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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.
Nursing students experience heightened stress and emotional burden during clinical training, but opportunities for structured resilience skill development remain limited.
To explore undergraduate nursing students' lived experiences of participation in a resilience-enhancement program.
Qualitative descriptive phenomenology.
Undergraduate students participated in a resilience-enhancement pilot program adapted from Japan for American nursing students. Upon program completion, four semi-structured focus groups were conducted. Sessions were audio-recorded, transcribed and analysed inductively.
Three themes were identified: (1) Intrapersonal Resilience Strategies; (2) Interpersonal & Accountability Supports; and (3) Intervention Design & Delivery Factors. Students described increased emotional insight, stronger coping tools and the value of social accountability.
This study demonstrates that an undergraduate resilience-enhancement program grounded in mindfulness, journaling and peer support is both feasible and meaningful for nursing students. Integrating brief, scalable resilience interventions into nursing curricula may help prepare the next generation of nurses to care effectively for patients and navigate the emotional, ethical and interpersonal demands of a rapidly evolving global healthcare landscape.
This study addresses the global challenge of preparing nursing students for the emotional and relational demands of contemporary healthcare. The program's scalability and alignment with global workforce priorities highlight its potential relevance for nursing education internationally.
This study adhered to the SRQR guidelines.
None.
To present the current evidence on the nature and principles of Equity, Diversity and Inclusion (EDI) in Nursing Education Institutions (NEIs).
Five databases (CINAHL, Medline, Scopus, ERIC and Educational Research Complete) and websites of Canadian nursing education institutions were searched for studies and grey literature on EDI. Information was analysed using the Diversio Diversity and Inclusion Survey (DDIS) framework to highlight the nature and principles of EDI in NEIs. A content analysis guided by a deductive approach informed the data synthesis.
Eighty-eight studies (90 papers) published between 1999 and 2025 were included from 1301 identified articles in the database search. The websites of seven nursing institutions in Alberta, Canada, were examined. The review revealed facilitators, barriers and gaps. The results illustrated the presence and need for diversity, inclusion, equal opportunity and fairness, employing the DDIS framework across participant groups, curricula and contexts.
The literature on EDI in NEI is diverse and provides many facilitators, barriers, challenges and gaps. This review reveals the need for intervention and review studies to highlight specific practices that can lead to successful EDI implementation in NEIs.
These results show that further research is required to refine the definition of EDI within the nursing academy. Evidence must be advanced to develop nursing theories, frameworks and methods specific to EDI implementation.
Promoting EDI is a vital goal for the nursing profession, and there is a need to understand how EDI behaves in NEIs. This review revealed facilitators, challenges, barriers, gaps and principles of EDI that exist within NEI in the literature. This data can support policy and practice change within NEIs and promote EDI within those organisations.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was adhered to in this review.
This study did not include patient or public involvement in its design, conduct, or reporting.
To review how life-course theories, models and frameworks define and classify life stages and transitions; how they characterise trajectories of care needs and care provision; and to consider how these insights might inform future developments of care-focused life-course frameworks.
Narrative review using a theory synthesis approach.
The review synthesised 56 theories, models and frameworks, drawn from 90 articles published up to 2024, using a three-stage process: extraction and summarisation of conceptual content; comparison to identify convergence and divergence; and interpretive synthesis to generate an overarching account of how frameworks conceptualise life-course development, care transitions and care trajectories.
Earlier life-course perspectives emphasise normative, age-graded stages, while more recent approaches highlight transitional junctures, relational contexts and structural influences on care trajectories. Life stages were defined variably, encompassing developmental phases, chronological age bands, major life transitions, historical and cultural perspectives and diverse lived experiences. Trajectories of care needs and provision were shaped by social networks, socioeconomic conditions, timing of transitions, transgenerational relationships and interdependencies, and intersectionality. Findings suggest that care needs and care provision fluctuate across time and are best understood as interrelated, dynamic processes influenced by life-course biographies, as well as broader social, economic and policy environments at individual (micro), relational (meso) and structural (macro) levels.
Life-course frameworks are shifting from age-based models towards personalised, context-sensitive perspectives that better capture the complexity and diversity of care trajectories.
Care planning should incorporate not only developmental stage but also individual, relational and structural factors influencing care needs, care provision and care trajectories over time.
Applying a personalised, multilevel life-course perspective may improve assessment accuracy, coordination of resources and equity in care delivery.
This narrative review did not involve patients or the public.
To examine and define the concept of moral distress among family caregivers by identifying its key attributes, antecedents and consequences.
Concept analysis.
This study was guided by Walker and Avant's concept analysis framework. A comprehensive literature search was conducted to identify relevant studies, with 12 articles included in this analysis.
PubMed, CINAHL, Scopus and PsycINFO databases were searched for articles published between February 2000 and May 2025.
Three defining attributes of moral distress in family caregivers were identified: self-directed negative emotions, internal conflict and feelings of powerlessness and helplessness. Antecedents included caregiving burden, role conflict, ethical dilemmas, complex decision-making and internal and external constraints. Consequences encompassed long-term health effects, social withdrawal, burnout and moral residue. These findings led to a conceptual definition of moral distress in family caregivers.
Moral distress in family caregivers is a significant and underrecognised issue that affects caregiver well-being and the quality of care they provide. This concept analysis offers a clear conceptual definition, providing a foundation for developing research instruments and interventions.
Healthcare professionals should recognise moral distress in family caregivers as a key factor impacting both caregiver well-being and patient care. Support through education, counselling and peer groups can reduce moral distress and foster more ethical, collaborative care environments.
This study addressed the lack of clarity surrounding moral distress in family caregivers. It identified key attributes, antecedents, and consequences, and developed a clear conceptual definition. These insights will inform research, practice and policy. The findings will benefit caregivers, improve patient care and support healthcare teams.
This study followed Walker and Avant's framework and employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in article selection.
No patient or public involvement.
To locate and synthesise clinical guidelines for nurses and other health professionals undertaking routine virtual health (telehealth) assessment, triage and follow-up care. To locate practice guidelines where clinician and client are not in the same physical location and health assessments are undertaken ‘virtually’.
This review used JBI methodology for scoping reviews and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension (PRISMA-ScR).
Search considered primary research, practice guidelines, case reports, expert opinions, professional organisation web-based resources and grey literature. Medline (Ovid), Cumulative Index to Nursing & Allied Health (CINAHL) and Scopus databases were searched in relation to all health professions. Grey literature search included guideline databases, literature databases, customised Google search engines, targeted websites and consultation with content experts. Citation searching was included.
Search identified 2359 peer-reviewed articles and 31 sources of grey literature (1997–2024). After screening, 22 peer-reviewed and 9 grey literature sources met the eligibility criteria for inclusion. Studies were spread across diverse practice settings. Chronological sequencing provided visibility to innovations in telehealth practice over time from telephone-based practice to the introduction of video conferencing and the use of wearable devices for the transmission of remotely recorded clinical information.
Standardised guidelines to safe practice for virtual health assessment are not well documented. The paucity of clinically orientated guidelines may be due to complexity and the resourcing needed to maintain clinically current guidelines across the full breadth of clinical specialisations, practice settings and telehealth modalities. Further research and development are needed in this growing area of care.
The review highlights that clinically relevant guidelines are critical to safety and quality in virtual health contexts. Findings will inform future design and development of clinical practice guidelines for nurses engaged in virtual health assessment, triage and follow-up care.
Not applicable.
To co-identify adaptations with key stakeholders needed to optimise elements of a video-based intervention (i.e., PREEMIE PROGRESS [PP]), which trains parents in evidence-based family management skills to care for their very preterm infant in the neonatal intensive care unit (NICU).
Descriptive qualitative study oriented with a pragmatic philosophy, informed by the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework and the framework for reporting adaptations and modifications-expanded (FRAME).
Semistructured interviews to identify potential adaptations with key stakeholders: family management researchers (n = 5), clinicians (n = 9), technology experts (n = 5) and parents of preterm infants (n = 17). Weekly design team meetings to select and implement high-priority adaptations necessary for the next research phase. Monthly NICU parent partnership meetings to review adaptations and make recommendations for potential adaptations with conflicting data.
Stakeholders (N = 36) suggested 98 potential adaptations: 32 (33.0%) were completed, 8 (8.2%) were abandoned, 5 (5.2%) have work that is ongoing and 52 (53.6%) were tabled for future research phases. Content adaptations (70, 71.4%) were the most frequently suggested adaptation type. Potential adaptations mostly addressed RE-AIM dimensions of effectiveness (43, 43.9%), and implementation (46, 46.9%) and were directed at the parent (i.e., intervention recipient) level (79, 81.4%).
Use of the RE-AIM framework ensured we systematically identified needed adaptations with key stakeholders across a range of dimensions that would improve PP for parents now and in future phases of this research.
Co-identifying potential adaptations with key stakeholders, paired with FRAME documentation, can help nurses prioritise adaptations most appropriate for each phase of implementation.
Our paper highlights for nurse clinicians and researchers how FRAME documentation of potential adaptations can support stakeholder engagement and a systematic approach to incorporating adaptations throughout all phases of the research process, thereby shortening the evidence to practice gap.
COREQ guidelines for qualitative reporting.
The research team was supported by members of the NICU's Parent Partnership Council (PPC), whose mission is to promote family-centred care improvement projects and research within the NICU. This committee is comprised of nursing, physician, allied health leadership and parents of infants previously hospitalised in the NICU. The NICU PPC met monthly to review conflicting data on potential adaptations and provide recommendations on adaptation decisions.
To evaluate the implementation of the Transitional Care Model (TCM), an evidence-based, advanced practice registered nurse-led multi-component intervention, as part of a randomised controlled trial during the first year of the COVID-19 pandemic.
Parallel convergent mixed-methods approach.
Data for this study were collected between June 2020 and February 2021. Data from 78 patients who received the intervention and 68 recorded meetings with system leaders and clinical teams were analysed using descriptive statistics, directed content analysis, and joint display.
Fidelity to delivery of elements of the TCM components was variable, with the Hospital-to-Home visit elements having the widest range (14.3%–100%) and Maintaining Relationships elements having the highest range (97.3%–98.6%). There were 27 identified challenges and 15 strategies for implementing the TCM with fidelity during the pandemic.
The COVID-19 pandemic impacted all aspects of the delivery of the TCM across all sites. This historical event highlighted the need for services and support for patients and caregivers transitioning from the hospital to home.
Evidence-based solutions are needed to enhance healthcare delivery and patient outcomes. Findings will guide nurses in implementing proven transitional care interventions.
Findings will inform the implementation and scaling of transitional care and other evidence-based interventions across diverse healthcare settings.
GRAMMS reporting guidelines.
No patient or public contribution.
ClinicalTrials.gov identifier: NCT04212962. https://www.clinicaltrials.gov/study/NCT04212962?titles=NCT04212962&rank=1
To examine whether manpower and expertise understaffing are distinct, and whether they relate similarly to nursing stressors, burnout, job satisfaction and intentions to turnover.
A cross-sectional survey of hospital nurses nested within units was used.
The sample included 402 nurses. Nurses provided ratings of the study's variables using validated self-report measures. The data were analysed both as multilevel and single-level data.
Manpower and expertise understaffing contributed unique explained variance to all of the examined outcomes. Nurses within the same units experience different understaffing levels. Expertise understaffing emerged as a significantly stronger predictor than manpower understaffing for three of the six of the outcome variables (illegitimate tasks, job satisfaction and turnover intentions).
Manpower and expertise understaffing are distinct, and both are associated with nurse outcomes.
We have adhered to the STROBE guideline for cross-sectional studies.
Considering both manpower and expertise understaffing to maintain proper staffing levels in nursing units is crucial.
A Director of Patient Care Services from the hospital where the study was conducted is a member of the research team. This member contributed to designing and conducting the study as well as interpreting the results.
To explore the social context of violence for hospital-based and community nurses from different ethnic groups, the types of violence experienced or witnessed both in and outside the workplace, and its impact on mental and physical health.
Cross-sectional, qualitative study using semi-structured interviews.
Semi-structured interviews were conducted online with 12 hospital-based and community nurses recruited from London, England, between May and August 2021. Data were analysed using reflexive thematic analysis.
The sample comprised seven hospital nurses and five community nurses. Four themes were identified: (i) the social context in which nurses from different ethnic groups are exposed to community violence; (ii) types of workplace violence experienced or witnessed by hospital-based and community nurses from different ethnic groups; (iii) perceptions of the factors contributing to workplace violence; (iv) impacts of violence on mental and physical health outcomes. Using the social ecological framework and sociological theory of stress, these findings informed a conceptual stress process model of violence exposure for nurses.
Nurses from different ethnic groups are exposed to violence both in and outside the workplace which negatively affects their mental and physical health. Effective violence prevention requires a multi-factorial approach that addresses the social and institutional factors contributing to violence, shifting the focus from individual measures to systemic organisational changes.
The NHS workforce is currently more diverse than ever, and healthcare leaders must improve access to mental health and well-being resources for staff affected by workplace violence, particularly for those who hold multiple social identities at the intersection of ethnicity, gender and age. Prioritising this support is essential not only to safeguard against negative health outcomes but also to improve the recruitment and retention of healthcare professionals.
No patient or public contribution.
This study explored perceptions of older adults racialised as Black on structural resilience across the life course.
A qualitative descriptive study.
Using purposive sampling, we recruited 15 Black adults aged 50 and older residing in Baltimore, Maryland, including individuals possessing historical or current knowledge of the community. Semi-structured interviews were conducted to elicit participants' experiences with structural resources during childhood, adulthood and late adulthood. Interviews were audio-recorded, transcribed verbatim and analysed using content analysis.
Of the 15 participants, three identified as male (20.0%) and 12 as female (80.0%), with an average age of 70.9 ± 8.2 years. The analysis identified nine categories of structural resilience, confirming its multifaceted and dynamic nature. Common categories present across all life stages included: Built environment, civic engagement, food and housing, healthcare, and social capital and cohesion. Life stage–specific categories included child and family services, educational supports, and workforce development supports during childhood and adulthood, and financial support during adulthood and late adulthood.
These categories were interdependent and spanned across life stages, illustrating the dynamic, cumulative and relational qualities of structural resilience. Furthermore, structural resources were identified as key to safeguarding, empowering and restorative responses to adversity.
These findings contribute to the development of a nuanced, life course–informed framework of structural resilience and highlight the need for ecological strategies that address structural forces shaping health and well-being, particularly among older adults racialised as Black.
This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist.
No patient or public contribution.
To map existing sexual and gender minority (SGM) health research in Ireland, identify gaps in literature and outline priorities for future research and healthcare. SGM is an umbrella term that includes people who identify as lesbian, gay, bisexual, transgender, queer or intersex and is sometimes abbreviated as LGBTQI+.
A scoping review of peer-reviewed studies published between 2014 and 2024.
The review followed Joanna Briggs Institute (JBI) guidelines and PRISMA-ScR framework for scoping reviews. Articles were identified through systematic database searches and screened independently by reviewers.
PubMed, PsycINFO, CINAHL and Embase were searched for articles published between January 2014 and April 2024. Sixty studies met inclusion criteria.
The review highlighted a disproportionate focus on gay, bisexual and other men who have sex with men (gbMSM), particularly regarding HIV and sexual health. Mental health research revealed high levels of anxiety, depression and suicidality, largely attributed to minority stress and systemic discrimination. Transgender health studies documented barriers to accessing gender-affirming care and mental health services. Few studies explored experiences of sexual minority women, older SGM individuals or intersex people. Intersectional perspectives on race, disability and socio-economic status were notably absent.
SGM health research in Ireland reflects significant progress in documenting disparities in mental and sexual health. However, there is a lack of representation for some groups. There is also limited attention to intersectionality. Systematic gaps in sexual orientation and gender identity (SOGI) data impede targeted policymaking and service delivery.
Findings underscore the need for inclusive, culturally competent healthcare services, better integration of SGM health topics into nursing education, and community-centred interventions. Addressing structural barriers and improving provider competence can enhance equitable healthcare access for SGM populations.
This review addresses the fragmented state of SGM health research in Ireland, highlighting gaps in representation and systemic issues.
Authorship includes individuals from various sexual and gender minority communities.
To synthesise the existing literature on effective interventions aligned with the 2015 U.S. Occupational Safety and Health Administration guidelines to address workplace violence against nurses.
An integrative review.
PubMed, Embase, CINAH, and PsycINFO databases were searched for articles published between 2010 and 2023. Articles addressing WPV interventions and published in English were included.
Thirty-seven of 834 articles met the inclusion criteria. The review revealed several strategies to address workplace violence in healthcare settings, with staff training being the most common strategy. However, most interventions were researcher-designed, often excluding input from nurses or other stakeholders. Limited managerial support for nurses following the incidents was another prominent finding.
Although safety training programmes are common, there are critical gaps in managerial support and nurse involvement in intervention development. Further research should focus on incorporating nurse contributions and strengthening managerial support to enhance prevention efforts.
Addressing workplace violence in healthcare settings requires a comprehensive approach beyond safety training. Active nurses' participation in intervention design and enhanced managerial support are essential for creating effective solutions. Healthcare administrators should create environments that empower nurses to contribute to solutions.
This review highlights existing gaps in interventions and emphasises the need for collaborative and nurse-centered approaches to address workplace violence.
The reporting of this review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
No patient or public contribution.
To describe nurses' roles in transitional care planning during intensive care unit (ICU) family meetings for patients with prolonged mechanical ventilation (PMV).
A qualitative descriptive study.
Using secondary data from a trial of a decision aid about PMV, transcripts from 19 unstructured ICU family meetings were purposively sampled and analysed using directed content analysis.
Among 76 recorded ICU family meetings where nurses engaged and spoke at length beyond introduction, nurses spoke at length in 19 (25%) of them. These 19 family meetings were analysed in depth. Three themes were identified describing the roles nurses served: (1) Transitional care liaisons (e.g., introducing next levels of care, identifying/engaging family members, providing patient/family education, managing medications, planning for discharge, assessing patient/family needs, coordinating care, setting goals, providing care continuity, offering provider guidance and referring to resources); (2) information and communication facilitators (e.g., moderating family meetings, facilitating family understanding and serving as communication intermediaries) and (3) family support providers (e.g., providing emotional support, describing expectations and advocating for patients/families).
Although nurses play a central role in patient care, they engage in only a minority of ICU family meetings addressing transitional care planning. Increased nursing involvement in these discussions may enhance care coordination and better support families navigating complex care transitions.
Findings suggest that more consistent engagement of nurses in ICU family meetings has the potential to support transitional care planning and family-centred care for patients with PMV and their families.
This work adds to a growing body of knowledge about nurses' role in ICU transitional care planning. These findings provide valuable guidance for future research and development of transitional care standards to guide nurses in ICU transitional care planning.
The Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ).
No patient or public contribution.
FreshRSS 