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To identify healthcare professionals' experiences of innovation competence and the factors associated with it; and to examine the instruments developed to assess innovation competence and its associated factors among healthcare professionals.
A mixed-methods systematic review.
Researchers independently screened original studies by title and abstract (n = 2996) and then full text (n = 189). Eighteen studies were included: 16 quantitative and two qualitative. Qualitative data were analysed using inductive content analysis, and quantitative data were tabulated and synthesised narratively.
The review followed the Joanna Briggs Institute Mixed Methods Systematic Review methodology. Searches were conducted in Scopus, CINAHL, Ovid Medline, ProQuest, Web of Science, PsycArticles, and Medic. Articles published in English or Finnish with no date restrictions were included. The search covered records from database inception to August 2024.
From qualitative studies, we identified three categories describing experiences of innovation competence: Competences for Innovation in Healthcare, Application and Impact of Innovation in Healthcare, and Challenges and Strategies for Implementing Innovation. Quantitative studies identified three conceptual domains: Individual Capacities in Innovation, Innovation-related Competence Behaviours, and Social and Organisational Enablers. Four categories of factors associated with innovation competence emerged: sociodemographic, career-related, organisational, and academic factors.
Healthcare professionals' innovation competence is a multifaceted construct encompassing individual abilities, behavioural expressions, and social and organisational engagement. A systematic and multilevel approach that targets both personal attributes and organisational enablers is needed to strengthen competence. Enhancing innovation competence can improve the healthcare sector's ability to respond to complex challenges and sustain innovation capacity.
Findings inform the development of education programmes and leadership strategies to enhance innovation competence among healthcare professionals, supporting innovation implementation in healthcare organisations.
No patient or public involvement was included in this study.
PROSPERO: CRD42024614551
Nurse practitioner-sensitive outcomes (NPSOs) are critical indicators of the quality and effectiveness of nursing care provided to older adults. These outcomes, which include metrics such as falls, pressure ulcers, infection rates, frailty, delirium, length of stay, hospital readmissions, and quality of life (QoL), are essential for assessing the impact of nurse practitioners (NPs) and enhancing patient safety. Despite their importance, the current literature on NPSOs in services for older adults remains limited. This scoping review aims to address this gap by systematically mapping the existing research, identifying key themes, and uncovering areas needing further exploration. By doing so, the authors seek to provide a comprehensive overview that will inform future research directions and contribute to the enhancement of clinical practice in older person services (OPS). This review is important for healthcare providers, policymakers, and researchers who are committed to improving the quality of nursing care and outcomes for older people.
The aim of this scoping review is to map the existing research on NPSOs in services for older adults. This review seeks to identify key themes and gaps in the current literature to guide future research and enhance clinical practice in this area.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were utilised to structure this scoping review.
From initial screening of 3593 manuscripts drawn from seven databases, 66 were deemed eligible for full screen. Five studies met the inclusion criteria and were ultimately selected for data extraction and analysis. The most common outcome measures reported were complications and comorbidities, and QoL.
This review highlights that the reporting of NPSOs in older person care is lacking and requires further attention.
Research and evidence-based practice in nursing have a direct impact on the quality of care to patients. Its enactment in daily practice remains challenging, with nurses' insufficient research capacity and capability being one challenge, and the limited current state of knowledge another.
To map the knowledge landscape around capacity-building programmes aiming to increase evidence-based nursing practice and research activity in acutecare hospitals.
Scoping review using Joanna Briggs Institute methodology and PRISMA-ScR reporting guidelines.
Articles from 2013 to 2023 were searched on PubMed, CINAHL, Medline/OVID, Cochrane Library, PsycINFO, Scopus and Web of Science. Two researchers screened their eligibility independently. To be eligible, studies needed to focus on nursing/midwifery in acute care settings, address research capacity-building practices and be either an empirical, review or theoretical publication. Data were extracted in a structured format and synthesised narratively.
Twenty-four articles were included, consisting of 12 empirical, 6 reviews and 6 non-data-based articles. Our analysis identified two dimensions of research capacity: (1) individual research capability and (2) organisational research capacity, each influenced by various determinants. Findings suggest that four key elements are required to build a research capacity programme: (1) context assessment, (2) multilevel leadership and management engagement, (3) programme tailored to context and (4) clear outcome indicators. We found nursing research capacity programmes lacked clear definitions and a consensus on a conceptual framework.
This review systematically synthesised the knowledge landscape on nursing research capacity building programmes in acute care hospitals, bringing clarity regarding concepts, dimensions, determinants and structural key elements.
The conceptual model developed through this review encourages comprehensive and comparable research capacity-building programmes, which can accelerate enhancement of research skills, literacy, activities and evidence-based practice among nurses, thereby improving quality of care and patient outcomes.
No patient or public contribution.
To explore the roles and training of advanced practice nurses specialised in acute pain management, as reported in the current literature.
Scoping review.
We searched PubMed, Scopus and CINAHL in December 2023 to identify relevant studies published from 1996.
Relevant literature was identified, screened, and analysed using a structured scoping review process. Two reviewers independently selected and extracted data from eligible studies, with a third reviewer resolving any disagreements.
A total of 1682 records were screened, and 36 studies met the inclusion criteria. Four main themes emerged: job titles, roles, training, and barriers. The review revealed substantial variation in job titles and role descriptions across clinical settings and geographic regions, with more comprehensive role definitions found in countries like the United States and the United Kingdom. Training pathways, including postgraduate qualifications and certification, varied significantly and many low- and middle-income countries lacked structured training frameworks. Barriers identified included regulatory limitations, insufficient educational infrastructure and lack of legal authority to practice.
This review highlights significant international variation in the definition, training and regulation of advanced practice nurses in acute pain management. There is an urgent need to develop global standards, including unified competencies and certification pathways, to ensure consistent and effective care.
Standardising competencies and training will support role recognition, improve consistency in clinical practice and promote high-quality care for individuals experiencing acute pain.
This review addresses the global inconsistency in role definition and training of advanced practice nurses in acute pain management. Findings may inform educators, health professionals, policymakers and regulators, particularly in resource-limited settings.
This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).
No patient or public contribution.
This scoping review aimed to explore what is known about Indigenous peoples' experiences with palliative and end-of-life care in Canada.
A scoping review.
A systematic search was performed from database inception to May 2022: CINAHL, Academic Search Complete, ERIC, Cochrane, Medline, PsychINFO, Indigenous Collections, Indigenous Peoples of North America and EMBASE. No date limitations were applied. Unpublished and grey literature was searched using the Google search engine. A search update was conducted in April 2024.
This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Titles, abstracts and full text were screened for inclusion by two reviewers. Mapping and thematic analysis were used to analyse, collate and summarise extracted data.
Fifty-three sources were included in the review. While the methods, locations and context vary across the literature, common themes emerged: Disparities in Indigenous representation in palliative and end-of-life care literature, challenges in accessing palliative and end-of-life care, priorities related to palliative and end-of-life care and experiences specific to end of life.
This scoping review revealed several key insights into Indigenous peoples' experiences with palliative and end-of-life care.
Findings identify the need to enhance cultural safety in palliative and end-of-life care and support community capacity to develop and lead palliative and end-of-life care research and initiatives. Furthermore, findings suggest the need for palliative and end-of-life care initiatives that are Indigenous-led, grounded in Indigenous research methods and distinctions-based.
We have adhered to relevant EQUATOR guidelines. We followed the PRISMA-Scr in the reporting of this scoping review.
No patient or public contribution. This study did not include patient or public involvement in its design, conduct or reporting.
To synthesise current evidence on the development and implementation of quality care metrics for nurses working in general practice.
A Scoping review guided by Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR).
Articles included peer-reviewed primary research, published in English between 1989 and 2024, reporting on the development, implementation and evaluation of quality care nursing metrics in general practice settings. EndNote was used for citation management, while Covidence facilitated screening and data extraction by four reviewers. The Donabedian model of quality care assessment (2005) and the WHO tool for primary care nurse competencies (2020) were used to synthesise the findings.
A systematic search of PubMed, CINAHL, EMBASE and Web of Science databases was conducted between June 2022 and June 2024. The search strategy was developed using Population, Concept and Context criteria, with keywords including ‘Nurse’, ‘General Practice’, ‘Metric’ and ‘Indicator.’
Eleven studies conducted between 2005 and 2024 met the inclusion criteria. Five studies focused on quality care indicators or measures, and six examined nurse competencies or standards of care.
Quality care metrics are underutilised in general practice. There is ambiguity in metric terminology and nursing roles, education and primary care systems. Quality care metrics must align with nursing values, with digital technology and leadership as core enablers.
Adoption of nursing metrics in general practice provides insights into nursing contributions to patient care. Standardising the definitions of nursing care metrics will enable valid and reliable comparisons.
Quality care nursing metrics will enable the nurse's role to be manifested in general practice settings in relation to patient outcomes.
PRISMA reporting guidelines have been adhered to.
Understanding of the role of the nurse in general practice will support improved quality, safety, policy and governance in general practice settings.
No patient or public contribution.
Huntington's disease has a disruptive effect on entire families. While previous reviews have examined lived experiences of individuals with Huntington's Disease, their informal caregivers, or their offspring, none have provided a comprehensive overview that integrates these three perspectives.
A scoping review.
Providing an integrated view and a holistic understanding of the multifaceted challenges faced by families affected by Huntington's disease.
We operationalised the lived experiences using the keywords: “barriers”, “facilitators” and “needs”. We extracted and thematically analysed data from 35 articles searched from 1993 to 2023.
Twelve themes were identified, organised into three dimensions: (1) Having the Disease: encompassing the symptoms and progression of the disease; (2) Family Dynamics: reflecting the challenges of living in a household affected by Huntington's disease; and (3) Outside World: describing relationships and interactions with relatives, friends, health services and wider social structures.
The dimensions and related experiences of all three perspectives are intertwined. These experiences are mutually reinforcing, with fluid shifts in perspective occurring between family members. While the needs of family members overlap, they also diverge, highlighting the need for a systemic, family-centred approach to address the evolving challenges faced by all family members.
No Patient or Public Contribution.
To map self-care activities related to indwelling urinary catheters in community-residing adults.
Scoping review guided by Joanna Briggs Institute methodology.
Systematic searches of electronic databases (CINAHL, MEDLINE, Embase) and targeted grey literature search were conducted for documents published between 2000 and October 2023.
Documents describing self-care activities and the management of catheter-related complications in community-residing adults (aged ≥ 18 years) were included. Three independent reviewers used Covidence to screen titles and abstracts and full-text articles, appraise the quality of the literature, and extract data. Directed content analysis of the extracted data was conducted, informed by the mid-range theory of self-care of chronic illness, and summarised narratively.
A total of 32 documents were included; nine qualitative studies, eight expert opinions, six quantitative studies, five guidelines, two quality improvement projects, and two reviews. The majority (81.3%) of the documents were concerned with the prevention and management of catheter-associated urinary tract infection (CAUTI; n = 26). Many self-care activities were reported across the self-care processes of maintenance, monitoring, and management. Maintaining the catheter and drainage system, and self-care education topics related to maintaining the catheter were the most cited (n = 17 [53.1%] and n = 20 [62.5%], respectively). Less emphasis was given to management self-care activities, such as seeking support from clinicians (n = 13, 40.6%).
The scoping review findings provide a greater understanding of how persons with indwelling catheters maintain and monitor their catheters and highlight that much less is known about how they manage situations when complications arise.
The findings can guide the design of community care programmes and serve as a basis for developing patient self-care education resources. These findings should be consolidated and examined by nursing researchers, clinicians, and persons with lived experience to provide holistic guidance on self-care of indwelling catheters and associated complications.
To present the current evidence on the nature and principles of Equity, Diversity and Inclusion (EDI) in Nursing Education Institutions (NEIs).
Five databases (CINAHL, Medline, Scopus, ERIC and Educational Research Complete) and websites of Canadian nursing education institutions were searched for studies and grey literature on EDI. Information was analysed using the Diversio Diversity and Inclusion Survey (DDIS) framework to highlight the nature and principles of EDI in NEIs. A content analysis guided by a deductive approach informed the data synthesis.
Eighty-eight studies (90 papers) published between 1999 and 2025 were included from 1301 identified articles in the database search. The websites of seven nursing institutions in Alberta, Canada, were examined. The review revealed facilitators, barriers and gaps. The results illustrated the presence and need for diversity, inclusion, equal opportunity and fairness, employing the DDIS framework across participant groups, curricula and contexts.
The literature on EDI in NEI is diverse and provides many facilitators, barriers, challenges and gaps. This review reveals the need for intervention and review studies to highlight specific practices that can lead to successful EDI implementation in NEIs.
These results show that further research is required to refine the definition of EDI within the nursing academy. Evidence must be advanced to develop nursing theories, frameworks and methods specific to EDI implementation.
Promoting EDI is a vital goal for the nursing profession, and there is a need to understand how EDI behaves in NEIs. This review revealed facilitators, challenges, barriers, gaps and principles of EDI that exist within NEI in the literature. This data can support policy and practice change within NEIs and promote EDI within those organisations.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was adhered to in this review.
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore the impact of Doctor of Nursing Practice (DNP) education on career advancement, job satisfaction, leadership competencies and contributions to healthcare systems.
The study utilised a scoping review methodology based on Arksey and O'Malley's (2005) framework.
The search strategy was developed with an academic librarian to ensure thoroughness and relevance. Seven databases were searched using MesH terms. Inclusion criteria focused on peer-reviewed studies examining DNP education's influence on career advancement, job satisfaction and leadership. Thematic analysis was used to identify patterns and themes.
Studies were selected based on their focus on DNP-prepared nurses, nursing faculty or advanced practice nursing students in healthcare or academic settings, published between 2004 and 2024.
Twenty-one studies met the inclusion criteria, highlighting DNP education's role in fostering leadership, professional development and evidence-based practice. Thematic analysis revealed the benefits of being a DNP graduate include contribution to professional development, contribution to leadership and contribution to the practice environment. The challenges to DNP graduates include underrecognition of competencies, high educational costs and limited academic opportunities that were also identified.
DNP education contributes to individual and professional growth, leadership development and healthcare system improvements. However, barriers such as financial constraints and inadequate recognition of DNP competencies must be addressed to maximise the impact of this educational model.
DNP education empowers nurses to lead healthcare innovations, enhance patient care quality and reduce disparities in health outcomes. Strengthening financial and systemic support for DNP graduates is essential for sustaining these contributions.
DNP education is a transformative force in nursing, offering significant opportunities for leadership development and healthcare advancements. Aligning DNP programmes with evolving global healthcare challenges can further strengthen their impact on the profession and patient care.
PRISMA-ScR guidelines were followed.
To synthesise and critically analyse existing reviews of evidence on mentorship in nursing and midwifery, providing a comprehensive overview of current knowledge.
A scoping meta-review.
The review was conducted using the scoping meta-review framework outlined by Sarrami-Foroushani et al. (2015), alongside the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to ensure rigour and transparency. The following steps were included: (i) defining the problem, (ii) literature search and criteria, (iii) study selection and data extraction, (iv) data synthesis, (v) presentation of results and (vi) interpretation and recommendations.
A comprehensive search strategy was designed, utilising Boolean operators, truncation and predefined keywords across seven databases including MEDLINE, CINAHL, Embase, PsycINFO, Epistemonikos, ERIC and Google Scholar.
Following double-blind screening of 269 papers, 14 literature reviews were included. The findings provided a detailed overview of mentorship programme types (formal and informal), outcome measures used to evaluate mentorship effectiveness and recommendations for future programmes. Identified themes included skill development, job satisfaction, career progression and retention outcomes, together with challenges including time constraints and balancing clinical responsibilities with mentorship roles. Formal mentorship programmes that are adequately supported and integrated into the organisational culture can improve healthcare systems, workforce stability and patient outcomes. Informal mentorship continues to offer valuable, flexible support, particularly when used alongside formal structures. Implementation challenges exist, such as time constraints, limited organisational support, and mismatched mentor-mentee pairings.
This review highlights the critical role of mentorship in nursing and midwifery, offering insights into effective practices, challenges and potential areas for further research. The findings suggest that formal, structured mentorship programmes produce consistent benefits, including enhanced clinical skills, confidence and satisfaction among mentees, as well as leadership development and professional fulfilment for mentors, while positively impacting organisational efficiency and patient outcomes. Successful mentorship programmes require organisational commitment, with protected time, resources, and ongoing mentor training.
Mentorship programmes in nursing and midwifery enhance professional development, job satisfaction, and retention, enabling a stable healthcare workforce. Mentorship for mentors and mentees is linked to increased confidence, competency and readiness for advanced roles among nurses and midwives. Fostering mentorship in healthcare can lead to improved quality and continuity of care as mentees grow into more competent and confident practitioners.
Formal mentorship programmes that are adequately supported and integrated into the organisational culture can improve healthcare systems, workforce stability and patient outcomes. Policymakers responsible for healthcare workforce development can use these findings to advocate for mentorship as a strategic investment, potentially influencing policies related to nurse retention, professional development and funding allocations for mentorship initiatives. Structured mentorship improves job satisfaction, reduces turnover and fosters professional growth, thus reducing costs associated with recruitment and training.
The findings are reported in line with the PRISMA guidelines (Page et al., 2021) and through a narrative synthesis, summarising and analysing the results of various reviews to present a cohesive understanding of mentorship practices in nursing and midwifery. This method allowed for the integration of qualitative and quantitative findings and the identification of common themes and patterns across studies.
Patients or members of the public did not directly contribute to this review. However, by focusing on mentorship practices that support nurses and midwives, the study indirectly addresses public interests, as improved mentoring contributes to the quality of patient care. Future studies could benefit from patient or public feedback on desired qualities in care providers, further informing the development of mentorship programmes aligned with patient-centred care outcomes.
To explore current evidence regarding the provision of palliative care for individuals with very severe to extreme behavioural and psychological symptoms of dementia (BPSD) in a hospital setting.
Scoping review.
The PRISMA-ScR reporting guideline.
The JBI guidelines for scoping reviews were followed. A data extraction form assisted in the identification of key findings via a process of content analysis.
Studies were obtained from bibliographic databases of PubMed, CINAHL, and PsycINFO.
This review included six articles, and nine categories emerged from the findings. Symptom assessment and management, pain assessment challenges, atypical presentation of end-stage dementia, complex prescribing and treatment practices, principles of person-centred care, collaboration; training for health care professionals; emotional impact on staff; and family and caregivers.
This scoping review highlighted a significant gap in the literature regarding palliative care for people living with very severe to extreme BPSD in hospital settings. This review highlighted key differences in the presentation of people with BPSD needing palliative care. There is a need for tailored models of care, specialised training and education for health professionals, families, and carers, and recognition of dementia as a terminal illness.
The results of this review provide valuable insights into the level of understanding about the unique palliative care needs for people experiencing very severe to extreme BPSD, making an important contribution to the planning and development of future models of care.
Mapping the available literature highlights a paucity of research in palliative care for people with very severe to extreme BPSD in hospital settings. There is a need for rigorous research studies and models of care developed and informed by the evidence for this small population necessitating unique care needs.
No patient or public contribution.
Stroke survivors frequently experience multiple co-occurring symptoms that cluster together, significantly affecting their quality of life and rehabilitation outcomes. However, previous research has predominantly focused on individual symptoms in isolation, limiting the potential to inform more comprehensive, symptom cluster-based approaches to post-stroke care.
This scoping review aimed to synthesize existing evidence on the assessment tools used to evaluate them, the analytical techniques employed to identify them, and the composition of symptom clusters in people with stroke.
A comprehensive literature search was conducted across seven databases (PubMed, EMBASE, APA PsycInfo, CINAHL, Web of Science, China National Knowledge Infrastructure, and Wanfang) for studies published between 2001 and April 2025. Methodological quality was assessed using the JBI Critical Appraisal Checklists. Data were extracted on study characteristics, measurement instruments, analytical techniques, and symptom cluster composition.
Fourteen studies comprising 6556 stroke patients were included. A total of 11 assessment tools and six analytical techniques were identified, with exploratory factor analysis being the most commonly used. Seven common symptom clusters were synthesized: pain and fatigue, somatic movement dysfunction, cognitive impairment, affective disturbance, mood and sleep dysregulation, psychological distress, and gastrointestinal symptoms. The most frequently reported symptom cluster was pain and fatigue. Considerable heterogeneity was found across studies in terms of measurement instruments, analytical techniques, and symptom cluster composition.
This review highlights the methodological inconsistencies and diversity in symptom cluster research in stroke populations. The findings underscore the need for standardized, culturally adaptable assessment tools and longitudinal designs to capture the dynamic nature of symptom clusters. This comprehensive review summarizes common symptom clusters in stroke patients and provides clinicians and researchers with valuable insights to help them develop more effective symptom management strategies and ultimately improve patient outcomes.
PROSPERO: CRD420251069463
Nursing students are the primary reserve force for hospital nurses. With the shrinking of nurse human resources and the increase in turnover rates, understanding the job preferences of nursing students is crucial for attracting nursing students.
To systematically review published studies on discrete choice experiments involving nursing students.
Ten databases were systematically searched from their inception to January 15, 2025. Two researchers independently used the International Society for Pharmacoeconomics and Outcomes Research checklist to evaluate the quality of the included studies. Thematic analysis was used to classify the attributes into broad categories and corresponding subcategories. The frequency, significance, relative importance, and willingness-to-pay of each attribute in the included studies were analyzed.
Fifteen studies spanning 12 countries were included, with a total of 102 individual attributes extracted and divided into two broad categories and six subcategories. Non-financial attributes were the most frequently reported broad category. The subgroup analyses indicated that nursing students from high-income countries valued income and were highly concerned about the working atmosphere.
Linking Evidence to Action:
The results of this systematic review provide important evidence for developing incentive policies to attract nursing students to the nursing profession.
Nurse-led self-care interventions represent a promising approach for chronic pain management. However, a comprehensive synthesis of their efficacy is lacking.
This systematic review and meta-analysis assessed the impact of the interventions on four key outcomes in chronic pain patients: pain intensity, quality of life, anxiety levels, and depression severity.
The study was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search for relevant articles spanning from inception to November 2024 was carried out across multiple databases, including EMBASE, PubMed, CENTRAL, Web of Science (Core Collection), CINAHL, Scopus, and PsycINFO. The Cochrane Risk of Bias Tool was used to assess the quality of the included studies. The meta-analysis was conducted using Stata 18 and Review Manager 5.4, and a GRADE evidence profile was subsequently generated.
The systematic review and meta-analysis involved 30 studies in total. The results of the data analysis indicated that the interventions alleviated pain intensity (SMD = −0.30, 95% CI: −0.41 to −0.20, Z = 5.57, p < 0.001). They also enhanced quality of life (SMD = 0.28, 95% CI: 0.14 to 0.42, Z = 3.83, p < 0.001), while reducing anxiety (SMD = −0.15, 95% CI: −0.29 to −0.01, Z = 2.11, p = 0.03) and depression symptoms (SMD = −0.27, 95% CI: −0.45 to −0.09, Z = 2.88, p = 0.004).
This systematic review demonstrated that nurse-led self-care interventions benefit chronic pain patients. Future research should conduct more rigorous randomized controlled trials to strengthen the evidence base for using such interventions in chronic pain management.
Globally, doctorally-prepared nurses have pursued career paths centered on research and academic leadership. In the United States, alongside the PhD in nursing, there exists a distinct educational pathway, the Doctor of Nursing Practice (DNP), which emphasizes clinical practice. However, the actual career trajectories of individuals from both groups often diverge from these traditional expectations, prompting questions about how their roles are integrated within academic and clinical environments.
This systematic review aims to critically examine the career pathways of nurses with doctoral degrees, with a focus on the intersection of research and clinical practice.
Following the PRISMA guidelines, a systematic search of five databases (PROQUEST Nursing, Scopus, EBSCO, EMBASE, and PubMed) was conducted on October 14, 2024. We identified 6003 references, with 23 studies ultimately meeting inclusion criteria. Thematic analysis was used to synthesize findings.
PhD and DNP nurses in the US exhibit overlapping yet nontraditional career paths, with PhDs taking on clinical leadership and DNPs entering academia. Globally, PhD nurses often hold hybrid roles in research, education, and limited clinical practice. Across contexts, both groups face role misalignment and identity challenges, including marginalization and limited institutional support.
The findings highlight the blurring of traditional boundaries between PhD and DNP career paths, underscoring the need for flexible career models that combine academic and clinical practice as a viable option to address these challenges.
The review was registered in PROSPERO (Registration Number)
To review how life-course theories, models and frameworks define and classify life stages and transitions; how they characterise trajectories of care needs and care provision; and to consider how these insights might inform future developments of care-focused life-course frameworks.
Narrative review using a theory synthesis approach.
The review synthesised 56 theories, models and frameworks, drawn from 90 articles published up to 2024, using a three-stage process: extraction and summarisation of conceptual content; comparison to identify convergence and divergence; and interpretive synthesis to generate an overarching account of how frameworks conceptualise life-course development, care transitions and care trajectories.
Earlier life-course perspectives emphasise normative, age-graded stages, while more recent approaches highlight transitional junctures, relational contexts and structural influences on care trajectories. Life stages were defined variably, encompassing developmental phases, chronological age bands, major life transitions, historical and cultural perspectives and diverse lived experiences. Trajectories of care needs and provision were shaped by social networks, socioeconomic conditions, timing of transitions, transgenerational relationships and interdependencies, and intersectionality. Findings suggest that care needs and care provision fluctuate across time and are best understood as interrelated, dynamic processes influenced by life-course biographies, as well as broader social, economic and policy environments at individual (micro), relational (meso) and structural (macro) levels.
Life-course frameworks are shifting from age-based models towards personalised, context-sensitive perspectives that better capture the complexity and diversity of care trajectories.
Care planning should incorporate not only developmental stage but also individual, relational and structural factors influencing care needs, care provision and care trajectories over time.
Applying a personalised, multilevel life-course perspective may improve assessment accuracy, coordination of resources and equity in care delivery.
This narrative review did not involve patients or the public.
To identify and synthesise intervention programs designed to address compassion fatigue among nurses, with a focus on their types and core characteristics.
A scoping review.
This review was conducted according to the scoping review guidelines proposed by Arksey and O'Malley and met the requirements of PRISMA-ScR guidelines.
Literature published between January 2015 and March 2025 was thoroughly searched in Scopus, PubMed, Cochrane Library, APA PsycNet, Science Direct, and ProQuest. Major search terms included ‘compassion fatigue’, ‘secondary traumatic stress’, ‘burnout’, ‘nurses’ and ‘intervention’.
Fourteen studies met the inclusion criteria. Interventions were categorised as: (1) Enhancement of Organisation and Social Support, (2) Development of Individual Psychological Capacities, (3) Systemic-level Interventions, these results align with the framework of the job demands resources theory.
This review highlights diversity in the focus. While some emphasised on strengthening the job resources and building the personal individual-based resources, few others focused on system level interventions to address compassion fatigue in nurses. The findings also emphasise the importance and need for customised and accessible support strategies at both individual and organisational levels. Nurse well-being and resilience interventions promote balanced job settings and quality health care support.
This review provides a foundation for designing comprehensive, empirically supported strategies to address compassion fatigue in nursing. Future research should focus on integrating individual and systemic support to build a healthy work environment.
This review helps to understand the core characteristics and types of existing interventions addressing compassion fatigue among nurses, and highlights the need to focus on both individual as well as organisational needs and outcomes, thereby enhancing the well-being of nurses and creating healthy work environments.
PRISMA-ScR was used in this scoping review.
No patient or public contribution.
To examine factors influencing emergency nurse turnover and retention pre- and post-COVID-19 and inform planned Participatory Systems Mapping research.
A scoping review of the literature reporting reasons emergency nurses leave, intend to leave or stay.
Following the Joanna Briggs Institute methodology and a pre-registered protocol, databases and grey literature were systematically searched in January 2025 (updated August 2025). Literature published after 1st January 2010, was included. Two reviewers independently screened records, and 10% of extractions were cross-checked. Data were grouped thematically on a visual coding system using the Miro platform. Pre- and post-COVID-19 sources were categorised and analysed using a two-dimensional framework of intensity and frequency.
MedLine, CINAHL, PsycINFO, Web of Science, Cochrane and grey literature.
Ninety-three sources were included. Burnout, workload, staffing and workplace violence (WPV) were linked across study designs to turnover, while job satisfaction, supportive leadership and team cohesion appeared to support retention. Problem-focused and resilience-based coping were associated with retention across study designs (n = 5); emotion-focused strategies were linked with poorer outcomes (n = 3). In a subset of 86 sources, traditional protective factors (leadership support and team camaraderie) appeared weakened post-COVID-19. A novel theme of moral obligation to remain, despite personal risk, emerged. Adaptive coping gave way to downshifting and emotional suppression.
The included evidence indicates that multiple, interacting factors shape emergency nurse turnover and retention, whilst systemic strategies aligning operational demands with psychological safety and core nursing values may contribute to sustainable retention.
Workforce interventions should address the psychological legacy of COVID-19 and focus on rebuilding trust, flexibility and moral sustainability in emergency departments.
While individual drivers of turnover are known, their complex interplay and retention factors are underexplored. This review identifies themes transcending boundaries and recurring across the turnover pathway, underscoring the need for multi-level interventions relevant to both nurse managers and policy makers.
Reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR).
This study did not include patient or public involvement in its design, conduct or reporting.
Nurse-led interventions have demonstrated effectiveness in managing emergence delirium (ED), but there is a lack of evidence in pediatric studies.
To systematically synthesize the evidence on the effectiveness of the nurse-led interventions on ED in pediatric patients.
A comprehensive literature search was conducted in PubMed, CINAHL, EMBASE, MEDLINE, Web of Science, Cochrane Library, and APA PsycINFO from the inception to January 13, 2025. Risk of bias was assessed by using the revised Cochrane risk-of bias tool (ROB2) and the Cochrane risk of bias in non-randomized studies-of interventions (ROBINS-I). The meta-analysis was performed using Stata16.0. The forest plots showed the overall effect of the included study.
A total of 20 studies were included, involving 2369 children, comprising 17 RCTs, 1 quasi-experimental study and 2 cohort studies. Compared with usual care, nurse-led interventions significantly reduced the incidence of ED (risk ratio [RR]: 0.50, 95% confidence interval [CI]: 0.33 to 0.77, p = 0.002, I 2 = 77.2%), m-YPAS scores (weighted mean difference [WMD]: −7.67, 95% CI: −10.96 to −4.39, p = 0.000, I 2 = 91.7%), PAED scores (WMD: −1.47, 95% CI: −2.35 to −0.60, p = 0.000, I 2 = 91.3%), and FLACC scores (WMD: −0.97, 95% CI: −1.59 to −0.35, p = 0.000, I 2 = 92.9%). However, no significant effect was observed on the length of PACU stay or the anesthesia induction compliance.
Nurse-led interventions can reduce the incidence and severity of ED in children, as well as in alleviating preoperative anxiety and postoperative pain. However, more research is needed on influencing PACU length of stay and induction compliance.
Nurse-led interventions can be integrated into the perioperative management of children to reduce the incidence of ED. However, in clinical practice, these interventions should be flexibly adapted based on the individual differences of pediatric patients.
This study protocol was registered on PROSPERO with the registration number CRD42024601191
FreshRSS 