Conectar
To examine the association between compassion fatigue and spiritual care competence amongst palliative care nurses, investigate the mediating role of palliative care quality and determine the moderating effect of job satisfaction.
Palliative care nurses face intense emotional demands and end-of-life stressors, increasing their risk of compassion fatigue and potentially affecting care delivery. Spiritual care competence is central to holistic palliative nursing; however, its association with compassion fatigue and the organisational factors shaping this relationship remain unclear.
A cross-sectional, correlational study.
Using a convenience sampling approach, 141 nurses working in palliative care units across hospitals in different regions of Türkiye were recruited. Data were collected between April and August 2024 via an online questionnaire including demographic variables and validated instruments measuring compassion fatigue, palliative care quality, spiritual care competence and job satisfaction. Data were analysed using SPSS and PROCESS macro.
The mean spiritual care competence score was 107.9 ± 14.7. Compassion fatigue was negatively associated with palliative care quality and spiritual care competence, whereas palliative care quality was positively associated with spiritual care competence. Mediation analysis indicated a significant indirect association between compassion fatigue and spiritual care competence through palliative care quality. Moderated mediation analysis indicated that this indirect effect was significant only amongst nurses reporting higher job satisfaction.
Compassion fatigue was negatively associated with palliative care nurses' spiritual care competence. Mediation analysis suggested that this association was statistically explained by palliative care quality, whilst job satisfaction moderated the relationship between compassion fatigue and care quality.
Addressing compassion fatigue as a critical occupational risk in palliative care nursing is essential. Organisational strategies that enhance job satisfaction and support high-quality care delivery may help sustain nurses' spiritual care competence and promote high-quality palliative nursing practise.
No patients or members of the public were involved in this study. Palliative care nurses participated by completing online questionnaires.
This cross-sectional study was reported in accordance with the STROBE Statement.
The aim of this study was to explore end-of-life simulation in undergraduate nursing curricula in Australian and New Zealand institutions.
A cross-sectional descriptive research design was employed. The study is reported using the CROSS checklist.
A survey was distributed to 45 institutions with an accredited Bachelor of Nursing programme in Australia or New Zealand. The instrument comprised eight domains: simulation orientation, simulator type, simulation environment, instructional design, simulation event, pre-brief, debrief, and facilitation preparation and requirements.
Thirty institutions responded to the survey, with 25 suitable for data analysis. Eleven institutions included end-of-life simulation in their curriculum. The dominant modality used in the end-of-life simulation was high-technology manikins. All institutions used a validated approach to conducting the pre-brief and debrief. Variations were reported in the skill and clinical expertise required of end-of-life simulation facilitators and the approaches and modalities used in end-of-life simulations across institutions.
A small number of institutions reported including end-of-life simulations in their undergraduate nursing curriculum. This study found the end-of-life simulations integrated into undergraduate nursing curricula in Australia and New Zealand align with many elements of the Healthcare Simulation Standards of Best Practice. There were variations in the simulation modality and facilitation style used to deliver end-of-life simulations across institutions. While a pre-brief session was included, the elements covered and information conveyed to participants varied across institutions. Additionally, the content expertise required of simulation facilitators lacked clarity.
The influence the pre-brief has on the student learning experience requires further research. Moreover, the learning experiences of the participants in various simulation modalities, including the influence of SPs and debriefing approaches, warrant investigation. The role and impact of professional development and facilitator requirements, such as skills and clinical expertise, on the student learning experiences and outcomes in EOL simulation offer opportunities for further research.
There were no patient or public contributions in this study.
To investigate whether patient safety culture is associated with nurses' turnover intention and to examine correlational sequential pathways involving burnout and job satisfaction, drawing on Conservation of Resources theory.
A descriptive, correlational design.
This study used data collected during 2023 from a hospital-wide patient safety culture survey conducted in four hospitals in South Korea. The sample comprised 3082 nurses from diverse units. Relationships among patient safety culture, burnout, job satisfaction, and turnover intention were examined using a mediation model within a structural equation modelling framework (WLSMV estimator with probit link), controlling for age and hospital tenure.
Patient safety culture was associated with lower burnout and higher job satisfaction. Burnout was associated with lower job satisfaction and with a higher likelihood of turnover intention, whereas job satisfaction was associated with a lower likelihood of turnover intention. When burnout and job satisfaction were considered together, the association between patient safety culture and turnover intention was explained through these two factors rather than by a direct pathway.
Patient safety culture functions as an organizational resource that relates to reduced burnout and enhanced job satisfaction, which together relate to lower intention to leave.
Strengthening patient safety culture—alongside efforts to reduce strain and foster positive job attitudes—may support nurse well-being and improve retention, thereby supporting continuity and safety of patient care.
This study addresses persistent nurse turnover intention in hospitals and identifies patient safety culture as an organizational lever that operates through reduced burnout and improved job satisfaction. The findings can guide nurse leaders and policymakers in hospitals to implement culture-focused strategies that support staff well-being, enhance retention, and sustain safe patient care.
STROBE guidelines were followed.
No patient or public contribution.
To examine the role of self-efficacy in the relationship between medication adherence and self-care behaviours in patients with Inflammatory Bowel Disease by describing their levels and exploring the interconnections among these variables.
Multicenter, cross-sectional.
A total of 452 patients were recruited through consecutive non-probabilistic sampling across nine Italian outpatient Inflammatory Bowel Disease Units. Data were collected using validated tools: the Morisky Medication Adherence Scale-8, the Self-Care Self-Efficacy Scale, and the Self-Care of Chronic Illness Inventory. Descriptive statistics, Pearson correlations, and mediation analyses were performed to explore associations and the mediating role of self-efficacy between medication adherence and self-care behaviours.
Participants had a mean age of 43.49 years; 50.9% were male, 49.2% had Crohn's disease, and 50.8% had ulcerative colitis. Only 10.2% reported high medication adherence, while most showed medium or low adherence. The mean self-efficacy score was 74.82. Medication adherence was positively associated with self-care maintenance, and self-efficacy statistically accounted for part of this association. Lower levels were observed in self-care monitoring and management behaviours.
Medication adherence was positively associated with self-care maintenance, and self-efficacy partially explained this relationship.
Routine assessment of medication adherence and self-efficacy may help identify patients at risk of poor self-care. Interventions aimed at strengthening self-efficacy, such as motivational interviewing, nurse-led counselling, and digital monitoring tools, may improve adherence and self-care maintenance.
The study addressed low medication adherence and suboptimal self-care in patients with IBD. Findings support integrating self-efficacy-enhancing strategies into multidisciplinary care to improve adherence and self-care behaviours.
Patients completed validated self-report questionnaires; however, they were not involved in the study design, conduct, analysis, or manuscript preparation.
To evaluate whether simulation-based I-PASS handoff training improves ICU nurses' knowledge, perceptions of handoff communication and safety attitudes.
Effective handoff communication is crucial for ensuring patient safety and reducing errors. However, simulation-based training (SBT) with structured protocols, such as I-PASS, is rarely used in Egyptian nursing education, highlighting a gap.
A quasi-experimental design was employed.
A convenience sample of 57 ICU nurses was studied from June to December 2023. Data were collected using the I-PASS Handoff Knowledge Questionnaire, Perception of Handoff Communication Tool and Patient Safety Questionnaire. Nurses completed baseline assessments, participated in two simulation-based I-PASS scenarios and repeated assessments post-intervention. Statistical analyses examined the training's impact and its relationships with participants' socio-demographic characteristics.
Significant improvements were observed in I-PASS knowledge, perceptions of handoff communication and safety attitudes (all p < 0.001). Nursing qualifications and place of residence have shown a significant correlation with perceptions of handoff communication and safety attitudes (p < 0.05).
Simulation-based I-PASS handoff training significantly enhances ICU nurses' knowledge, perceptions of handoff communication and safety attitudes. Targeted, context-sensitive educational interventions are necessary to strengthen handoff practices and improve patient safety within the Egyptian healthcare system.
Structured simulation-based training, such as I-PASS, can be effectively integrated into nursing education to standardise handoff communication and improve patient safety outcomes in intensive care settings.
No patient or public contribution.
To evaluate the accuracy of the Emergency Severity Index (ESI) assignments by GPT-4, a large language model (LLM), compared to senior emergency department (ED) nurses and physicians.
An observational study of 100 consecutive adult ED patients was conducted. ESI scores assigned by GPT-4, triage nurses, and by a senior clinician. Both model and human experts were provided the same patient data.
GPT-4 assigned a lower median ESI score (2.0) compared to human evaluators (median 3.0; p < 0.001), suggesting a potential overestimation of patient severity by the LLM. The results showed differences in the triage assessment approaches between GPT-4 and the human evaluators, including variations in how patient age and vital signs were considered in the ESI assignments.
While GPT-4 offers a novel methodology for patient triage, its propensity to overestimate patient severity highlights the necessity for further development and calibration of LLM tools in clinical environments. The findings underscore the potential and limitations of LLM in clinical decision-making, advocating for cautious integration of LLMs in healthcare settings.
This study adhered to relevant EQUATOR guidelines for reporting observational studies.
To evaluate the artificial intelligence-assisted lymphedema education material in patients undergoing breast cancer surgery.
A comprehensive, successful methodological design was used to evaluate the portability of the expandable, AI-supported lymphedema education material for breast cancer. The study was reported in accordance with the STROBE statement (see Data S1 for the completed STROBE [Strengthening the Reporting of Observational Studies in Epidemiology] checklist). When preparing the AI-supported lymphedema education material managed with breast cancer treatment, it is first determined in the education of patients. Then, the commands of the Chat GBT-4 program are included in the scope of the transferred education content. For the created education content, readability was first evaluated and expert opinion was taken for the final version of the draft.
While preparing the AI-assisted lymphedema education material in the study, expert opinions were obtained, and the educational needs of the patients were determined by scanning the literature. Then, 12 commands were given in the ChatGPT-4 program to create the educational content. Formulas were used to evaluate the readability of the created educational content in Turkish and the readability of the health literature. The validity of the lymphedema education material was presented to 10 experts. The experts evaluated the understandability and actionability of the educational material using the Patient Education Materials Evaluation Tool and the Global Quality Scale, which evaluates the quality of the educational material.
It was concluded that the readability index of the lymphedema education material for Turkish was 67.3, and the Turkish readability level was ‘easily understandable’. The readability index of health literature was found to be 11.28, 9.68, 10.58, 39.0, and 11.26, respectively. When the internal consistency coefficient between the experts was examined, it was found to be 0.74. It was determined that the Patient Education Materials Evaluation Tool understandability score average was 92.10 ± 9.03, and the actionability score average was 81.60 ± 18.47. The Global Quality Scale score average, which evaluates the suitability and quality of the content of the AI-supported educational material, was found to be 4.10 ± 0.87.
At the end of the study, it was determined that the educational material was reasonable regarding understandability and actionability. The Turkish readability level was also reasonable and easily understandable.
This study is one of the proactive attempts to use AI in preparing educational materials for nurses and healthcare professionals.
No patient or public contribution.
Advanced simulation is a methodology that allows the development of technical skills and transversal skills such as teamwork and leadership. There are tools to measure the development of technical competencies and student satisfaction with the methodology, but not to measure the development and use of transversal competencies in the clinical practice setting.
To develop and validate a scale to measure the impact of clinical simulation on the development and application of teamwork and leadership competencies.
A multicentre study was carried out in two Spanish universities in which the Clinical Simulation Learning Teamwork and Leadership Scale was developed and validated.
The study was carried out in several phases: development of the questionnaire using a Delphi method, pilot test and validation of the construct with a sample of 207 nursing students. Reporting of this research adheres to STROBE guidelines.
Content validity was checked according to Aiken's V for the three attributes of the questionnaire. Reliability or internal consistency was assessed with Cronbach's α and the sensitivity analysis showed no significant variation when any item was eliminated. On the other hand, McDonald's Omega statistic was used. Intraobserver reliability was taken from a sample of 47 students, in which it was observed that the intraclass correlation was positive.
The Clinical Simulation Learning teamwork and leadership scale is a valid instrument for measuring the development of transversal competencies.
This scale will provide information to evaluate the weight of the clinical simulation in the students' knowledge.
It is a tool for evaluating transversal skills that is proven valid and will improve the training of students.
The instructions of the STROBE checklist have been followed.
The students have participated in the knowledge transfer self-assessment.
This study examined the anxiety levels of nurses and nurse candidates regarding humanoid nurse robots and artificial intelligence health technologies in perioperative patient care.
Descriptive and cross-sectional study.
The research was conducted with 158 intern students and 167 surgical nurses. Socio-demographic characteristics form, Questions Form Regarding Humanoid Nurse Robots and Artificial Intelligence Health Technologies, Artificial Intelligence Anxiety Scale and The Medical Artificial Intelligence Preparedness Scale were used. The independent t-test and one-way analysis of variance (ANOVA) were used. This study complied with Appendix S1.
The total scores on the Artificial Intelligence Anxiety Scale for nurses and nursing students are 73.089 ± 31.667 and 73.624 ± 28.029, respectively. The total scores on the Artificial Intelligence Readiness Scale for nurses and nursing students are 71.736 ± 15.064 and 72.183 ± 13.714, respectively. When comparing the sociodemographic characteristics and scale scores of nurses, a statistically significant difference was found between age and the Artificial Intelligence Anxiety Scale scores (p < 0.05). There was also a statistically significant difference between age, gender and work duration and the Artificial Intelligence Readiness Scale scores for nurses (p < 0.05).
Both groups exhibited moderate levels of anxiety and readiness regarding artificial intelligence. Comprehensive research is needed to elucidate the impact of artificial intelligence technologies on nursing professionals.
The proper use of Artificial Intelligence technologies can enhance the quality of patient care, alleviate the workload, increase patient and staff satisfaction and foster new perspectives on acceptance. With their integration into clinics, a patient-centred care environment will emerge, improving patient safety, outcomes and overall well-being. Thus, the anxieties of nurses and students towards artificial intelligence technologies will decrease, and their readiness will increase.
No Patient or Public Contribution.
To assess perceived patient safety competencies among nursing students and to examine their associations with their perceptions regarding clinical learning environment and unfinished nursing care.
An international comparative cross-sectional study.
A total of 1442 nursing students from the Czech Republic, Italy, Slovakia, and Türkiye participated between February and December 2025. Data were collected using the Health Professional Education in Patient Safety Survey, the Clinical Learning Environment, Supervision and Nurse Teacher scale, and the Unfinished Nursing Care Survey for Students. Descriptive statistics, non-parametric tests, Spearman correlations, and multivariate general linear modelling were applied.
Students reported significantly higher patient safety competencies in clinical compared with academic settings (p ≤ 0.001). Significant cross-country differences were observed across all competency domains (p ≤ 0.001). Perceived patient safety competencies were positively correlated with the overall quality of the clinical learning environment (r = 0.356–0.420; p < 0.001) and negatively correlated with unfinished nursing care (r = −0.107 to −0.171; p < 0.001). Multivariate analysis demonstrated that pedagogical atmosphere, premises of nursing care, supervisory relationship, and particularly the role of the nurse teacher were significant predictors of patient safety competencies.
The development of nursing students' patient safety competencies is closely linked to the quality of clinical learning environments. Strengthening educational and organisational conditions within clinical placements may play an important role in preparing future nurses for safe clinical practice.
Improving the quality of clinical learning environments, strengthening supervision, and addressing unfinished nursing care may support the development of nursing students' patient safety competencies and contribute to safer patient care.
The study was carried out according to the STROBE checklist.
No Patient or Public Contribution.
Standardised triage systems have been in place for decades with minor modifications, while nurses' skills and knowledge have significantly advanced.
To determine whether nurses' clinical expertise outperforms triage systems in simulated clinical cases.
A multicenter simulated observational study.
The study was conducted from January 1, 2024 to March 31, 2024, in four Italian emergency departments, enrolling triage-performing nurses. Thirty clinical cases, based on real patients representing daily emergency department influx, were reconstructed. The primary outcome was the agreement between the triage code assigned by the Manchester Triage System and the code assigned based on clinical expertise. The secondary outcome compared the predictive ability of the codes assigned by nurses regarding clinical outcomes, such as death within 72 h, the need for hospitalisation, and the need for life-saving intervention. The study was reported in accordance with the STROBE statement.
Seventy-seven triage nurses completed the 30 vignettes. The agreement between the MTS-assigned code and the clinical expertise triage reported a Cohen's kappa of 0.576 (95% CI: 0.564–0.598). For death within 72 h, the clinical expertise code reported better results than the Manchester Triage System. For life-saving interventions, the Manchester Triage System reported a lower performance than clinical expertise. The variability in triage code assignment was higher for clinical expertise compared to the Manchester Triage System.
Triage codes assigned by nurses based on clinical expertise perform better in terms of clinical outcomes, suggesting a need to update triage systems to incorporate nurses' knowledge and skills. However, standardised triage systems should be maintained to reduce variability and ensure consistent patient classification.
The study was conducted and reported according to the STROBE statement.
No patient or public contribution.
To evaluate the health-related quality of life (HRQOL) of adults with Long COVID 2 years and beyond after COVID-19 illness.
Cross-sectional study.
Health status was assessed using the EQ-5D-5L instrument among 226 adults diagnosed in primary care with mild-to-moderate COVID-19 during the 2021 pandemic. Data were collected through a cross-sectional survey using a standardized questionnaire with a set of validated clinical outcomes for Long COVID. The sample consisted of adults aged ≥ 18 years who attended the specified ambulatory settings, tested positive for SARS-CoV-2, and agreed to be interviewed; the response rate was 70%. Health utility scores were compared between adults with and without Long COVID. Multivariate logistic regressions were applied to investigate the relationship between Long COVID and health-related quality of life outcomes.
Primary data were collected from six public Family Health Care Units in João Pessoa, Brazil, between May 2023 and July 2024.
Adults with Long COVID had statistically significantly lower median utility scores (0.784, IQR: 0.633–0.902) than those without persistent symptoms (1.0, IQR: 0.877–1.0). Poorer HRQOL was more evident among women, older adults, non-White individuals, participants with pre-existing chronic diseases, and those with lower educational attainment. Long COVID was associated with impairments in anxiety/depression, pain/discomfort and usual activities.
Adults with Long COVID experienced poorer HRQOL 2 years or longer after mild-to-moderate infection compared with those without persistent symptoms, regardless of sex, age, ethnicity, education level or comorbidities. These findings support the implementation of targeted interventions and rehabilitation services in primary care for individuals experiencing long-term health problems following COVID-19 illness.
Identifying adults at greater risk of persistent health impairments following COVID-19 may help health professionals, caregivers and policymakers better address the aspects of patients' lives that lack quality and develop a multidisciplinary approach in primary care to managing this condition.
What problem did the study address? ○
This study examined the association between persistent symptoms 2 years or longer after non-severe COVID-19 illness and health-related quality of life.
What were the main findings? ○
Long COVID was associated with poorer health-related quality of life, particularly in the domains of anxiety/depression, pain/discomfort and usual activities.
Where and on whom will the research have an impact? ○
The findings highlight the need for multidisciplinary management of long-term health problems among adult COVID-19 survivors in primary care.
The STROBE checklist was followed.
No patient or public contribution.
To determine the level of obstetric violence among pregnant women and identify associated sociodemographic and obstetric factors in Türkiye.
A descriptive cross-sectional study.
The study was conducted with 505 pregnant women attending antenatal clinics in Training and Research Hospitals in the Black Sea region of Türkiye between July and December 2025. Data were collected using a self-administered sociodemographic form and the validated 18-item Obstetric Violence Scale for Pregnant Women (OVS-Pregnant Women). Total scale scores range from 0 to 72 (higher scores indicate higher perceived obstetric violence) across three subdimensions: Supportive Care and Information Support (0–28), Achieving Professional Standards of Care and Effective Communication (0–28), and Health Promotion and Encouragement (0–16). Data were analysed using descriptive statistics, and univariate and multivariate linear regression.
The mean age of participants was 30.02 ± 5.46 years. The mean total OVS score was 16.681 ± 13.961 (out of 72). Subdimension mean scores were 9.853 ± 8.428 for Supportive Care and Information Support, 4.310 ± 4.314 for Achieving Professional Standards of Care and Effective Communication, and 2.516 ± 3.470 for Health Promotion and Encouragement. Multivariate analysis identified two factors independently associated with lower obstetric violence: family monthly wage above the minimum wage and receiving antenatal care at a training and research hospital.
Perceived obstetric violence scores were toward the lower end of the possible range, with socioeconomic status and healthcare institution type influencing women's care experiences.
Obstetric violence should be recognized as a structural issue, necessitating standardized measurement tools and observational studies. Future studies should examine how exposure to obstetric violence shapes women's care preferences, informing patient-centered interventions.
The findings provide actionable evidence for maternity care providers, hospital administrators, and healthcare policymakers to foster respectful, patient-centered care.
STROBE.
No patient or public contribution.
To investigate the impact of a workplace leadership development programme on nurse manager leadership capability, knowledge, skills and confidence.
Quasi-experimental repeated-measures design without a control group.
Associate Nurse Unit Managers at a large tertiary hospital in Melbourne, Australia, were invited to engage in a clinical leadership programme involving education and subsequent peer group reflective practice. A longitudinal survey with multiple pre- and post-programme timepoints was conducted. Measures included the Leader Efficacy Questionnaire, researcher-developed Likert-scale items to evaluate programme learning outcomes and free response items. Quantitative items were analysed using descriptive statistics and repeated measures analyses; free response items were explored using content analysis.
At baseline (T1), 103 Associate Nurse Unit Managers pooled from three cohorts consented to participate, of whom 98 provided sufficient data for analysis. Data were collected across 5 timepoints (T1–T5); T2 was used primarily to assess baseline comparability with T1; longitudinal analyses focused on T1, T3, T4 and T5. Sixteen participants provided data at all relevant follow-up timepoints and were included in the main longitudinal analyses. Following the leadership programme scores on the Leadership Efficacy Scale increased significantly. There were no significant changes in perceptions of organisational support or confidence in giving and receiving feedback. Participants reported positive experiences of the programme and identified future opportunities to refine topics, teaching and learning approaches and opportunities for peer networking.
A workplace clinical leadership programme for Associate Nurse Unit Managers demonstrated sustained increased leadership efficacy. Embedding coaching, mentoring and peer networks within leadership development may be an effective strategy to translate learning to practice and foster a sustainable healthy work environment. Further evaluation of education translation to practice and long-term organisational outcomes are important next steps.
For Associate Nurse Unit Managers, supporting leadership education by establishing organisation-wide peer groups and structured coaching and mentoring may help consolidate and embed leadership knowledge and skills into practice. Future leadership education programmes should intentionally combine workplace learning with mentoring, organisational supports and peer networks to provide ongoing feedback and protected time, maximising long-term benefits for staff wellbeing, retention and patient outcomes.
Effective clinical leadership is essential to nurse wellbeing and retention; however, the role preparation of these clinical leaders is variable and at times absent. A workplace leadership programme integrating education and peer-group reflective practice for Associate Nurse Unit Managers produced measurable increases in leadership efficacy, strengthening frontline leadership capability. Embedding coaching, mentoring and peer networks into these programmes underpins future translation of learning into practice to build health work environments that promote staff wellbeing and patient safety.
Transparent Reporting of Evaluations with Non-randomised Designs (TREND).
No patients, service users, caregivers or members of the public were involved in this study. Instead, this study was focused on the experiences and perceptions of nurses.
To examine immediate within-person changes in experienced nurses' self-reported clinical decision-making and patient safety competency after a structured simulation programme.
A single-site, one-group pretest–posttest intervention evaluation.
The study was conducted in educational hospitals affiliated with King Faisal University. Fifty-eight registered nurses in unit-based advanced or specialist clinical roles completed baseline and immediate post-programme assessments. The programme comprised three high-fidelity simulation scenarios addressing septic shock, acute respiratory deterioration and medication safety. Sessions were delivered in small groups over a 4-week window; each session included a 15-min prebriefing, a 20-min scenario and a 40-min debriefing structured using Debriefing for Meaningful Learning. Self-reported clinical decision-making was assessed with the Clinical Decision-Making in Nursing Scale (CDMNS), and patient safety competency was assessed using an adapted reporting structure derived from the Patient Safety Attitudes, Skills and Knowledge Scale (PS-ASK). Paired-sample t-tests, Cohen's dz, and Pearson correlations were reported at both time points.
The mean total CDMNS score increased from 136.85 (SD 14.22) at baseline to 152.22 (SD 12.74) immediately after the programme, t(57) = 6.14, p < 0.001, Cohen's dz = 0.81. The overall patient safety competency score increased from 3.35 (SD 0.44) to 3.84 (SD 0.36), t(57) = 6.21, p < 0.001, dz = 0.82. CDMNS and patient safety scores were positively correlated at baseline (r = 0.41, 95% CI [0.17, 0.60], p = 0.001) and immediately post-programme (r = 0.62, 95% CI [0.43, 0.76], p < 0.001).
Self-reported clinical decision-making and patient safety competency scores were higher immediately after the programme than at baseline. Because the study had no concurrent control group, used self-report measures and did not assess retention or transfer to practice, it cannot establish that simulation caused the score changes or that clinical performance or patient outcomes improved.
No patient or public contribution was made.
Structured simulation and debriefing may be useful components of continuing professional development for experienced nurses. The present findings are hypothesis-generating and support controlled, multisite evaluations that combine self-report with observer-rated performance and practice-based safety outcomes.
To explore the trajectories of supportive care needs and identify influencing factors in lung cancer surgical patients.
Prospective cohort study.
Data from 287 patients at a Chinese tertiary hospital were collected at admission (T0), 2 weeks post-surgery (T1), 3 months (T2), 6 months (T3) and 1 year post-surgery (T4). Latent class growth models were used to identify supportive care need trajectories, and logistic regression was used to analyse influencing factors.
Three trajectories emerged: Sustained High Needs Group (C1, 10.8%), Moderate Gradual Declining Group (C2, 56.4%), High-Rapid Decline-Rebound Group (C3, 32.8%). Compared with C2, C1 membership was positively associated with no regular exercise, severe baseline symptoms, and adjuvant therapy; C3 membership was positively associated with segmentectomy, no regular exercise, and high social support but inversely associated with civil servant or professional status.
Our study identified heterogeneity in the trajectories of supportive care needs among lung cancer surgery patients. Regular exercise, symptom burden, adjuvant therapy, segmentectomy, social support and occupation were associated with these trajectories.
Nurses may incorporate dynamic, trajectory-informed assessment into postoperative follow-up. The associated factors identified in this study may provide practical cues for earlier recognition of patients who may benefit from closer monitoring and anticipatory supportive care planning. This approach may be particularly relevant for patients with factors associated with persistent high needs or late rebound trajectories.
Provides longitudinal insights into the heterogeneous evolution of supportive care needs from preoperative to 1-year post-surgery. Identifies three distinct supportive care needs trajectory patterns and their associated sociodemographic and clinical factors. Offers practical cues for identifying patients who may benefit from closer follow-up and for informing dynamic, trajectory-informed supportive care planning.
This study adhered to the STROBE checklist.
None.
To estimate the incidence of unplanned transfers to the emergency department among nursing home residents and to identify resident and organizational factors associated with transfer risk.
A 12-month prospective multicentre dynamic cohort study.
The study was conducted in nine nursing homes in a northern Italian region between July 2023 and June 2024. All long-stay residents aged 65 years or older were included and followed for up to 12 months.
A total of 643 residents were included; 204 residents experienced at least one unplanned transfer, accounting for 271 events during follow-up. The incidence of first transfers was 4.47 per one hundred resident-months and varied across facilities. At the resident level, recent admission, a higher number of chronic conditions and dependence in eating were associated with a higher likelihood of transfer, whereas female sex was associated with a lower likelihood. At the organizational level, larger bed capacity was associated with a lower risk of transfer. In contrast, the presence of a physician on site and a higher ratio of general practitioners to residents per occupied bed were associated with increased transfer risk.
Unplanned transfers from nursing homes to the emergency department are frequent. Strategies to reduce transfers should address resident vulnerability and organizational characteristics.
Nurses should recognize the early period after admission as a critical window for risk stratification and advance care planning and consider how resident vulnerability and organizational characteristics influence transfer patterns.
Prospective evidence on unplanned transfers from nursing homes in Europe is limited. Nearly one third of residents experienced at least one transfer, highlighting the importance of addressing multimorbidity, functional dependence and organizational features when planning prevention strategies.
The study adheres to STROBE guidelines.
No patient or public contribution.
To identify latent profiles of perceived workplace violence climate (PWVC) among nurses in tertiary hospitals and explore central network characteristics across profile groups.
A cross-sectional study.
A multicentre cross-sectional study was conducted from July to September 2023 among 2064 nurses from eight tertiary hospitals across eight provinces in China. Data were collected using the Nurses' PWVC Scale, Clinical Communication Ability Scale, and Emotional Intelligence Scale. Latent Profile Analysis (LPA) identified heterogeneous subgroups, multinomial logistic regression examined factors associated with profile membership, and network analysis explored central and bridge nodes.
The prevalence of workplace violence (WPV) exposure was 82.4%. Three distinct PWVC profiles were identified: Vulnerable-Sensitive (17.0%), Stable-Perceptive (48.3%), and Resource-Empowered (34.7%). Nurses classified within the Resource-Empowered profile generally demonstrated higher emotional intelligence, stronger communication ability, better health status, and more frequent participation in violence-prevention training. Network analysis identified profile-specific central nodes, including violence-prevention visibility, management responsiveness, and post-incident managerial support, while individualised risk assessment emerged as a key bridge node across networks.
PWVC among nurses demonstrates substantial heterogeneity across profile groups. Findings suggest that organisational strategies addressing management responsiveness, violence-prevention visibility, and individualised risk assessment may help strengthen perceived workplace safety, particularly among nurses with less favourable perception profiles.
This study identifies distinct violence climate profiles among nurses and highlights several central network components that may represent potential organisational intervention targets. These findings may support the development of more tailored workplace violence prevention strategies within nursing management contexts.
No patient or public contribution.
To determine the prevalence and characteristics of urinary catheter blockage in older patients using objective indicators and to characterize obstructive materials and microbiota.
A cross-sectional study.
Patients aged ≥ 65 years with an indwelling catheter for ≥ 24 h were recruited from a long-term care hospital. Blockage was defined using objective indicators including residual urine volume, leakage, reinsertion urine volume and resistance to saline injection. Samples were analysed for composition and microbiota.
Among 77 patients, 29.9% experienced catheter blockage. Blockage was associated with shorter catheterization duration and greater intraluminal narrowing. Proteus mirabilis and Campylobacter ureolyticus were more abundant. Most blockages occurred at the catheter tip (81.0%), with struvite as the predominant material (71.4%). Microbiota varied by material composition.
Catheter blockage occurred in 29.9% of patients, mainly at the catheter tip and associated with struvite. Microbiota differed by blockage status and material composition.
Objective identification of catheter blockage supports early detection and targeted management and provides a basis for research on mechanisms. These findings provide a foundation for future research to develop and evaluate evidence-based nursing interventions for preventing catheter blockage in older adults.
This study addressed the lack of objective criteria and limited understanding of catheter blockage. It showed that about 30% of patients experienced blockage and identified distinct microbiota and material characteristics. These findings may improve catheter management and support future research on mechanisms and prevention.
STROBE checklist.
Patients contributed to data collection by providing information on symptoms related to catheter blockage through structured assessments, while nurses during the study period facilitated data collection and conducted clinical assessments.
To examine the association between nursing experience and paediatric adverse nursing event (ANE) harm risk, and whether SOP accessibility modifies this association.
Retrospective cohort study, 2015–2024.
We analysed paediatric ANEs reported from 2015 to 2024 at a tertiary children's hospital in western China. The primary outcome was whether an ANE resulted in harm (yes/no). The exposure was years of nursing experience, grouped into five categories (< 1, 1–< 3, 3–< 5, 5–< 10 and ≥ 10 years), and SOP accessibility served as an effect modifier. Multivariable logistic regression models and stratified analysis with interaction tests were applied.
Among the 3199 paediatric ANEs, 1341 (41.92%) resulted in harm. Harm risk was highest among nurses with ≥ 10 years of experience (adjusted OR = 1.93, 95% CI: 1.33–2.81 vs. < 1 year), with no significant elevation in the intermediate nurses (1–10 years). SOP accessibility modified this association (p for interaction = 0.004). When SOPs were accessible, the elevated risk in the ≥ 10-year group persisted (adjusted OR = 1.95, 95% CI: 1.33–2.87); when SOPs were inaccessible, it was no longer evident, and a protective association appeared in the 3–< 5-year group (adjusted OR = 0.15, 95% CI: 0.03–0.76).
Nursing experience exhibited nonlinear association with paediatric ANE harm risk, and this relationship was significantly modified by SOP accessibility. Harm risk was highest among nurses with ≥ 10 years of experience. However, given the retrospective observational design, causal inference is precluded, and the underlying mechanisms remain to be elucidated.
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