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AnteayerJournal of Clinical Nursing

Measuring Advanced Practice in Health Visiting: Development and Psychometric Testing of the Health Visiting Advanced Practice Scale in Public Health Nursing

ABSTRACT

Background

The debate about whether health visiting, a specialist community public health nursing role, is at the level of advanced practice nurse has gone on for more than a decade. There is little empirical evidence that the role matches the traditional role of an advanced practice nurse, although many of the attributes of advanced practice nursing such as prescribing rights, managing complex cases, caseloads with undifferentiated need and advanced assessment and decision-making are certainly present.

Aim

The current study aimed to develop, refine and test the Health Visiting Advanced Practice Scale to assess the scope of advanced practice of UK health visitors.

Design

A cross-sectional and methodological scale validation design, following classical test theory.

Methods

The design consisted of three phases; the first involved scale development including item generation, phase two assessed the content validity index, and the third phase involved a cross-sectional survey to establish construct validity, content validity, and internal consistency reliability, and conduct exploratory and confirmatory factor analysis.

Results

The initial 44-item scale underwent iterative exploratory and confirmatory factor analyses, leading to a refined 5-factor structure with 29 items covering domains such as family-centred care, leadership, prescribing, diagnostic reasoning, and professional practice. This final version demonstrated strong reliability and construct validity in the EFA but mixed fit indices in the CFA, supporting both internal consistency and validity of the scale.

Conclusion

The final scale offers a rigorously validated tool for assessing advanced practice among UK health visitors, capturing core domains such as family-centred care, leadership, prescribing, and diagnostic reasoning. By bridging theoretical frameworks with real-world practice, it fills a critical gap in evaluating and supporting the professional scope of this public health nursing specialty.

Impact

These findings provide valid and reliable insights for measuring and improving health visitors' advanced practice and developing future professional policies.

Patient or Public Contribution

No patient or public contribution.

Reporting Method

STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies.

An Exploration of Emergency Healthcare Provision When Intimate Partner Abuse Is Identified

ABSTRACT

Aim

This paper aims to synthesise the current, global evidence on addressing psychological concerns of women presenting with domestic and family violence within the ED and suggest avenues for future research.

Design

This discursive paper draws on clinical experience and research of the authors and critical synthesis of current literature on management of victim-survivors of DFV presenting with psychological symptoms in ED.

Methods

Academic databases and grey literature were systematically searched to identify relevant sources, and findings were narratively synthesised.

Results

DFV victim-survivors often present with mental health symptoms in ED; however, many health professionals in EDs fail to correctly identify the underlying trauma and offer support to address DFV. The most reported barriers to DFV screening/identification include time constraints, privacy issues, and lack of education/training about DFV and its support mechanisms. As a result, only mental health symptoms are being treated, ignoring the broader psychosocial needs of DFV victim-survivors. Use of trauma-informed support models is recommended to address the mental and psychosocial needs of DFV victim-survivors visiting the ED.

Conclusions

DFV victim-survivors visiting the ED are often treated for their mental health symptoms without addressing their underlying trauma and risk of future victimisation. To address the ongoing adverse impact of DFV, it is necessary to ensure holistic and continual support from ED professionals for victims.

Implications for the Profession and Patient Care

The importance of not only education but the implementation of sustained education and training programs surrounding DFV identification, screening, and cannot be understood. DFV is a global problem whereby many victim-survivors become healthcare patients. It would be poor decision making for clinicians to not prioritise appropriate responses to this societal problem within their clinical practice.

Parent's Process of Escalation of Care for Their Deteriorating Children Admitted to Paediatric Wards: A Grounded Theory

ABSTRACT

Aim

Explore the care escalation process initiated by parents concerned about their hospitalised child's deterioration and healthcare providers' response to parental concerns.

Design

A qualitative study using Charmaz's constructivist grounded theory.

Methods

Participants included healthcare providers, cultural mediators and parents of children hospitalized for ≥ 3 days, who had experienced previous urgent intensive care admission or parental concern during hospitalization, in a tertiary pediatric hospital. Data were collected through focus groups, and analyzed using a grounded theory methodology with NVivo Software.

Results

A total of 13 parents, 7 cultural mediators and 68 healthcare providers participated in 16 focus groups. Two main categories were identified: (1) Parents navigating the uncertainty of the escalation system to get a response; (2) Healthcare providers balancing parents' concerns, their own situation awareness, escalation processes and team relations. We developed a Grounded theory called ‘Parents Supporting Timely Escalation Processes’ (P-STEP). By monitoring their children, parents identify early signs of deterioration and advocate for escalation. Reasons for concern are their child's behaviour, communication failure and admission on an off-service ward. Parents escalate by contacting ward providers, their child's specialist or the most trusted staff and, only selected parents, the Rapid Response Team. Staff escalate parents' concern according to their own situation awareness, parent evaluation and ward escalation practices. Parent's emotions and trust are influenced by the timeliness and type of staff response.

Conclusion

While some parents effectively advocate for their child, others face obstacles due to unclear and lack of formal care escalation systems. Understanding how parents escalate care and healthcare providers respond is essential to identify facilitators, barriers, key stakeholders, and implement a formal system for parent-initiated escalation of care.

Implications for the Profession and Patient Care

Integrating parents into processes of escalation and rapid response systems could optimise early recognition and improve responsiveness in paediatric deterioration.

Reporting Method

The study adheres to the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines.

Patient or Public Contribution

Parents and HCPs participated as interview respondents.

Relationship Between Weight Loss and Problems With Oral Intake in Institutionalised Older Adults: A Japanese Multi‐Institutional 1‐Year Follow‐Up Study

ABSTRACT

Aim

To examine the relationship between weight loss and problems with oral intake in institutionalised older adults.

Design

A 1-year longitudinal observational study.

Methods

Data were obtained from a prospective study conducted in three nursing homes and two long-term care facilities in Japan. Participants' problems with oral intake were assessed using items published in 2021 by the Japanese Ministry of Health, Labour and Welfare. Baseline and follow-up factors were compared between individuals who experienced a weight loss of 5% or more and those who did not. Separate multivariable logistic regression models were constructed for each oral intake assessment item to examine its independent association with weight loss of 5% or more, accounting for transitions in each item between baseline and the 1-year follow-up.

Results

In total, 172 institutionalised older adults were included in the analysis. Among them, 57 (33.1%) participants experienced a weight decrease of 5% or more. The emergence of somnolence or clouding of consciousness during meals at the 1-year follow-up in participants without these signs at baseline was independently associated with a weight loss of 5% or more, after adjustment for baseline characteristics.

Conclusion

Recognising signs of somnolence or clouding of consciousness during meals may be useful for the early detection and prevention of weight loss in institutionalised older adults.

Implications for the Profession and/or Patient Care

Early detection of individuals at risk is essential to prevent significant weight loss and its associated adverse outcomes. Recognising somnolence or clouding of consciousness during meals may enable earlier detection and intervention to prevent weight loss and improve the quality of care for older adults.

Reporting Method

Strengthening the Reporting of Observational Studies in Epidemiology.

Patient or Public Contribution

No patient or public contribution.

Which Cultural Safety Strategies Are Making a Difference? Exploring Hospital Initiatives for First Nations Peoples in Australia. A Scoping Review

ABSTRACT

Aim

To explore the barriers, facilitators, and outcomes of strategies that have been implemented to improve the experience of cultural safety for First Nations inpatients in the Australian hospital setting.

Design

Scoping review.

Methods

Guided by the Joanna Briggs Institute scoping review methodology and reported using PRISMA-ScR, six databases were searched with data extracted and synthesised.

Data Sources

Cumulative Index to Nursing and Allied Health Literature (CINAHL), Emcare, Informit, Medline, ProQuest and Scopus databases. Searches were undertaken in March 2024.

Results

Forty-three articles representing 39 studies were included. Strategies were categorised as governance, service delivery, hospital environment, clinician education, and First Nations workforce. First Nations researchers were co-authors in most studies, and emergent themes were grounded in First Nations priorities, with an emphasis on developing the First Nations health workforce. Findings included (i) First Nations health staff being identified as cultural brokers between First Nations patients and non-First Nations clinicians; (ii) experiences of cultural safety being amplified when First Nations and non-First Nations health staff worked together; and (iii) strong governance being critical to addressing institutional racism and enabling cultural safety.

Conclusions

Embedding the voice of First Nations peoples in governance and an organisational commitment to strengthening the First Nations workforce are essential drivers for implementing cultural safety strategies in Australian hospitals.

Implications for the Profession and/or Patient Care

Working together respectfully and collaboratively offers a pathway forward for First Nations and non-First Nations health service clinicians and management to deliver culturally safe hospital care.

Impact

Culturally safe hospital care is integral to promoting the health of First Nations people. This study maps cultural safety strategies used in the Australian inpatient hospital setting, explores if and how these strategies have improved cultural safety and identifies barriers and facilitators to implementation. Fostering approaches to support understanding and respect between First Nations and non-First Nations clinicians and staff is integral to promoting culturally safe hospital care. Hospital leadership, policymakers and staff can benefit from understanding the drivers of culturally safe hospital care.

Reporting Method

Reported using PRISMA-ScR.

Patient or Public Contribution

Guidance on this research was received from Aboriginal leaders at the first author's hospital workplace.

Protocol Registration

A research protocol was prepared in advance and registered: https://osf.io/sfzby/?view_only=03c2349ebdae4a7ba95a621d9b7e8bc4.

Preventing Child Maltreatment in Early Childhood: The Clinical Role of Public Health Nurses in Primary Care

ABSTRACT

Aim and Objective

To explore how public health nurses at child and family health clinics work to prevent maltreatment and the experiences of public health nurses in the maltreatment prevention efforts.

Background

Child maltreatment is a serious societal issue with major consequences. Preventive efforts are increasing and have broad political support. A key objective of the child and family health clinic services is to prevent, identify, and stop maltreatment, abuse, and neglect. National clinical guidelines outline, in general terms, how such work should be conducted. However, limited research exists on how public health nurses prevent maltreatment and the effectiveness of their methods.

Design and Method

A qualitative and explorative design was used, based on semi-structured interviews with 14 public health nurses conducted as part of the project ‘Public Health Nurses in Child and Family Clinics' Role in Preventing and Detecting Child Maltreatment’ at Oslo Metropolitan University. The interviews were carried out between August and November 2021. We used qualitative content analysis with an inductive approach to analyse the data.

Result

Three main categories were developed: 1. Structure and system: weaving prevention into daily practice; 2. To dare and endure: a negotiation of courage and understanding, and 3. To empower and uphold: the goal of strengthening and supporting parents. The results show the importance of early intervention, barriers to discussing maltreatment with parents, and the importance of building trust and empowering parents.

Conclusion

Preventing maltreatment is a key part of public health nurses' clinical work, focusing on early risk identification and parental guidance. While building trust with families is prioritised, structural, resource, and guideline-related challenges persist.

Implications for Practice

This study provides knowledge about Norwegian public health nurses clinical work with child maltreatment at the child and family health clinics, which can serve as a valuable foundation for further research as well as for collaborating services.

Reporting Method

EQUATOR guidelines were followed, using the COREQ checklist.

Patient or Public Contribution

No patient or public contribution.

Knowledge and Opinions of Operating Room Nurses About Artificial Intelligence: A Descriptive Cross‐Sectional Study

ABSTRACT

Aims and Objectives

To assess the knowledge and opinions of operating room nurses about artificial intelligence.

Background

Artificial intelligence technologies play a significant role in improving the quality of care and ensuring patient safety. Operating room nurses play a crucial role in adopting technological innovations and improving patient safety.

Design

A descriptive cross-sectional study.

Methods

This study was conducted among 95 nurses working in the operating room departments of a private hospital between December 2023 and March 2024. Data were collected via Google Forms, which included questions about personal information, knowledge about artificial intelligence and opinions about artificial intelligence. Data analysis was performed using descriptive statistics.

Results

The level of knowledge about artificial intelligence among nurses was high. Social media emerged as the most commonly reported and predominant source of AI-related information, despite being considered unreliable. Nurses widely expressed ethical concerns, particularly regarding issues such as the lack of empathy and potential malfunctions. Nevertheless, many believed that AI could reduce workload and enhance the quality of patient care.

Conclusions

Although nurses have good knowledge about artificial intelligence, they require training to access reliable information. Nurses should be trained on artificial intelligence, and the technology should be integrated in a way that supports their professional roles.

Relevance to Clinical Practice

This study, which presents operating room nurses' knowledge and opinions on artificial intelligence, emphasises the need for nurses to receive training in artificial intelligence, highlighting that this will support the integration of artificial intelligence into nursing practices. Consequently, it suggests that the quality of nursing care can be enhanced.

Assessing the Effectiveness of Interventions Implemented by Nurses to Reduce Medication Administration Errors in Hospitalised Acute Adult Patient Settings: Systematic Review and Meta‐Analysis

ABSTRACT

Background

Medication administration errors are high-risk patient safety issues that could potentially cause harm to patients, thereby delaying recovery and increasing length of hospital stay with additional healthcare costs. Nurses are pivotal to the medication administration process and are considered to be in the position to recognize and prevent these errors. However, the effectiveness of interventions implemented by nurses to reduce medication administration errors in acute hospital settings is less reported.

Aim

To identify and quantify the effectiveness of interventions by nurses in reducing medication administration errors in adults' inpatient acute hospital.

Methods

A systematic review and meta-analysis was conducted up to 03/24. Six databases were searched. Study methodology quality assessment was conducted using the Joanna Briggs Institute (JBI) critical appraisal tools, and data extraction was conducted. Meta-analysis was performed to combine effect sizes from the studies, and synthesis without meta-analysis was adopted for studies that were not included in the meta-analysis to aggregate and re-examine results from studies.

Results

Searches identified 878 articles with 26 studies meeting the inclusion criteria. Five types of interventions were identified: (1) educational program, (2) workflow smart technologies, (3) protocolised improvement strategy, (4) low resource ward-based interventions, and (5) electronic medication management. The overall results from 14 studies included in meta-analysis showed interventions implemented by nurses are effective in reducing medication administration errors (Z = 2.15 (p = 0.03); odds ratio = 95% CI 0.70 [0.51, 0.97], I 2 = 94%). Sub-group analysis showed workflow smart technologies to be the most effective intervention compared to usual care. Findings demonstrate that nurse-led interventions can significantly reduce medication administration errors compared to usual care. The effectiveness of individual interventions varied, suggesting a bundle approach may be more beneficial. This provides valuable insights for clinical practice, emphasizing the importance of tailored, evidence-based approaches to improving medication safety.

Reporting Method

PRISMA guided the review and JBI critical appraisal tools were used for quality appraisal of included studies.

Lives Transformed—The Experiences of Significant Others Supporting Patients With Severe Burn Injury: A Narrative Inquiry

ABSTRACT

Aim

To explore the experiences of significant others of patients with severe burn injury in the intensive care unit. Specifically, how severe burn injury impacted the significant other and their role within their loved one's life.

Design

This qualitative study employed a Narrative Inquiry approach.

Methods

Interviews were undertaken during 2021–2022 with 17 participants who were the significant others of a patient with severe burn injury in the Intensive Care Unit. Recruitment occurred in New South Wales, Australia, from two tertiary hospitals providing care for people with major burns. A narrative inquiry approach was utilised, capturing stories through semi-structured interviews.

Results

Significant others experienced necessary changes in their life in response to the catastrophe. These included advocating, being present and ensuring their loved one's needs were met, while often neglecting themselves. Significant others contemplated their future as a carer to their loved one with severe burn injury, and adjusting their own career, finances and lifestyle, often as a long-term measure. The shifting of their role to carer ultimately transformed and redefined their relationships and lives.

Conclusion

Significant others endure immense trauma when a loved one sustains a severe burn injury. They require support but prioritise the patient by virtue of their critical illness. The life of the significant other is changed as they take on the role of carer and provide support. It is, therefore, imperative that the support needs of significant others are recognised, understood and addressed to ensure their well-being while processing the trauma.

Implications for Practice

With increased understanding of the significant others' experiences, healthcare providers can adopt a consultative approach, where roles and boundaries can be clearly identified. Through this process, healthcare providers can strengthen rapport and provide targeted support for significant others, as they navigate this traumatic life-altering event.

Patient or Public Contribution

No patient or public contribution.

Community Dwelling Adults’ Lived Experiences of Participating in Death Cafés: A Phenomenological Study With Photovoice

ABSTRACT

Aim

To explore community dwelling adults' lived experiences of participating in death café in Singapore.

Design

A descriptive phenomenological study with Photovoice.

Methods

A purposive sample of community dwelling adults who participated in a community-based death café was recruited for this study. Data was collected through online individual semi-structured interviews. The Colaizzi's six-step descriptive phenomenological analysis was conducted for data analysis.

Results

Twenty community dwelling adults who participated in a death café were recruited. Participants' experiences of the death café were expounded in four themes: appeals of attending death cafés, enabling features of death café, engaging in die-logues, and perceived impacts of death café on everyday lives. The participants were attracted to death cafés for various reasons including curiosity and grief. A comfortable environment, accompanied by open dialogues and refreshments, was credited as enablers for death conversations. Through these ‘die-logues’, the participants had a deeper understanding of death and began engaging in advance planning.

Conclusions

Death cafés provide a supportive environment for individuals to engage in death-related conversations that may not easily occur in daily life. By engaging in conversations about mortality within death cafés, participants are encouraged to take proactive steps towards advance planning.

Implications for the Profession and/or Patient Care

Findings from this study can guide the development of community-based interventions by highlighting the essential components required for a death café tailored to the Asian context.

Impact

This study describes the community dwelling adults' lived experiences of participating in a death café. The findings from this study underscore the role of informal conversations about death as a tool to promote population health based palliative care initiatives such as overcoming death taboos and stimulating advance care planning among community dwelling adults.

Reporting Method

The Consolidated Criteria for Reporting Qualitative Studies was used.

Patient and Public Contribution

Community-dwelling adults participated in the interviews.

Orchestrating Human Connection in Digital NICUs: Leadership Strategies for Technology‐Enhanced Family‐Centred Care

ABSTRACT

Aim(s)

To explore how neonatal nurse leaders sustain human-centred care while implementing digital technologies in neonatal intensive care units (NICUs).

Design

Qualitative descriptive multi-site study across four NICUs in the Eastern Region of Saudi Arabia (November 2024–May 2025), reported in accordance with COREQ.

Methods

Purposive maximum-variation sampling recruited 24 neonatal nurse leaders across leadership levels, hospital types and digital maturity stages. Semi-structured interviews were conducted in Arabic or English, transcribed, translated as needed and thematically analysed in NVivo 14 using a hybrid inductive–deductive approach. Directed content analysis of key organisational documents enabled triangulation. Trustworthiness was supported through member checking, peer debriefing, audit trail, external review and double coding of a subset of transcripts.

Results

Four interrelated strategies were identified: (1) embedding a values-based human-centred vision; (2) selecting and customising digital tools to strengthen, not replace, nurse–family connection; (3) redesigning workflows (e.g., device-free openings, protected presence time, family-inclusive portals) to preserve presence and partnership; and (4) fostering team capability and psychological safety for digital–human integration.

Conclusion

Human-centred care in digital NICUs is intentionally led and structurally engineered. The study offers a practice-ready framework that translates values into reproducible routines within complex sociotechnical systems.

Implications for the Profession and/or Patient Care

The framework supports nurse leaders in aligning digital transformation with family-centred care, protecting nurse–family presence, and enhancing safety, trust and partnership for high-risk neonates.

Impact

Addresses risks of relational erosion in digital and AI-enabled NICUs and provides transferable nurse-led strategies to sustain ethical, family-centred practice.

Reporting Method

COREQ-compliant qualitative study.

Patient or Public Contribution

No Patient or Public Contribution.

Validity and Reliability of the Stoma Self‐Efficacy Scale in Patients With Intestinal Stoma: A Descriptive, Cross‐Sectional and Validation Study

ABSTRACT

Aim(s)

The aim was to validate the stoma self-efficacy scale and assess the psychometric properties of the Czech version of the scale in patients with intestinal stoma. Another aim was to assess self-efficacy in patients with intestinal stoma.

Design

Descriptive, cross-sectional and validation study.

Methods

Two hundred and ninety patients with intestinal stoma participated in the study during 2023. The original SSES instrument was linguistically validated into Czech. Content validity of the scale, test–retest, intraclass coefficient, Cronbach's alpha, McDonald's ω, construct and convergent validity were assessed for psychometric properties. The study followed STROBE guidelines.

Results

The stoma self-efficacy scale was adopted into Czech, demonstrating excellent content validity. An intraclass correlation coefficient was calculated to establish test–retest reliability, showing excellent reliability of the Czech version. Cronbach's alpha and McDonald's ω showed high reliability. Factor analysis was applied for construct validity. Exploratory factor analysis was used to extract three factors on the Czech version of the scale: Stoma care self-efficacy, social self-efficacy and burden self-efficacy. The factors accounted for 62.05% of the total variance and showed strong internal consistency. Confirmatory factor analysis was applied separately to the data of respondents with colostomy and respondents with ileostomy. The fit indices were satisfactory for respondents with colostomy after adjustment. The composite reliability coefficient showed acceptable values in each factor.

Conclusion

The Czech version of the stoma self-efficacy scale has excellent psychometric properties in patients with intestinal stoma. It is a reliable tool for use in patients with intestinal stoma to assess self-efficacy. The scale can also be used by nurses who care for these patients and based on this, meet the individual needs related to patients' self-efficacy.

A Mixed‐Methods Exploration of Staff Needs for Coping With Grief and Loss in Residential Aged Care

ABSTRACT

Aims

To examine residential aged care staff's experience of death and grief, and their support needs.

Methods

A mixed-methods sequential explanatory design, using an online cross-sectional survey that included the Texas Revised Inventory of Grief and the Grief Support in Health Care Scale. Followed by semi-structured interviews with direct care workers and managers working in residential aged care homes were conducted.

Results

Over 60% of participants experienced five or more resident deaths in the previous 12 months. Although, different levels of grief were experienced among different roles, the importance of open communication and opportunities for farewells after resident death was highlighted. Participants suggested support and education to normalise grief and promote self-care.

Conclusion

Recognising staff grief following the resident death is important. Providing support and education may help improve staff wellbeing and contribute to the delivery of high-quality care for both residents and their families.

Implication for the Profession and/or Patient Care

Staff grief after a resident death needs to be recognised, and continuing education and support are required for their wellbeing.

Reporting Method

The STROBE and SRQR checklists were applied.

Patient or Public Contribution

No Patient or Public contribution.

Artificial Intelligence Technologies Supporting Nurses' Clinical Decision‐Making: A Systematic Review

ABSTRACT

Background

The use of technology to support nurses' decision-making is increasing in response to growing healthcare demands. AI, a global trend, holds great potential to enhance nurses' daily work if implemented systematically, paving the way for a promising future in healthcare.

Objectives

To identify and describe AI technologies for nurses' clinical decision-making in healthcare settings.

Design

A systematic literature review.

Data Sources

CINAHL, PubMed, Scopus, ProQuest, and Medic were searched for studies with experimental design published between 2005 and 2024.

Review Methods

JBI guidelines guided the review. At least two researchers independently assessed the eligibility of the studies based on title, abstract, and full text, as well as the methodological quality of the studies. Narrative analysis of the study findings was performed.

Results

Eight studies showed AI tools improved decision-making, patient care, and staff performance. A discharge support system reduced 30-day readmissions from 22.2% to 9.4% (p = 0.015); a deterioration algorithm cut time to contact senior staff (p = 0.040) and order tests (p = 0.049). Neonatal resuscitation accuracy rose to 94%–95% versus 55%–80% (p < 0.001); seizure assessment confidence improved (p = 0.01); pressure ulcer prevention (p = 0.002) and visual differentiation (p < 0.001) improved. Documentation quality increased (p < 0.001).

Conclusions

AI integration in nursing has the potential to optimise decision-making, improve patient care quality, and enhance workflow efficiency. Ethical considerations must address transparency, bias mitigation, data privacy, and accountability in AI-driven decisions, ensuring patient safety and trust while supporting equitable, evidence-based care delivery.

Impact

The findings underline the transformative role of AI in addressing pressing nursing challenges such as staffing shortages, workload management, and error reduction. By supporting clinical decision-making and workflow efficiency, AI can enhance patient safety, care quality, and nurses' capacity to focus on direct patient care. A stronger emphasis on research and implementation will help bridge usability and scalability gaps, ensuring sustainable integration of AI across diverse healthcare settings.

Summary of the Best Evidence for Weaning From Mechanical Ventilation in Neurocritical Care Patients

ABSTRACT

Aim

The best evidence on programmed weaning from mechanical ventilation in neurocritical care patients should be gathered, evaluated, and integrated to provide an evidence basis for determining the optimal weaning program for these patients.

Methods

According to the ‘6S’ pyramid model of evidence-based practice resources, Chinese and international guideline websites, websites of relevant professional societies, and Chinese and English databases were systematically searched. The databases were searched from the time of establishment to October 2024. Literature screening was subsequently performed according to the inclusion and exclusion criteria. Two researchers independently evaluated the literature quality and extracted and summarised the evidence.

Results

A total of 21 publications were included, including 3 guidelines, 5 expert consensus papers, 1 evidence summary, and 12 systematic reviews. A total of 29 pieces of best evidence in the following 5 aspects were summarised: preweaning preparation and screening, a weaning protocol, extubation assessment, extubation preparation and procedure, and postextubation management.

Conclusions

This study summarises the best evidence for the programmed weaning of neurocritical care patients from mechanical ventilation and provides a basis for clinical medical personnel to standardise this weaning process. Evidence-based application of these strategies should be implemented to verify their clinical efficacy and safety in practice.

Implications for Clinical Practice

Successful weaning is key in the management of neurocritical care patients receiving mechanical ventilation. The establishment of a localised extubation protocol guided by a multidisciplinary team can significantly reduce the extubation failure rate, the duration of mechanical ventilation and the incidence of related complications. However, evidence-based application is needed to verify the efficacy and safety of these strategies in clinical practice.

Reporting Method

This evidence review adhered to the evidence review report guidelines formulated by the Evidence-Based Nursing Center of Fudan University. These guidelines cover aspects such as problem establishment, literature search, literature screening, literature evaluation, evidence summary and classification, as well as the formulation of practical suggestions. This evidence summary followed the evidence summary reporting specifications of the Fudan University Center for Evidence-Based Nursing (http://ebn.nursing.fudan.edu.cn) with registration number ES20244849.

Trial Registration

This study was based on the evidence summary reporting specifications of the Fudan University Center for Evidence-based Nursing; the registered name is ‘Summary of the best evidence for weaning from mechanical ventilation in neurocritical care patients’; the registration number is ES20231823

Cultural considerations at end‐of‐life for people of culturally and linguistically diverse backgrounds: A critical interpretative synthesis

Abstract

Purpose/Aim

To establish cultural considerations for people from culturally or linguistically diverse backgrounds at the end-of-life in Australia.

Background

Globally, there is a rapidly increasing proportion of the ageing population, and high levels of migration to Australia, the Australian healthcare community must recognise individualised and cultural needs when approaching death and end-of-life care. Many people from culturally and linguistically diverse backgrounds do not traditionally practice the palliative care approaches that have been developed and practised in Australia.

Design

A Critical Interpretive Synthesis.

Methods

A review protocol was established using PRISMA 2020 guidelines and the literature searched using CINAHL, PubMed, Psych INFO and Medline from January 2011 to 27th February 2021. This search protocol results in 19 peer-reviewed results for inclusion in critical analysis.

Results

Included studies were qualitative (14), quantitative (4) and mixed methods (1). Four themes were identified from the literature: (i) communication and health literacy; (ii) access to end-of-life care services; (iii) cultural norms, traditions and rituals; and (iv) cultural competence of healthcare workers.

Conclusions

Healthcare workers have an essential role in providing care to people with life-limiting illnesses. Cultural considerations during end-of-life care are imperative for the advancement of nursing practice. To achieve effective care for people of culturally and linguistically diverse backgrounds during end-of-life care, healthcare workers need to increase their education and cultural competency. There is inadequate research conducted within specific cultural groups, rural and remote Australian communities and individual cultural competence of healthcare workers.

Implications for Practice

Continuing advancement within nursing practice relies on health professionals adopting a person-centred and culturally appropriate approach to care. To ensure individualised person-centred care is provided in a culturally appropriate way, healthcare workers must learn to reflect on their practice and actively advocate for people with culturally and linguistically diverse backgrounds during end-of-life care.

Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID‐19 pandemic

Abstract

Aims and objectives

This study aimed to examine the psychosocial impact and identify risk factors for poor psychosocial outcomes in healthcare professionals during the Coronavirus disease 2019 (COVID-19) pandemic in Cyprus.

Background

Healthcare professionals are in the forefront of the COVID-19 pandemic facing an unprecedented global health crisis, which can have consequences on their psychosocial health. There is a need to identify risk factors for poor psychosocial outcomes to inform the design of tailored psychological interventions.

Design

Cross-sectional online study.

Methods

A total of 1071 healthcare professionals completed self-report questionnaires. Measures included sociodemographic information, COVID-19-related characteristics, quality of life (Brief World Health Organization Quality of Life; WHOQOL-Bref), anxiety (Generalized Anxiety Disorder-7; GAD-7), depression (Patient Health Questionnaire-8; PHQ-8), occupational burnout (Copenhagen Burnout Inventory; CBI), and coping (Brief Coping Orientation to Problems Experienced; Brief COPE). This article follows the STROBE reporting guidelines.

Results

The prevalence of moderate to severe anxiety and clinically significant depression was 27.6% and 26.8%, respectively. Significant risk factors for poor psychological outcomes included being female, being a nurse or doctor (vs non-medical professional), working in frontline units (inpatient, intensive care), perceptions of inadequate workplace preparation to deal with the pandemic, and using avoidance coping. Depression and occupational burnout were significant risk factors for poor quality of life.

Conclusion

The findings suggest several individual, psychosocial, and organisational risk factors for the adverse psychological outcomes observed in healthcare professionals during the COVID-19 pandemic.

Relevance to clinical practice

This study highlights the urgent need for screening for anxiety and depression and psychological interventions to combat an imminent mental health crisis in healthcare professionals during the COVID-19 pandemic. Pandemic response protocols and public health initiatives aiming to improve and prevent mental health problems in healthcare professionals during the current and future health crises, need to account for the various factors at play.

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