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To evaluate the feasibility, effectiveness, and acceptability of a spherical video-based virtual reality training programme aimed at helping nurses manage workplace violence.
A convergent mixed-methods study.
This study included nurses from a tertiary medical centre in Taiwan. The training programme involved four interactive 360° scenarios focused on recognising, de-escalating, and responding to workplace violence. Quantitative measures included risk perception, confidence in coping with aggression, and technology acceptance. Qualitative measures included the participants' learning experiences. Quantitative and qualitative findings were integrated through joint displays.
The programme was feasible, with all participants completing the training. Nurses reported high levels of perceived usefulness and ease of use. Quantitative data revealed considerable improvements in risk awareness and confidence in responding to incidents of violence. Qualitative data revealed that immersion and emotional resonance enhanced engagement, fostered self-reflection, and reinforced learning. Technical challenges included subtitle placement and speech recognition accuracy.
Spherical video-based virtual reality is a feasible, acceptable, and effective training approach that improves nurses' preparedness for managing workplace violence by enhancing situational awareness and confidence in addressing high-risk situations.
Integrating spherical video-based virtual reality into continual education may strengthen nurses' workplace safety competencies, prevent harm from incidents of violence, and improve patient care in stressful environments.
Workplace violence undermines nurse safety and patient care. Current training modules often lack contextual realism. Our programme improved nurses' awareness, confidence, and reflective learning and was feasible and well accepted. The findings are relevant to nursing educators, hospital administrators, and policymakers seeking sustainable strategies for addressing workplace violence.
This study adhered to the Revised Standards for Quality Improvement Reporting Excellence.
Patients or the public were not involved in the design, conduct, or reporting of this study.
To investigate the relationship between nursing ethical leadership style, work environment (workload, interpersonal conflicts) and patients' objective nursing-sensitive outcomes (accidental falls, pressure ulcers, nosocomial infections, restraints and deaths).
Nationwide multicentre cross-sectional multilevel survey.
Validated self-report scales were used to assess nurses' perceptions of ethical leadership, workload and interpersonal conflict. Nursing staffing and objective patient' nursing-sensitive outcomes were measured at the ward level. Descriptive and inferential analyses were conducted. Structural equation modelling examined the relationships among these variables based on Donabedian's conceptual framework.
Data from 2349 nurses across 158 wards in 25 Italian acute care hospitals were analysed. The multilevel model showed an excellent fit. Ethical leadership was negatively associated with both workload and interpersonal conflict. Workload was significantly linked to higher rates of pressure ulcers, falls and deaths in patients. Ethical leadership was indirectly associated with improved patient outcomes through reduced workload.
Head nurses' ethical leadership has a pivotal role in shaping the work environment and enhancing nursing-sensitive outcomes by reducing workload and fostering positive interpersonal dynamics. These findings emphasise the need for healthcare organisations to invest in ethical leadership development as a critical strategy for improving care quality and promoting better patient outcomes.
These findings emphasise the need for healthcare organisations to invest in ethical leadership development as a critical strategy for improving care quality and promoting safer, more effective patient outcomes.
The study adhered to The Strengthening the Reporting of Observational Studies in Epidemiology checklist.
This study did not include patient or public involvement.
Cultivating moral values and principles in leadership enables leaders to effectively communicate these values to their staff. Addressing unethical behaviours, fostering open dialogue about organisational ethics, and supporting leaders in the ethical decision-making process contribute to a healthier nurses' work environment. Healthcare organisations investing in the development and promotion of ethical leaders improve care quality.
The study was registered in the research registry (www.researchregistry.com) under the record number (researchregistry7418), following a published protocol.
This study aimed to assess the psychological outcomes of family members of patients who were resuscitated in the Emergency Department (ED) and analyse factors associated with these outcomes.
This study utilised a cross-sectional design
Data were collected using a self-reported questionnaire sent to family members of patients who had undergone resuscitation in the ED from February 2024 to January 2025. Instruments for data collection included The Impact of Event Scale-Revised (IES-R), the short version of The Depression, Anxiety and Stress Scale–21 items (DASS-21), the Multicultural Quality of Life Index (MQLI) and questions related to demographic variables and the resuscitation event.
A total of 106 family members completed the questionnaire. Of this, 64.2% (n = 68) reported witnessing the resuscitation attempt, and 35.8% (n = 38) did not witness the event. Family members who witnessed the resuscitation displayed more symptoms of post-traumatic stress disorder (PTSD), measured by the IES-R, compared to those who did not witness the event. A statistically significant negative correlation was found between the IES-R and the MQLI scores, indicating that higher PTSD symptoms correlate with lower quality of life (QoL) ratings.
The findings of this study indicated that witnessing the resuscitation of a loved one in the ED is associated with increased PTSD symptoms.
Patients' and family members' cultural and religious needs should be acknowledged by the health care providers. Study findings indicate that family members prefer to be with the patient during the patient's resuscitation. However, without adequate support from hospital staff, this experience may cause adverse psychological effects. Strategies to support family members during and after resuscitation should be developed and integrated into the management of in-hospital resuscitation.
This study followed the STROBE guidelines.
No patient or public contribution.
To identify the latent frailty trajectory and explore corresponding predictors among older adults living with frailty who experience hip fracture surgery within 3 months after discharge.
From December 2022 to November 2024, 178 individuals were consecutively enrolled in a longitudinal observational study conducted at a tertiary hospital in Zhejiang Province, China.
The Reported Edmonton Frail Scale measured the frailty level at 5 points, which included baseline (pre-fracture), at discharge, 2 weeks, 1 and 3 months after discharge. Latent class growth models were set up for the frailty trajectory. Multinomial logistic regression was performed to explore the predictors of frailty trajectory classes.
One hundred fifty-three participants completed the full follow-up. Latent class growth models identified 3 frailty trajectories. Class 1: moderate frailty transformed to severe frailty (n = 27; 17.65%); Class 2: mild frailty transformed to moderate frailty (n = 86; 56.20%); Class 3: pre-frailty transformed to mild frailty (n = 40; 26.15%). A higher-level D-Dimer at admission and the five-item version of the Geriatric Depression Scale increased the incidence of Class 2 compared to Class 3. The higher scores of the Abbreviated Mental Test decreased the incidence of Class 2 compared to Class 3. Longer surgical waiting time, a higher-level five-item version of the Geriatric Depression Scale and the Age-Adjusted Charlson Comorbidity Index increased the incidence of Class 1 compared to Class 3. The higher scores of the Abbreviated Mental Test and Mini Nutritional Assessment Short Form decreased the incidence of Class 1 compared to Class 3.
Three frailty trajectory classes were identified among older adults living with frailty who experience hip fracture surgery after discharge within 3 months. D-Dimer at admission, surgical waiting time, depressive symptoms, cognitive status, comorbidity index and nutritional status are associated with these fluctuating frailty trajectories.
Modifiable factors such as improving nutrition and cognitive status and managing depression, comorbidities and preoperative evaluations provide methods for future interventions to prevent or mitigate frailty among this population.
What problem did the study address? Frailty is an inherent dynamic among older adults living with frailty who experience hip fracture surgery after discharge within 3 months. Some factors affect the mitigated frailty process in this population. What were the main findings? Three frailty trajectory classes were identified in this study. And the level of their frailty worsens 3 months after surgery compared to pre-fracture. D-Dimer at admission, surgical waiting time, depressive symptoms, cognitive status, comorbidity index and nutritional status are associated with these fluctuating frailty trajectories. Where and on whom will the research have an impact? The findings of this study provide screening, intervention and discharge plan evidence for healthcare workers in orthopaedics and geriatrics Departments. Helping community healthcare workers and primary caregivers set the theoretical basis for home-based intervention programs.
We have adhered to relevant EQUATOR guidelines using the STROBE reporting method.
No patient or public contribution.
Hospital falls and associated injuries are a global issue associated with harm and significant costs to individuals and society, especially for older adults. Hospital standards specify the minimum level of care required to optimise patient safety, quality and outcomes. Standards are often used during hospital accreditation. This investigation analysed the content and quality of hospital falls standards across the globe.
Hospital standards were located by searching online databases (PubMed, CINAHL, Google Scholar, MEDLINE), ChatGPT, the grey literature via internet search engines, and websites of accreditation agencies, government agencies, and other relevant organisations. We searched for standards from the 60 largest countries by population plus the 60 countries with the highest gross domestic product (n = 82 after accounting for duplicates). For inclusion, hospital standards had to mention ‘fall/s’. Data were analysed using a deductive framework synthesis and content analysis to identify emergent themes.
Forty-one standards used by at least 72 countries were identified from our search. Sixteen were excluded from detailed analysis because they did not mention falls and 3 could not be retrieved. A total of 22 standards were included in the final detailed analysis. Included standards showed wide variations in content and quality. Seven were assessed as high quality, 12 medium quality, and 3 were deemed to be of low quality. Some lacked details on hospital falls screening, assessment, prevention, and management. Consumer engagement in development, implementation, or evaluation was not mentioned in all standards. Procedures for falls data collection and reporting were seldom documented. Hospital standards infrequently referred readers to contemporary research or clinical practice guidelines.
There are variations in the quality and content of standards on hospital falls. International collaboration is recommended to increase the consistency and validity of hospital falls standards across nations, in order to optimise healthcare outcomes.
The findings of this global analysis of hospital falls standards have the potential to impact falls rates and fall-related injuries in hospital patients by providing data to inform the content, evidence base and use of hospital standards to optimise the safety and quality of care delivery. The findings inform the review, design and implementation of hospital accreditation procedures to improve patient outcomes, patient experiences, and service quality.
To explore the lived experiences and daily interactions of older couples living with multimorbidity.
A descriptive-interpretive qualitative study based on a generic interpretive description framework.
A total of 20 dyads were recruited using a purposive sampling strategy, and 24 semi-structured in-depth interviews were conducted between May 2023 and January 2025. Reflexive thematic analysis was used to analyse data.
Four overarching themes were generated: (1) dynamic relationship structures; (2) diverse interaction patterns; (3) double burdens; and (4) double resilience. Dynamic relationship structures occurred in dyadic and triadic forms. Diverse interaction patterns involved independence, interdependence and dependence. Double burdens manifested as physical toll, financial hardship, emotional contagion and perceptual misalignment, whereas double resilience was reflected in the nudge effect, emotional resonance and promotion of family ownership of health.
This study adopted a dyadic perspective to explore the experiences and interactions of older couples living with multimorbidity. The caring dynamics and blurred roles of patient and care partner deviate from the traditional unidirectional, linear model of ‘one person caring for the other’. Formal or informal caregiving support from third parties, as well as the nudge effect and emotional resonance between spouses, may help orient older couples as they navigate the challenges associated with multimorbidity.
Our findings indicate that community nurses can play a proactive role in identifying older couples living with multimorbidity through routine care attendance and assessments, enabling early recognition of health management needs. Geriatric nurses can leverage insights into couples' interaction patterns to tailor more effective care plans at different stages of illness, monitor emerging risks and identify optimal timing for third-party support. By facilitating a responsive triadic network, nurses can help ensure continuous and sustainable health care.
Adhered to SRQR guidelines for qualitative research.
This study did not include patient or public involvement in its design, conduct, or reporting.
To report on the unique perspectives of senior nursing leaders on the value proposition of the Clinical Nurse Specialist (CNS) role, their organisational experience and the barriers and facilitators to optimise and promote the long-term sustainability.
A qualitative sub-study of a larger multi-method study focused on informing policy recommendations to optimise the CNS workforce, informed by integrated knowledge translation.
Chief Nursing Officers (CNOs) and other senior leaders in all health authorities in British Columbia, Canada, were invited to participate in semi-structured interviews via video call between August–December 2023. We recruited 13 participants from diverse health regions, including 5 CNOs.
Leaders collectively conveyed a renewed interest in the CNS role to support nursing and multidisciplinary teams to better meet patient and system needs, and a sense of urgency to optimise the role in diverse settings. The overarching theme of “success by design” was supported by three thematic priorities: (1) understanding the CNS role, (2) a role that needs protection and connections and (3) moving forward together. Views were aligned to co-construct implementation-ready policy recommendations to guide provincial strategies.
Senior leaders reported a common understanding of the value-add of the CNS workforce and had a shared experience of barriers to optimisation. Contemporary policy guidance is needed to equip health systems to address this gap.
Across international regions, the role of CNSs is not fully optimised. This is a wasted opportunity to address the pressing need for nursing practice leaders to transform health systems and improve outcomes. This study provides new knowledge about the perspectives of Chief Nursing Officers and other nursing leaders to shape comprehensive and targeted policy recommendations and address enduring and new challenges to realise the full impact of the CNS workforce.
We have adhered to COREQ reporting guidelines (See supplemental file).
This study did not include patient or public involvement in its design, conduct, or reporting.
This study aims to explore the views and experiences of people with dementia, informal caregivers and professionals regarding eating and drinking difficulties.
A qualitative systematic review was conducted.
The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used to conduct this systematic review. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the data were thematically synthesised using Thomas and Harden's three-stage method.
Six electronic databases (PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL and PsycINFO) were searched from their respective inception dates to August 2025 to identify relevant studies.
Thematic analysis of the 16 included studies identified four key themes: (1) Physiological and psychological changes in people with dementia and caregivers; (2) factors influencing eating and drinking in people with dementia; (3) needs and recommendations for people with dementia, informal caregivers and professionals; (4) selection of eating methods for end-stage people with dementia.
Eating and drinking difficulties affect the well-being of both patients and caregivers. A good dining environment improves mealtime pleasure but demands caregivers' time and energy. All parties emphasised the importance of effective communication. In end-stage dementia, professional assistance is crucial for enteral nutrition decisions.
Collaboration among patients, caregivers and professionals is vital for creating tailored nutritional plans and improving mealtime environments, thereby enhancing nutritional intake. In advanced dementia, providers must provide balanced information on comfort feeding versus enteral nutrition to aid decision-making.
What problems were addressed in this study? This study addressed the lack of a consolidated, tri-perspective understanding of eating and drinking difficulties in dementia care settings. What are the main findings? Four key themes were identified: physiological and psychological changes, influencing factors, stakeholder needs and end-of-life decision-making. Where and on whom will the research have an impact? This will impact care practices for people with dementia and inform the training and support of informal caregivers and healthcare professionals.
This study aimed to investigate the network structural characteristics of self-efficacy and professional resilience among emergency nurses, identify core nodes within the network, and elucidate the key interactive mechanisms between these constructs.
Descriptive cross-sectional study.
A multi-center cross-sectional study was conducted from January to February 2025, involving 612 emergency nurses from 20 hospitals in Sichuan, China. Data were collected using a self-administered demographic questionnaire, the General Self-Efficacy Scale, and the Chinese Emergency Nurse Professional Resilience Tool. An adjacent network integrating professional resilience and self-efficacy was developed. Key covariates—including title, position, tenure in the hospital or emergency department, education, and exposure to workplace violence—were included as control variables. Network precision and stability were evaluated using the correlation stability coefficient and confidence intervals for edge weights. To further test the robustness of the network model, sensitivity analyses were performed by adding each significant covariate to the original model. The Network Comparison Test was then used to compare the covariate-adjusted and unadjusted networks, assessing differences in network structure, overall strength, and edge weights.
The analysis identified S9 as the central node in the network. The overall network showed satisfactory stability and precision. The Network Comparison Test showed no significant differences in network structure or global strength between the adjusted and unadjusted models, indicating that the network was stable and robust to covariate adjustment.
This network analysis revealed the interaction mechanisms between self-efficacy and professional resilience among emergency nurses through contemporaneous network modelling and identified S9 as the core node, suggesting that this coping strategy plays a key role in regulating psychological resources. The overall network demonstrated good stability and precision, with no statistically significant differences between the adjusted and unadjusted models according to the Network Comparison Test. These findings indicate that the network structure was robust to covariate adjustment and provide a reference for developing and optimising intervention strategies to enhance professional resilience among emergency nurses.
For Emergency Nurses and the Management of Emergency Nursing Practice: What problem does this study address?
This study addresses the gap in understanding how self-efficacy and occupational resilience interact in emergency nurses under high-stress conditions.
A contemporaneous network analysis revealed a central node linking self-efficacy and resilience, highlighting key pathways in their mutual influence.
The findings offer practical guidance for emergency nursing management, supporting the development of targeted strategies to strengthen nurses' resilience, enhance professional competence, and improve the quality of emergency care.
This study is reported using the STROBE guidelines.
No Patient or Public Involvement: This study did not include patient or public involvement in its design, conduct, or reporting.
To translate, culturally adapt and validate the first Spanish version of the Person-centred Practice Inventory-Care (PCPI-C) instrument.
Cross-cultural adaptation and psychometric validation.
Two-phase research design: (1) the PCPI-C's translation and cultural adaptation from English to Spanish following the ‘Translation and Cultural Adaptation of Patient-Reported Outcomes Measures-Principles Guide of Good Practice’ tool; and (2) a cross-sectional quantitative survey to assess the Spanish version's psychometric properties.
A sample of 200 patients participated to obtain the PCPI-C's Spanish version. No significant issues arose during the translation process or the consulting sessions. No item exhibited an inadequate value following adjustment via the weighted kappa index (−scale-level content validity average of 0.95 for clarity and 0.97 for relevance). Psychometric evaluation revealed acceptable internal consistency (Cronbach's alpha from 0.67 to 0.84) and strong construct validity. Exploratory and confirmatory factor analyses supported a five-dimensional structure consistent with the domain Person-Centred Processes. Fit indices improved after model refinements, achieving CFI = 0.92, SRMR = 0.05 and RMSEA = 0.07. This study's observed psychometric properties confirm that the PCPI-C's Spanish version retains the original instrument's theoretical integrity, while showing strong reliability and validity in the new context.
The PCPI-C's Spanish translation was psychometrically valid when tested with Spanish patients, thus providing a culturally appropriate, psychometrically sound tool to evaluate Spanish-speaking patients' perception of person-centred care.
This study provides a validated instrument that allows for the assessment of person-centred practice in Spanish-speaking clinical environments. It enables healthcare professionals to measure patients' perceptions, track the implementation of person-centred principles and supports international comparative studies, contributing to the development of more ethical and responsive models of care.
Patients participated in cognitive consultations and completed the survey for psychometric testing, ensuring that the translated items were understandable, culturally appropriate and reflective of their experiences of person-centred care.
To examine the relationship between ethical conflicts and ethical decision-making ability, ethical sensitivity and demographic factors as mediator/moderator roles.
A cross-sectional survey was conducted from June to December 2024.
This study involved 503 intensive care unit nurses from eight tertiary hospitals across Zhejiang, Guangdong and Guangxi provinces. Participants completed validated instruments including the Ethical Conflict Nursing Questionnaire-Critical Care Version, the Chinese Moral Sensitivity Questionnaire-Revised version and the Chinese Version of Judgement About Nursing Decision. SPSS 27.0 was used for descriptive statistics and Pearson correlation analysis, while PROCESS macro handled mediation and moderation analysis.
The relationship between ethical conflict and decision-making ability was significantly mediated by both moral responsibility/strength and burden, with the latter demonstrating a stronger indirect effect. Furthermore, exploratory moderated mediation analysis showed that this mediation model varied significantly across different levels of work experience and types of intensive care unit. Given the exploratory nature of these findings, they require verification in future confirmatory studies.
The association between ethical conflict and decision-making ability was mediated by ethical sensitivity. This pathway was moderated by work environment and qualifications, indicating the need for tailored interventions.
Developing nurses' ethical sensitivity is a key strategy for managers aiming to improve ethical decision-making when nurses face ethical conflicts.
This study addressed ambiguous findings regarding the relationship between ethical conflict and nurses' decision-making ability. For nurse managers, fostering ethical sensitivity among staff represents a key strategy for mitigating the ethical conflicts that are negatively associated with decision-making ability.
The strengthening the reporting of observational studies in epidemiology statement (STROBE) was followed.
No patient or public contribution.
Chinese Clinical Trial Registry (ChiCTR): MR-33-24-032956
In this paper, the development of an evidence-informed, data-driven strategy for implementation of the HIRAID emergency nursing framework in Thailand is reported. HIRAID stands for H istory including I nfection risk, R ed flags, A ssessment, I nterventions, D iagnostics, reassessment and communication.
This exploratory descriptive study was underpinned by the Knowledge-to-Action framework.
The study was conducted in Chiangrai Prachanukroh Hospital (CRH) in Northern Thailand. The identified problem was no standardised approach to patient assessment and management. Adaptation of knowledge to local context occurred by feasibility assessments and experience-based co-design. Surveys designed and analysed using the Behaviour Change Wheel and Theoretical Domains Framework were used to understand the barriers to knowledge use. Selecting, tailoring and implementing the intervention was guided by the Behaviour Change Wheel.
Practice environment and behavioural diagnostics surveys were completed by 49 nurses (response rate 100%) who identified 19 enablers and 33 barriers to HIRAID implementation at CRH. Enablers and barriers were mapped to seven intervention functions (education, modelling, persuasion, enablement, training, environment restructuring, incentivisation) and 19 behaviour change techniques most likely to be effective. The study methods and results culminated in an evidence-informed, data-driven HIRAID Thailand Implementation Strategy.
In-depth understanding of context-specific enablers and barriers, active engagement of end-users was critical to maximising likelihood of successful implementation. Development of an evidence-informed implementation strategy for a limited resource setting was achievable with robust application of theory, key stakeholder and end-user engagement and multi-agency collaboration.
Implementation of clinical interventions in emergency care settings is challenging, even in well-resourced settings. For end-users, knowledge that an intervention would improve patient care was a powerful enabler coupled with meaningful organisational support is critical to sustained implementation in complex nursing environments.
This study addresses the lack of standardised approach to patient assessment and management in the emergency department in a resource-limited setting. Application of robust theory is possible in middle-resource settings, and this study identified 19 behaviour change techniques that were distilled to develop a sustainable, context specific implementation strategy. Development of an evidence-informed implementation strategy for a limited resource setting with robust application of theory is possible with key stakeholder and end-user engagement and multi-agency collaboration.
There is no EQUATOR guideline available for this study.
This study did not include patient or public involvement in its design, conduct or reporting.
To identify and synthesise qualitative and quantitative evidence of nurse managers' qualities, practices and styles related to leading nurses' interprofessional collaboration.
Mixed-methods systematic review.
Two authors independently selected studies based on predefined inclusion criteria, assessed quality and extracted data. A thematic synthesis with a convergent qualitative design was used.
CINAHL, PubMed and Scopus were searched from January 1, 2010, to September 7, 2025. Citations of relevant articles were screened.
A total of 32 articles were included. The analysis revealed two leadership core qualities, five core practices, and three core styles of nurse managers that promote nurses' interprofessional collaboration. Core qualities were proficiency and mindset. Core practices comprised empowering, communicating and informing, commitment to interprofessional collaboration, creating possibilities, and establishing an enhancing atmosphere. Core styles included authentic, transformational, and transactional leadership styles.
The results reflect the situational nature of nursing leadership related to interprofessional collaboration. Successful leadership requires managers to adopt primarily a transformational leadership style, yet more traditional leadership is required occasionally. Results indicate that nursing leadership is foremost a process that evolves within its context.
Greater clarity on how leadership influences nurses' interprofessional collaboration supports leaders, organisations, and educational institutions in developing and sustaining effective leadership.
This review demonstrates that the quality of nursing leadership is a central factor for successful interprofessional collaboration.
The PRISMA guidelines for Systematic Reviews and Meta-Analysis were used.
This study did not include patient or public involvement in its design, conduct or reporting.
To combine the Job Demand-Resource (JD-R) model with machine learning (ML) techniques to identify the key factors affecting job burnout (JB) among Chinese nurses.
A Cross-Sectional Study.
This study utilised a stratified sampling method to recruit 3449 eligible nurses from eight cities in Shandong Province between June and December 2021. After data cleaning, 2998 valid samples were retained. The dataset was randomly split into a training set (75%) and a test set (25%). The Boruta algorithm was used to select relevant variables for model construction. Six-millilitre models were compared using cross-validation, with mean absolute error (MAE), root mean square error (RMSE) and R-squared (R 2) used to select the best model. The Shapley Additive Explanation (SHAP) method was used to identify key predictors of JB.
The average JB score among nurses was (32.88 ± 11.45). Among the 20 variables, 17 were identified by the Boruta algorithm as strongly associated with JB, including 7 job demand-related variables and 10 job resource-related variables. After comparing 6-ml models, the Random Forest was identified as the optimal model (MAE = 6.56, RMSE = 8.86, R 2 = 0.63). SHAP analysis further revealed the importance ranking of these 17 variables and identified four key predictors: psychological distress (SHAP = 4.07), perceived organisational support (SHAP = 2.03), emotional intelligence (SHAP = 1.81) and D-type personality (SHAP = 1.73).
By integrating the JD-R model framework, ML algorithms proved effective in identifying critical predictors of nurses' JB. SHAP analysis identified four primary determinants: psychological distress, perceived organisational support, emotional intelligence and D-type personality. These findings provide novel insights for nursing administrators to optimise intervention strategies.
Not applicable.
This study did not include patient or public involvement in its design, conduct or reporting.
To explore factors influencing the implementation of a nursing care delivery model in a hospital setting.
A qualitative evidence synthesis with a thematic synthesis was conducted.
The search string consisted of four ‘cluster topics’: (1) nursing, (2) care delivery models, (3) hospital setting, (4) qualitative and mixed methods designs. Four electronic databases were searched from January 2000 until July 2024: MEDLINE (PubMed interface), Embase (embase.com interface), CINAHL (EBSCOhost interface) and Web of Science. A thematic synthesis was conducted consisting of the following steps; the ‘line-by-line’ coding of the text, the development and allocation of ‘descriptive themes’ and the generation of ‘analytical themes’.
In total, 3976 references were screened, of which 25 were included in the qualitative evidence synthesis. Eight analytical themes were generated that influence the implementation of a nursing care delivery model in a hospital setting: shared understanding of the care delivery model, ownership of the change, scope of practice and role clarity, collaboration, communication, responsibility, a double-loop process and aggregated recommendations. The themes were categorised on four different levels: vision, process, interactional factors and contextual factors.
The eight themes identified in this qualitative evidence synthesis showed that during the implementation of a nursing care delivery model, a clear implementation strategy is often missing. It is advised that future implementation processes have a clear guide and goal.
The analytical themes can guide the future implementation of a new nursing care delivery model in a hospital setting. This review can support nurses, researchers, hospital management and policymakers when implementing organisational alternatives to reorganise nursing care in a hospital setting.
The qualitative evidence synthesis was reported according to the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) statement.
No patient or public contribution.
FreshRSS 