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Nursing research often tests complex interventions. For example, the intervention may be delivered by different nurses, with varying levels of seniority and expertise and in diverse geographical locations. The efficacy (can it work) or effectiveness (does it work in the real world) of complex interventions is often evaluated within randomised controlled trials (RCTs). The most recent UK Medical Research Council (MRC) guidance
Commentary on: Ayers JW, Poliak A, Dredze M, Leas EC, Zhu Z, Kelley JB, Faix DJ, Goodman AM, Longhurst CA, Hogarth M, Smith DM. Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum. JAMA Intern Med. 2023 Jun 1;183(6):589-596. doi: 10.1001/jamainternmed.2023.1838.
AI assistants could be used to draft responses for physicians and nurses, potentially addressing a key element of burn-out. Further research is needed to assess the impact of communication on healthcare outcomes and should incorporate patient evaluations and feedback.
In the setting of increasing adoption of virtual healthcare and the surge in electronic patient messages, there has been a higher workload for physicians and nurses, contributing to burnout and potentially terse, unanswered or unhelpful patient messages. Given these challenges, there is a need to explore innovative solutions...
Commentary on: Dawson LP, Nehme E, Nehme Z, Zomer E, Bloom J, Cox S, Anderson D, Stephenson M, Ball J, Zhou J, Lefkovits J, Taylor AJ, Horrigan M, Chew DP, Kaye D, Cullen L, Mihalopoulos C, Smith K, Stub D. Chest Pain Management Using Prehospital Point-of-Care Troponin and Paramedic Risk Assessment. JAMA Intern Med. 2023 Mar 1;183(3):203-211. doi: 10.1001/jamainternmed.2022.6409.
In patients calling the emergency medical system for acute chest pain without ST-segment elevation, prehospital risk stratification using validated risk scores and point-of-care (POC) cardiac troponin measurement by emergency nurses or paramedics can result in substantial cost savings. The safety of this strategy needs confirmation by sufficiently powered prospective randomised clinical trials.
Acute chest pain is one of the most common reasons for emergency system activation and transfer to the emergency department (ED).
Over 200 health journals call on the United Nations (UN), political leaders and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency.
The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28th Conference of the Parties (COP) on climate change is about to be held in Dubai while the 16th COP on biodiversity is due to be held in Turkey in 2024. The research communities that provide the evidence for the two COPs are unfortunately largely separate, but they were brought together for a workshop in 2020 when they concluded that: ‘Only by considering climate and biodiversity as parts of the same...
Commentary on: Goeddel L, Murphy Z, Owodunni O, et al. Domains of Frailty Predict Loss of Independence in Older Adults after Non-Cardiac Surgery. Ann Surg. 2022 Sep 20. doi: 10.1097/SLA.0000000000005720. Epub ahead of print.
Frailty screening with the Edmonton Frailty Scale can be used to identify risk factors for loss of independence after surgery, including a patient’s functional performance, functional dependence, social support and urinary incontinence. Prospective studies are needed to test whether risk factors can be modified before surgery to prevent loss of independence among frail patients.
Frailty is a common syndrome of physiological decline among older adults characterised by vulnerability to adverse outcomes and loss of functional independence after major surgery.
Commentary on: Yurtbasi MK, Melvin G, Pavlou C, Gordon M. Staff perspectives on the effects of seclusion in adolescent psychiatric inpatient care. Int J Ment Health Nurs. 2023 Apr;32(2):567–578. doi: 10.1111/inm.13102. Epub 2022 Dec 15.
Nursing staff find adolescent seclusions necessary but also experience related guilt and self-doubt. Seclusion protocols in adolescent psychiatric units should include alternatives to seclusion and debriefing processes.
Seclusions cause distress in patients and lead to negative outcomes, including death. Growing research demonstrates that seclusion rates vary by age, sex, race, diagnosis and personal history of adverse events.
Commentary on: Mikovits JC. "I don't feel like I'm a person": Nursing knowledge of transgender care through the lens of transgender people. J Adv Nurs. 2022 Sep;78(9):3012–3024. doi: 10.1111/jan.15308. Epub 2022 Jun 1.
Nurses have an ethical imperative to provide patient-centered care that honours all aspects of one’s identity, including gender identity. Further research is needed to better understand the healthcare experiences of transgender people of intersecting identities and those with varying economic resources.
Transgender people experience numerous health inequities due to societal discrimination and stigma.
Commentary on: Clair A, Baker E. Cold homes and mental health harm: Evidence from the UK Household Longitudinal Study. Soc Sci Med. 2022 Dec;314:115461. doi: 10.1016/j.socscimed.2022.115461. Epub 2022 Oct 22 .
Supporting people to live in warm housing during a period of increasing living and energy costs in many countries will avoid social, economic and mental health harm. Further research to understand the pathways between cold housing and increased mental health distress is needed.
Cold housing, driven by poor housing quality and energy poverty, is a significant public health issue in many countries.
Commentary on: Mazalová L, Gurková E, Štureková L. Nursing students' perceived stress and clinical learning experience. Nurse Educ Pract. 2022 Oct;64:103 457. doi: 10.1016/j.nepr.2022.103457. Epub 2022 Sep 24.
Clinical nursing supervisors may be unfamiliar with the demands and challenges students encounter in the clinical environment, and the amount of encouragement and assistance they require to be successful in the nursing profession. Further research should focus on intervention studies examining how clinical nursing supervisors control nursing student clinical stressors to improve student outcomes.
The clinical environment is the prevailing source of stress during nursing students’ educational experience. Although clinical supervisors are predominantly supportive to students in the clinical environment, current literature recognises certain clinical nursing supervisor actions and behaviours as causes of nursing student clinical stress.
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