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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.
To identify and describe AI technologies for nurses' clinical decision-making in healthcare settings.
A systematic literature review.
CINAHL, PubMed, Scopus, ProQuest, and Medic were searched for studies with experimental design published between 2005 and 2024.
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.
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).
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.
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.
To explore aspects of interpersonal relationships in palliative care nursing, focusing on confidential conversations between patients and registered nurses (RN).
A qualitative study employing focused ethnography.
Data were collected through unstructured participant observations, field notes and interviews with patients and RN in specialist palliative care. Data were analysed using reflective thematic analysis.
Confidential conversations in palliative care are founded on trust that is fragile and develops dynamically through consistent interactions. Small talk, presence and silence are essential for initiating and maintaining trust and the interpersonal relationship. The environment, patient condition and RN emotional presence and competence shape these conversations. As the relationship evolves, conversations adapt to the patient's changing needs. Missed signals or interruptions can disrupt flow, but the potential for repair remains, allowing for restoration and strengthening of trust and connection.
Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations.
Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.
This study explores key aspects of confidential conversations in palliative care, emphasising trust and emotional sensitivity. It addresses a research gap in palliative care using rare observational methods to deepen understanding of nursing relational aspects. The findings offer practical guidance for enhancing communication and relational skills, informing training and policy development and ultimately, improving emotional support and care.
Findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.
This study did not involve patient or public participation in its design, conduct or reporting.
To evaluate the quality of care from the patients' perspective after receiving either person-centred, nurse-led follow-up or standard care after surgical treatment of intermittent claudication.
Secondary analysis of a randomised controlled trial.
Patients at two centres for vascular surgery in Stockholm, Sweden were randomised to either a person-centred, nurse-led follow-up programme (intervention group) or a standard follow-up programme with surgeons. During their visits at 4 to 8 weeks and 1 year after surgery, they received the questionnaire Quality from patients' perspective with 28 items. The patients responded to each item from two aspects: (1) how they perceived the quality of received care and (2) subjective importance (how important the care was for them).
A total of 104 of 138 patients at 4–8 weeks and 159 of 193 patients at 1 year after surgery completed the questionnaire. At 4–8 weeks, the intervention group scored significantly higher perceived quality of care regarding five items: receiving useful information about “How I should take care of myself” and “Which nurse were responsible for my care”, “Nurses were respectful towards me”, “Nurses showed commitment/cared about me” and “Easy to get in contact with the clinic through telephone”. At 1 year, the intervention group scored higher regarding two items: “Which nurses were responsible for my care” and “Next of kin treated well”.
Person-centred, nurse-led follow-up as implemented in this study has been shown to lead to a higher perception of quality of care regarding information about self-care, the experience of being respected, and knowing the care provider responsible for their care. Thus, it could contribute towards improved patient satisfaction without compromising the perception of quality of care regarding other factors such as receiving the best medical care or timeliness.
This study addresses how patients with intermittent claudication, who underwent revascularisation, perceive a follow-up care that is person-centred and nurse-led compared to standard care delivered by surgeons. The results indicate that patients find the person-centred and nurse-led follow-up programme satisfactory, with equal or higher quality of care and that follow-up can be delivered by nurses with retained patient safety. Thus, vascular units may consider transitioning follow-up care from surgeons to nurses while maintaining positive patient's perception of quality of care, patient satisfaction and safety.
Reporting of the work was made using the Consolidated Standards of Reporting Trials (CONSORT) statement.
No patient or public contribution.
Study Details | Person-centred Follow-up and Health Promotion Programme After Revascularization for Intermittent Claudication | ClinicalTrials.gov: NCT03283358
Explore how previous patient safety research has described issues related to patient participation in psychiatric hospital care.
Integrated literature review.
The literature review was conducted according to Cooper's framework with the following five-step protocol: problem identification, a literature search, data evaluation, data analysis, and the presentation of results.
CINAHL, PubMed, PsycINFO, Scopus databases, years 2005–2023. After quality appraisal, a total of 62 articles were reviewed.
Three main categories related to patient participation in psychiatric hospital care were identified: communication (having information, being heard, therapeutic relationships and interaction quality), decision-making (treatment planning, treatment decisions, activities and working on behalf of patients) and restrictive measures (setting limits, exercising power, balancing patient autonomy and safety).
Psychiatric hospital care nursing staff continuously balance patients' autonomy, self-determination, and safety, taking into account their well-being and issues of responsibility. Wider use of positive risk-taking is needed to increase patient participation and safety in psychiatric hospital care.
Nursing staff should create favourable facilities for patient participation, foster an atmosphere of trust, respect, and encouragement, provide patients individual time to improve patient safety and recognise that they can exert power over patients due to constantly balancing patient autonomy and safety.
PRISMA guidelines.
No patient or public contribution.
Evidence-based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC.
To identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors.
A systematic review.
CINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar.
Databases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis.
The review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies.
The development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs.
We should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice.
The review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist.
None.
To describe patients' experiences of the quality of counselling to develop new digital counselling solutions for patients with cerebrovascular disease.
A descriptive, qualitative approach.
Semi-structured in-person interviews were conducted among 22 patients diagnosed with acute cerebrovascular disease and treated as inpatients at a single university hospital in Finland between September 2021 and February 2022. Data were analysed using deductive and inductive content analysis.
The identified facilitators, barriers and possible solutions for the development of new digital counselling solutions were deductively categorized into five main categories: (1) background factors, (2) resources, (3) implementation, (4) sufficiency, and (5) effects and 12 generic categories. Patients with cerebrovascular diseases worry about symptoms affecting their ability to receive information and valued a supportive atmosphere. Staff should have more time for counselling and use motivational digital counselling solutions in plain language, moderate length and with multimedia content. Patients desired reminders, easy search functions and possibilities for two-way communication.
New digital counselling solutions could be beneficial in supporting the patients' knowledge, emotions and adherence. For the success of such solutions, patients' special needs concerning different levels of cognitive impairment need to be considered.
The results of this study may benefit healthcare organizations in the development of digital counselling solutions that meet the patients' needs.
We have adhered to relevant EQUATOR guidelines with the COREQ reporting method.
Patients were involved as the study population.
To identify and synthesise nurses' experiences of competence in lifestyle counselling with adult patients in healthcare settings.
Modifiable lifestyle risk behaviours contribute to an increased prevalence of chronic diseases worldwide. Lifestyle counselling is part of nurses' role which enables them to make a significant contribution to patients' long-term health in various healthcare contexts, but requires particular competence.
Qualitative systematic literature review and meta-aggregation.
The review was guided by Joanna Briggs Institute's methodology for conducting synthesis of qualitative studies. PRISMA-checklist guided the review process. Relevant original studies were search from databases (CINAHL, PubMed, Scopus, Medic and Psych Articles, Ebscho Open Dissertations and Web of Science). After researcher consensus was reached and quality of the studies evaluated, 20 studies were subjected to meta-aggregation.
From 20 studies meeting the inclusion criteria, 75 findings were extracted and categorised into 13 groups based on their meaning, resulting in the identification of 5 synthesised findings for competence description: Supporting healthy lifestyle adherence, creating interactive and patient-centred counselling situations, acquiring competence through clinical experience and continuous self-improvement, collaborating with other professionals and patients, planning lifestyle counselling and managing work across various stages of the patient's disease care path.
The review provides an evidence base that can be used to support nurses' competence in lifestyle counselling when working with adult patients in healthcare settings. Lifestyle counselling competence is a complex and rather abstract phenomenon. The review identified, analysed and synthesised the evidence derived from nurses' experience which shows that lifestyle counselling competence is a multidimensional entity which relates to many other competencies within nurses' work.
Recognising the competencies of nurses in lifestyle counselling for adult patients can stimulate nurses' motivation. The acquisition of these competencies can have a positive impact on patients' lives and their health.
No Patient or Public Contribution.
The research may enhance nurses' competence in lifestyle counselling, leading to improved health outcomes, better adherence to recommendations and overall well-being. It may also drive the development of interventions, improving healthcare delivery in lifestyle counselling.
The review was undertaken and reported using the PRISMA guidelines.
Blinded for the review.
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