Conectar
To explore intensive care nurses' perceptions of their work environments at the unit and organisational levels according to the American Association of Critical Care Nurses standards, their impact on care quality, national differences, and demographic associations.
Cross-sectional study using a survey design.
Study conducted between January 2021 and April 2022, using a convenience sample of intensive care unit nurses across Cyprus, Spain, Croatia, and Poland, Romania. The Critical Elements of a Healthy Work Environment Scale (CEHWES) developed by the American Association of Critical Care Nurses and cross-culturally adapted by the authors was used, which included four sections, including sociodemographic data and a total of 50 questions. The core section of the tool comprised 16 questions using Likert-type response (1—strongly disagree—4 strongly agree). Perception of fulfilment of healthy work environment standards was calculated using the aforementioned Likert-type scale.
A total of 1183 nurses participated reporting moderate perception of fulfilment of the standards, with mean scores ranging from 2.6 to 2.8. Skilled communication and effective decision making were the highest rated. 56% (n = 662) reported awareness of some standards and while 25.8% (n = 305) reported full or significant implementation in their unit. Significant differences related to the perception of all standards were observed across countries. Implementation of the standards was significantly associated with higher quality of care having better perception when standards were fully implemented.
This study shows moderate perception of healthy work environment standards among intensive care nurses. Country differences highlight the need for more awareness, training, and further implementation of the standards, which is linked to better care quality.
Work environment still need to improve and needs to be prioritised by organisations, considering local and national particularities. Having a measuring tool available in multiple languages facilitates comparisons and getting a global picture.
The questionnaire used is validated in different languages, allowing results to be compared with other countries. Novel data from countries that were poorly investigated is now available. More evidence points out the need to prioritise work environment for maintaining quality in patient care.
The study has been reported following the STROBE checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
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.
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.
A cross-sectional and methodological scale validation design, following classical test theory.
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.
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.
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.
These findings provide valid and reliable insights for measuring and improving health visitors' advanced practice and developing future professional policies.
No patient or public contribution.
STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies.
Women with overweight or obesity tend to engage in low levels of exercise and face challenges in initiating and maintaining exercise throughout pregnancy.
This study aimed to evaluate the effectiveness of a peer-led walking and mobile health (mHealth) app intervention on self-efficacy and change in exercise behavior stage, based on the transtheoretical model (TTM), of women with overweight or obesity from pregnancy to one month postpartum.
The study was a randomized controlled trial with an experimental design. A total of 114 pregnant women (BMI ≥ 24 kg/m2 and gestation < 16 weeks) were recruited from prenatal clinics in Taiwan from July 2021 to May 2022. The intervention group (IG) received the peer-led walking program with mHealth support, while the control group (CG) received standard antenatal care. Follow-ups were conducted at 24–28 weeks (T2), 36–40 weeks (T3), and one month postpartum (T4).
The IG had significantly higher exercise self-efficacy scores from T1 to T3 compared to the CG. IG participants showed notable progress in exercise behavior stages, transitioning from the contemplation stage at T1 to preparation and action stages at T2 (χ 2 = 13.208, p < 0.01), with some reaching the maintenance stage by T3 (20.9%, χ 2 = 9.49, p < 0.05). In contrast, most of the CG participants remained at the contemplation stage throughout pregnancy to early postpartum.
The peer-led walking intervention with mHealth has the potential to enhance self-efficacy and promote sustained exercise behavior of women with overweight or obesity during and after pregnancy and is a valuable approach to establishing long-term exercise behavior.
ClinicalTrials.gov: NCT 05022680
Patients undergoing abdominal surgeries have a chance to experience surgical-related anxiety. But the most effective non-pharmacological interventions in managing this anxiety have not yet been identified.
To examine the effectiveness of different types of non-pharmacological interventions, and identify the effective components on pre- and postoperative anxiety management among patients undergoing abdominal surgeries.
A systematic search of randomized control trials (RCTs) examined the effects of non-pharmacological interventions on preoperative and/or postoperative anxiety (Primary outcomes) among patients undergoing abdominal surgery was conducted across MEDLINE, Ovid Nursing, AMED, PsycINFO, CINAHL, EMBASE, Cochrane Library, HyRead, and WANFANG DATA from 1987 to March 1, 2024. Secondary outcomes including postoperative pain, postoperative analgesics consumption, resumption of postoperative bowel movements, and length of hospital stay were also examined. Cochrane Risk of Bias Tool (version 2.0) was used for quality assessment. Meta-analysis was performed to synthesize the findings. Narrative summaries were provided for the studies that could not be included in the meta-analysis.
This review included 35 RCTs. The interventions of included studies were categorized as prehabilitation, sensory stimulation, preoperative counseling, information provision, and psychological interventions. Meta-analysis revealed that preoperative counseling was beneficial in managing preoperative anxiety (SMD = −1.36; 95% CI = −1.96, −0.76), postoperative anxiety (SMD = −1.30; 95% CI = −1.62, −0.98), and postoperative pain (SMD = −0.84; 95% CI = −1.21, −0.47). Meanwhile, psychological interventions adopting relaxation exercises had potential effects in reducing postoperative opioid consumption and shortening time to postoperative bowel movement.
Adopting preoperative counseling is suggested for the management of pre- and postoperative anxiety and postoperative pain among patients undergoing elective abdominal surgeries. A one-off lasting for 20–45 min preoperative counseling including individualized information about the coming surgery and perioperative process, and a discussion addressing patients' concerns is recommended. Future research is needed to explore the effects of relaxation exercise on important patients' outcomes such as postoperative analgesics consumption and time to resume bowel movement among patients undergoing abdominal surgery.
PROSPERO registration number: CRD42023359484
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 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.
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.
Academic databases and grey literature were systematically searched to identify relevant sources, and findings were narratively synthesised.
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.
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.
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.
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 explore the impact of systems thinking in nursing leadership on healthcare quality, decision-making and resource management.
A systematic review.
A comprehensive literature search was conducted in PubMed, CINAHL, Scopus and Web of Science for studies published in English and Italian up to 2024.
Studies were selected based on predefined eligibility criteria, focusing on nursing leadership integrating systems thinking. The Joanna Briggs Institute (JBI) checklist was used to assess methodological quality. A narrative synthesis was conducted to identify key themes and patterns.
Fifteen studies met the inclusion criteria. Findings suggest that systems thinking enhances resource management, decision-making and patient safety, while also reducing errors and improving staff collaboration. Adopting a systems approach allows nursing leaders to navigate complex healthcare environments effectively. However, variability in study designs and implementation strategies limits the generalizability of findings.
Integrating systems thinking into nursing leadership promotes a proactive, holistic approach to problem-solving, optimising healthcare outcomes. While evidence supports its benefits, further empirical studies are needed to confirm its effectiveness across diverse healthcare settings.
What problem did the study address? The need for structured systems thinking in nursing leadership. What were the main findings? Improved decision-making, resource optimisation and patient safety through systems-oriented leadership. Where and on whom will the research have an impact? Nurse leaders, healthcare administrators and policymakers in diverse healthcare settings.
Although patients and the public were not directly involved, this study has implications for enhancing patient safety and healthcare efficiency.
To describe the factors associated with work engagement in newly graduated nurses.
Systematic review of original quantitative studies according to Joanna Briggs Institute guidelines.
The systematic review utilised PEO inclusion criteria. Original peer-reviewed quantitative studies were identified. Two researchers independently conducted a screening of study eligibility based on title, abstract, and full text. The JBI critical appraisal tool for analytical cross-sectional studies was employed to perform a rigorous methodological quality assessment. The data was extracted, tabulated, and then analysed narratively.
The literature search was conducted in November 2023 by screening four databases: Scopus, CINAHL (Ebsco), ProQuest, and Ovid Medline.
The review included 19 articles, presenting an overview of factors associated with newly graduated nurses' work engagement. Factors were classified into seven categories explaining supportive workplace, transition and orientation to workplace, competence and career development in nursing practice, personal and psychological characteristics, work environment characteristics, stress and challenges in a work environment, and satisfaction with work.
To support newly graduated nurses' work engagement, nurse leaders should provide a supportive working environment and focus on new nurses' effective support systems in the workplace. Their abilities to develop and educate themselves need to be prioritised to enhance their knowledge and skills in nursing. Additionally, organisations should have policies and procedures to ensure quality orientation, and units need to implement transition and mentorship programmes.
This research could be valuable to health care when wanting to develop and improve work engagement, especially among newly graduated nurses. The economic significance of nurses' work engagement is evident, as the cost of nurse turnover is considerable. Reducing nurse turnover and improving retention relies on understanding the factors influencing nurses' decisions to leave the organisation and the profession.
What problem did the study address? The global shortage of nurses, worsened by newly qualified nurses leaving the health sector, necessitates understanding factors influencing their work engagement; The factors associated with newly graduated nurses' work engagement were supportive work environment, transition and orientation to work, success and career development in nursing, personal and psychological characteristics, characteristics of the work environment, stress and challenges in the work environment, and job satisfaction. Where and on whom will the research have an impact? The results can be used by health care organisations to plan the preceptorship/mentoring programmes of new nurses. Identifying and understanding the factors associated with the retention of newly qualified nurses can help to attract and retain nurses and to promote the adaptation and integration of new nurses into healthcare organisations.
The YNEPR author checklist has been completed and implemented during this systematic review process. Also, the Prisma 2020 checklist has been used.
No patient or public contribution: systematic review.
PROSPERO number: CRD42023408705 (https://www.crd.york.ac.uk/PROSPERO/)
To explore women's experience of the period after completion of cancer treatment for gestational trophoblastic neoplasia (GTN): a descriptive exploratory study.
A descriptive exploratory qualitative study.
Women diagnosed with the rare pregnancy-related cancer GTN who had completed their treatment participated in semi-structured telephone interviews. Twenty-two interviews were conducted in June 2024 and digitally recorded and transcribed verbatim. The analysis used reflective thematic analysis.
Complex responses to treatment completion were revealed, described by some as a ‘double-edged sword’. The end of treatment routine, coupled with recovery from physical effects, left space for the impact of all they had experienced to ‘hit home’. Multiple concerns and losses were described, including issues relating to pregnancy, self-identity, confidence, fear of recurrence, work and relationships. Gaps in immediate post-treatment support services created challenges for recovery.
The study provides valuable insight into the physical, emotional and social impact of GTN experienced by patients following treatment. The findings highlight the importance of continuing support in the immediate post-treatment period. This study has identified ways in which services can be improved, recognising the need for an individual-tailored approach to reflect the complex responses of patients to treatment completion.
The findings reveal that many women begin to process the implications of their diagnosis and treatment following the completion of their treatment. The end of treatment can be a time when support from healthcare staff is reduced due to fewer routine contacts with healthcare staff. However, these findings suggest the need for nurses to ensure services continue to provide support during the post-treatment recovery phase.
The interview schedule was reviewed by women previously treated for GTN.
To describe and compare attitudes toward hand hygiene and the perceived effectiveness of prevention methods among nursing students and registered nurses at a university and its affiliated university hospital.
A descriptive cross-sectional comparative survey.
A total of 201 first- and final-semester nursing students and registered nurses completed the World Health Organisation's ‘Perceptions Survey for Health-Care Workers’. The survey examined perceptions on hand hygiene, patient safety and the usefulness of improvement measures. Responses were analysed using descriptive statistics.
Nursing students consistently rated the importance of hand hygiene and related interventions higher than registered nurses. Students particularly emphasised the availability of hand disinfectants, ongoing education and supportive leadership. Both groups acknowledged the role of management support, regular feedback and organisational policies in reinforcing optimal hand hygiene.
Differences in attitudes between nursing students and registered nurses underscore the need for ongoing education, strong managerial involvement and supportive policies to sustain adherence. Strengthening these factors can help maintain positive perceptions formed during training and enhance patient safety in clinical practice.
Educational curricula and workplace strategies that prioritise hand hygiene may help lower healthcare-associated infections. Management-led feedback, continuous training and accessible hand hygiene resources offer additional support for safe patient care.
What problem did the study address? Low adherence to hand hygiene is a key driver of preventable infections. What were the main findings? Nursing students rated hand hygiene and improvement measures more highly than registered nurses, highlighting a need for strategies that sustain positive attitudes during the transition from education to clinical practice. Who will benefit? Nurse educators, clinical leaders and healthcare workers can use these findings to improve infection prevention across educational and practice settings.
We adhered to STROBE guidelines for cross-sectional research.
No patients or members of the public were involved in designing or conducting this study, which focused on perceptions of nursing students and registered nurses.
To describe professionals' perceptions of the management of digital competence sharing in healthcare and associated background factors.
A descriptive cross-sectional study.
The study used an online survey involving 227 healthcare professionals from three public and one private healthcare organisation in Finland. Data was collected using the management of digital competence sharing (MDCS) instrument and analysed using descriptive statistics, independent sample t-tests and one-way ANOVA.
Based on the professionals' perceptions, the overall management of digital competence sharing was weak. They perceived the highest level of creation of a friendly and safe digital organisational atmosphere while the lowest level of provision of resources and opportunities for digital competence sharing. Background factors, including gender, age, work experience in healthcare, organisation and clinical environment, showed statistically significant differences in how professionals perceived the management of digital competence sharing.
The results emphasised the need for increased managers' attention to digital competence development, prioritising and supporting digital competence sharing among healthcare professionals.
The results can be utilised in healthcare management to enhance the digital competence sharing among healthcare professionals and the use of existing digital competence to benefit the work community.
The importance of digital competence is increasing among healthcare professionals, but at the same time, they perceive inadequate management support in this area. This study revealed limited management of digital competence sharing in healthcare organisations, particularly among older professionals and those in inpatient and primary care settings. These results can be applied in managers' training to support and promote digital competence among healthcare professionals.
The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist.
There is no patient or public contribution.
It is important for the treatment and care of adolescents using substances to bring out their life experiences relating to substance use.
To analyse and synthesise qualitative evidence on substance use-related life experiences of adolescents with substance use disorder.
A systematic review of qualitative studies.
Systematic searches on the databases PubMed, Science Direct, Scopus, EBSCO CINAHL Complete and Web of Science were conducted between December 2023 and February 2024 and supplemented by manual search strategies. As a result of the search, 1271 articles were accessed and 11 articles were included in the study. In order to assess quality, the critical appraisal skills programme was used. Synthesis of the data was performed using the thematic analysis method recommended by Thomas and Harden (2008). In study reporting, the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 checklist and enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) guidelines were used.
From 11 included publications, four main themes emerged: starting and continuing substance use, duration of dependence and related factors, the results of substance use and experiences of the treatment process.
Substance use disorder had serious negative effects on the adolescents themselves, their families and their environments. In line with these negative experiences, adolescents made suggestions regarding the substance use disorder treatment process.
Professionals working with adolescents can plan their interventions in line with the experiences and suggestions of adolescents who use substances. In addition, governments can take into account the experiences and suggestions of adolescents with substance use disorder when structuring health policies.
No patient or public contribution.
This meta-synthesis was registered with PROSPERO (CRD42022298218).
To describe the challenges related to the flow of medication information in home care, their contributing factors, and home care registered nurses' and nurse leaders' views on preventing them.
A descriptive qualitative study.
Six group and one individual semi-structured interview were conducted remotely with 15 home care registered nurses and nurse leaders between 12 February 2023 and 9 November 2023 in Finland. The data were analysed using reflexive thematic analysis.
We identified four main themes related to the challenges of medication information flow: the complexity of home care work in cooperation and the medication process, technology-related challenges, the healthcare professionals' individual factors and client-related challenges. These factors contributed to the challenges: the lack of healthcare professionals' resources, the healthcare professionals' attitudes to work and individual characteristics, the lack of healthcare professionals' uniform practices and client-related factors. Preventing challenges and incidents: strengthening standard healthcare practices, increasing healthcare resources, improving the individual factors of healthcare professionals, and guiding the client in the management of medication.
The medication information flow can be improved by discussing standard practices for the flow of medication information in home care and between home care and hospital teams.
It is crucial to identify challenges, contributing factors and prevention in the medication information flow from the home care registered nurses' and nurse leaders' perspective. These elements play an important role in developing medication information flow by collaborating extensively with other healthcare providers, clients, and relatives.
Healthcare professionals, nurse leaders, and educators can utilise this study's findings to develop the flow of medication information within and between organisations.
The Standards for Reporting Qualitative Research checklist was used.
No patient or public contribution.
To explore how a staff and managers experienced a multi-component and multi-level intervention to influence the psychological safety climate within nursing teams.
Qualitative, to explore the experiences of registered nurses, licensed practical nurses, and managers in a Swedish hospital.
Four focus group discussions were conducted in March 2023 with staff and managers (n = 20). A deductive thematic analysis was conducted, guided by a theoretical model of psychological safety, to examine work climate perceptions and antecedent conditions. An inductive approach was used to explore how participants experienced the intervention.
Participants experienced a shift from a blame-oriented to a more psychologically safe work climate. These developments were enabled by enhanced self-awareness, more supportive interpersonal dynamics, and leaders adopting a more accessible and vulnerable role. The intervention created a safe space to reflect on team dynamics.
Sustained efforts that integrate self-awareness, interpersonal dynamics, and managerial support are important to intentionally develop psychological safety. The creation of safe spaces can serve as a first step to confront unaddressed group beliefs.
Interventions aimed at improving psychology safety can have positive effects if they focus on developing individual trust and vulnerability, targeting group dynamics, and including leaders.
Problem addressed: Inadequate psychological safety among nursing teams, hindering effective collaboration. Main findings: By changing work conditions, the intervention led to improved perceived psychological safety. Research impact: Creating conditions for psychological safety can improve how teams function.
COREQ-checklist.
No PPI patient or public contribution.
To explore individual and organisational factors affecting near-miss reporting in healthcare settings.
Systematic review following the PRISMA 2020 guidelines.
Five electronic databases from 2013 to 2024 studies published were searched.
A comprehensive search was conducted across PubMed, Web of Science, MEDLINE, Scopus and OpenAlex, covering English, full-text literature from 2013 to 2024. Inclusion criteria focused on studies investigating factors influencing near-miss reporting in healthcare. The risk of bias was assessed using the Risk of Bias in Non-randomised Studies of Interventions tool. Data were synthesised using the Health Belief Model and the Hospital Patient Safety Culture framework.
A total of 20 studies were included. Key individual barriers to near-miss reporting included a lack of knowledge and negative perceptions. Organisational factors, including hospital safety culture, leadership support, error communication, and non-punitive responses to reporting, significantly impacted reporting behaviours.
Promoting a structured and supportive reporting culture, educational initiatives, and simplified reporting mechanisms can improve near-miss reporting practices.
Improving near-miss reporting practices by addressing identified barriers can lead to safer healthcare environments and better patient outcomes.
This paper addresses a gap in the literature regarding near-miss underreporting. The findings will have an impact on healthcare administrators, healthcare professionals, and ultimately, patients. Implementing strategies such as peer mentoring and constructive feedback, targeted training and simplified reporting systems can encourage consistent near-miss reporting. These efforts will ultimately lead to safer healthcare environments and improved patient outcomes.
The review methodology, including data selection, extraction and synthesis, follows PRISMA standards to ensure clarity, transparency and reproducibility.
This study did not include patient or public involvement in its design, conduct, or reporting.
This systematic review has been registered with the OSF and is publicly available at https://doi.org/10.17605/OSF.IO/EJGY2
To elucidate the essential strategies used by home-visit nurses to support the independence of individuals with dementia who live alone.
Qualitative interview study employing the Interpretive Description methodology.
Purposive sampling was conducted across three home-visit nursing offices in Tokyo. Individual semi-structured interviews were conducted with 14 home-visit nurses between June and August 2022. The interviews explored the strategies the participants employed while caring for individuals with dementia living alone. The transcribed data were analysed using reflexive thematic analysis.
Four strategies were identified: Strategy 1. Cultivating a relationship of trust to manage client refusal, Strategy 2. Fostering a balance between client and practical realities, Strategy 3. Optimising limited support resources and Strategy 4. Educating and advocating for a lack of understanding among supporters.
Home-visit nurses incorporate their standard practices into four strategies at both the direct care and support network levels to support independent living of individuals with dementia living alone. These strategies address the challenge of balancing autonomy with safety and health protection, which is a key consideration in supporting this population.
The findings provide guidance for home-visit nursing practice and inform the development of educational programmes to enhance their training.
This study advances understanding of how home-visit nurses navigate the challenges of autonomy, safety and health for people with dementia living alone, offering insights to inform future research and educational initiatives.
This study adhered to the Consolidated Criteria for Reporting Qualitative Research.
This study did not include patient or public involvement in its design, conduct, or reporting.
To measure patients' views of nurses' communication and interpersonal skills during acute hospitalisation.
This was a descriptive cross-sectional study.
From January to June 2024, a convenience sampling approach was used to recruit patients hospitalised in acute care wards across two healthcare organisations in regional Victoria, Australia. A self-report survey, the Communication Assessment Tool for Nurses, included 15 items that measured patients' opinions about the quality of nurses' communication using a 5-point scale. Data were analysed by descriptive and univariate statistics and logistic regression.
The sample included 204 participants. Higher ratings were found for respectful care: ‘Treated me with respect’ and ‘Showed care and concern’. Lower ratings largely related to shared decision-making: ‘Encouraged me to ask questions’, ‘Informed me about my plan of care’, ‘Involved me in decisions as much as I wanted’ and ‘Showed interest in my ideas about my health’. Logistic regression revealed lower ratings for the quality of nurses' communication based on longer hospital stay for items related to greetings and shared decision-making.
Whilst this study found that patients perceive a high quality of respectful nursing care, the findings underscore the need for communication skills training to enhance shared decision-making by nurses. Consideration is needed regarding how nurses are prepared to engage in shared decision-making with patients during acute hospitalisation, particularly for longer hospital stays.
This study addresses a gap in evidence regarding patients' perceptions about the quality of nurses' communication during acute hospitalisation in the Australian context. Whilst they perceive that nurses communicate in a respectful and caring manner, opportunities for shared decision-making may not be capitalised on. Hospital managers and nurse academics should develop interventions to address essential communication skills.
This study did not include patient or public involvement in its design, conduct or reporting.
To explore the views of community registered general nurses and directors of public health nursing on the current and future role of the community registered general nurse in the Republic of Ireland.
Anonymous cross-sectional descriptive survey.
Two questionnaires were developed; one targeted at community registered general nurses and one targeted at assistant directors of public health nursing or directors of public health nursing who were working with community registered general nurses. Social media was used to recruit participants. Descriptive statistics were used while data from open-ended questions were analysed using NVivo software.
A total of 97 community registered general nurses and 28 assistant directors of public health nursing or directors of public health nursing completed the surveys in 2023. There was consensus that community registered general nurses provide holistic care, including case management of adults with complex health needs living in the community. However, lack of promotional opportunities coupled with poor remuneration has resulted in job dissatisfaction. Respondents felt that community registered general nurses should focus on older adults, whereas public health nurses should focus on child health.
The role of the community registered general nurse needs to be clarified, and a promotional pathway developed to attract new graduates to this post.
This paper outlined the current role and vision for the future role of community registered general nurses.
CROSS guidelines.
No patient or public contribution.
This paper contributes to the challenges community nurses face regarding increased demand for community nursing, lack of career structure for some community nurses, and difficulties with staff retention within the community.
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