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Purpose: The current study performed a post-occupancy evaluation on a new cancer infusion center with pod-like layout and compared results to a pre-occupancy evaluation to investigate the impact of different cancer infusion center designs on staff efficiency and patient and staff satisfaction. Background: The new cancer infusion center opened in October 2020 and replaced two previously existing infusion centers, in the same healthcare system. Methods: The study used a similar mixed-method approach as the pre-occupancy research, which included staff shadowing, medication delivery shadowing, and staff and patient questionnaires. Results: The new infusion center improved staff efficiencies by reducing nurse travel time compared to pre-occupancy infusion centers. Results also showed an increase in satisfaction with different aspects of the new infusion center including patient privacy, by both patients and nurses. The pod design allowed for better audio and visual privacy for patients, provided a higher amount of worksurface and availability of workstations, reduced noise levels, and enhanced nurse concentration at workstations. Findings indicated that nurses who had prior experience working in the pre-occupancy infusion centers expressed significantly lower levels of satisfaction in the new infusion center, especially in the ability to connect with nurses in other pods. Conclusions: Although the new pod design had limitations in terms of collaborative opportunities across pods, it showed to provide a more efficient work environment for the staff and increase staff and patient satisfactions. The results also highlight the importance of effective change management strategies when nurses transition to a new work environment. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to develop a comprehensive competency framework for advanced practice nurses in Belgium. Design: A co‐design development process was conducted. Methods: This study consisted of two consecutive stages (November 2020–December 2021): (1) developing a competency framework for advanced practice nurses in Belgium by the research team, based on literature and (2) group discussions or interviews with and written feedback from key stakeholders. 11 group discussions and seven individual interviews were conducted with various stakeholder groups with a total of 117 participants. Results: A comprehensive competency framework containing 31 key competencies and 120 enabling competencies was developed based on the Canadian Medical Education Directions for Specialists Competency Framework. These competencies were grouped into seven roles: clinical expert and therapist, organizer of quality care and leader in innovation, professional and clinical leader, collaborator, researcher, communicator and health promoter. Conclusion: The developed competency framework has resemblance to other international frameworks. This framework emphasized the independent role of the advanced practice nurse and provided guidance in a clear task division and delegation to other professionals. It can provide a solid foundation for delivering high‐quality, patient‐centred care by advanced practice nurses in the years to come. Implications for the profession: This competency framework can guide further development of advanced practice nursing education in Belgium and represents a starting point for future evaluation of its feasibility and usability in education and clinical practice. Advanced practice nurses and healthcare managers can also use the framework as an instrument for personal and professional development, performance appraisal, and further alignment of these function profiles in clinical practice. Finally, this framework can inform and guide policymakers towards legal recognition of advanced practice nursing in Belgium and inspire the development of advanced practice nursing profiles in countries where these profiles are still emerging. Impact: What problem did the study address? The absence of a detailed competency framework for advanced practice nurses complicates legal recognition, role clarification and implementation in practice in Belgium.A rigorously developed competency framework could clarify which competencies to integrate in future advanced practice nursing education, mentorship programs and practice. What were the main findings? The competency framework outlined seven roles for advanced practice nurses: clinical expert and therapist, organizer of quality care and leader in innovation, professional and clinical leader, collaborator, researcher, communicator, and health promoter.Differentiation from other expert nursing profiles and clinical autonomy of advanced practice nurses were pivotal. Where and on whom will the research have impact? The comprehensive competency framework for advanced practice nurses and the collaborative methodology used can inspire other countries where these profiles are still emerging.The competency framework can be used as an instrument for role clarification, performance appraisals, continuous professional development, and professional (e‐)portfolios.The competency framework can guide policymakers when establishing Belgian's legal framework for advanced practice nurses. Reporting method: The authors have adhered to CONFERD‐HP: recommendations for reporting COmpeteNcy FramEwoRk Development in health professions. Patient or public contribution: No patient or public contribution in the design of the study. A patient advisory panel commented on the developed competency framework. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to present the third position statement from the International Learning Collaborative (ILC). The ILC is the foremost global organization dedicated to transforming fundamental care. Internationally, fundamental care is reported to be poorly delivered, delayed or missed, negatively impacting patients, their families/carers and healthcare staff and systems. Overcoming this global challenge requires profound transformation in how our healthcare systems value, deliver and evaluate fundamental care. This transformation will take both evolutionary and revolutionary guises. In this position statement, we argue how this [r]evolutionary transformation for fundamental care can and must be created within clinical practice. Design: Position paper. Methods: This position statement stems from the ILC's annual conference and Leadership Program held in Portland, Maine, USA, in June 2023. The statement draws on the discussions between participants and the authors' subsequent reflections and synthesis of these discussions and ideas. The conference and Leadership Program involved participants (n = 209) from 13 countries working primarily within clinical practice. Results: The statement focuses on what must occur to transform how fundamental care is valued, prioritized and delivered within clinical practice settings globally. To ensure demonstrable change, the statement comprises four action‐oriented strategies that must be systematically owned by healthcare staff and leaders and embedded in our healthcare organizations and systems: Address non‐nursing tasks: reclaim and protect time to provide high‐value fundamental care.Accentuate the positive: change from deficit‐based to affirmative language when describing fundamental care.Access evidence and assess impact: demonstrate transformation in fundamental care by generating relevant indicators and impact measures and rigorously synthesizing existing research.Advocate for interprofessional collaboration: support high‐quality, transdisciplinary fundamental care delivery via strong nursing leadership. Conclusion: The ILC Maine Statement calls for ongoing action – [r]evolution – from healthcare leaders and staff within clinical practice to prioritize fundamental care throughout healthcare systems globally. Implications for the Profession and/or Patient Care: We outline four action‐oriented strategies that can be embedded within clinical practice to substantially transform how fundamental care is delivered.Specific actions to support these strategies are outlined, providing healthcare leaders and staff a road map to continue the transformation of fundamental care within our healthcare systems. Impact: Fundamental care affects everyone across their life course, regardless of care context, clinical condition, age and/or the presence of disability.This position statement represents a call to action to healthcare leaders and staff working specifically in clinical practice, urging them to take up the leadership challenge of transforming how fundamental care is delivered and experience globally. Patient or Public Contribution: Patients, service users and caregivers were involved in the ILC annual conference, thus contributing to the discussions that shaped this position statement. What Does this Paper Contribute to the Wider Global Clinical Community?: The strategies and actions outlined in this position statement are relevant to all clinical settings globally, providing practical strategies and actions that can be employed to enhance fundamental care for all patients and their families/carers.By outlining the importance of both evolutionary and revolutionary change, we identify ways in which healthcare systems globally can begin making the necessary steps towards radical fundamental care transformation, regardless of where they are in the change journey. [ABSTRACT FROM AUTHOR]

Introduction. Nursing is widely recognized as a public trust profession due to its emphasis on professionalism, ethical standards, and patient-centered care. The profession demands adherence to legal regulations and ethical norms, fostering trust through its critical role in healthcare delivery. This study aims to explore patients' perceptions of nursing as a public trust profession, focusing on key factors such as professionalism, ethical compliance, and personal attributes of nurses. Objective. The primary goal of this study was to assess patients' opinions regarding nursing as a public trust profession and identify the specific attributes and competencies that underpin this perception. Methods. The study employed a diagnostic survey method using a structured questionnaire. A total of 100 patients from a healthcare facility in the Mazovian Voivodeship participated. Statistical analyses, including descriptive statistics, chi-square tests, t-tests, ANOVA, correlation analyses, and factor analysis, were conducted using IBM SPSS 29. Results. The findings revealed that 95% of respondents identified professionalism and high engagement in care as crucial factors for trust. Empathy and compassion were also rated highly (95%), along with confidentiality (90%). The chi-square test showed significant differences in the perception of professionalism (Chi2 = 140.80, P < 0.001), and ANOVA demonstrated the impact of nurses' attitudes on trust (F = 116.93, P < 0.001). Factor analysis indicated that professionalism and engagement were the primary components influencing trust perceptions, explaining 100% of variance. Conclusions. Professionalism, ethical conduct, and interpersonal skills are pivotal in establishing nursing as a public trust profession. These attributes are essential for patient trust and align with global standards in nursing practice. The study underscores the need to maintain high ethical and professional standards to sustain public trust in the profession. [ABSTRACT FROM AUTHOR]

The scope and standards of professional nursing practice define and guide high-quality nursing care. This article describes the collaboration between the International Home Care Nurses Organization and the American Nurses Association to develop evidence-based scope and standards of practice relevant to home-based nursing around the world. This article describes the collaboration between the International Home Care Nurses Organization and the American Nurses Association to develop evidence-based scope and standards of practice relevant to home-based nursing around the world. [ABSTRACT FROM AUTHOR]

Adherence to professional ethics in nursing is fundamental for high-quality ethical care. However, analysis of the use and impact of nurses' codes of ethics as a part of professional ethics is limited. To fill this gap in knowledge, the aim of our review was to describe the use and impact of the Code of Ethics for Nurses with Interpretive Statements published by the American Nurses Association as an example of one of the earliest and most extensive codes of ethics for nurses with their interpretative statements and constituting a strong basis for the International Council of Nurses' Code of Ethics for Nurses. We based our review on previous literature using a scoping review method. We included both non-scientific and scientific publications to provide an analysis of codes of ethics which can be utilized in development and revision of other nurses' codes of ethics. In the searches, we used CINAHL and PubMed databases limiting publications to texts with a connection to the Code of Ethics for Nurses published from January 2001 to November 2022 and written in English. Searches yielded 1739 references, from which 785 non-scientific and 71 scientific publications were included for analysis of the data. Although non-scientific and scientific publications addressed different number of categories, the results indicated that in the both groups the use and impact focused on professional ethics, nursing practice, and work environment and less on education, research, or social health issues. Nurses' ethical standards were not addressed in non-scientific publications, and clinical issues and leadership were not in focus in scientific publications. To increase evidence-based knowledge of the impact of codes of ethics additional research is needed. Good scientific conduct was followed. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the daily practices of community nurses working in Primary Health Care Centers (PHCCs) and their learning needs. Participants and Methods: This descriptive cross-sectional correlational study was guided by the eight sections of the Canadian Community Health Nursing Standards of Practice 2019 expressing daily clinical activities and learning needs based on a five-point Likert scale. Participants were recruited from three Saudi Arabian cities. Descriptive data were processed regarding mean and Confidence Intervals for items, subscales, and the entire instrument. Comparisons for subgroups' mean scores were assessed using one-way ANOVA followed by a Tukey HSD pairwise comparison. Results: 318 nurses participated in the study (75.5% response rate). The top practiced nursing activities were health education and supporting those who are unable to take action for themselves. On the other hand, the least practiced were participating in research invitations and research groups. Participants expressed their learning needs in utilizing health education theories and strategies and using Health informatics to support optimum nursing care. Conclusion: Saudi Arabia has a young community health nursing taskforce that needs to upgrade its knowledge and skills to match international standards. Understanding the real-life activities and learning needs of community health nurses in comparison to international standards will help health policymakers support the optimal contribution of nursing to patients outcomes and healthcare system utilization. [ABSTRACT FROM AUTHOR]

Background: The ability of nurses to deliver culturally mindful health care may be vital to improving the patient-clinician relationship and subsequent health outcomes for marginalized populations. Continuing education in cultural training should be designed to enhance a nurse's cultural humility. Method: This study explores the concept of nurse cultural humility using the methods outlined by Walker and Avant (2018): define the attributes, offer a model case exemplifying the attributes, discuss the antecedents and consequences, and determine empirical referents. Results: The defining attributes of cultural humility in nursing are a lifelong process of reflexivity, an understanding and appreciation that the cultural backgrounds of both nurse and patient influence health care encounters, and a commitment to redress and mitigate power imbalances in the patient-clinician relationship. Conclusion: By clearly defining nurse cultural humility, leaders will be able to develop cultural training interventions to enhance nurse cultural humility and measure the concept accurately. [J Contin Educ Nurs. 2024;55(12):596–603.] [ABSTRACT FROM AUTHOR]

Inpatient care facilities globally are facing a critical shortage of staff, posing significant challenges to resident well-being and care quality. This issue is further compounded by demographic shifts and increasing care demands. While technological advancements offer promise in alleviating nursing staff burdens, their effective integration remains complex, with nursing staff acceptance playing a pivotal role. This paper describes a systematic approach designed to streamline the process of identifying, categorizing, and prioritizing suitable technologies in inpatient care settings. By taking into account the specific needs and requirements of nursing staff, this approach, validated through a comprehensive case study, aims to facilitate targeted technology adoption, thereby contributing to the successful digitization of this occupational domain. [ABSTRACT FROM AUTHOR]

Despite recognized benefits, regulatory and institutional constraints hinder the full utilization of nurses in care delivery. Recent reforms demonstrate enhanced access and care quality with APRN full practice authority, yet persistent institutional barriers necessitate continued advocacy for advancing health equity. [ABSTRACT FROM AUTHOR]

Purpose This analysis aims to clarify the concept of nursing-sensitive outcomes (NSOs) and provide an operational definition that can be applied in practice, research, and policy, offering nurses and health care professionals a clearer understanding of the specific contributions of nursing care. Methods The concept analysis of NSOs follows Walker and Avant's 2005) framework, which includes selecting a concept, determining the aims of the analysis, identifying uses of the concept, defining attributes, identifying a model case, identifying additional cases, identifying antecedents and consequences, and providing empirical references. Findings This study identified three key attributes of NSOs: 1) measurable changes in health, 2) responsiveness to nursing contributions, and 3) the quality of nursing care. The antecedents of NSOs included empirical evidence, specificity to nursing care, and provision of nursing care. Moreover, consequences of NSOs included improvements in the quality of care, representation of the value of nursing care, and standardization of nursing care. Conclusions A thorough understanding of NSOs is essential for comprehending nursing processes and setting appropriate fees for nursing activities. Identifying the characteristics of this concept enables the measurement of nursing activities' contributions to patient health within health care systems. Addi - tionally, this concept helps us recognize patient responses to nursing interventions and emphasizes the importance of ensuring the quality of nursing care. The most important outcome of NSOs is the improvement in the quality of nursing care. [ABSTRACT FROM AUTHOR]

Aim: To identify and examine the explanatory variables associated with clinical competence among registered nurses (RNs) and practical nurses (PNs) working in long‐term care facilities (LTCF) for older adults. Design and Methods: This was a cross‐sectional study. The competence test, 'the Ms. Olsen test', was used for data collection. A convenience sample of 337 nursing staff working in LTCFs for older adults was selected between December 2020 and January 2021. A quantitative, non‐experimental approach with multiple linear regression analysis examined the explanatory variables associated with clinical competence and the outcome variables. Results: The main findings of the linear regression analysis show that the nursing staff's increasing age, use of Swedish as a working language and use of the Finnish nursing practice standards had statistically significant relationships with clinical competence among the participating nursing staff. Conclusion: This is the first knowledge test that has been developed to test nursing staff's clinical competence in elderly care. In this study in Finland, the highest clinical competence was among the nursing staff who were Swedish‐speaking RNs working in institutional care homes caring for patients according to national practice standards. Implications: These results may be useful to nursing staff and managers working in elderly care to understand the explanatory variables associated with clinical competence in elderly care in Finland and in bilingual settings. The study highlights the importance of using national nursing standards in elderly nursing care. Knowing the explanatory variables associated with clinical competence can provide guidance for the further education of nursing staff in these settings. Impact: Caring according to national practice standards and caring for severely ill patients are associated with clinical competence. Reporting Method: The authors adhered to the EQUATOR network guidelines Appendix S1 STROBE to report observational cross‐sectional studies. Patient or Public Contribution: Registered and PNs completed a questionnaire for the data collection. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the importance of recognising the specific healthcare needs of children and young people • To be aware of the concerns that have been raised in response to the potential move towards a generalist approach in nursing • To learn about some of the suggestions for protecting the field of children and young people’s nursing and optimising care for this patient group. At certain points in nursing history, it has been necessary to make a case for children and young people to be cared for by specialist nurses educated to meet their specific needs. However, in 2018 the updated Nursing and Midwifery Council (NMC) standards of proficiency for registered nurses adopted a generic rather than field-specific approach. This article reiterates that children, young people and their families have unique needs that are best met by nurses who are trained specifically to care for them. The case is made from a historical and legal perspective, concluding with a proposal that in the best interests of children, young people and their families, the NMC should embed specific competencies for children’s nurses into its standards of proficiency to future-proof this field of practice. [ABSTRACT FROM AUTHOR]

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ABSTRACT Aims Design Methods Results Conclusion Implications for the Profession Impact Reporting Method Patient or Public Contribution To explore and describe the meaning of nurses working in care for older adults give to the nursing professional identity.A qualitative approach was taken.Semi‐structured interviews were conducted with 50 bachelor and vocational‐educated nurses working in care for older adults. Interviews were conducted between December 2019 and May 2020. Data were analysed and interpreted through inductive content analysis.Five themes embody the meaning of the nursing professional identity of nurses who work in care for older adults. The five themes are: born to care: a lifelong motivation to nursing; nursing through the noise: dedication in a demanding profession; the silent backbone: caught in the crossfire of interdisciplinary teams; learning under pressure: the demand for expanded nursing expertise and against the current: the barriers to advocacy in nursing.The professional nursing identity of nurses working in care for older adults is multi‐faceted. A personal dedication to patient care, where patients ‘human’ aspect is heavily valued, commits nurses to their profession and underscores their dedication to upholding the quality standard in nursing practice.The older adults' nursing identity highlights that nursing deserves acknowledgement as a professional occupation. Nurses should speak to the public about their professional roles to improve the public view of older adult nursing.A clear understanding of the older adult nursing professional identity clarifies specific roles, experiences and expectations. This can help attract and retain nurses whose views of older adult nursing align with the nursing professional identity. This could help resolve nurse turnover and reduce shortages in older adult care.We adhered to Consolidated Criteria For Reporting Qualitative Research guidelines.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims and Objectives: (I) To identify the opinion and practices of nursing professionals regarding the presence of family members during invasive procedures in hospitalised children; (II) to determine the knowledge of nursing professionals about the patient‐and family‐centred care model. Background: Family presence in invasive procedures benefits the patient and their relatives, but varied attitudes exist among healthcare personnel, with some being favourable and others unfavourable toward family presence. Design: Observational, descriptive, cross‐sectional study. Methods: Study population: Nurses from paediatric critical care services, emergency services, hospital wards, day hospitals and outpatient clinics at a Catalan tertiary hospital who participated voluntarily between September 2021 and July 2022. Data collection instrument: A questionnaire prepared by the researchers, based on the literature and reviewed by experts. REDCap link with access to the questionnaire was sent out to potential respondents through the institutional email. Bivariate analysis was performed with the R 4.2 program. The study was approved by the hospital's Clinical Research Committee and participants gave informed consent before responding to the questionnaire. Results: A total of 172 nurses participated, and 155 valid responses were obtained. All respondents consider the family as a key element in paediatric care and report inviting family members to participate in the care given to their child. However, 12.0% of nurses do not invite the family to be present in invasive procedures. Almost all respondents note the need for training to acquire communication skills and improve the management of emotions. Conclusions: The results show a favourable opinion towards the presence of family members and highlight the need to train nurses to develop communication skills. Relevance to clinical practice: The data provided can favour the design of measures to improve and promote the presence of parents during invasive procedures, reinforcing the patient‐and family‐centred care model and improving the quality of care provided. One example is the creation of family care protocols where the inclusion of parents and the roles of each individual involved in the care process appears. [ABSTRACT FROM AUTHOR]

There is a global shortage of nurses, leading many countries to recruit internationally qualified nurses (IQNs) to fill the gap. However, IQNs encounter challenges in integrating into their new professional environment, particularly in their interactions with locally qualified nurses (LQNs). Intraprofessional cultural competence (IPCC), defined as 'a set of congruent behaviours and attitudes that enable professionals to work respectfully and effectively in cross‐cultural situations', may be a strategy to address these challenges. Content analysis was used to examine nursing regulatory documents (Standards for Practice [Standards] and Codes of Conduct [Codes]) from the United Kingdom, New Zealand and Australia. Data were extracted and organised based on four key themes relevant to IPCC. The analysis revealed a focus on 'Mutual collaboration and professional relationships' in six regulatory documents, with explicit commitments to preventing racism and discrimination in the Australian and NZ Codes. However, issues such as racism, discrimination, bullying and harassment faced by IQNs are not comprehensively addressed, as the documents mainly prioritize culturally appropriate patient interactions over relationships between colleagues. Using regulatory documents to address IPCC may influence positive change such as improving communication, and preventing racism, bullying, discrimination and harassment within nursing. [ABSTRACT FROM AUTHOR]

We aimed to reveal the attitudes and perceptions of a group of nurses toward collaborative work and the barriers to collaborative practice. At the end of the study, we obtained four main themes: leadership in health services, interpersonal interaction factors, cooperation in patient care, standardization. The nurses emphasized the critical elements of respect, relationships and communication as components of effective collaborative practice. As a result, it was stated that the practice of cooperation between doctors and nurses is weak and there are some difficulties and obstacles. [ABSTRACT FROM AUTHOR]

Background: Diarrhea during enteral nutrition may induce various complications and increase the nursing workload. Local Problem: The diarrhea rate in our intensive care units (ICUs) was 37.14% from May to July 2021. Nurses reported a moderate to heavy burden regarding care for those with diarrhea. Methods: A pre-post implementation design was used to evaluate the impact of evidence-based interventions for diarrhea screening and prevention. Interventions: A diarrhea risk screening tool and countermeasures were developed through an extensive literature review. Tools were integrated into the electronic health record system. Results: The rate of diarrhea decreased from 37.14% to 17.33% (P = .000). Nurse's compliance with practice standards increased for diarrhea assessment, risk factor screening, agent choice, and countermeasures provision (P < .05). Conclusions: The evidence-based tools developed for this project helped decrease the diarrhea rate in our ICUs. [ABSTRACT FROM AUTHOR]

Infection prevention and control (IPC) is essential in nursing practice to safeguard patient health and reduce healthcare-associated infections. This article explores IPC strategies, including hand hygiene, the use of personal protective equipment, environmental cleaning, safe injection practices, and antimicrobial stewardship. It discusses the implementation challenges and solutions, such as ensuring compliance through education, monitoring and strong leadership. IPC measures are crucial in preventing infections such as catheter-associated urinary tract infections, central line-associated bloodstream infections, surgical site infections, and ventilator-associated pneumonia. By integrating personalised IPC strategies into nursing practice, healthcare providers can significantly improve infection control outcomes and enhance overall patient safety and quality of care. [ABSTRACT FROM AUTHOR]

Documentation of nursing care is authentic proof of nursing service activities, serving as the basis for fulfilling nurses' responsibilities and accountabilities. Family nursing documentation holds distinct characteristics compared to other nursing practice settings. The Indonesian nursing professional organization has established three standards for nursing care: diagnosis, intervention, and outcome. This research aimed to understand how the implementation of family nursing care documentation is conducted by community nurses in Tarakan City. The research was a correlational study with a cross-sectional approach. The study population consisted of all the nurses working in Community Health Centers in Tarakan City, totaling 80 individuals. The sample was selected using total sampling. The research variables included demographic factors, nurses' knowledge about the documentation concept, and the application of family nursing documentation; these were measured using a modified researcher-made questionnaire and declared valid and reliable. The analysis of research data used descriptive analysis and the Spearman Rank correlation test. This research identified that the majority of community nurses in Tarakan City did not implement family nursing documentation, and the level of knowledge regarding nursing documentation concepts was low. The Spearman's rank correlation test yielded a p-value of 0.874, indicating no significant correlation between the level of knowledge and the implementation of family nursing documentation. The inhibiting factors for the implementation of family nursing care documentation primarily included a high workload, a limited number of health center nurses, motivation, and the lack of clear and uniform documentation guidelines. [ABSTRACT FROM AUTHOR]

Background: Avoiding futile treatment for patients at the end of life is among one of the care challenges of nurses in intensive care units (ICUs). Aims: This study aimed to determine the attitude of intensive care unit nurses toward futile treatment and its relationship with missed care for patients at the end of life. Method: This cross-sectional study was conducted on 307 ICU nurses. Eleven teaching hospitals were selected from three Iranian provinces, Zanjan Province, East Azerbaijan and West Azerbaijan, in 2021. The data were collected using The Attitudes Toward Futile Treatment Scale (ATFTS) and The Missed Nursing Care Survey (MISSCARE Survey) as self-reports. Results: According to the obtained results, 94.8% of the nurses agreed that futile treatment should not be performed. However, 97.7% of the nurses reported that missed care occurs less for patients at the end of life. The correlation between the MISSCARE Survey's total scale and the ATFTS's total scale was positive and statistically significant (r =.11). Conclusion: This research contributes to understanding nurses' attitudes toward futile treatment. Nurses oppose futile treatment, so obstacles to avoiding it should be eliminated. This attitude does not have a significant impact on nursing care quality or missed care for patients at the end of life, but it can lead to enduring distress for nurses. It is recommended to study the reasons for futile treatment, and its link to nurses' mental and physical health. [ABSTRACT FROM AUTHOR]

Purpose: Determine if the SPIKES method was associated with less distress and more compassion than current modes of delivering negative pregnancy test results to patients undergoing in vitro fertilization. Methods: Twenty-seven nurses from two centers were randomized to use the modified SPIKES script or continue their standard of care; 136 patients with a negative hCG following embryo transfer were included. SPIKES nurses received 1 h of training by a study psychologist; nurses in the control group were instructed to deliver the news as done previously. Patients who underwent embryo transfer and received a call by a participating nurse with a negative test result received an email invitation on the following day. Results: Control patients reported significantly less distress than SPIKES patients; 33% of SPIKES patients reported that they had felt "extremely sad," compared to 15.2% of the control patients (p = 0.01). Perceived compassion did not differ between the groups (all p ≥ 0.22). Conclusion: Patients who received a negative pregnancy test result from the nurses who received a brief training and a script on how to deliver bad news via the modified SPIKES protocol reported significantly more distress than patients receiving negative results from nurses utilizing their standard of care. It is unclear whether a modified SPIKES method to deliver negative pregnancy test results will benefit patients undergoing in vitro fertilization. Trial registration: Clinical trials.gov NCT04917445. [ABSTRACT FROM AUTHOR]

Emergency nurses are the first clinicians to see patients in the ED; their practice is fundamental to patient safety. To reduce clinical variation and increase the safety and quality of emergency nursing care, we developed a standardised consensus-based emergency nurse career pathway for use across Australian rural, regional, and metropolitan New South Wales (NSW) emergency departments. An analysis of career pathways from six health services, the College for Emergency Nursing Australasia, and NSW Ministry of Health was conducted. Using a consensus process, a 15-member expert panel developed the pathway and determined the education needs for pathway progression over six face-to-face meetings from May to August 2023. An eight-step pathway outlining nurse progression through models of care related to different ED clinical areas with a minimum 172 h protected face-to-face and 8 h online education is required to progress from novice to expert. Progression corresponds with increasing levels of complexity, decision making and clinical skills, aligned with Benner's novice to expert theory. A standardised career pathway with minimum 180 h would enable a consistent approach to emergency nursing training and enable nurses to work to their full scope of practice. This will facilitate transferability of emergency nursing skills across jurisdictions. [ABSTRACT FROM AUTHOR]

Background: Because of the growth of nursing care in ambulatory clinics, nursing education and professional development needs have increased. Method: At one academic medical center, development of a combined centralized-decentralized nursing professional development model addressed the needs of this expansion. Results: Hiring dedicated nursing professional development staff for prioritized education programs improves throughputs and outputs associated with nursing professional development. Conclusion: Implementation of unit-based clinic rounding has improved staff engagement with education, professional development, and quality outcomes. [J Contin Educ Nurs. 2024;55(9):449–455.] [ABSTRACT FROM AUTHOR]

This study focuses on the automatic generation of architectural floor plans for standard nursing units in general hospitals based on Stable Diffusion. It aims at assisting architects in efficiently generating a variety of preliminary plan preview schemes and enhancing the efficiency of the pre-planning stage of medical buildings. It includes dataset processing, model training, model testing and generation. It enables the generation of well-organized, clear, and readable functional block floor plans with strong generalization capabilities by inputting the boundaries of the nursing unit's floor plan. Quantitative analysis demonstrated that 82% of the generated samples met the evaluation criteria for standard nursing units. Additionally, a comparative experiment was conducted using the same dataset to train a deep learning model based on Generative Adversarial Networks (GANs). The conclusion describes the strengths and limitations of the methodology, pointing out directions for improvement by future studies. [ABSTRACT FROM AUTHOR]

Background: Despite increasing interest in quality end-of-life care (EOLC), critically ill patients often receive suboptimal care. Critical care nurses play a crucial role in EOLC, but face numerous barriers that hinder their ability to provide compassionate and effective care. Methods: An integrative literature review was conducted to investigate barriers impacting the quality of end-of-life care. This review process involved searching database like MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, EBSCO, and ScienceDirect up to November 2023. Search strategies focused on keywords related to barriers in end-of-life care and critical care nurses from October 30th to November 10th, 2023. The inclusion criteria specified full-text English articles published between 2010 and 2023 that addressed barriers perceived by critical care nurses. This integrative review employs an integrated thematic analysis approach, which combines elements of deductive and inductive analysis, to explore the identified barriers, with coding and theme development overseen by the primary and secondary authors. Results: Out of 103 articles published, 11 articles were included in the review. There were eight cross-sectional descriptive studies and three qualitative studies, which demonstrated barriers affecting end-of-life care quality. Quality appraisal using the Mixed Method Appraisal Tool was completed by two authors confirmed the high credibility of the selected studies, indicating the presence of high-quality evidence across the reviewed articles. Thematic analysis led to the three main themes (1) barriers related to patients and their families, (2) barriers related to nurses and their demographic characteristics, and (3) barriers related to health care environment and institutions. Conclusion: This review highlights barriers influencing the quality of end of life care perceived by critical care nurses and the gaps that need attention to improve the quality of care provided for patients in their final stages and their fsmilies within the context of critical care. This review also notes the need for additional research to investigate the uncover patterns and insights that have not been fully explored in the existing literature to enhance understanding of these barriers. This can help to inform future research, care provision, and policy-making. Specifically, this review examines how these barriers interact, their cumulative impact on care quality, and potential strategies to overcome. [ABSTRACT FROM AUTHOR]

BACKGROUND: Literature on advanced practice providers (APPs) prescribing chemotherapy independently, without physician cosignature, is limited. OBJECTIVES: This project assessed safety and provider satisfaction for an existing independent APP chemotherapy prescribing privilege at a National Cancer Institute-designated comprehensive cancer center. METHODS: Rate of Reporting to Improve Safety and Quality events associated with APPs with independent chemotherapy prescribing privileges was compared to that of physicians during a threeyear period. Satisfaction of APPs with independent chemotherapy prescribing privileges was evaluated. FINDINGS: The odds of a reported event were higher for physicians than for APPs. APP survey responses were positive for readiness, confidence, and satisfaction with independent chemotherapy prescribing privilege. [ABSTRACT FROM AUTHOR]

This editorial comments on the article by Mueller et al. [ABSTRACT FROM AUTHOR]

Background: The 2005 revision of the code of ethics for nurses has been in effect in Taiwan for more than 17 years. Although this code has been smoothly implemented during this time, changing social expectations and ethical perspectives, advancements in science and technology, and the evolution of the nurse-patient relationship suggest this code should be once again be updated. Purpose: This study was conducted to suggest revisions to the Taiwan code of ethics for nurses necessary to meet current needs and address social and medical care environment trends. Methods: A multivariate research approach was adopted. The classification of the code of ethics for nurses norms in six international nursing organizations and evidence-based ethical and philosophical thinking literature were referenced, with the main notification demands incorporated into the Ministry of Health and Welfare's Nursing Workplace Controversy Reporting Platform. After drafting the aspects and provisions of Taiwan code of ethics for nurses norms, expert review procedures such as focus groups, Delphi expert consensus, and public forums were conducted. Results: After three expert focus group discussion rounds, a structured questionnaire was completed, and 50 Delphi experts in six fields completed the online questionnaire. After the second consensus round, the importance and clarity of the 47 ethical code provisions in the four aspects were determined with 100% and 99.8% agreement reached, indicating no significant difference in scores between the multidisciplinary expert group and the ethical code. The resulting revision proposed for the Taiwan code of ethics for nurses includes: nursing staff and care recipients (14 provisions), nursing staff and practice (13 provisions), nursing staff and the profession (10 provisions), and nursing staff and society (10 provisions). Conclusions/ Implications for Practice: In terms of education, the revised Taiwan code of ethics for nurses should be integrated into the nursing education curriculum of nursing colleges and used as teaching material for the continuing education of nurses. In terms of policy, these norms should be included as evaluation benchmarks and inspection items for hospitals. In addition, the attention and support of senior managers in institutions must be secured and a handling protocol for moral dilemma cases and related consultation mechanisms must be established. Nursing supervisors should be guided to develop the ability to address these dilemmas to help foster a positive workplace and a respectful team atmosphere. All professional groups should participate actively in promoting issues related to nursing ethics, organize seminars and continuing education activities, and make the revised Taiwan code of ethics for nurses and learning cases available online for reference by nursing staff nationwide. [ABSTRACT FROM AUTHOR]

Aims Background Introduction Methods Results Discussion Conclusion and implications for nursing and health policy To explore the experience of registered nurses and their mentors in the implementation of the Gerontological Nursing Competencies in long‐term aged care and the perceived effectiveness and suitability of the programme to support nurse development.The global population is ageing and needs a reliable aged‐care nursing workforce.Opportunities for education and mentorship for newly qualified and experienced aged‐care nurses warrant investigation.Qualitative evaluation using semi‐structured focus groups was conducted following the implementation of the programme into five not‐for‐profit long‐term aged‐care organisations and analysed by a reflexive qualitative thematic approach and reported according to COREQ criteria.A total of 21 nurses (7 mentors and 14 mentees) participated in six focus groups. Five themes were generated: (1) nurses gained confidence and competence through the programme; (2) the facilitation of suitable mentoring activities and approaches was crucial to success; (3) the programme helps nurses recognise gerontology as a specialty; (4) the programme contributes to building a strategy of recruitment/retention/quality improvement in the sector; (5) barriers, challenges, changes and recommendations were identified.The Gerontological Nursing Competency model, which combined adaptive mentoring supported by reflective practice embedded in a gerontological nursing competencies framework, was perceived to improve nurse confidence and competence to lead and improve nursing standards of care.The evidence‐based competencies are an acceptable and effective method for supporting gerontological nurse development. Expansion of, and accessibility to, the programme may aid global responses to aged‐care reform, by building the recognition of gerontological nursing as a specialty and contributing towards recruitment, retention and quality care improvements. [ABSTRACT FROM AUTHOR]

Standardized blood pressure (BP) measurements for patients with chronic kidney disease (CKD) are paramount in the management of hypertension. Evidence shows nursing staff adherence to best practice guidelines for BP measurement are suboptimal. A pre-/posttest pilot study implementing a six-week hybrid educational intervention for nursing staff was conducted in an outpatient nephrology office. The Evidence-Based Practice (EBP) Beliefs Scale was administered to participants (n = 6) to assess individual beliefs about EBP and implementing EBP guidelines for BP measurement. One Likert-type question measured participant change in BP measurement. Improvement was noted in EBP beliefs and ability to implement EBP guidelines post-intervention. A favorable response was present for participant change in BP measurement per guidelines post-intervention. The intervention is a feasible method to improve staff adherence to EBP guidelines for BP measurement. [ABSTRACT FROM AUTHOR]

This article provides an update on patient safety data recently reviewed by and recommendations of the President's Council of Advisors on Science and Technology. This article attempts to capture the impact of the eroding ability of the nursing workforce to perform its traditional role of blocking errors before they harm patients. Some strategies, tactics, and practice examples to assist in renewing this protective capacity in today's challenging environment are presented. Finally, acknowledging the variability of substantive support for maintaining a safety culture provided by individual health care organizations, this article encourages and applauds the personal courage of nephrology nurses and other health care providers as they engage and assist their clinical and quality improvement teams in addressing the persistence of what Hughes (2008) termed the "everydayness of errors" (p. 1-7). [ABSTRACT FROM AUTHOR]

Standard precautions are essential to prevent cross-infections among emergency nurses, particularly during a pandemic of infectious diseases. However, poor adherence to such standard precautions is an ongoing global health system problem. This may be due to nurses' lack of adequate understanding regarding the influencing mechanisms of various factors that cause cross-infection in practice. In this cross-sectional study, we rigorously utilized the Theory of Planned Behaviors as a guiding framework to develop and test a causal model of factors influencing adherence to standard precautions practices among Chinese emergency nurses. From July 2022 to February 2023, purposive sampling was used to recruit 310 emergency nurses from eight tertiary hospitals in four cities in Sichuan Province, China, during the COVID-19 pandemic. Research instruments included a Demographic Data Form, the Standard Precautions Questionnaire, the Leading Culture of Quality in Infection Prevention Scale, and the Compliance with Standard Precautions Scale. Data were analyzed using descriptive statistics and the Analysis of Moment Structure program to test the influencing factors. The final model of factors influencing adherence to standard precautions practices among Chinese emergency nurses explained 36% of the variance. This model provides a practical tool for understanding and improving adherence to standard precautions. Infection prevention climate and intention can affect adherence practices directly. In addition, nurses' attitudes to standard precautions, social norms of standard precautions, perceived behavioral control of standard precautions, and infection prevention climate indirectly affected adherence practices through intention as the mediator. Among these factors, infection prevention climate had the most substantial effect on adherence practices. These findings underscore the pivotal role of nursing administrators in highlighting the remarkable benefits of standard precautions, shaping emergency nurses' positive attitudes and confidence toward standard precautions, and creating a supportive climate for infection control. By implementing these strategies, nursing administrators can significantly improve adherence to standard precautions, ensuring a safer healthcare environment for workers, patients, and the public. [ABSTRACT FROM AUTHOR]

School nurses are more likely to support students' health, safety, and readiness to learn if they approach their practice through the lens of the School Nursing Practice Framework™ (the Framework). Practicing with an intentional focus on the Framework principles is called practicing with a Framework mindset. This article is the first in a 5-part series discussing how to be a school nurse who practices with a Framework mindset. In this article, school nurses will discover the basis for updates to the Framework's Standards of Practice principle, differences between the Standards of Practice principle and the authoritative standards of school nursing practice, activities that exemplify the Standards of Practice principle, and how to address a real-world school nursing challenge with a Framework mindset attuned to the Standards of Practice principle. [ABSTRACT FROM AUTHOR]

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Life Care Planners may find themselves working with a niche industry of healthcare professionals that are involved in projecting healthcare services in the context of personal injury cases. Healthcare services received and those likely needed in the future in the context of a personal injury case are often reviewed and allocated by medical audit/ billing specialists as well as life care planners. Prospective healthcare service determinations are typically determined by a life care planner and supported by collaboration with treating providers to help them understand the specific future care needs required to address the injury over the life expectancy of the injured party. Life care planners may incorporate the spirit of a case management function; however, this type of projected services and cost research often involves obtaining specific details as to what procedure codes would represent the projected services. In addition, life care planners may rely on prognosis research in their discussions with the treating providers to support and strengthen the future care allocations. [ABSTRACT FROM AUTHOR]

Background and Purpose: An education program to improve the delirium care competency of nurses is important as they play an integral role in caring for patients with delirium. This study aimed to examine the effects of a standardized patient (SP)-based delirium care education program on new graduate nurses' performance and self-confidence. Methods: A waitlist control group with a crossover design was adopted. The SP-based delirium care education program was designed, implemented, and evaluated. Generalized estimating equations were used to analyze differences in performance and self-confidence scores between the intervention and waitlist control groups. Results: The education program was found to significantly affect rater-assessed performance, SP-assessed performance, and self-confidence when controlled for gender and age. Implications for Practice: An SP-based delirium care education program improved new graduate nurses' performance and self-confidence in caring for patients with delirium. Nurse educators should provide experiential learning opportunities to ensure that recent nurse graduates have achieved optimal delirium care competency. [ABSTRACT FROM AUTHOR]

The adult/gerontology (gero) nurse practitioner (NP) delivers primary and/or specialty palliative care to persons and their families who live each day with a myriad of serious illnesses. In this role, the adult/gero nP uses their skill set to address the whole person (physical, psychological, social, and spiritual/existential) to improve the quality of life for persons they care for. This article is the fourth in a series of 6 highlighting the different roles of the adult/gero NP and the advanced certified hospice and palliative registered nurse, and how these 2 roles overlap. The purpose of this article was to provide details of education and certification pathways for these NP roles, describe the overlaps in clinical care, and illustrate how the adult/gero NP in palliative and hospice care can contribute to leadership in program development for care of persons and their families who live with serious illness. [ABSTRACT FROM AUTHOR]

Objective: Investigate the impact of combined computerized cognitive training and occupational therapy on individuals with mild cognitive impairment (MCI). Methods: We randomly assigned 118 MCI patients into two groups: a combined intervention group (n = 37) and a control group (n = 81), the latter receiving standard nursing care. The intervention group additionally underwent 12 weeks of computerized cognitive training and occupational therapy. Blind assessors evaluated cognitive performance, anxiety, depression, and daily living activities before the intervention, post-intervention, and at a 3-month follow-up. Results: Repeated-measures analysis of variance showed that the sMoCA scores, HAMA scores, and ADL scores of the experimental group at T2 (post-intervention) and T3 (3-month follow-up) were higher than those of the control group, and the difference was statistically significant (p < 0.001, p < 0.001, p = 0.026). Conclusion: Computerized cognitive training combined with occupational therapy can improve patients' cognitive status, enhance their compliance with continuing care, and maintain their anxiety and self-care ability at a stable level. [ABSTRACT FROM AUTHOR]

A registered nurse from the United States was hospitalized while traveling internationally. She reflects on the hospitalization experience, patient-provider communication when there is a language barrier, nursing scope of practice, and healthcare standards of practice. [ABSTRACT FROM AUTHOR]

The article examines the characteristics of a world-class nursing school, highlighting the essential attributes that contribute to its excellence. Topics discussed include the impact of strong leadership and vision, the importance of values and rigorous accreditation, and the role of international collaboration and local clinical partnerships.

The article presents the position statement of the American Nephrology Nurses Association (ANNA) on the delegation of nursing care activities.

South Korea is an aging society with a rapidly increasing number of people with dementia. In that context, this study aimed to compare dementia nursing home building standards in South Korea and Germany, based on the minimum physical and architectural requirements specified by both countries' relevant laws, to gain insights into improving South Korean building standards. I examined South Korea's Welfare of Senior Citizens Act and its Enforcement Regulations, and Germany's Federal Nursing Home Act (HeimG), Regulation on Minimum Standards for Nursing Homes (HeimMindBauV), and the corresponding state regulations. The analysis revealed differences regarding the basic requirements, facility sizes, composition of necessary rooms, and detailed regulations pertaining to these rooms. South Korea emphasized autonomy, including barrier-free and compensatory environments, as well as safety and security. Meanwhile, Germany enhanced similar aspects of autonomy to those in South Korea, including the barrier-free standard DIN 18040-2. Additionally, Germany incorporated features such as familiarity, sensory stimulation, legibility, and social interaction, reflecting aspects that offer orientational cues for autonomy. Improving South Korean building standards requires stronger regulations on the autonomy of individuals with dementia. Further, additional regulations on familiarity, sensory stimulation, legibility, and social interactions should be considered. The results provide foundational data for cross-national comparisons to establish building standards for dementia-friendly built spaces in dementia nursing homes in South Korea. Further surveys on spatial utilization, discussions, and the application of proposed improvements in Korea would contribute to enhancing the dementia-friendly nursing home design in the country. [ABSTRACT FROM AUTHOR]

Background: During the COVID619 pandemic, hospitals implemented several infection control measures that could affect the quality of insertion and management of peripheral intravenous catheters $PIVCs). Pre-pandemic studies found a high rate of PIVC complications, but no studies to date have assessed the quality during the pandemic period. Objective: This prospective study aimed to investigate the effect of the pandemic on PIVC management and care. Method: Data were collected from adult patients $_18 years) at a university hospital in Norway during a three-week period in February 2020 (pre-pandemic: PP group) and a three-week period in October 2020 (pandemic: P group). The primary outcome measure was PIVC quality as determined by the validated PIVC Mini Questionnaire $PIVC-miniQ%, which consists of 16 items relating to deviations from best practice. Results: The study included 483 PIVCs and 413 patients. Of these, 238 PIVCs $49.3%% were collected in the PP group and 245 $50.7%% in the P group. In the PP group, 41.8% of the PIVCs were 18 gauge (green PIVC% or larger, compared to 53.3% in the P group. The median PIVC-miniQ score was 2 in both groups, with a range of 0710 in the PP group and 078 in the P group. Improved quality in terms of fewer patients reporting pain was registered in the P group $14.3% compared to 6.7%%, and 36.3% had blood in the IV line in the PP group, compared to 26.5% in the P group. However, a poorer quality was observed in the P group for the PIVC-miniQ items 'purulence' $0% in the PP group compared to 6% in the P group) and 'loose dressing' $15.2% in the PP group compared to 24.9% in the P group). Documentation of PIVC insertion and indication was equally insufficient in both groups (p = 0.857%. Conclusion: Although some differences were observed at item level, the PIVC quality as measured by the PIVC-miniQ total score remained unchanged during the pandemic. Given the low workload of our hospital during the pandemic, it is a paradox that the PIVC care did not improve. [ABSTRACT FROM AUTHOR]

Outpatient services and specialized wound care clinics have become an expanding practice worldwide, which may be related to the increased life expectancy, rise in chronic diseases, favoring the occurrence of vascular and diabetic ulcers, as well as prolonging their treatment and delaying improvement. The high costs and risks associated with hospitalization lead to the patient being referred to a specialized wound center for continued treatment. The adoption of value-based healthcare models seeks cost reduction but primarily focuses on improving patient health outcomes. Its design and implementation depend on data that allows for measuring the health outcomes and costs of care for each patient and utilizing that information to drive continuous improvements. This study aims to propose quality and performance indicators for becoming a standard practice in specialized nursing services in wound care to enable the adoption of value-based healthcare models. The consultation of 19 experts through the Delphi method enabled the systematic organization of a large number of indicators identified in the literature into 8 categories and 43 specific indicators. [ABSTRACT FROM AUTHOR]

As modern nursing advances at an astounding rate, existential advocacy (EA) is vital for delivering patient care in line with wellness goals and personal values. This concept analysis aims to define EA within the context of nursing and align the concept with Jean Watson's Unitary Caring Science (UCS) and her 10 Caritas Processes. A comprehensive literature search identified 12 relevant publications from the following databases: PubMed, PsycINFO, Google Scholar, and CINAHL. Subsequently, utilizing Walker and Avant's method for concept analysis, a standardized structure to identify EA's defining attributes, antecedents, consequences, and empirical referents emerged. Antecedents for EA are patient vulnerability, nurse-patient rapport, nurse autonomy to act as an advocate, and patient request for advocacy. Defining attributes of EA include the following: supporting patient self-determination, caring-trusting nurse-patient relationship, promoting individualized meaning of health and wellness, and encouraging values-based problem-solving. The optimal consequence of EA is patients' awareness of their current health status, leading to individualized care and decision-making based on a patient's values. EA is a nurse's effort to support and promote their patients' right to self-determination by helping them discern their holistic health and wellness situation and then clarify their values within that reality. Watson's UCS and 10 Caritas Processes align with EA to facilitate nurse-patient transpersonal caring occasions. EA explicates the care and advocacy nurses provide into a defined concept while highlighting nurses' essential role in patients' physical, emotional, and spiritual well-being. With EA better defined, the concept can be assessed, measured, and implemented within the discipline of nursing. [ABSTRACT FROM AUTHOR]

The article presents a question and answer related to enabling registered nurses, licensed practical and vocational nurses, and assistive personnel to practice to the fullest extent of their license or certification.