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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 Aims Background Methods Results Conclusion Relevance to Clinical Practice Patient or Public Contribution To explore the incidence and factors influencing medication administration errors (MAEs) among nurses.Medication administration is a global concern for patient safety. Few studies have assessed the incidence of MAEs or explored factors that considered the interplay between behaviour, the individual and the environment.This retrospective study included 342 MAEs reported in the electronic nursing adverse event reporting system between January 2019 and September 2023 at a university‐affiliated teaching hospital in China. Data on nurses' demographics and medication administration were extracted from the nursing adverse event reports. The reports were classified according to the severity of patient harm. The causes of the 342 MAEs were retrospectively analysed using content analysis based on Bandura's social cognitive theory. Descriptive statistics were used to calculate the proportion of medication errors and the distribution of subcategories.In total, 74.3% of MAEs were adverse events owing to mistakes and resulted in no harm or only minor consequences for patients. Nurses aged 26–35 years and those with 6–10 years of experience were the most common groups experiencing MAEs. Factors influencing MAEs included personal (‘knowledge and skills’ and ‘physical state’), environmental (‘equipment and infrastructure,’ ‘work settings’ and ‘workload and workflow’) and behavioural (‘task performance’ and ‘supervision and communication’) factors. The study further highlighted the interrelationships among personal, behavioural and environmental factors.Multiple factors influence MAEs among nurses. Nurse‐related MAEs and the relationship between behaviours, individual factors and the environment, as well as ways to reduce the occurrence of MAEs, should be considered in depth.Understanding the factors influencing MAEs can inform training programs and improve the clinical judgement of healthcare professionals involved in medication administration, ultimately improving patient prognoses and reducing MAEs.The findings can help develop clinical guidelines for preventing MAEs. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Impact Patient or Public Contribution This study aims to conduct a comprehensive analysis of the interrelationships among career stress, work stress, career regret, job satisfaction and career adapt abilities within the nursing profession.The research involved a sample of 576 nurses from ten urban hospitals, distributed across five distinct cities in Turkiye, between December 2023 and January 2024. The study employed regression models to systematically test hypotheses, providing nuanced insights into the complex dynamics of the variables under investigation.Regression models were utilized to test the hypotheses systematically, considering the moderating role of career adapt abilities. The study included a sample of 576 nurses from 10 urban hospitals in Turkey, distributed across five distinct cities. This approach allowed for a detailed examination of the intricate relationships between career stress, work stress, career regret, job satisfaction and career adapt abilities within the nursing profession.The findings underscore the delicate balance between the positive gains of job satisfaction and the challenges posed by career stress, work stress and career regret in the multifaceted landscape of nursing.In nursing, the relationship between career stress, work stress, career regret and job satisfaction include progress, resilience and obstacles. Developing strategies requires a cooperative effort from health care organizations, nursing leaders and individual nurses.The research provides valuable insights into the interplay of these factors and emphasizes the moderating role played by career adapt abilities. The implications of the study extend to healthcare organizations, nursing leaders and individual nurses. The research advocates for collaborative strategies aimed at enhancing job satisfaction, alleviating stressors and addressing career regret. The ultimate goal is to contribute to the retention of a resilient nursing workforce, emphasizing the importance of strategies that support the well‐being and satisfaction of nurses in their careers.No patient or public contribution. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Method Results Conclusion Implications for the Profession and Patient Care Impact Patient or Public Contribution Describe the stressors that long‐term care facility (LTCF) residents and their family members were exposed to during the COVID‐19 pandemic, the resources they mobilised to cope with them, and the strategies used by professionals to support them.A descriptive qualitative design study.Between March 2021 and February 2022, we carried out semi‐structured interviews with 8 LTCF residents, 11 family members, and 6 focus groups made up of healthcare and support staff from 8 LTCFs.Three themes emerged: (1) residents and family members: separated and suffering, (2) residents and family members: reinventing themselves, and (3) staff: attempts to maintain residents' well‐being.LTCF Residents' and their family members' exposure to the various stressors linked to the COVID‐19 pandemic generated suffering. Healthcare and support staff implemented strategies to support them, notably to maintain links between them. Some deep reflection must occur on the concepts of LTCF residents' autonomy and self‐determination when implementing protective measures in future pandemic situations.This study has provided new insights into the nature of the stressors faced by LTCF residents and their families, and the measures implemented by professionals to support them. The role of the families of LTCF residents needs to be better recognised. Our results indicate the importance of involving nurses in discussions on patient autonomy and self‐determination when implementing protective measures (in a pandemic situation).Exploring the nature of the stressors experienced by LTCF residents and their families enables professionals to tailor strategies to support them. Maintaining residents' self‐determination is essential when implementing protective measures. Families involved with residents must be recognised and included in the assessment of stressors and the personalisation and implementation of strategies to support LTCF residents.No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background: Anorexia nervosa is a complex mental disorder that has severe physical and psychological consequences, often requiring hospitalisation, and in the most severe cases, patients receive coercive treatment. Among the various nursing tasks associated with encountering these patients, the administration of nasogastric tube feeding under restraint stands out. It is crucial to recognise and address the unique practical and ethical challenges nurses face when caring for adults struggling with severe anorexia nervosa. The aim of the study was to gain a deeper understanding of registered nurses' experience of nasogastric tube feeding under restraint in hospitalised patients with severe anorexia nervosa. Methods: A naturalistic design guided this study. Narrative interview data were analysed using reflexive thematic analysis. The participants were twelve registered nurses recruited from an inpatient ward for adult patients with an eating disorder in a Norwegian psychiatric hospital. Results: Three main themes were developed: providing good nursing care during coercive treatment; having ethical concerns about nasogastric tube feeding under restraint when the patient reaches a body mass index that is not immediately life-threatening; and having concerns about involving personnel from another ward in the nasogastric tube feeding under restraint procedure. Conclusions: Nurses find nasogastric tube feeding under restraint to be part of life-saving nursing for patients with severe anorexia nervosa. It raises ethical concerns, especially with patients with a body mass index that is no longer life-threatening. Our results demonstrate the vulnerability of nurses as well as the difficulties and ethical dilemmas of nursing during nasogastric tube feeding under restraint. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution To explore and validate an end of shift survey with a low response burden, practical application and generated evidence of related associations between workload, quality of work and patient care, missed care and job satisfaction.A retrospective cross‐sectional survey of the experiences of nursing staff.Data were collected from 265 nurses who responded to a questionnaire at the end of their shift in 2022. Exploratory factor analysis was undertaken using IBM SPSS v.27 and confirmatory factor analysis was undertaken using IBM AMOS v27. Hypotheses testing was undertaken using IBM SPSS v.27 using multiple regression analyses.All of the hypotheses were supported. There was a negative association between workload and quality of work and job satisfaction. Quality of work was negatively associated with workload and missed care and positively associated with job satisfaction. The association between missed care and job satisfaction was negative.The EOSS is a valid and reliable tool with a low response burden. The tool supports previous research which demonstrated there is a negative relationship between level of workload and shift type with satisfaction, quality of work and potentially nurse retention.In the context of a global nursing shortage nursing leaders must ensure that care we provide is of the highest quality. We must take every action to address high workload to reduce the risk that fundamental care is not sacrificed, job satisfaction is improved and nurses remain in the profession. The EOSS gives nurse leaders a reliable, practical, consistent, applied tool that will better enable associations to be observed between resource configuration, workload and critical impacts on nursing and patient care.We have adhered to the relevant EQUATOR guidelines using the STROBE reporting method.No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Remote consulting using the Microsoft HoloLens 2 device has implications for continuity of patient care, improved patient experience and reduction in the need for patients to attend additional consultation appointments. We present an innovative evaluation of the use case for HoloLens 2-based remote consultations in a breast cancer dressings clinic and document our experiences. Two nurses wore the HoloLens headset during the clinic. The consultant surgeon was able to review individual cases remotely. Prior to the implementation of HoloLens-based consultations, the nurses were given training to reach a level of confidence where they could operate the device unassisted. During the patient appointment, the nurses were able to request wound assessment remotely and securely from the consultant, which would have otherwise necessitated an additional appointment and a second visit to the hospital for the patient. Patients were also able to communicate directly with the consultant through the headset worn by the nurses. This use case demonstrates that the consultant can be off site (e.g. in the operating theatre or working from another location) while still being able to consult remotely with patients and advise nursing staff. The HoloLens 2 device can improve breast cancer care practice. Value may be added through reducing the number of appointments for patients, allowing consultants to work efficiently, overall improved staff and patient experience, and cost savings for the hospital. [ABSTRACT FROM AUTHOR]

Background & Objective: Therapeutic communication with patients is one of the most critical competencies for nursing students in clinical settings. In this study, we investigated the impact of an online education program based on the COMSKIL model on the communication skills of undergraduate nursing students. Material & Methods: This quasi-experimental study involved presenting a specific education program based on the COMSKIL model to a group of undergraduate nursing students in the 4th to 8th academic semesters. The program was delivered through the online platform of the university during the COVID-19 pandemic. The data were collected at three time points: baseline (T1), immediately after education (T2), and two months after education (T3). Two instruments were used to collect data: a sociodemographic information questionnaire and a Persian version of the Quindam Communication Skills Questionnaire. The data were analyzed using independent t tests, one-way Analysis of Variance (ANOVA), and repeated measures analysis of variance. Results: The study's hypothesis was accepted, showing that the education program had a positive impact on the communication skills of the students over time. The total mean score of students' communication skills significantly improved (p < 0.0001) from T1 (107.91 ± 7.53) to T3 (121.76 ± 4.91) two months after the education program. The effect size indicated that this increase was moderate. Conclusion: The findings of this study have practical implications for nursing students in realworld patient care scenarios in clinical settings. The innovative and evidence-based educational model used in this study can replace outdated methods of instruction. Given that effective communication between nurses and patients is vital for providing high-quality patient care in a supportive environment, we recommend integrating this person-centered program into the curriculum planning of undergraduate nursing students. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We aimed to assess the feasibility, clinical accuracy, and acceptance of a hospital-wide continuous glucose monitoring (CGM) policy with electronic health record (EHR)–integrated validation for insulin dosing. RESEARCH DESIGN AND METHODS: A hospital policy was developed and implemented at Stanford Health Care for using personal CGMs in lieu of fingerstick blood glucose (FSBG) monitoring. It included requirements specific to each CGM, accuracy monitoring protocols, and EHR integration. User experience surveys were conducted among a subset of patients and nurses. RESULTS: From November 2022 to August 2023, 135 patients used the CGM protocol in 185 inpatient encounters. This group included 27% with type 1 diabetes and 24% with automated insulin delivery systems. The most-used CGMs were Dexcom G6 (44%) and FreeStyle Libre 2 (43%). Of 1,506 CGM validation attempts, 87.8% met the 20% or 20 mg/dL (%20/20) criterion for CGM-based insulin dosing and 99.3% fell within Clarke zones A or B. User experience surveys were completed by 27 nurses and 46 patients. Most nurses found glucose management under the protocol effective (74%), easy to use (67%), and efficient (63%); 80% of nurses preferred inpatient CGM to FSBG. Most patients liked the CGM protocol (63%), reported positive CGM interactions with nursing staff (63%), and felt no significant interruptions to their diabetes management (63%). CONCLUSIONS: Implementation of a hospital-wide inpatient CGM policy supporting multiple CGM types with real-time accuracy monitoring and integration into the EHR is feasible. Initial feedback from nurses and patients was favorable, and further investigation toward broader use and sustainability is needed. [ABSTRACT FROM AUTHOR]

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Background: Implementation strategies targeting individual healthcare professionals and teams, such as audit and feedback, educational meetings, opinion leaders, and reminders, have demonstrated potential in promoting evidence-based nursing practice. This systematic review examined the effects of the 19 Cochrane Effective Practice and Organization Care (EPOC) healthcare professional-level implementation strategies on nursing practice and patient outcomes. Methods: A systematic review was conducted following the Cochrane Handbook, with six databases searched up to February 2023 for randomized studies and non-randomized controlled studies evaluating the effects of EPOC implementation strategies on nursing practice. Study selection and data extraction were performed in Covidence. Random-effects meta-analyses were conducted in RevMan, while studies not eligible for meta-analysis were synthesized narratively based on the direction of effects. The quality of evidence was assessed using GRADE. Results: Out of 21,571 unique records, 204 studies (152 randomized, 52 controlled, non-randomized) enrolling 36,544 nurses and 340,320 patients were included. Common strategies (> 10% of studies) were educational meetings, educational materials, guidelines, reminders, audit and feedback, tailored interventions, educational outreach, and opinion leaders. Implementation strategies as a whole improved clinical practice outcomes compared to no active intervention, despite high heterogeneity. Group and individual education, patient-mediated interventions, reminders, tailored interventions and opinion leaders had statistically significant effects on clinical practice outcomes. Individual education improved nurses' attitude, knowledge, perceived control, and skills, while group education also influenced perceived social norms. Although meta-analyses indicate a small, non-statistically significant effect of multifaceted versus single strategies on clinical practice, the narrative synthesis of non-meta-analyzed studies shows favorable outcomes in all studies comparing multifaceted versus single strategies. Group and individual education, as well as tailored interventions, had statistically significant effects on patient outcomes. Conclusions: Multiple types of implementation strategies may enhance evidence-based nursing practice, though effects vary due to strategy complexity, contextual factors, and variability in outcome measurement. Some evidence suggests that multifaceted strategies are more effective than single component strategies. Effects on patient outcomes are modest. Healthcare organizations and implementation practitioners may consider employing multifaceted, tailored strategies to address local barriers, expand the use of underutilized strategies, and assess the long-term impact of strategies on nursing practice and patient outcomes. Trial registration: PROSPERO CRD42019130446. [ABSTRACT FROM AUTHOR]

Background Aim Study Design Results Conclusions Relevance to Clinical Practice The visit restrictions imposed as a result of COVID‐19 precluded the entrance of the patient's family into the confines of the intensive care unit.This study evaluated the experiences of intensive care nurses (ICNs) regarding COVID‐19 visit restrictions and their opinions on these restrictions.From May 2023 to July 2023, semi‐structured interviews with 15 ICNs from intensive care units in a tertiary public hospital in Türkiye were conducted. Data were analysed using qualitative content analysis with an inductive approach. Reporting of the study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.The analysis revealed two main themes, ‘widespread negative impacts of visit restrictions’ and ‘adaptive strategies to the visitation ban’, and seven sub‐themes supporting the main themes. Nurses perceived that the visit restrictions imposed during the COVID‐19 pandemic had a severe negative effect on patients, their relatives, themselves and the care environment. They also did not support visit restriction in future pandemics.The COVID‐19 visitation policy weakened the involvement of family members in patient care and created serious challenges in the intensive care setting. The study revealed an urgent need for patient‐centred, family‐sensitive and consistently applied protocols in future pandemics.In future pandemics, strategies such as the benefit–benefit ratio of the visit, the provision and use of adequate personal protective equipment, and vaccination requirements should be considered in visiting decisions of patients hospitalized because of infection. Participation of nurses responsible for patient care in decisions regarding visitor practices should be supported. [ABSTRACT FROM AUTHOR]

Aim Background Methods Finding Conclusion Implications for nursing and health policy To explore the interplay between the perceived nursing work environment, general self‐efficacy, and compassion fatigue among registered nurses in Chinese hospitals.Compassion fatigue emerges as a significant occupational stress response globally, with the nursing work environment being a pivotal influencer. There is a knowledge gap in understanding how the nursing work environment and general self‐efficacy interrelate to affect compassion fatigue, particularly among Chinese nurses.Employing a cross‐sectional, descriptive design, this study utilized validated questionnaires to gather data from 7085 nurses across public and private hospitals in China. The analysis focused on assessing the interrelations among the perceived nursing work environment, general self‐efficacy, and different dimensions of compassion fatigue.More than half (65.67%) of the participants experienced moderate or high burnout levels, with 76.43% experiencing secondary traumatic stress. The lowest rating in the nursing work environment was for nurse/physician collaboration (10 ± 2.07), while general self‐efficacy scored higher (27.54 ± 6.26). A positive relationship existed between the work environment and both general self‐efficacy and compassion satisfaction, with a negative correlation to burnout and traumatic stress. General self‐efficacy was a partial mediator in the link between work environment and compassion fatigue, suggesting that improving the work environment can decrease compassion fatigue by boosting nurses' self‐efficacy.This study underscores the profound impact of the nursing work environment on compassion fatigue, mediated by general self‐efficacy. It highlights the necessity of fostering a supportive work environment to enhance nurses' self‐efficacy and overall well‐being.Healthcare managers and institutions must create supportive work environments to reduce compassion fatigue among nurses. This includes professional development programs to enhance self‐efficacy and job satisfaction. Policies should address high workloads and inadequate support. Nurse leaders should foster environments that promote psychological well‐being, improving outcomes for both nurses and patients. Regular assessments and adjustments of work conditions are essential to maintain a healthy work environment. [ABSTRACT FROM AUTHOR]

Background Aim Study design Results Conclusions Relevance to Clinical Practice Medical devices commonly used for the treatment and care of critically ill patients can cause pressure injuries in intensive care units (ICUs). The endotracheal tube (ETT) is one of the most common medical devices to cause pressure injuries.This study investigated the incidence of, characteristics of and risk factors for ETT‐related pressure injuries for ICU patients.This study adopted a prospective descriptive research design. The sample consisted of 146 endotracheally intubated patients. Data were collected using a patient information form, an Endotracheal Tube‐Related Pressure Injuries Assessment Form, the Braden Risk Assessment Tool and the Nutritional Assessment Test.The study revealed that 80.14% of the patients developed ETT‐related pressure injuries. Over half of the ETT‐related pressure injuries appeared on Day 3 or 4 (56.41%). High body mass index was found to be associated with the development of ETT‐related pressure injuries (OR: 1.15, 95% CI: 1.05–1.26, p = .003). None of the other variables were statistically significant in the development of pressure injuries.The incidence of ETT‐related pressure injuries was quite high in the internal, surgical and anaesthesia ICUs. High body mass index was associated with the development of ETT‐related pressure injuries. Intensive care nurses should implement interventions to prevent ETT‐related pressure injuries in critically ill patients receiving mechanical ventilation support.ETT‐related pressure injuries are common in ICU patients. High body mass index was associated with the development of ETT‐related pressure injuries in critically ill patients. The skin and mucosa should be assessed for the development of ETT‐related pressure injuries during the daily assessment of the patients receiving mechanical ventilation support. The ETT should be repositioned regularly, and the most suitable ETT fixation method should be used. [ABSTRACT FROM AUTHOR]

Background: Palliative care is paramount in the modern clinical field worldwide. However, in Bangladesh, its acceptance is limited compared to other related sectors, despite the country suffering from a huge burden of life-limiting diseases. Besides, PC teams and their approach to care are entirely different from the conventional clinical approach. This study aimed to explore the challenges faced by healthcare providers working in the palliative care unit in Bangladesh, including all groups. Design: This was a cross-sectional descriptive survey involving palliative care providers. Methods: A self-administered pre-tested questionnaire was used for data collection. Data was analyzed using descriptive statistics and Chi-square at p <0.05. Result: The mean age of the respondents was 33.59 ± 8.05 years, and barely most (82.5%) had served for 7–9 years. More than half (51%) of doctors and 31% of nurses claimed patient agitation as a challenge. Almost all groups of respondents exhibit ethical dilemma as a barrier, although a significant relationship was found between professional level and ethical dilemma. More than half of doctors (51%), 41.5% of nurses, and 29.5% of PCA-ward staff mentioned the lack of telemedicine facilities as a challenge. Nearly half (47.1%) of doctors and nurses claimed that patients' families had made patient care difficult, on the other hand, PCA-ward staff (70%) group ignorance of family did the same thing. Opioid phobia of other health professionals restricted the growth mentioned by the majority of all four groups of respondents. A significant relationship was found between limited dose formulation and experience of HPs (p<0.07). At the institutional level, 93.3% of nursing staff agreed that the lack of supporting staff was a drawback. A significant relationship was also found between the type of institution and the lack of a support system to conduct home-based care (p<0.002). Moreover, the majority (83.3%) of PCA-WS exhibit a lack of career development opportunities (p<0.001) as a barrier, besides, more than 7 out of 10 doctors (7.2%) felt social discrimination as a challenge(p<0.001). Conclusion: Introducing new concepts comes with obstacles, but proper planning and awareness can make it necessary. Incorporating it into primary healthcare can create new job opportunities and increase familiarity among the general population. Training healthcare professionals on opioid handling can also increase its acceptance. [ABSTRACT FROM AUTHOR]

Background: Home care provides an excellent opportunity for personalizing treatment as nurses see patients in their natural environment. Along with its many advantages, the home care environment carries unique risks, as nurses are usually alone, without the protection and security provided by primary care clinics. There are no accurate data in Israel on the scope and characteristics of client violence against nurses during home visits. We conducted a qualitative study to investigate the nature of client violence faced by Israeli nurses during home visits, to gain insights into their perceptions and experiences, and to contribute to the development of effective policies and strategies to combat client violence in the healthcare sector. Methods: Twenty-seven female nurses from primary care clinics, who were exposed to client violence during a home visit, were interviewed using a semi-structured interview guide. The interviews were transcribed and analyzed, and categories and themes were extracted. Results: Most nurses interviewed experienced at least three incidents of client violence, the most common of which was verbal abuse. The nurses perceived that the location of the encounter between the nurse and the patient in the patient's natural surroundings, rather than within the controlled boundaries of a clinic, contributes to the risk of violence. Violence affected the nurses' professional decisions. The nurses reported that their organization had no established guidelines or instructions for safely conducting home visits, they were not provided with protective or security measures for emergencies, nor did they perceive that they had sufficient training to deal with client violence in clients' homes. Conclusions: Nurses encounter a range of challenges that make it difficult for them to deal with client violence during home visits, affecting their personal safety and professional decisions. Their ability to manage such situations is shaped by a complex interplay of personal and organizational factors and requires a range of strategies and resources to effectively address them. [ABSTRACT FROM AUTHOR]

Background: Bladder ultrasound (BUS) provides an accurate measurement of post-void residual (PVR) volume and bladder assessment. Access to BUS is dependent on practitioner availability with delays resulting in poor symptom management, delayed discharge and dissatisfaction. Developing nursing practice to perform BUS can address these patient’s needs.Aims: Through a quality improvement initiative the aims were (1) to develop theoretical knowledge and practical competence of nurses to perform BUS, (2) to evaluate nursing activity in relation to BUS, (3) to evaluate stakeholders perceptions of the initiative.Methods: Based on the Deming Plan-Do-Study-Act (PDSA) cycle, an interprofessional team was created and a theoretical/practical based education program was devised. Activity in relation to the nurse-performed BUS was collected and analysed descriptively. Stakeholder perceptions were evaluated via patient and physician questionnaires subject to descriptive analysis and a focus group with nurses analysed descriptively.Results: The team developed a training program to perform BUS, certifying 11 nurses. Investigation of nursing activity related to BUS (n = 202) showed its use for PVR evaluation, and symptom and catheter assessment. It aided decision-making and nurse-physician communication. Stakeholders were satisfied with the initiative. Patients (n = 30) felt nurses were competent, clearly explaining the procedure, results and inspiring confidence. Physicians (n = 2) saw BUS as enhancing efficiency and care quality, while nurses (n = 7) felt this new skill enhanced nursing care providing a more holistic approach. Team reflection on the results of the evaluation confirmed BUS utility and activity, while nurses requested continuing education and a post-certification refresher course.Conclusion: Through reflection on clinical practice areas for improvement to enhance patient care were identified by the nursing team. Application of the PDSA cycle provided a structured approach to guide the quality improvement initiative. Improvements in nursing care and patient care processes have been observed and this has been a positive experience for stakeholders. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Methods Results Conclusion Reporting Method Implications for the Profession and/or Patient Care Impact To assess the knowledge of nurses in Chinese hospitals regarding skin tears, focusing on evaluating their understanding and proficiency in managing and preventing skin tears, exploring the impact of demographic and professional factors on their knowledge levels and identifying specific areas where additional training or education is needed.This study is a multicentre cross‐sectional survey conducted in the Henan province of China using a stratified cluster sampling method.The study utilised the Chinese version of the Skin Tear Knowledge Assessment Instrument (OASES) for evaluating nurses' knowledge levels based on a questionnaire comprising 22 questions on the online platform Wenjuanxing (www.wjx.cn). All questions had to be answered, with only one option selectable per question. Response validity was ensured by excluding questionnaires that showed a clear response pattern, were completed in under 60 s, or scored 0 points. Descriptive analysis, item‐level analysis and multiple linear regression analysis were performed.A total of 1675 clinical nurses participated in this study. Age was a significant factor influencing skin tear knowledge, with older nurses (age, 41–60 vs. 18–40 years) demonstrating higher knowledge scores. Additionally, female nurses exhibited higher average knowledge scores compared to male nurses. Further, different departments, education levels, job titles and having completed relevant courses significantly influenced skin tear knowledge among nurses. However, on multivariate analyses, we found that working in the intensive care unit, having a higher education background and job title and having studied courses on wound, ostomy or incontinence were independent factors influencing knowledge on skin tear, indicating the need for targeted educational interventions.In conclusion, targeted educational interventions and continuous professional development are essential to bridge the identified knowledge gaps among nurses in Chinese hospitals regarding skin tear management.The Strengthening the Report of Observational Studies in Epidemiology checklist guidelines were followed.Enhancing nurses' knowledge and skills in skin tear management through targeted educational programmes could improve patient care quality, reduce the incidence of skin tears and promote better wound care outcomes in clinical settings.This study addresses the problem of knowledge gaps in skin tear management among nurses. The main findings indicate varied understanding and significant factors influencing this knowledge. The research impacts nurses and patients in Chinese hospitals, emphasising the need for specialised training and professional development to improve skin tear management and patient care. No patient or public contribution. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionLower levels of patient physical activity in hospital are associated with poorer functional outcomes. Physiotherapists may influence physical activity outside of therapy time through nursing workforce training.To estimate physical activity levels in acute inpatients after the Risk Assessment for Moving Individuals SafEly (RAISE) manual handling training intervention for nurses. The secondary aims evaluated nurse experiences of training and the extent to which nurses learnt RAISE skills and incorporated them in clinical practice.Using a pre-post design, nurses from an acute neurological and medical ward participated in a physiotherapy-led, 4-hour training session teaching dynamic risk assessment to safely move patients. Patient physical activity and clinical observation audits of patient transfers were assessed prior to, and 1-week following, training. Surveys evaluated nurse experiences of training.Among 26 patients, there was a non-significant, moderate positive effect size favoring increased daily steps by 43% (g=.35, MD 208, 95% CI −263 to 679, p = .370). There was no change in sit-to-stand transitions (g=-.02, MD −0.4, 95% CI −16 to 15, p =.963) or daily sedentary hours (g=.05, MD 0.05, 95% CI −0.8 to 0.9, p=.908). Training was well received by all nurse participants, and the physical risk assessment was implemented into practice 89% of the time post training (X2(1) = 5.00, p = .025).A physiotherapy-led manual handling training program involving dynamic risk assessment may help hospital inpatients to increase physical activity outside of therapy time. [ABSTRACT FROM AUTHOR]

Background Aims Study Design and Methods Results Conclusion Relevance to Clinical Practice Intermediate Care Units (IMCs) are specialized facilities located within other departments in many Western countries. They are designed to manage patients with conditions that are not severe enough to require an intensive care unit. IMCs aim to fill the gap between regular wards and intensive care units, necessitating an adequate allocation of nursing resources.The aims of the study are to (1) evaluate and compare the nursing workload for patients admitted to a regular ward or to an IMC; (2) quantify nursing workload in terms of activities and time spent to perform them; and (3) evaluate which patient characteristics predict nursing work overload.This is an observational, prospective, single‐centre study. We included patients admitted to the Internal Medicine department in a general hospital in Italy, between 1 September and 31 December 2022, either in the regular ward or in the IMC. Clinical characteristics, comorbidity, functionality, frailty, severity and acuity of patients were recorded using validated assessment tools. Nursing activities in the first 3 days of hospitalization were recorded and standardized as activities/5 min/patient/day. An average number of nursing activities/5 min/patient/day exceeding the 85th percentile was considered nursing work overload. Multivariate logistic regression models were conducted to identify patient‐related risk factors associated with nursing work overload.We included 333 patients, 55% (183/333) admitted to the IMC and 45% (150/333) to the regular ward. In the IMC, the average nursing activities were 32.4/5 min/patient/day compared with 22.6 in the regular ward. Nursing work overload was found in 6% (9/150) of patients admitted to the regular ward compared with 23% (42/183) in the IMC.There is a significantly higher demand for nursing care among patients in the IMC, with higher daily average of nursing activities.The allocation of nursing resources within the IMC should be greater than in the regular ward because of higher workload. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim(s) Design Methods Data Sources Results Conclusion Implications for the Profession and/or Patient Care Patient or Public Contribution To explore whether nurses' use of different approaches to manage patient mistreatment can exert distinctive effects on their emotional exhaustion and life satisfaction, and to examine whether supervisor support can mitigate the negative effects of emotional exhaustion on nurses' life satisfaction.A time‐lagged three‐wave survey study with a 2‐week time interval was conducted in 2022.A total of 257 nurses from a Joint Commission International (JCI) accredited general hospital located in eastern China in 2022 completed three‐wave surveys. Descriptive analyses, confirmatory factor analyses and mediation and moderated mediation analyses were performed.Data were collected by using three‐wave self‐reported questionnaires from 257 nurses from a Joint Commission International (JCI) accredited general hospital located in eastern China in 2022.Nurses who managed patient mistreatment more cooperatively experienced lower levels of emotional exhaustion, whereas those who managed patient mistreatment more competitively experienced higher levels of emotional exhaustion. Emotional exhaustion was negatively related to life satisfaction. Moreover, emotional exhaustion mediated the positive and negative relationships between cooperative and competitive conflict management approaches and overall life satisfaction. Additionally, supervisor support mitigated the negative impact of emotional exhaustion on life satisfaction and the indirect effects of conflict management approaches on life satisfaction.To effectively manage the negative impact of patient mistreatment on nurses, both nurses themselves and their supervisors play an important role. Nurses who adopt a cooperative conflict management approach experience lower levels of emotional exhaustion and higher levels of life satisfaction. Supervisor support can alleviate the negative effect of emotional exhaustion on life satisfaction.The findings provide a better understanding for nurses on how to mitigate the detrimental effects of patient mistreatment on nurses and highlight the role of both nurses themselves and their supervisors in protecting nurses' well‐being.No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Methods Results Conclusions Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To compare nurses' and patients' reports of missed nursing care, explore patients' perspectives and utilise these insights to elucidate discrepancies or congruence between perceptions.A descriptive mixed‐methods design combining quantitative (questionnaires) and qualitative (semi‐structured interviews) methods.In the quantitative phase, 143 nurses and 643 patients completed the MISSCARE and MISSCARE‐Patient surveys. Correlations between their total missed care scores were examined. In the qualitative phase, 68 patients participated in semi‐structured interviews analysed using thematic analysis.The correlation between nurses' and patients' perceptions of missed nursing care was nonsignificant. Qualitative findings revealed three themes: (1) patients' need to preserve individuality; (2) most patients attributed missed care to systemic factors, while some attributed it to nurses' attitudes and (3) emotional responses varied from empathetic understanding, inadvertently enabling more missed care, to frustration and assertiveness to ensure receiving necessary care.This study reveals a significant discrepancy between nurses' and patients' perceptions of missed care. Patient perspectives offer insights into this misalignment, highlighting differences in care priorities and role understanding.Enhancing nurse–patient communication and patient empowerment are crucial. Healthcare institutions should integrate patient feedback into quality initiatives, create supportive work environments and foster a patient‐centred care culture. Effectively marketing nurses' expertise and implementing strategies to manage patient assertiveness are essential.This study addresses the discrepancy in perceptions of missed nursing care between nurses and patients. It reveals how patients' care priorities and attributions influence their experience of missed care. Findings will impact healthcare policymakers, nursing educators and hospital administrators, informing strategies to improve care quality, patient satisfaction and nurse work environments across healthcare settings.The study has adhered to STROBE guidelines for the quantitative component and SRQR guidelines for the qualitative component.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Stroke patients often experience limb dysfunction, which can significantly impact their quality of life and daily living abilities. This study aimed to explore the effectiveness of nursing programs that incorporate multidisciplinary continuing care with the participation of nursing staff for patients with stroke and limb dysfunction. Methods: This was a randomized controlled trial (RCT) conducted from August 2021 to August 2023. Ninety stroke patients were randomly assigned to a control group (n = 45) and an observation group (n = 45). The control group received routine discharge care, while the observation group received multidisciplinary continuing care with the participation of nursing staff. Outcomes measured included Fugl-Meyer Assessment (FMA) scores for upper and lower limb function, quality of life, daily living ability (Barthel Index, MBI), and adverse reactions. Results: The FMA scores for upper and lower limbs were significantly higher in the observation group compared to the control group. The observation group also had significantly higher scores in all quality of life dimensions and MBI scores compared to the control group. There were 10 adverse reactions reported in the observation group and 22 in the control group. Conclusions: Implementing multidisciplinary continuing care with the participation of nursing staff for stroke patients with limb dysfunction has a positive effect on improving limb function, quality of life, and daily living abilities, while also being relatively safe. [ABSTRACT FROM AUTHOR]

AbstractMany people with intellectual disabilities have complex health needs that are not met by the Australian healthcare system. The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (the Commission) looked at the failings of the healthcare system and the improvements needed. Services provided by allied health professionals are one part of the healthcare system. This article describes the evidence the Commission heard about the unmet allied health needs of people with intellectual disabilities, the resulting harms caused, and the recommendations to address these. Despite identifying unmet allied health needs, the Commission heard evidence predominantly about nursing and medical care, although many of its recommendations were applied to the entire health workforce, including allied health professionals. The article reflects on the challenges of implementing the Commission’s recommendations and the risk that positive change in health outcomes for people with intellectual disabilities may not be achieved. [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]

Patient satisfaction is crucial in nursing services and could be influenced by nurses' caring behavior. This study aimed to discover the relationship between Swanson's caring nurse approach and patient satisfaction in the 3rd-grade inpatient room. This quantitative descriptive research employed an explanatory survey with a cross-sectional approach. Purposive sampling is the sampling technique used in this research, with a total of 73 participants. Data analysis was conducted using the Chi-square test, and data were collected using an instrument. The results indicated that 47 responders (64.4%) perceived that nurses' caring behavior was not good. Specific indicators revealed that "maintaining belief" was not good for 39 respondents (53%), "knowing" for 53 (73%), "being with" for 45 respondents (62%), "doing for" for 48 respondents (66%), and "enabling" for 49 respondents (67%). Regarding patient satisfaction, 43 people (58.9%) expressed being quite satisfied. Bivariate analysis demonstrated a significant relationship between caring nurses and patient satisfaction, with a p-value of 0.000 or p<0.05. It was recommended that nurses in the inpatient room incorporate improvements in caring behavior into nursing planning and goals. Policies related to the obligation of providing caring actions should be established to enhance patient satisfaction. Nurses were encouraged to consistently apply caring principles, including "maintaining belief", "knowing", "being with", "doing for", and "enabling", to ensure patients were satisfied with their care experience. [ABSTRACT FROM AUTHOR]

BACKGROUND: Standardised management of day surgery for haemorrhoids and achieving standardised nursing in the painless ward of colorectal surgery are important. OBJECTIVE: To explore the role of segmented nursing pathways in patients undergoing day surgery for anorectal procedures and to provide theoretical and practical guidance for day surgery nursing. METHODS: A total of 146 patients undergoing anorectal surgery in our day surgery ward between April 2023 and July 2023 were selected as the study participants, with 74 patients in the control group receiving routine nursing and 72 patients in the experimental group receiving segmented nursing. The preoperative preparedness, preoperative anxiety, complication rate, discharge preparedness and nursing satisfaction were compared between the two groups. RESULTS: The experimental group had higher rates of admission before 8:30 am (77.78% vs 45.95%), awareness of the day surgery process (63.89% vs 24.32%), completion rate of preoperative preparation (81.94% vs 59.46%), satisfaction with preoperative preparation (94.44% vs 74.32%), discharge preparedness (112.42 ± 3.28 vs 95.82 ± 3.41) and nursing satisfaction (97.22% vs 70.27%) compared with the control group (P < 0.05). After the intervention, the self-rating anxiety scale score (43.14 ± 12.44 vs 52.51 ± 13.21) and the self-rating depression scale score (45.03 ± 11.37 vs 55.37 ± 10.14) were lower in the experimental group than in the control group (P < 0.05). CONCLUSION: Segmented nursing pathways can improve the preoperative preparedness of patients undergoing day surgery for anorectal procedures, alleviate patient anxiety, enhance discharge preparedness, improve the quality of nursing care and increase nursing satisfaction. [ABSTRACT FROM AUTHOR]

BACKGROUND: Aortic dissection is usually managed with interventional therapy, conservative therapy, and surgery to inhibit disease progression and improve prognoses. Nevertheless, the absence of meticulous and effective nursing during the treatment greatly increases the complication rates, which is detrimental to the recovery of patients. OBJECTIVE: This study aimed to explore the efficacy of predictive pain intervention in the nursing process of patients with aortic dissection. METHODS: Sixty patients with aortic dissection who were admitted to our hospital from December 2018 to December 2020 were observed in this study. Specifically, these patients were randomly and equally classified into Group A (patients who were given conventional nursing intervention) and Group B (patients who were given predictive pain intervention). Subsequently, the pain score, complication rates, and nursing satisfaction in the two groups were compared and analyzed. RESULTS: Compared with patients in Group A, patients in Group B had significantly lower pain scores (P < 0.05); complication rates were significantly lower in Group B than in Group A (6.67% vs. 23.33%, P < 0.05); patient satisfaction with care was significantly better in Group B compared to Group A (96.67% vs. 73.33%, P < 0.05). CONCLUSION: Predictive pain intervention is widely recognized as useful in the treatment of patients with aortic dissection. It has significant clinical application value as it can largely alleviate pain and is relatively safe for patients. [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]

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The flexibility level allowed in nursing care delivery and the uncertainty in infusion durations are important factors for chemotherapy scheduling. The nursing care delivery scheme employed in an outpatient chemotherapy clinic (OCC) determines the strictness of the patient-to-nurse assignment policies, while the estimation of infusion durations affects the trade-off between patient waiting time and nurse overtime. We study the problem of daily scheduling of patients, assignment of patients to nurses and chairs in the presence of uncertainty in infusion durations for an OCC that functions according to any of the commonly used nursing care delivery system representing fully, partially, and inflexible care systems. We develop a two-stage stochastic mixed-integer programming model minimizing expected weighted cost of patient waiting time and nurse overtime. We propose multiple variants of a scenario grouping-based decomposition algorithm to solve the model using data from a major university oncology hospital. We compare input-based, solution-based, and random scenario grouping methods within the decomposition algorithm. We obtain near-optimal schedules that are also significantly better than the schedules generated based on the policy used in the clinic. We analyze the impact of nursing care flexibility in order to determine whether a partial or fully flexible delivery system is necessary to adequately improve waiting time and overtime. [ABSTRACT FROM AUTHOR]

Background: Complications such as forearm hematoma after coronary intervention through the radial artery are a common complication. Material and methods: By observing, describing, and analyzing the pictures taken during clinical diagnosis and consultation, we summarize the prevention, treatment, and nursing of forearm hematoma after percutaneous coronary intervention, to provide reference for the nursing of patients with forearm hematoma. Results: We have innovatively summarized the risk classification of forearm hematoma and the three key time points for preventing hematoma. Conclusion: Complications such as forearm hematoma after coronary intervention through the radial artery are a common complication. We have innovatively summarized the risk classification of forearm hematoma and the three key time points for preventing hematoma, providing reference for the prevention and management of forearm hematoma in clinical practice. For patients undergoing transradial coronary intervention, the three key time points for preventing hematoma and symptomatic management based the risk classification of forearm hematoma are crucial. Highlights: By identifying risk factors and mastering management measures, the incidence of forearm hematoma after intervention can be effectively reduced, and patient comfort can be improved.Strengthening preoperative evaluation, standardized intraoperative procedures, postoperative care, and rational drug treatment are key measures for prevention.In the future, intelligent monitoring devices can be used for real‐time monitoring and pressure adjustment of forearm hematoma to improve the timeliness and accuracy of hematoma observation. [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]

Nursing performance and empowerment play a crucial role in enhancing patient safety culture. Objective: The goal of this study was to identify how nursing performance and empowerment improve patient safety culture. This research used a literature review design. Twelve publications from the ScienceDirect, MEDLINE PubMed, and ProQuest databases were analysed for this project. Only English-language articles released between May 2017 and September 2023 were included in the literature. A total of 12 articles included for review, with articles rated as high-quality. Several studies have shown that enhancing nursing performance through better education, training, and clinical competence significantly contributes to a positive patient safety culture. This literature review highlights the crucial role of nursing performance and empowerment in improving patient safety culture Based on the scientific data presented in this literature review, decision-makers should consider developing pay systems incorporating credentialing, re-credentialing, and career ladders. It is recommended that future research examine the establishment of well-administered compensation systems for nurses. [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]

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Study Aim: This study aims to describe the transition-in-care work process for sepsis survivors going from hospitals to home health care (HHC) and identify facilitators and barriers to enable practice change and safe care transitions using a human factors and systems engineering approach. Background: Despite high readmission risk for sepsis survivors, the transition-in-care work process from hospitals to HHC has not been described. Methods: We analyzed semi-structured needs assessment interviews with 24 stakeholders involved in transitioning sepsis survivors from two hospitals and one affiliated HHC agency participating in the parent implementation science study, I-TRANSFER. The qualitative data analysis was guided by the Systems Engineering Initiative for Patient Safety (SEIPS) framework to describe the work process and identify work system elements. Results: We identified 31 tasks characterized as decision making, patient education, communication, information, documentation, and scheduling tasks. Technological and organizational facilitators lacked in HHC compared to the hospitals. Person and organization elements in HHC had the most barriers but few facilitators. Additionally, we identified specific task barriers that could hinder sepsis information transfer from hospitals to HHC. Conclusion: This study explored the complex transition-in-care work processes for sepsis survivors going from hospitals to HHC. We identified barriers, facilitators, and critical areas for improvement to enable implementation and ensure safe care transitions. A key finding was the sepsis information transfer deficit, highlighting a critical issue for future study. Application: We recommend using the SEIPS framework to explore complex healthcare work processes before the implementation of evidence-based interventions. [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]