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☐ ☆ ✇ Journal of Clinical Nursing

Nursing Students' Perceptions of Acceptable Use of Smartphones During Clinical Placement: A Cross‐Sectional Study

ABSTRACT

Background

The rise in smartphone use presents opportunities and challenges in clinical settings. Despite guidelines restricting mobile phone use, nurses frequently rely on them for various purposes. While beneficial, smartphone use poses risks to information security, patient safety, and care quality, prompting the need for monitoring.

Objective

This study examined smartphone usage among nursing students and their perspectives on acceptable and unacceptable use during clinical placements.

Design

This cross-sectional study used convenience sampling to recruit undergraduate nursing students from five universities in Australia and New Zealand. Participants completed the Attitude Towards Digital Device Use during Clinical Placement (Adduct) Scale online between September 2021 and August 2022. The survey included closed and open-ended questions. Descriptive and inferential analyses were conducted using SPSS. Exploratory factor analysis identified attitudinal dimensions, while group comparisons assessed demographic variations. Qualitative responses were thematically analysed. Reporting followed the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).

Results

Among 279 respondents, drawn from an eligible population of 2682 students, the response rate was 10.4%. Age significantly influenced perceptions of unacceptable smartphone use. Younger students (mean age = 25.0, SD = 9.8) were more likely to view such use as acceptable, with those up to 21 years reporting higher scores on the Unacceptable Use sub-scale compared to older peers (p = 0.024). Most respondents found smartphone use beneficial for accessing information and learning, though concerns included distractions and confidentiality breaches. Younger students were at greater risk of non-adherence to guidelines.

Conclusion

Smartphones can enhance learning and efficiency, but clear guidelines and education are needed to balance benefits with risks, particularly for younger students.

Relevance to Clinical Practice

This study highlights the need for clear guidelines and structured training to balance educational benefits of smartphone use with the risks of distraction and breaches of patient confidentiality in clinical practice.

Patient or Public Contribution

No patient or public pontribution.

☐ ☆ ✇ Journal of Clinical Nursing

Assessing the Impact of Supplemental Oxygen Use on Deterioration Detection in the General Care Setting With Pulse Oximetry‐Based Continuous Monitoring

ABSTRACT

Aims

Continuous pulse oximetry monitoring has been used in patient deterioration recognition systems for decades. For patients on supplemental O2, questions related to the effectiveness of this approach have been raised due to elevation of SpO2 from O2 therapy. We examine this issue in the context of a stable inpatient continuous pulse oximetry-based rescue system with the aim of ascertaining if patients receiving supplemental oxygen are at risk of experiencing clinically meaningful delays in deterioration recognition as compared to patients on room air.

Design

Retrospective observational analysis.

Methods

Clinical markers of deterioration recognition timeliness and impact were compared for patients receiving various levels of supplemental oxygen and those on room air over 6 years. Chart review was conducted to assess cause and likelihood of preventability and improvement in detection with other monitoring modalities for emergent cases.

Results

Analysis adjusted for patient characteristics, and population level supplemental oxygen use showed no difference between patients on supplemental oxygen vs. room air for transfer rate, emergent transfer rate, or death after rescue or transfer. Analysis excluding population supplemental oxygen modeling showed limited increases in event likelihood, but not for emergent transfers. Chart review of emergent transfers revealed no pattern of delay in recognition of deterioration for patients on supplemental oxygen.

Conclusions

This study found no evidence that pulse oximetry-based continuous monitoring significantly degrades or delays detection of severe deterioration episodes for patients receiving supplemental oxygen. These findings challenge arguments suggesting pulse oximetry is not an appropriate continuous monitoring modality for general care patients receiving oxygen.

Implications for the Profession and/or Patient Care

This study provides clinical nurses with information about using continuous monitoring when caring for patients who are receiving supplemental oxygen in the general care setting. The study also assesses patient safety of the practice of using pulse oximetry for monitoring in this patient population.

Impact

This study addresses concerns related to using continuous pulse oximetry monitoring for deterioration detection when patients are receiving supplemental oxygen. This study found no evidence that pulse oximetry-based continuous monitoring significantly degrades or delays detection of severe deterioration episodes for patients receiving supplemental oxygen. The results can be used by the inpatient nursing community to ensure safe practices are in place for patient care.

Reporting Method

This study adheres to the STROBE reporting method.

No Patient or Public Contribution

Patient and/or public contribution was not deemed applicable for the rigorous design and execution of this study.

☐ ☆ ✇ BMJ Open

Comparing perspectives of volunteers and patients on the Health Champions intervention in secondary mental healthcare: a qualitative study

Por: Pinto da Costa · M. · Chang · W. C. A. · Wu · Y. · Spence · S. · Cho · H. J. · Mcgrath · R. · Sadler · E. · Tredget · G. · Mdudu · I. · Gaughran · F. · Sevdalis · N. · Bakolis · I. · Williams · J. — Febrero 5th 2026 at 13:02
Background

People with serious mental illness (SMI) can experience significant physical health challenges. The Health Champions intervention was developed to support their physical health through using trained volunteers. However, volunteer and patient perspectives on the impact and implementation of this intervention have yet to be understood.

Aims

To compare the views of patients and volunteers on the Health Champions intervention.

Design and setting

A qualitative thematic analysis was conducted on interviews with 29 study participants. Interviews were carried out either face-to-face, via Microsoft Teams, or by telephone and included 12 patients (6 men and 6 women) and 17 volunteers (the Health Champions) (5 men and 12 women).

Results

Four overarching themes were identified, highlighting both similarities and differences between stakeholders’ perspectives: (1) supporting goal setting; (2) impact on positive lifestyle; (3) experiences and perception of the programme and (4) navigating challenges during the programme. Both groups found the programme to be largely successful, by motivating patients to work towards their physical health goals and facilitating successful matching of patients with volunteers. Volunteers and patients valued good communication with the research team. Though both groups shared some views on the challenges with scheduling and a lack of face-to-face contact during the COVID-19 pandemic, their perceptions on how patients incorporated their health changes during and after the programme, as well as other administrative concerns such as views on the efficacy of journaling and breakdown of roles, differed.

Conclusions

The Health Champions intervention was perceived as useful to improve the physical health of patients with SMI. Differences in the views between the two stakeholders may result from their distinct experiences and expectations. Future volunteering programmes should further support the diverse physical health needs of patients with SMI.

☐ ☆ ✇ BMJ Open

UNIversity students LIFEstyle behaviours and Mental health cohort (UNILIFE-M): study protocol of a multicentre, prospective cohort study

Por: Schuch · F. B. · Waclawoscky · A. · Tornquist · D. · Oyeyemi · A. L. · Sadarangani · K. P. · Takano · K. · Teychenne · M. · Balanza-Martinez · V. · ONeil · A. · Romain · A. J. · McGrath · A. · Alselmi · A. · Andrade-Lima · A. · Zanetti · A. C. G. · Trompetero-Gonzalez · A.-C. · Heiss — Enero 12th 2026 at 15:08
Introduction

Students enrolling in higher education often adopt lifestyles linked to worse mental health, potentially contributing to the peak age onset of mental health problems in early adulthood. However, extensive research is limited by focusing on single lifestyle behaviours, including single time points, within limited cultural contexts, and focusing on a limited set of mental health symptoms.

Methods and analysis

The UNIversity students’ LIFEstyle behaviours and Mental health cohort (UNILIFE-M) is a prospective worldwide cohort study aiming to investigate the associations between students’ lifestyle behaviours and mental health symptoms during their college years. The UNILIFE-M will gather self-reported data through an online survey on mental health symptoms (ie, depression, anxiety, mania, sleep problems, substance abuse, inattention/hyperactivity and obsessive/compulsive thoughts/behaviours) and lifestyle behaviours (ie, diet, physical activity, substance use, stress management, social support, restorative sleep, environment and sedentary behaviour) over 3.5 years. Participants of 69 universities from 28 countries (300 per site) will be assessed at university admission in the 2023 and/or the 2024 academic year and followed up for 1, 2 and 3.5 years.

Ethics and dissemination

The study was first approved at a national level in Brazil (CAE:63025822.8.1001.5346). Study sites outside Brazil obtained additional ethics approval from their institutions using the main approval. Results from the UNILIFE-M cohort will be disseminated through scientific publications, presentations at scientific meetings, press releases, the general media and social media.

☐ ☆ ✇ BMJ Open

Implementation strategies to improve adoption of screening and linkages for non-medical drivers of health in care management using enabling technologies: study protocol for a cluster randomised trial

Por: Cook · N. · Gunn · R. · McGrath · B. M. · Donovan · J. · Pisciotta · M. · Owens-Jasey · C. · Fein · H. L. · Templeton · A. · Larson · Z. · Gold · R. — Noviembre 6th 2025 at 06:00
Introduction

Practice guidelines recommend addressing patient non-medical drivers of health such as access to nutritious food and transportation as part of whole-person care. Emergent electronic health record (EHR)-based tools can enable non-medical needs care coordination, but adoption commonly faces workflow and infrastructure barriers. Targeted implementation support strategies (eg, training, practice facilitation) can enhance technology adoption in healthcare settings, but no prior research has assessed if implementation strategies can improve how care managers use enabling technologies for non-medical needs care coordination. This study will test whether providing implementation support to primary care health centre care management teams improves the adoption of EHR-based enabling technologies to address patients’ non-medical needs.

Methods and analysis

This hybrid implementation-effectiveness type 2 pragmatic trial has a mixed methods design. The primary outcomes include: (1) Whether patients enrolled in care management programmes have been screened for unmet non-medical health-related needs and (2) Whether patients with identified unmet non-medical health-related needs received a referral to a community organisation to address their need. The secondary outcomes include: (1) Whether referrals for financial-related non-medical needs had a documented outcome in the EHR, such as successful connection to services, service unavailability or other disposition statuses, (2) Whether the referral outcomes indicated ‘successful connection to services’ and (3) Clinical markers including hypertension and diabetes control. Formative evaluation of barriers and facilitators to using EHR tools to conduct non-medical needs screening, referrals and tracking of receipt of services will include semi-structured interviews and a ‘guided tour’ of enabling technology used by care managers. A modified Delphi process will then inform the development of a set of implementation strategies for inclusion in the intervention. The intervention will be piloted in three health centres, refined, then tested in a stepped-wedge cluster-randomised trial in 20 health centres.

Ethics and dissemination

We obtained ethics approval for all study activities from Advarra Institutional Review Board (registration number #00000971). Results will be disseminated to Health Centres and Health Centre network nationally at meetings and we will disseminate to researchers via manuscripts in peer-reviewed journals and scientific meetings.

Trial registration number

NCT06489002.

☐ ☆ ✇ BMJ Open

What is the impact of an allied health service-learning programme for rural communities: a study protocol using the RE-AIM/PRISM framework

Por: McNeil · R. · McGrath · R. L. · Ackland · K. · Oates · R.-K. · Woodhart · L. · Wright · K. — Octubre 1st 2025 at 08:29
Introduction

People in rural areas of Australia experience poorer health in almost every indicator compared with urban populations; however, rural communities have lower access to primary health, allied health and specialist healthcare. Timely access to care is compounded by persistent and widespread health workforce issues, including attracting and retaining staff.

Australian University Departments of Rural Health (UDRH) have been established to address the needs of rural populations with the goal of improving recruitment and retention of health professionals across rural and remote Australia. The work-integrated learning team within The University of Melbourne works with nursing and allied health university students on clinical placement to provide exposure to working in rural health, with a remit to build the capacity of the existing and future workforce. The service-learning model aims to provide reciprocal benefits to stakeholders through purposefully co-designed placements that respond to rural health needs by providing services to underserved communities and ensuring university students are exposed to real world, diverse practice settings.

The overarching aim of this project is to determine the impact of the SL programme for key stakeholders, predominately end users and those stakeholders involved in the delivery of the SL model. The key stakeholders are host site staff, allied health university students, allied health supervisors and the end users of the programme. End users are those individuals that have received allied health services through the programme, such as clients, residents and children.

Methods and analysis

This study will adopt a convergent mixed methods methodology underpinned by a RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance)/PRISM (Practical, Robust Implementation Sustainability Model) approach. Data collection will include document review, existing programme data review and primary data collection. This will involve conducting surveys and interviews with allied health university students, host organisations and allied health supervisors, and interviews with adult recipients of the service-learning programme. Art-based consultation will be conducted with school-aged children recipients of the service-learning programme. Analysis will be underpinned by the RE-AIM/PRISM framework to inform programme learnings and impact for key stakeholders.

Ethics and dissemination

This study has been approved by the University of Melbourne Human Research Ethics Committee (Project ID: 30409).

Findings will be published in a stakeholder project report and peer-review journals in the fields of rural health, implementation science and work integrated learning.

☐ ☆ ✇ BMJ Open

Ward AdmiSsion of Haematuria: an Observational mUlticentre sTudy (WASHOUT) - study protocol

Por: Bhatt · N. · Byrnes · K. · Ippoliti · S. · Varma · R. · Jie Chow · B. · Mak · Q. · Kerdegari · N. · Asif · A. · Nathan · A. · Ng · A. · McGrath · J. · Lamb · B. · Catto · J. · Challacombe · B. · Ribal · M. · MacLennan · G. · Gallagher · K. · Khadhouri · S. · Kasivisvanathan · V. — Agosto 17th 2025 at 08:12
Introduction

Haematuria contributes significantly to emergency urology admissions with over 4 per 1000 annual UK emergency admissions and 10% readmitted within 30 days. However, there is limited focus on optimising inpatient pathways internationally. Existing studies highlight a substantial underlying malignancy rate (32%) in patients presenting with visible haematuria, yet many receive inconsistent care, leading to prolonged hospital stays and increased resource use. A systematic review performed by our research group found no large-scale prospective studies have been performed in this area, and little is known about current practice. This study aims to address these gaps by investigating current management practices and their impact on outcomes, with the goal of informing evidence-based guidelines and improving patient care.

Methods and analysis

The Ward AdmiSsion of Haematuria: an Observational mUlticentre sTudy is an international, multicentre prospective observational study designed to describe the management of patients with unplanned admission to hospital with haematuria under the care of the urology team. The study will use a collaborative methodology using the British Urology Researchers in Surgical Training model. This model delivers international multicentre studies by empowering trainees to lead all aspects of multi-centre clinical studies, building research skills cost-effectively while shaping the future urological consultant workforce. Data on demographics, comorbidities, management practices and outcomes will be collected using a standardised case report form and analysed using multilevel linear regression modelling. Primary outcomes include length of stay, while secondary outcomes cover hospitalisation free survival, mortality, readmission rates at 90 days and resource use. The study was launched in January 2024 and will continue follow-up data collection through December 2025. Patient and public involvement (PPI) has been integral to the study design, ensuring that outcomes reflect patient priorities and that the research addresses key areas of concern.

Ethics and dissemination

Ethical and regulatory approvals will be obtained as required in each participating region. In the UK, the study is classified as a service evaluation and does not require individual patient consent. Participating sites must obtain local audit department approval. Data will be collected and stored securely, ensuring patient confidentiality. Results will be disseminated through scientific conferences, peer-reviewed publications and patient advocacy groups.

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