures to calculate risk ratios (RRs) with 95% confidence intervals (95% CIs). Results: According to the adjusted (multivariable) models for the 38,805 studied nursing home decedents, when studying the actual period of stay in nursing homes, we found significantly greater medical costs associated with male sex (RR 1.29 (1.25–1.33), p < 0.0001) and younger age (65–79 years vs. ≥90 years: RR 1.92 (1.85–2.01), p < 0.0001). Costs were also greater for those at risk of frailty according to the Hospital Frailty Risk Score (HFRS) (intermediate risk: RR 3.63 (3.52–3.75), p < 0.0001; high risk: RR 7.84 (7.53–8.16), p < 0.0001); or with advanced cancer (RR 2.41 (2.26–2.57), p < 0.0001), while dementia was associated with lower medical costs (RR 0.54 (0.52–0.55), p < 0.0001). The figures were similar when calculating the costs for the entire last year of life (regardless of whether they were nursing home residents throughout the year). Conclusions: Despite any obvious explanatory factors, male and younger residents had higher medical costs at the end of life than women. Having a risk of frailty or a diagnosis of advanced cancer was strongly associated with higher costs, whereas a dementia diagnosis was associated with lower external, medical costs. These findings could lead us to consider reimbursement models that could be differentiated based on the observed differences. [ABSTRACT FROM AUTHOR]

BACKGROUND: Electronic coloscopy is an invasive procedure and achieving an ideal result can be challenging, leading to low intestinal cleanliness scores and a poor intestinal polyp positive rate. OBJECTIVE: (1) To demonstrate the impact of intensified nursing intervention on electronic colonoscopy. (2) To improve patients' satisfaction with medical services related to intestinal cleanliness during preparation, the accuracy of the intestinal polyp-positive rate, and nursing. METHODS: Our study included 120 patients who underwent electronic coloscopy. These patients were randomly assigned to either the observation group or the control group, with 60 cases in each group. Patients in the control group received conventional nursing intervention, which included face-to-face oral and written instructions. In addition to the conventional intervention, patients in the observation group received intensified guidance interventions, which included instructions via phone, as well as WeChat messages and pictures. RESULTS: The patients in the observation group who received intensified guidance interventions demonstrated better intestinal cleanliness during preparation compared to the control group (P < 0.05). Besides, the accuracy of the intestinal polyp positive rate was higher in the observation group than in the control group (P < 0.05). Finally, regarding patient satisfaction with the nursing service provided by the endoscopy center, the observation group had a higher level of satisfaction than the control group (P < 0.05). CONCLUSION: The intensified guidance interventions provided to patients undergoing electronic colonoscopy resulted in a significant improvement in intestinal cleanliness during preparation, as well as an increase in the accuracy of the intestinal polyp-positive rate and patient satisfaction with our nursing service. Therefore, we believe that these interventions are highly beneficial and should be promoted and applied in clinical settings. [ABSTRACT FROM AUTHOR]

The article discusses the Centers for Medicare & Medicaid Services' (CMS) minimum staffing rule for long-term care facilities. The rule requires facilities to meet phased-in staffing requirements, including a total of 3.48 hours per resident day (HPRD) of nursing care, with a minimum of 0.55 hours per day consisting of registered nurse (RN) care and 2.45 hours per day consisting of nurse aide (NA) care. Facilities must also have an RN onsite 24/7. The rule will be implemented gradually over several years, and facilities can apply for exemptions under certain circumstances. The article acknowledges controversies and legal battles surrounding the rule but emphasizes the importance of proactively working towards meeting the requirements. [Extracted from the article]

Abstract Background The demographic changes affecting Switzerland and other European countries, including population ageing, will continue to challenge policymakers in building accessible, affordable, comprehensive and high-quality long-term care (LTC) systems. The purpose of this paper is to investigate how Switzerland’s LTC system compares to other European countries, in order to inform how to respond to the increasing need for LTC. We carried out a descriptive study using secondary data from key national and international organizations. Methods By comparing the financing, workforce, service delivery and need for LTC in Switzerland, Germany, Italy, Norway and the United Kingdom, we described similarities and differences in these five European countries between 2005-2019. Thirty-three indicators within five domains were analysed: (1) Population statistics and health expenditure, (2) Need for LTC, (3) LTC financing, (4) LTC service delivery, and (5) LTC workforce. Results Switzerland has the highest life expectancy in comparison to the other four high-income countries. However, similarly to other countries, the years lived with disability are increasing in Switzerland. Switzerland’s public expenditure on LTC as a share of GDP is lower than that of Norway and Germany, yet out-of-pocket expenditure on LTC is highest in Switzerland. Switzerland has the highest proportion of persons receiving formal LTC both in institutions and at home. Switzerland has had the most pronounced increase in the proportion of over 65-year-olds receiving LTC at home. Even though more than fourfold more persons receive care at home, Switzerland still has more workforce in LTC institutions than in home-care. In comparison to Germany and the UK, Switzerland has a lower number of informal carers as a proportion of 50-year-olds and over, as well as fewer nationally available services for informal carers compared to Germany, Italy, Norway and the UK. Conclusions Our comparative study corroborates the importance of improving the affordability of LTC, continuing to support the movement towards home care services, improving the support given to both the professional workforce and informal carers, and improving the amount and quality of LTC data. It also provides a valuable contrast to other European countries to support evidence-informed policymaking.

Aim Background Methods Results Discussion and conclusion Implications for nursing and health policy To determine the effect of nurses' perceptions of the effectiveness of nursing services management on their professional commitment.Effective healthcare management is crucial for improving patient care quality. Understanding nurses' perspectives on nursing services management and their commitment provides valuable insights for management strategies, improving well‐being and healthcare outcomes.This descriptive, cross‐sectional, and correlational study involved 265 state hospital nurses. Data were collected between November 2020 and June 2021 using descriptive characteristic form, Nursing Services Management Effectiveness Scale, and Nursing Professional Commitment Scale. This study adhered to the STROBE checklist.Nurses' views on the effectiveness of nursing services management and their professional commitment were found to be influenced by age, professional experience, and institutional positions. The average scores for nursing services management perception and professional commitment were 2.65 ± 0.72 and 66.63 ± 12.40, respectively. A statistically significant positive and low‐level correlation was observed between nurses' nursing services management perception and professional commitment scores. Nurses' positive perception of nursing services management explains 17.1% of the variance in nurses' professional commitment levels.This study outlines how nurses' views on effective nursing services management can enhance their professional commitment. Managers should contribute to increase nursing services management efficacy by eliminating deficiencies in management practices to make their institutions successful and to increase their employees’ professional commitment level.Assuming positive perceptions of nursing management increase nurses' professional commitment, developing policies to boost organizational support is vital. Managers should focus on improving nursing services management to increase organizational success, increase nurses' professional commitment, and achieve the best health outcomes by eliminating management deficiencies. [ABSTRACT FROM AUTHOR]

Aim: Most new ostomy patients are not able to manage ostomy self‐care when they are discharged and rely on visiting nurse services for ostomy care. The aim of this study was to determine if a perioperative ostomy educational pathway increases the level of independence and decreases the need for visiting nurse services in new ostomy patients. Method: A prospective longitudinal study was conducted between July 2018 and February 2020. Patients who received a colostomy or ileostomy and were treated on the surgery ward were included. Patients who followed a perioperative ostomy educational pathway were compared to a historical control group. The primary outcome measure was the level of independence in ostomy care and the need for visiting nurse services. Results: After discharge, 67.6% of patients in the intervention group (n = 244) were able to independently perform ostomy care and were therefore not relying on visiting nurse services, compared to 15.2% of the patients in the control group (n = 33). The need for visiting nurse services was higher in patients aged ≥70 years (OR 3.20, P < 0.001), those who did not attend the preoperative practice session (OR 3.02, P = 0.002), those with a history of transient ischaemic attack (OR 10.22, P = 0.045) and those with mild cognitive impairment (OR 28.98, P = 0.002). Conclusion: A perioperative ostomy educational pathway effectively increased the level of independence and decreased the need for visiting nurse services in new ostomy patients. [ABSTRACT FROM AUTHOR]

Community health centers play a key role in promoting health justice and equity. Health justice, which is the attainment of health equity, or the fair, unambiguous, and non‐arbitrary distribution of all health resources necessary for optimal health of the individual, family, and community, is necessary to optimize their wellbeing and to build healthy communities. Community‐based health centers are well‐positioned to lead in these efforts, as they connect with, seek to understand, and innovatively serve communities that experience complex health‐related needs and are differentially impacted by structural vulnerabilities (i.e., racism). The purpose of this article is to present a nurse‐led model of culturally responsive health care that is rooted in partnerships designed to address medical and health‐related social needs. Current health inequities in the United States across constructs of race and socioeconomic status warrant comprehensive healthcare models that explicitly incorporate health justice, trauma‐informed, and antiracist approaches into practice, especially when serving high/complex‐need and under‐resourced communities. Foundationally, it is imperative that these models of care strive toward equity regarding access to compassionate, affordable, culturally relevant health care; center community members' voices and guidance; promote growth and development of staff in understanding structural barriers and act to dismantle them; and create learning opportunities for students and staff to understand and address social determinants of health to provide high‐quality care, with an ultimate goal to improve community health. [ABSTRACT FROM AUTHOR]

The Syrian civil war caused humanitarian tragedy, resulting in significant losses and massive migration movement, significantly impacting nursing services. The purpose of this study was to identify the problems and experiences of nurses who provided care for Syrian asylum seekers in Turkish border hospitals during the war. This phenomenological and qualitative research selected participants with maximum diversity sampling. Interviews were conducted with 68 nurses who provided care and treatment to asylum seekers during the peak of the war. Data analysis identified two main themes and nine sub‐themes: language differences, interpreting services, intercultural differences, complex patients, non‐compliance with hospital rules, treatment programmes and discharge issues. The nurses experienced both positive and negative emotions during the process. During the Syrian war, patient care issues were identified as being primarily caused by language and cultural differences among asylum seekers and nurses. During this process, nurses who cared for severe injuries and asylum‐seekers experienced both positive and negative emotions simultaneously. [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]

Purpose : This study aimed to investigate changes in critical nursing activities from 2009 to 2020 and explore the relationship between nurse staffing and such activities in intensive care units. Methods : A total of 446,445 adult patients admitted to intensive care units in tertiary and general hospitals from 2009 to 2020 were identified using the National Health Insurance claims database. The Critical Nursing Activities Index was calculated based on the following critical nursing activities: ventilator, extracorporeal membrane oxygenation (ECMO), and continuous renal replacement therapy (CRRT). Trend analysis was performed to analyze changes in critical nursing activities over 12 years and to assess linear trends across different staffing levels. Results : The annual utilization days for ventilators, ECMO, and CRRT, as well as the Critical Nursing Activities Index significantly increased over the study period (p-for-trend <.001) in tertiary and general hospitals, except for ventilator use in general hospitals. Ventilator, ECMO, and CRRT utilization exhibited a significant upward trend with higher nurse staffing levels (Bonferroni adjusted p-for-trend <.001). The Critical Nursing Activities Index was significantly higher in hospitals with higher staffing levels compared to those with lower staffing levels (Bonferroni adjusted p <.05). Conclusion : The findings underscore the need for improved nurse staffing levels in intensive care units. Government policies should ensure that staffing levels align with critical nursing activities among critically ill patients to uphold the quality of care. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the effects of the nursing practice environment and reciprocity among hospital nurses on their intent to leave, and to investigate the mediating effect of reciprocity in this process. Methods: This study was conducted with 218 full-time nurses working for more than 6 months at four general hospitals located in two cities in South Korea. Data were collected using questionnaires from July 26 to August 12, 2022, and analyzed using IBM SPSS/WIN 23.0 and SPSS Process Macro. Results: The nursing practice environment (r=-.38, p<.001) and reciprocity (r=-.33, p<.001) were negatively related to the intention to leave. The nursing practice environment and reciprocity affected intent to leave, reciprocity had a partial mediating effect between the nursing practice environment and intent to leave. Conclusion: Nursing managers should strengthen the nursing work environment and reciprocity levels to reduce nurses' intention to leave. Additionally, nursing managers need to effectively manage the organizational culture so that nursing services can be provided in a friendly medical culture that values fair and equal cooperation. [ABSTRACT FROM AUTHOR]

Background: Community medical institutions play a vital role in China's healthcare system. While the number of these institutions has increased in recent years, their construction contents remain insufficient. The potential of community medical institutions in preventing, screening, diagnosing, and treating non-communicable chronic diseases (NCDs) has not been fully utilized. This study aims to assess the status of construction contents in community medical institutions in Southwest China and examine how these contents influence the medical choices of NCD patients. Methods: Descriptive statistics were used to evaluate the construction content of community medical institutions. Multiple-sets of multinomial logistic regression were employed to analyze the associations and marginal impacts between construction content and medical choices. Shapley value analysis was applied to determine the contribution and ranking of these impacts. Results: Descriptive statistics revealed satisfactory construction contents in community medical institutions. Notably, factors such as service attitude, nursing services, expert consultations, charging standards, medical equipment, medical examinations, privacy protection, and referrals significantly influenced medical choices. Among these, service attitude, charging standards, and privacy protection had the most significant marginal improvement effects on NCD patients' choices, with improvements of 12.7%, 10.2%, and 5.9%, respectively. The combined contribution of privacy protection, medical examinations, service attitude, charging standards, and nursing services to medical choices exceeded 80%. Conclusion: Optimizing the service contents of community institutions can encourage NCD patients to seek medical care at grassroots hospitals. This study addresses crucial gaps in existing literature and offers practical insights for implementing new medical reform policies, particularly in underdeveloped regions of Southwest China focusing on hierarchical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

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Background: Older adults living in nursing home organizations are eager to get voluntary help, however, their past experiences with voluntary services are not satisfactory enough. To better carry out voluntary services and improve the effectiveness of services, it is necessary to have a deeper understanding of the experiences and needs of older adults for voluntary services. Methods: The purposive sampling method was used to select 14 older adults from two nursing home organizations in Hangzhou and conduct semi-structured interviews, Collaizzi's seven-step method was used to analyze the data. Results: Older adults in nursing home organizations have both beneficial experiences and unpleasant service experiences in the process of receiving voluntary services; Beneficial experiences include solving problems meeting needs and feeling warmth and care, while unpleasant service experiences include the formality that makes it difficult to benefit truly, lack of organization, regularity, sustainability, and the mismatch between service provision and actual demands. The needs for voluntary services mainly focuses on emotional comfort, Cultural and recreational, and knowledge acquisition. Conclusion: Older adults in nursing home organizations have varied voluntary experiences, and their voluntary service needs are diversified. Voluntary service needs of older adults should be accurately assessed, and voluntary service activities should be focused upon. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the existing level of emergency capabilities among shared nurses and analyze the factors influencing these capabilities. Methods: An descriptive cross-sectional survey was conducted from September to October 2023, a purposive sampling method was employed to select 340 shared nurses as the subjects for investigation in Nanchang and Ganzhou cities of Jiangxi Province, as well as Wenzhou city in Zhejiang Province. A self - designed questionnaire on the emergency capabilities of shared nurses was utilized for data collection. Results: This investigation encompassed the collection of 340 valid questionnaires, assessing the overall emergency response proficiency of shared nurses. The cumulative score amounted to (170.81± 24.62), averaging (4.27± 0.62). It is noteworthy that the dimension scoring the highest was preparedness (4.33± 0.68), whereas the recovery capability dimension received the lowest score (4.17± 0.75). Through multiple linear regression analysis, it was determined that marital status, participation in emergency capability training, and experience in home nursing services significantly influenced the emergency capabilities of shared nurses (P< 0.05). Conclusion: Shared nurses in China demonstrate a moderately high level of emergency response capability. The marital status, participation in emergency capacity training, and on-site nursing service experience are pivotal factors influencing the emergency capabilities of shared nurses. Nursing administrators should prioritize the development of emergency capacity training and team building for shared nurses, establishing a scientifically standardized mechanism for training, assessment, and management. The implementation of performance evaluation mechanisms for shared nurses is crucial to enhance professional awareness within the workforce. [ABSTRACT FROM AUTHOR]

Efficient and effective meetings are critical for busy health care leaders who are often juggling multiple demands on their time. Creating a shared sense of purpose post COVID and having engagement with all leaders are critical to a department's success. This improvement project offers leaders direction on thinking through meeting redesign. [ABSTRACT FROM AUTHOR]

The failure of many hospitals to staff at safe and efficient levels has created pressure for mandating minimum staffing through regulation or legislation. This article reviews national and global efforts for regulation or legislation to ensure appropriate nurse staffing levels are in place to keep patients safe. [ABSTRACT FROM AUTHOR]

Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening blood disorder with a mortality rate of over 90% if left untreated, multiple long-term complications for survivors, and a lifelong risk of relapse. There is a valuable role for the clinical nurse specialist in both the acute and long-term care of patients with TTP. Historically part of the team caring for patients with TTP, specialist nurses have played a vital role in co-ordinating and facilitating treatment for patients, promoting patient advocacy, supporting continuous service improvement, and delivering education to the wider clinical team to disseminate best practice. In 2021, the TTP specialist nurse role was commissioned within the NHS England National Service Framework for TTP Specialist Centres. This article aims to appraise the role of the TTP specialist nurse and share the multidimensional reach of the role in achieving better outcomes for patients with TTP. [ABSTRACT FROM AUTHOR]

Background: Indirect calorimetry (IC) is the gold standard to monitor energy expenditure in critically ill patients. In several intensive care units (ICUs), nurses are responsible for carrying out the measurements. Aim: The aim of this study was to assess nurses' perception of their involvement in IC. Study design: This was a prospective survey conducted in the surgical ICU of a French university hospital after 18 months of use of the Q‐NRG + ® calorimeter (COSMED©, Italy). All nurses who have used the calorimeter in the previous 6 months in this ICU were questioned through a questionnaire about their theoretical and practical knowledge and experience in using it. Results: The participation rate was 93% (28/30 surveyed). All the respondents understood the objectives of performing an IC and 23 of them (82%) had used the device at least once in the previous 6 months. All the users thought it was pertinent that ICU nurses were in charge of the IC measurements, 16 of them (70%) reported having been formally trained, mostly by a colleague, and 17 (77%) felt comfortable with the device after 2 to 5 uses. The five non‐users (8%) did not have the opportunity to do so. Theoretical and practical knowledge could be improved as only 5 of the users (22%) declared to know the main criteria of reliability of the IC measurement and 4 of them (18%) declared to know the maintenance and cleaning protocol of the device. Conclusion: Nurses quickly felt comfortable with the Q‐NRG + ® in this ICU. Formal initial and ongoing training of all staff completing IC is essential to perform IC measurements safely and to obtain reliable and interpretable results in practice. Relevance to Clinical Practice: Involving the nursing team in nutritional care, even if it is technical, seems to bring satisfaction in terms of overall patient care. [ABSTRACT FROM AUTHOR]

Using qualitative interview data (n = 142 interviews) generated with 50 nurses, over the course of the COVID-19 pandemic, this paper traces the trajectories of nurses in the UK and attempts to unpick the interplay between structure and agency in their narratives. Interviews were inductively analysed for themes and an additional narrative analysis was undertaken to preserve the form of each participant's narrative. We argue that nurses' pandemic trajectories occurred within the 'psychological vulnerability-stigma nexus' which operates within health and social care providers in the UK and whilst constraining nurses' agency at times it could also provide an impetus to act agentically. We found that the nurses' COVID-19 trajectories were characterised by: getting by, getting out (job-hopping) getting needs met and getting organised. We call for more considered systemic support to be generated and consistently provided to nurses to ensure retention of nurses and the security of society to avoid exacerbating existing workforce shortages. [ABSTRACT FROM AUTHOR]

Background: The Internet Plus Nursing Service (IPNS) is being instigated in all provincial-level regions throughout China, in which registered nurses (with more than five years of experience from qualified medical institutions) will provide services to those in their communities or homes after receiving online applications. The growing shortage of human resources in nursing is a critical issue for this project, so effective policies for recruiting and retaining nurses are critical. Objective: This study aims to pinpoint the significant job characteristics that play a crucial role in shaping the job decisions of sharing nurses in the IPNS program, and to estimate the strength of job attributes. Methods: A discrete choice experiment (DCE) was used to assess job attributes influencing sharing nurses' preferences. A qualitative design, including in-depth interview and focus interview methods, was conducted to determine the inclusion of attributes. The final included six attributes were: work modes, duration per visit, income per visit, personal safety, medical risk prevention, and refresher training. This study was conducted at 13 hospitals in Guangdong Province, China, from April to June 2022, and a total of 220 registered sharing nurses participated in the survey. The multinomial logit model explored attributes and relative valued utility. Preference heterogeneity is explored via latent class analysis (LCA) models. Results: A total of 220 participants answered the questionnaire. Income was the most influential characteristic of a sharing nursing position, followed by personal safety management, duration per visit, medical risk prevention, and refresher training, and nurses' preferences differed among different types of classes. Conclusions: Sharing nurses place most value on income and personal safety with career-related decisions, which indicates an urgent need to develop complete security for personal safety. This study can be helpful to decision-makers in the Chinese government. [ABSTRACT FROM AUTHOR]

States are struggling to assure an adequate number of registered nurses are active in the clinical workforce to serve patients and communities. Nurse compact legislation—enacted in 39 states—facilitates interstate recognition of nurse licensure. We used a cross-sectional email survey of registered nurses in Michigan to measure their opinions on compact licensure legislation and examined differences in compact licensure opinions by nurses' personal characteristics. Primary analyses reported herein are from 7,098 Michigan nurses with complete data. Most respondents felt that the compact would make it easier to redeploy nurses in an emergency (76.6%), improve access to nursing care (66.6%), and boost their personal career options (55.1%). Most nurses disagreed that compact legislation would weaken patient protections (60.7%). The majority expressed neutral feelings on whether compact licensure would make disciplinary actions more difficult to enforce (50.9%) and a plurality that current licensure policies were satisfactory (44.0%). The majority were supportive of Michigan joining the compact (72.3%). In multivariable analysis, stronger support for joining the compact was associated with advanced degrees, male sex, and younger age. Less support was associated with membership in a collective bargaining unit. Policymakers who wish to ease acute nurse vacancies should consider enacting nurse licensure compact legislation. Careful attention to patient protections and disciplinary review would address potential safety concerns. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) nursing has been identified as a crucial component in the IBD service delivery. This article aims to provide a comprehensive overview of the state of IBD nursing care in Finland, and to identify areas that would benefit from further research. Tertiary IBD outpatient clinics nationwide were invited to participate in a cross-sectional descriptive study conducted using an electronic survey. The quality of IBD nursing services was assessed using the Nursing Care Quality in IBD (NCQ-IBD) evaluation tool. Of the 34 identified clinics, 27 participated (79.4%) in the study. The NCQ-IBD tool classifies the clinics in four categories, where A indicates the highest level of quality, and D the lowest. In this study, 26 clinics (96.3%) were classified at level C, and one clinic (3.7%) at level D. Nursing responsibilities in IBD management and informing the patients were at a high level of quality, whereas nursing research in IBD was at a low level. An IBD database (i.e. clinical IBD registry) was in use only in 10 clinics. Although training in the clinical aspects of IBD was readily available, there was a lack of training plans for IBD, and clinics seldom held an annual review of the IBD nursing activities and outcomes. There were very few clinics using structured indices and questionnaires, and only 16 clinics (59.3%) applied a written IBD protocol. In the Finnish IBD nursing service, as measured with the NCQ-IBD tool, several areas for future improvement were identified. [ABSTRACT FROM AUTHOR]

Background: Groote Schuur Hospital is a large Academic Hospital in South Africa that is in the process of integrating palliative care (PC) via a vertical nurse-led doctor-supported (VNLDS) service that was initially established to deliver clinical care. PC integration should occur across multiple dimensions and may result in variable degrees of integration between levels of the healthcare system. This research evaluates the VNLDS through a theory-driven evaluation to describe how the service affected integration. Methods: A mixed-method sequential design consisting of a narrative literature review on the theory of integration and PC, retrospective quantitative data from a PC service delivery database, qualitative data from semi-structured interviews and document analyses. It was structured in three phases which assisted in confirming and expanding the data. Statistical analyses, deductive thematic coding and documentary analyses were conducted according to the conceptual framework of PC integration. Results: The PC integration process was facilitated in the following ways: (i) the service provided good clinical PC; (ii) it was able to integrate on a professional level into specific diseases, such as cancer but not in all diseases; (iii) developing organizational structures within the service and (iv) the observed benefit of good clinical care increased the value stakeholders assigned to PC, thereby driving the adoption of PC. However, there are still clinicians who do not refer to PC services. This gap in referral may be grounded in assumptions and misconceptions about PC, especially at the organizational level. Discussion: Observed PC service delivery is core to integrating PC across the healthcare system because it challenges normative barriers. However, the VNLDS could not achieve integration in leadership and governance, education and hospital-wide guidelines and policies. Whole system integration, foregrounding organizational commitment to PC excellence, is core to integrating PC. Conclusion: The VNLDS service has effectively linked PC in specific disease profiles and normalized the PC approach where healthcare workers observed the service. These integrational gaps may be grounded in assumptions and misconceptions about PC, especially at the organizational level. Plain language summary: How does a nurse led palliative care service affect palliative care integration in a big teaching hospital? This article evaluates a nurse led doctor supported service in providing palliative care and how it affected the integration of palliative care in an Academic Hospital in South Africa. This study will help us understand the goals of integration, the extent of integration achieved by this service and how and why it was achieved or not. [ABSTRACT FROM AUTHOR]

Background: China is experiencing an aging population, leading to a significant demand for "Internet + nursing services" tailored for elderly individuals. However, there are many risk problems in the process of nurse service, which hinder the development of the service, and a scale is needed to assess the risk problems faced by nurses in "Internet + nursing services" for the elderly. Objective: The purpose of this study is to develop an assessment scale for risk factors and outcomes related to nurses' involvement in the "Internet + Nursing Service" for the elderly and to assess its reliability and validity. Methods: Based on literature analysis, focus group, the Delphi method, and a presurvey, we designed an initial scale. The initial scale comprised two sections: risk factors and risk outcomes for nurses. In January and February of 2023, nurses engaged in "Internet + nursing services" for the elderly in Shanxi Province were chosen through a convenience sampling technique for a questionnaire survey. Subsequently, item analysis and exploratory factor analysis were employed to refine and develop a test version of the scale further. A follow-up questionnaire survey was carried out in March and April 2023 using a similar approach. The reliability and validity of the scale were assessed through confirmatory factor analysis, culminating in the formation of the final scale. Results: The initial survey yielded 244 valid responses. The cumulative variance contributions of the two segments from the exploratory factor analysis were 84.584% and 90.089%, respectively. A subsequent survey garnered 220 valid responses. The confirmatory factor analysis results indicated: χ2/df = 2.086, comparative fit index (CFI) = 0.918, normative fit index (NLI) = 0.855, root mean square of residuals (RMR) = 0.045, and root mean square of error of approximation (RMSEA) = 0.070. These results demonstrate good structural, convergent, and discriminant validity. The content validity index at the item level (I-CVI) ranged between 0.875 and 1.000, while the content validity index at the scale level (S-CVI/Ave) was 0.941. Cronbach's alpha coefficient for the entire scale stood at 0.970. Moreover, the scale exhibited a split-half reliability of 0.876 and a retest reliability of 0.980 (p < 0.01). Conclusion: The risk factors and risk outcomes associated with nurses involved in "Internet + nursing services" for elderly individuals, as developed in this study, demonstrate strong reliability and validity. They are well suited to the Chinese national context. [ABSTRACT FROM AUTHOR]

Background: The ageing of the population has become an escalating problem in China, which has led to an increasing demand for healthcare throughout society. The care services of elderly institutions, as a more mature way of aging, can alleviate various social problems brought about by ageing to a certain extent. The aim of this paper is to explore the degree of acceptance of institutional care by rural elderly people in Shandong Province and the factors that influence whether rural elderly people accept institutional care services. Methodology: Based on the theory of planned behavior, an analytical framework was constructed for the willingness of rural elderly people to receive nursing services from elderly care institutions. Using survey data from 192 rural elderly people in Shandong Province, descriptive statistics, binary logistic regression, and horizontal comparative analysis methods were used to analyze the willingness of rural elderly people to provide for the elderly and its influencing factors. Result: Only 17.71% of respondents expressed willingness to receive services from elderly care institutions. Among them, education level, trust in elderly care institutions, and support from adult children have a significant positive impact on whether rural elderly people receive nursing services from elderly care institutions; The number of children, the level of understanding of elderly care institutions, neighbors' choices of elderly care methods, and their ability to contribute to the family have a significant negative impact on whether rural elderly people receive nursing services from elderly care institutions. There are significant differences in the willingness and influencing factors of rural elderly people to provide for the elderly among different regions. Conclusion: The non-acceptance of institutional care by rural older people is a general phenomenon rather than a sample characteristic, thus justifying the supplementary status of institutional care services. The pension intention of the rural elderly in Shandong Province is obviously affected by personal will factors, and the influencing factors are various. The traditional concept of old-age care in Shandong province has a strong path-dependent effect on the choice of the rural elderly. There is heterogeneity in the willingness and influencing factors of the rural elderly in different regions and countries. Based on this, this paper puts forward the following suggestions: strengthen the spiritual and cultural construction of residents; The government should pay attention to the correct guidance of public opinion; And increase pension subsidies. It is hoped that reduce the burden of national elderly care through these suggestions. [ABSTRACT FROM AUTHOR]

Background: Globally, healthcare systems encounter significant challenges during disasters, necessitating healthcare professionals to react with readiness and efficiency. Among these professionals, nurses assume a crucial role in disaster preparedness and response, often positioned at the forefront of delivering healthcare amid such events. Methods: The study employed a quantitative descriptive design by the respondents who were registered nurses who had worked under the Nursing Services Department in different units such as ER, ICU, OR, Inpatients, OPD, and nursing administration at a tertiary hospital, utilizing a self-formulated questionnaire. Result: The evidence-based practice helps nurses in their disaster preparedness in the workplace. Conclusion: Hospitals can cultivate a culture of evidence-based practice among nurses in the area of disaster preparation by putting into action this structure for an innovative program. [ABSTRACT FROM AUTHOR]

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The Association of Nephrology Nurses Advanced Kidney Care (AKC) Nurses Community of Practice provides a summary of a recent audit of advanced kidney care nursing services, roles and activity. [ABSTRACT FROM AUTHOR]

Background: Cancer is a disease that is linked to aging, and in Norway, the median age at diagnosis is quite near to 70. A reliable indication of overall satisfaction with the hospital environment is patient satisfaction with nurse care. It's critical to identify the variables that influence patient satisfaction with nursing care in order to assure service improvement at the necessary hospital levels. Aim: To assess the satisfaction of geriatric patients toward the quality of nursing services in the oncology unit. Design: A descriptive design. Setting: This research was established in oncology outpatient clinic in the oncology unit, at Beni-Suef university hospital. Subjects: A convenient sample of elderly patients (n=152 elderly patients) selected by from the previously mentioned setting was included and aged from (65 - 75) years of both sex. Tools: Interview questionnaire: this tool was developed by the researcher; it was divided into three parts; Part 1: elderly people socio-demographic characteristics, Part 2: assess the patients' satisfaction and Part 3: assess the quality of nursing services presented to elderly patients in the oncology unit. Results: revealed that, 63.8% of the studied elderly patients were aged between 65 and 69 years, 57.9% of them were females and 32.9% of the studied elderly patients had breast cancer. Also, there were strong significant statistical positive relation between quality of nursing services and all the subdimensions of elderly satisfaction; communication, privacy, mutual confidence, and security. Conclusion: the studied elderly patients had high satisfaction and perception regarding quality of nursing care provided to them. Recommendations: Enhancing the trust relationship between geriatric patients and oncology nurses. [ABSTRACT FROM AUTHOR]

Background: Many countries are experiencing rapid population aging, and the provision of support for older adults with diseases or disabilities to continue living in their communities is a major global challenge. Japan has established multifunctional long‐term care in small group homes and home‐visit nursing (MLSH) as a service category that integrates medical and care services. These services focus on nursing functions to support continuous, long‐term home, and end‐of‐life care for older adults with high levels of medical care dependency. This study aimed to clarify the relationship between nurses' perceptions of nursing benefits/challenges and the degree of interprofessional collaboration in the context of MLSH. Methods: We conducted a mail questionnaire survey of MLSH facilities throughout Japan. All facilities in Japan that had been operating for at least 1 year were included. We analyzed 182 responses (response rate: 36.0%; valid response rate: 98.3%). Results: Comparison of scores representing the degree of interprofessional collaboration perceived by nurses showed the highest score was for colleague nurses (3.9 ± 0.5) and the lowest was for external care managers (2.5 ± 0.9). Compared with the weak collaboration group, the strong collaboration group had higher perceptions of the benefits of nursing and lower perceptions of the challenges. Conclusions: The results of this study suggest that strong collaboration allows teams to achieve sufficient effects of care while reducing related challenges. It may be necessary to promote collaboration with external professionals to appropriately manage service users' worsened conditions and improve the quality of care. [ABSTRACT FROM AUTHOR]

Introduction: Complexity in the healthcare environment causes problems in nursing practice. The nursing code of ethics has been designed as an appropriate guideline for behavior and helps decision-making. Nursing ethics requires nurses to comply with ethical principles to produce quality nursing care. Therefore, this study aims to illustrate the importance of nursing ethics as a foundation for nursing practice. Methods: In the case of the current research, the articles were selected according to PRISMA guidelines. A literature review used three journal databases: ScienceDirect, PubMed, and Google Scholar. The keywords in this literature review are adjusted to the Medical Subject Heading (MeSH), which consists of "nursing ethics," "code of ethics," AND "professional nurse." Several inclusion criteria were set to obtain eligible articles published between 2014 and 2023 and written in English and Bahasa. Fifteen eligible articles were finally included in the analysis. Results: These findings highlight the critical role of understanding ethics, integrity, and moral responsibility and the importance of nursing codes of ethics in implementing nursing practice to improve the quality of nursing care and improve the quality of care Conclusion: Nursing ethics is ethos. Integrity and moral responsibility are at the heart of ethics. Nurses must have an understanding of ethics for self-development and nursing services. As a relevant source, the code of ethics refers to the system of rules. Applying the code of ethics in nursing practice improves the quality of nursing care and service to guarantee patient safety.

Aim: Evaluation of the working conditions and recommendations of nurses during the COVID-19 pandemic period. Method: The cross-sectional, descriptive study was conducted with 199 nurses in a university hospital. Data were collected in May-December 2020 by face-to-face interview method using a questionnaire form prepared by the researchers. Results: 94% of the nurses were women, 60% were married, and their professional experience was 13.30+-7.91 on average. Of the nurses, 38% of whom were assigned to different services during the pandemic, 49.2% worked more than 8 hours in a shift, 23.6% worked more than 40 hours a week, 50.3% worked with 2-3 nurses in a shift, 36%, 7 of them looked at 10 or more patients in a shift, 33.2% of them entered the patient's room 16 times or more. These findings showed a significant difference according to the wards (p

Abstract Aim In response to the ageing population and shortage of human resources for nursing care, China is piloting internet‐based nursing services (nurses who provide this care are called online nurses). Nurses are the providers of this model, so it is important to understand their perceptions. We aim to explore nurses' perceptions of engaging in internet‐based nursing services. Design This study is descriptive qualitative research, so the data were analysed using a descriptive qualitative research method based on the theory of planned behaviour, using thematic analysis. Methods With personal semi‐structured interviews conducted by two Master of Science in Nursing with 18 online nurses and nine clinical nurses, terminated after information saturation. Results Nurses' emotional attitudes towards internet‐based nursing services were generally positive, but their behavioural intentions were negative. Social support, hospital organisational climate and family responsibilities had a statistically significant impact on nurses' behavioural decisions. Internet‐based nursing services place higher demands on nurses' knowledge and skills, and nurses are most concerned with ensuring patient and nurse safety. Patient or Public Contribution No Patient or Public Contribution.

In recent years, the incidence of disasters has increased worldwide due to various reasons, particularly climate change, resulting in death, injury, economic loss, and environmental damage. Recent large-scale earthquakes have reaffirmed that Turkey is a country with high disaster risk. It is possible to prevent or reduce deaths, injuries, and epidemics after disasters by planning before, during, and after disasters. For the sustainability of nursing services in disasters, executive nurses should effectively perform management functions related to planning, organizing, directing, coordinating, and controlling. This study examines the nursing services provided at a university hospital where earthquake victims were transferred following the Kahramanmaraş earthquake that impacted 11 provinces on February 6, 2023. The study uses the Plan, Do, Check, and Act cycle to present the nursing activities, aiming to contribute to disaster nursing literature and guide executive nurses. [ABSTRACT FROM AUTHOR]

The purpose of this research was to use neutrosophic logic as an approach to evaluate the quality of nursing care in a nursing home in the city of Puyo, Ecuador. To achieve this objective, the AHP method was used in its neutrosophic modality, using trapezoidal neutrosophic numbers for the selection of a set of criteria of interest that would later be subjected to evaluation by experts in the field. During the analysis, the critical importance of certain aspects such as patient safety, resident and family satisfaction, and other specific factors were emphasized as fundamental components to be considered when looking for indicators that contribute to improving the quality of the services provided in this nursing home. The incorporation of neutrosophy and neutrosophic numbers in the evaluation of medical quality in the context of elderly care provided a comprehensive and accurate approach, taking into account the intricate nature and subjectivity that characterize this area of study. [ABSTRACT FROM AUTHOR]

In Ecuador, management of nursing staff availability in healthcare settings is challenged by variability in demand for care, uncertainty in skill assessment, and imprecision in resource planning. Therefore, the objective of this study focuses on analyzing neutrosophic nursing staff assignment models that integrate uncertainty and imprecision in decision-making, in order to improve the quality of the service in healthcare settings. For the development and modeling of the study results, the Neutrosophic TOPSIS method was applied. The results revealed the need for continuous evaluation and adaptability in staff allocation, along with the application of strategies based on neutrosophy. These conclusions highlight the value of neutrosophy as a tool to address uncertainty and imprecision in medical care by improving the quality of nursing services in Ecuador. [ABSTRACT FROM AUTHOR]