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Parenting stress among clinical nurses has been associated with turnover-related outcomes. For many nurses, critical periods of career development and accumulated clinical responsibility overlap with reproductive and early parenting years. Features of nursing work may shape parenting stress through demands related to scheduling, workload, and limited flexibility.
Integrative literature review.
An integrative literature review was conducted following the methodological framework of Whittemore and Knafl. The final searches across three databases (CINAHL Complete, Medline, and Embase) were completed on May 14, 2026. Eligible articles were published in English, addressed parenting stress, and, when empirical, included nurses as a distinct population. Reporting followed PRISMA guidelines.
Eight articles met all inclusion criteria. Countries of origin included South Korea, Turkey, and China. Approximately 1667 nurse-parent participants were represented across the included studies. Main themes included as follows: (1) Work-Family Role Conflict and Parenting Stress, (2) Parenting Stress Across Career and Family Life Stages, (3) Parenting Stress and Nurse Workforce Outcomes, and (4) Organizational and Structural Contributors to Parenting Stress.
Parenting stress appears to be a relevant nursing workforce issue shaped by structural conditions of practice. The structure and demands of patient care may intensify parenting stress. Additional research is needed to examine the effects of parenting stress in clinical nurses and the implications for nurse retention.
Organizational and policy-level interventions (including family-friendly scheduling, accessible childcare, and structured peer support programs) may support workforce sustainability among nurse-parents.
The integration of robots into clinical practice requires careful consideration of their alignment with nursing workflows, patient needs, and clinical contexts. This scoping review aimed to support effective technology adoption by systematically identifying and classifying how robots are used in hospital-based nursing practice using standardized nursing terminology.
A scoping review following Arksey and O'Malley's five-stage framework.
A structured search was conducted in five peer-reviewed databases (PubMed, Web of Science, Cochrane Library, CINAHL, and EMBASE) for studies published between January 2019 and July 24, 2025. The data were analyzed to classify the types of nursing tasks supported by the robots. Robotic functions were classified into direct care, indirect care, and associated work using standardized nursing terminology, Hurst's framework, and the Clinical Care Classification system to provide a codified and structured analysis of nursing tasks.
A total of 40 studies were included in the final review. Thirty-three focused on direct care with robots, primarily supporting psychological, physiological, and functional care. The key interventions included coping support, emotional support, infection control, and vital sign monitoring. Only one study involved indirect care, and nine focused on associated work, such as errands and cleaning.
Robots are primarily used for direct care, such as emotional support and monitoring, while their role in indirect care—requiring professional judgment including documentation—remains limited. This suggests that future development should prioritize user-centered designs and ethical guidelines aligned with actual clinical needs. Properly implemented robotic technology will serve as a strategic tool to enhance nursing efficiency and improve practice environments amidst chronic workforce shortages.
By categorizing robotic functions using standardized nursing terminology, this review offers a structured understanding of how robots can support nursing. These insights help identify tasks that can be delegated to robots during crises, such as pandemics or staffing shortages, allowing nurses to focus on essential patient care.
Diabetes mellitus is a global burden that affects wound healing at nearly every stage, transforming what should be a coordinated and self-limited repair process into a chronic, non-healing state. In diabetic patients, sustained hyperglycemia drives persistent inflammation, impaired angiogenesis, fibroblast dysfunction and extracellular matrix instability, resulting in refractory ulcers and often causing severe complications such as infection, hospitalisation, amputation and premature death. This review integrates mechanistic insights with dermatological advancements providing a comprehensive picture of diabetic wound pathophysiology and emerging therapeutic approaches. The normal sequence of wound healing is outlined and contrasted with the cellular and molecular derailments seen in diabetes, with a focus on macrophage polarisation, neutrophil dysfunction, mast cell and dendritic cell dysregulation, impaired regulatory T cell function, pericyte loss, disrupted neuroimmunomodulation, oxidative stress and defective tissue remodelling. Current and novel interventions including hyperbaric oxygen therapy, negative pressure wound therapy, advanced dressings, biologic grafts, phototherapy, as well as regenerative strategies involving stem cells, nanomaterials and exosome-based treatments are critically examined for their clinical utility, limitations and translational promise. No single modality fully addresses the multifactorial nature of diabetic wounds, but multimodal, mechanism-driven strategies hold potential to synergistically restore tissue repair. Bridging basic science with innovative dermatological interventions remains essential to reduce the global burden of diabetic wounds and improving quality of life for diabetics.
Chronic diabetic foot ulcers and venous leg ulcers remain difficult to treat due to delayed healing and high complication rates. Biologic skin allografts derived from living or amniotic tissue provide extracellular matrix components, cytokines, growth factors and viable cells that facilitate tissue repair. This investigation systematically reviewed randomised controlled trials comparing Apligraf, Theraskin, Amnioband, Amnioexcel, EpiCord and Epifix for chronic lower extremity wounds. Searches were conducted in PubMed, Embase and Cochrane databases. Primary outcomes included complete wound closure at 12 weeks, time to healing and percent area reduction. Secondary outcomes included infection, amputation and recurrence rates. Nineteen trials with a total of 1303 participants met inclusion criteria. Analysis demonstrated statistical significance in 12-week wound closure (p = 0.0394), with Theraskin achieving the highest mean closure (84.7%) and Amnioexcel the lowest (37.5%). Epifix and Amnioband showed faster healing trends and greater closure advantages compared with standard care. Reported complications were uncommon and inconsistently defined. While no single graft demonstrated statistically superior outcomes, descriptive trends suggest Theraskin, Epifix and Amnioband may offer greater clinical benefit. These findings provide comparative insight to guide clinical selection of skin substitutes and highlight the need for large-scale head-to-head trials to establish relative efficacy.
The wound-scratch assay is a widely used in vitro model for studying collective cell migration, a fundamental process contributing to wound closure and re-epithelialisation. Owing to its simplicity, low cost, and adaptability, it has become a foundational tool for early-stage wound-healing research and therapeutic screening. The assay involves generating a defined gap in a confluent cell monolayer and monitoring gap closure over time as a surrogate readout of repair. This narrative review examined 199 published studies, identifying 73 relevant to wound healing. A technical hierarchy of wound creation methods was identified across three main categories: mechanical approaches (e.g., pipette tips and cell scrapers), accessible but prone to operator-dependent variability; semi-automated systems (e.g., inserts and wound maker devices), which improve reproducibility; and fully-automated robotic platforms offering high precision and high-throughput capability. While these advances enhance technical consistency, they do not overcome the assay's fundamental biological constraints. Importantly, gap closure in the wound-scratch assay primarily reflects planar collective cell migration and does not recapitulate the integrated inflammatory, vascular, metabolic, and extracellular matrix-dependent processes that govern wound repair in vivo. Consequently, bioactive compounds acting through antioxidant, anti-inflammatory, angiogenic, or matrix-modulating pathways may have their therapeutic potential underestimated or misclassified when assessed using migration-only readouts. Preliminary in-house (unpublished) data are presented to illustrate this limitation, demonstrating modest migration effects for compounds with established wound-healing activity in vivo. Despite these limitations, the wound-scratch assay remains a valuable first-line, hypothesis-generating tool when interpreted appropriately, with future utility dependent on integration with adapted models and complementary assays for translation.
Although Negative Pressure Wound Therapy (NPWT) has been increasingly used in wound care to improve impaired healing, there is little scientific evidence supporting its role and underlying biomolecular mechanisms. Aims of the present study are to provide a quantitative analysis of recent literature investigating NPWT in diabetic wound healing focusing on healing duration, wound closure, hospitalisation period and complications, and qualitative insight into studies analysing biomolecular mechanisms. The systematic review and meta-analysis were conducted following PRISMA guidelines (PROSPERO: CRD42024524813). 21 studies published in PubMed, Cochrane Library, EMBASE between 2019 and 2024 were included. Clinical studies indicated NPWT was superior to standard care dressings (SCD), promoting faster wound healing with significantly reduced hospitalisation times by 7.8 days (95% CI: −14.2 to −1.4, p = 0.017), and significantly reduced complications rates, particularly major and minor amputations (95% CI: −10.2 to −1.3, p = 0.01). Mechanistic in vitro and animal studies highlighted NPWT can reduce local inflammation, oxidative stress, support angiogenesis and improve scarring, essential components of normal healing. Although studies suggest NPWT is more effective than SCD for diabetic wound healing, the paucity of studies, small cohorts and scarce outcomes consistency make defining clear conclusions challenging. There is still more evidence required to fully understand NPWT's role in the complex diabetic wound healing.
Burnout is associated with adverse physical and psychological health outcomes in civilian nurses. Among military populations, these adverse health outcomes have the potential to degrade readiness at both individual and system levels. There are few scientific studies about burnout among military nurses.
The purpose of this systematic review was to critically examine the evidence regarding the prevalence and individual characteristics associated with burnout among active-duty military nurses.
A systematic review was conducted using a comprehensive, iterative search. Peer-reviewed reports of studies that included burnout in the stated aim or research question and used a validated instrument to measure burnout were included.
Five studies met inclusion criteria. The reported prevalence of burnout among military nurses was between 1.7% and 13.8%. Scoring, measurement, and operational definitions differed, so results should be interpreted with caution. Increased military and nursing experience, a higher volume of work hours, and working on non-day shifts may contribute to burnout among military nurses. Differences in burnout based on sex and military versus civilian status are mixed.
Researchers should consider alternative theoretical frameworks and measurement instruments when studying burnout among military nurses. Inconsistency in measurement methods from previous studies limits current understanding. Military-specific cultural concepts may play a role in mitigating burnout among military nurses.
CRD420251036405
Near-falls, defined as events in which individuals momentarily lose their balance but avoid falling, are strong predictors of subsequent falls. Wearable technologies have the potential to accurately detect near-falls in both laboratory and real-world settings, providing opportunities for early intervention in geriatric nursing practice.
This study has a two-fold aim: (1) to appraise and synthesize current evidence on wearable sensor technologies for near-fall detection, and (2) to discuss their potential applications for monitoring near-fall risk and implementing prevention strategies in older adults.
This is a systematic review. Articles were searched in five electronic databases (PubMed/MEDLINE, Embase, CINAHL, Web of Science, and IEEE Xplore) that explored wearable sensors for near-fall detection. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
A total of 18 studies, mostly experimental or observational, were included. Inertial Measurement Units (IMUs) were the most commonly used wearable technology, and the most frequently captured biomarker was linear acceleration. Lower-body placements (feet, ankles, and lower back) demonstrated superior performance in detecting near-falls. Single-sensor systems achieved sensitivities of 80%–98%, whereas multi-sensor configurations achieved 100% sensitivity, 99% specificity, and 100% accuracy.
Integrating wearable technologies for near-fall detection into geriatric nursing practice may enhance early identification of older adults at high risk for falls and enable timely, personalized interventions. Future research should validate these technologies in real-world settings and assess their acceptability among nurses, caregivers, and older adults.
To synthesize randomized controlled trials (RCTs) regarding the effectiveness of pre-pregnancy weight loss interventions on the risk of gestational diabetes mellitus (GDM) in women with overweight or obesity.
Comprehensive literature searches were conducted across nine databases from inception to May 2024. RCTs comparing pre-pregnancy weight loss interventions with blank control or active control among adult women with overweight or obesity were included. Meta-analyses, using a random-effects model, were performed to pool results of RCTs.
Six studies, including 1632 participants, were included. The effectiveness of pre-pregnancy weight loss interventions on changes in weight and body mass index (BMI) was statistically significant (mean difference [MD] = −6.02, 95% confidence interval [CI] [−8.94, −3.10], I 2 = 98%; MD = −2.22, 95% CI [−3.44, −1.00], I 2 = 98%). However, there was no statistically significant difference in the risk of GDM in women receiving pre-pregnancy weight loss interventions compared with controls (Odd Ratio [OR] = 0.70, 95% CI [0.48, 1.03], I 2 = 2%).
Pre-pregnancy weight loss interventions do not significantly impact the risk of GDM in women with overweight or obesity. Due to the small number of studies, small sample size, and large heterogeneity of pre-pregnancy weight loss interventions, further research is required.
Trial Registration: ClinicalTrials.gov identifier: CRD42023482808
Despite the evidence for the efficacy of lifestyle interventions for type 2 diabetes prevention, there remains a gap in translating this evidence-based practice into real-world settings.
To summarize current evidence regarding the relationship between participant characteristics, intervention components, and the effect of lifestyle interventions for individuals with prediabetes.
The initial search of PubMed, Embase, the Cochrane Library, and Web of Science was performed on 6th December 2023 and was subsequently updated on 5th October 2025. Randomized controlled trials on lifestyle interventions (diet and/or physical activity), compared to usual care, no intervention, or wait-list control, in adults with prediabetes were eligible. Outcomes included the incidence of type 2 diabetes and normoglycemia, fasting plasma glucose (FPG), 2-h plasma glucose, hemoglobin A1c (HbA1c), fasting insulin (FI), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Random-effects meta-analyses were performed to estimate relative risks (RRs) and mean differences. Subgroup analyses and meta-regressions were conducted by participant characteristics and intervention components.
Seventy-seven studies (n = 22,629 participants) were included. Greater weight loss (%) was associated with larger reductions in diabetes incidence (β = 0.07 [0.02, 0.12], p = 0.010). Achieving ≥ 5% (vs. < 5%) weight loss was associated with higher reversion rates to normoglycemia (RR = 1.80 [1.55; 2.08] vs. 1.32 [1.03; 1.70]; p subgroup = 0.036). Interventions with supervised exercise training more effectively reduced diabetes incidence than those without this component (RR = 0.40 [0.24; 0.65] vs. 0.69 [0.63; 0.76]; p subgroup = 0.031). Younger participants showed greater improvements in FPG, HbA1c, FI, and HOMA-IR. Higher baseline HbA1c levels were associated with a greater reduction in HbA1c but a smaller FI improvement.
This meta-analysis provides valuable insights into the implementation of diabetes prevention programs. Weight loss is a critical determinant for diabetes prevention, and weight loss goal setting and progress monitoring are recommended. Adding supervised exercise sessions can enhance the program's effectiveness. Early interventions for younger individuals with lower HbA1c levels may prevent diabetes more effectively.
PROSPERO (CRD42024486361)
Debridement is widely used across various wound types, but its biological significance differs fundamentally between acute and chronic hard-to-heal wounds. In acute wounds, debridement directly triggers the initiation of regeneration; however, in chronic wounds, persistent biofilm, insufficient angiogenesis and dysregulated inflammation lead to a prolonged cycle of inflammation and proliferation, making traditional one-off debridement insufficient to change the healing trajectory. Therefore, the concept of debridement needs to evolve from an acute wound model to a sequential, biologically driven continuous management strategy. Maintenance debridement, by dynamically regulating the microenvironment, reducing pathological load and restoring a ‘healable state’, has emerged as the crucial bridge between inflammation control and regenerative therapies. This review systematically explains the theoretical basis and clinical value of maintenance debridement and explores the future direction of AI-assisted precision debridement management.
Diabetic foot ulcers (DFUs) are one of the most serious and common complications that, if not treated properly, can lead to potential damage and even amputation. The aim of this systematic review and meta-analysis was to assess the drug-resistant Candida species in DFU. PubMed, Web of Science, Scopus and Google Scholar databases were systematically searched for eligible articles up to 22 June 2024. All articles on Candida diabetic foot infections that reported data on drug resistance were included in the study. In addition to general information, data on the type and number of fungi and the percentage of resistance to each drug were collected for analysis. A total of 238 studies were screened and finally, 16 articles were selected and analysed. Candida albicans was the most frequently isolated species in DFUs, followed by Candida tropicalis and Candida parapsilosis. For antifungal agents, the highest resistance was reported to Nystatin (32.48%, p-value = 0.30), Itraconazole (19.46%, p-value = 0.001) and Fluconazole (16.4%, p-value = 0.001). Miconazole (1.18%, p-value = 0.54) and Caspofungin (4.69%, p-value = 0.01) had the lowest resistance rates. For all drugs, resistance was higher in C. albicans than in non-albicans. This study found that antifungal drug resistance in Candida species is high in patients with DFUs, especially to itraconazole and fluconazole. Caspofungin, micafungin and voriconazole were more effective. Antifungal treatment in these patients should prioritize agents with lower resistance rates to improve outcomes and reduce the risk of treatment failure.
Protocol Registration: PROSPERO—CRD42024567133.
Chronic wounds represent a major global health and economic burden. Smart wound dressings integrate biosensing and stimuli-responsive materials to monitor and modulate biological parameters within the wound microenvironment. This scoping review maps the biological parameters monitored by smart wound dressings, an area not previously synthesized across preclinical and clinical contexts. Following Joanna Briggs Institute (JBI) and PRISMA-ScR frameworks, five databases were searched in March 2025. Studies published between 2008 and 2025 reporting biosensing or responding technologies in wound dressings were included. A total of 179 studies met the inclusion criteria, most being preclinical (in vitro or in vivo rodent models), with few human investigations. The most frequently monitored parameters were pH, temperature, oxygenation, moisture, bacterial burden, and protease activity (particularly MMP-9). Preclinical data showed enhanced collagen deposition, angiogenesis, and infection control compared with conventional dressings, whereas human studies mainly assessed feasibility and biocompatibility. Smart dressings demonstrate strong technical and biological performance, but clinical validation and standardized outcome reporting remain limited. Future interdisciplinary research should prioritize well-designed clinical trials to confirm therapeutic and economic benefits and enable translation into personalized wound care.
Calcium sulphate (CS) is a fully synthetic, sterile, bioabsorbable biomaterial extensively applied for the management of infected tissues and postoperative dead spaces resulting from surgical interventions. Residual DS may facilitate hematoma accumulation and bacterial colonisation, thereby heightening the risk of surgical-site infections. Within orthopaedic surgery, CS has been predominantly evaluated as a bone-void filler and an off-label antibiotic delivery vehicle—particularly in arthroplasty revisions, chronic osteomyelitis, and open fractures—yielding high rates of infection prophylaxis, bone regeneration, and low complication profiles. Commercially available as injectable ‘pearls’ or beads, CS permits local, sustained antibiotic elution while undergoing gradual biodegradation, thus obviating the need for secondary removal procedures. Over the last decade, Calcium Sulphate beads (CSBs) have transcended orthopaedics, gaining traction across general, vascular, and endocrine surgery disciplines for the prevention and treatment of complex wound infections. However, their application in plastic and reconstructive surgery remains underreported, despite the specialty's frequent engagement with complex soft-tissue defects, bone exposure, suture dehiscence, and trauma-related wounds vulnerable to infection. To our knowledge, this represents the first scoping review synthesising current evidence, clinical indications, and emerging roles of CSBs within plastic and reconstructive surgery.
Parenting concerns, stemming from cancer's projected impact on children, are a common and significant source of emotional distress for parents. A quantitative synthesis of existing data is critically absent, and the role of modulating factors (e.g., male sex, single parenthood, and the number of children) remains unclear.
This meta-analysis aims to quantify the association between parenting concerns and emotional distress in cancer patients, examining male sex, single parenthood, and number of children as key moderators.
This systematic review and meta-analysis followed PRISMA guidelines. Searches (PubMed, Embase, PsycINFO, Airiti Library; inception-November 2025) identified observational studies of adult cancer patients with minor children. Data on parenting concerns, anxiety, and depression were extracted and appraised using a modified JBI Checklist. Correlations were synthesized. Meta-regression addressed the quantitative void, examining male sex, single parenthood, and number of children as key moderators. Publication bias and sensitivity were assessed.
We included 12 studies (N = 3895). Our meta-analysis found significant positive associations (r = 0.50, p < 0.001) between parenting concerns and both anxiety and depression. Meta-regression, controlling for time since diagnosis, identified male sex, single parenthood, and fewer children as significant moderators for anxiety (p < 0.001), with similar trends for depression.
This meta-analysis highlights parenting concerns linked to distress in cancer patients, with fathers, single parents, and those with fewer children particularly vulnerable. Routine assessment and tailored, family-centered psychosocial interventions are urgently needed.
This systematic review was registered with the International Prospective Register of Systematic Reviews and Meta-analysis (PROSPERO; Registration No. CRD42024592899).
Children on the move in the ECOWAS subregion are part of historical mobility networks shaped by structural poverty, inadequate services, and inequalities. Using the Structural Violence Theory framework, the review examines how economic, social service, and governance policies interact to both create the demand for migration and increase the risks faced by children on the move. The review has three research objectives.
Systematic literature review guided by PRISMA.
There was an overwhelming response of relevant literature sources. Literature from 1966 to 2025 on child migration, trafficking, displacement, and protection by ECOWAS was collected. Among the 987 sources identified through a literature search of central academic databases and institutional repositories, 56 met the selection criteria. Qualitative analysis was employed to evaluate the robustness of the sources based on their methods.
Findings indicate rising levels of children on the move, driven by independent migration from rural areas to cities and cross-border migration along traditional migration routes. Factors such as economic hardship, limited access to quality education, conflict, gender-related labor market conditions, and family dynamics are interconnected and play crucial roles. Children on the move are increasingly vulnerable to exploitation, labor dangers, trafficking, and social exclusion. While international, regional, and national frameworks set standards legally, their implementation remains inefficient.
Children on the move within ECOWAS are seen as an inevitable result of structural factors rather than isolated incidents. One policy implication of this analysis is to include children on the move within the ECOWAS mobility framework. Additionally, social protection programs for children need to be expanded in countries with high emigration rates.
Nurses and allied frontline providers are well-positioned to identify mobility-related risks, deliver trauma-informed, non-discriminatory care, document safeguarding concerns, and activate referral pathways for child protection, psychosocial support, and legal assistance.
Despite numerous therapeutic approaches, the inhibition of hypertrophic scar formation remains a major challenge. Adipose-derived stem cells (ADSCs) have been shown to improve wound healing, including remodelling, in vivo. A systematic review was conducted using the electronic databases PubMed, Web of Science, Embase and Medline. The basic research question was formulated with the PICO framework. The aim of this review is to prove the role of ADSCs in the prevention of hypertrophic scar formation based on in vivo studies. Improved macroscopic outcomes with the use of ADSCs have been shown in nine of 10 studies included. Eight studies report inhibition on fibroblast activation, while all studies highlight the efficacy in promoting the extracellular matrix deposition and remodelling process. The immunomodulatory effects of ADSCs during inflammation have been demonstrated in six studies. One study each investigated the effect on adipogenesis or angiogenesis. In all studies the role of ADSCs in the prevention of hypertrophic scarring was conclusive. However, due to their heterogeneity and weighting of disparate outcomes, several investigations only converged upon distinct endpoints. Further research, preferably in pigs, is urgently required in order to assess the role of ADSCs in the prevention of hypertrophic scar.
Early detection of infection in superficial skin wounds remains a critical determinant of healing outcomes, particularly in paediatric populations, where developmental and behavioural factors often limit clinical assessment. Traditional diagnostic approaches, including visual inspection and culture-based microbiology, are constrained by subjectivity and diagnostic delay. Over the past decade, several innovative technologies have emerged that enable earlier, more objective identification of pathogenic activity in wounds. This focused mini-review summarizes recent advances in novel imaging, biosensor-enabled smart dressings, and molecular diagnostics, with an emphasis on the mechanisms, clinical evidence, and applicability to superficial wound care. Collectively, these technologies represent a shift toward precision wound diagnostics that may facilitate earlier intervention, reduce unnecessary antimicrobial exposure, and improve healing outcomes.
Situation-specific theories (SSTs) have emerged as an important approach for bridging the gap between nursing theory, research, and clinical practice. Unlike grand or middle-range theories, SSTs address specific nursing phenomena within clearly defined populations or contexts. Since their introduction, SSTs have gained prominence as tools for uniting empirical evidence, patient experience, and theoretical guidance. The purpose of this article is to provide an updated synthesis of nursing SSTs published between 2015 and 2025, mapping their purposes, target populations, theorizing methods, and linkages to research and clinical practice.
A comprehensive literature search was conducted to identify SSTs published between 2015 and 2025. Five electronic databases were systematically searched using the keywords “situation-specific theory”. Only peer-reviewed, English-language primary studies describing the development, testing, or application of SSTs were included. Titles, abstracts, and full texts were reviewed against inclusion criteria, resulting in 23 eligible studies. Data were extracted into a standardized table summarizing study characteristics, purposes, target populations, theorizing methods, and practice or research linkages. Findings were synthesized narratively to identify recurring themes and methodological trends in SST development, providing an integrated overview of the current state and application of SSTs.
Five overarching themes were identified across the 23 studies: (a) Broadened Scope, (b) Purpose-Driven Theorizing, (c) Dynamic Theory Lifecycle, (d) Methodological Maturity, and (e) Integration Across Practice, Education, and Research. Based on these findings, five recommendations are proposed: (a) Creative and Innovative Methods, (b) Collaborative and Interdisciplinary Development, (c) Broad Theoretical Integration, (d) Sustain Multi-Source Synthesis, and (e) Ongoing Theory Testing and Refinement.
In summary, this review demonstrates that SSTs have evolved into dynamic, context-sensitive frameworks that unite theory, research, and practice. Continued innovation, interdisciplinary collaboration, and empirical refinement will be essential to sustain their relevance and strengthen nursing's theoretical and clinical foundations.
Utilizing SSTs in clinical settings may enhance the relevance and effectiveness of care by aligning interventions with the unique needs of particular patient populations or situations.
This scoping review explores the environmental impact of nursing interventions in acute care settings, focusing on waste reduction, energy consumption, and carbon emissions, while identifying nurse-led sustainability practices, assessment frameworks, and implementation barriers/enablers.
Guided by Arksey and O'Malley's framework and reported per PRISMA-ScR guidelines.
Data Sources: PubMed, CINAHL, Scopus, and Google Scholar were searched for peer-reviewed, English-language studies published between 2020 and 2025. Review Methods: A five-stage process was employed: (1) research question formulation, (2) comprehensive literature search, (3) study selection using the Population–Phenomenon–Context (PPC) framework, (4) data charting via a structured extraction form, and (5) thematic synthesis. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools.
Of 400 identified records, 25 met inclusion criteria. Findings show nurses reduce environmental impact through reusable linen use (e.g., 496 kg/year ICU waste reduction), energy-efficient equipment, and improved waste segregation. However, time constraints, limited resources, and inadequate sustainability training impede consistent implementation. Awareness among nurses and students is moderate but rarely translates into practice.
Nursing interventions hold significant potential to reduce healthcare's environmental footprint. Embedding sustainability competencies into curricula and reinforcing them with institutional policies and leadership support are essential.
This review informs nurses and clinical leaders that sustainable practices—such as switching to reusable linens and optimizing energy use—are both feasible and impactful in acute care. It provides actionable evidence for reducing waste and carbon emissions while maintaining patient safety, supporting the integration of environmental stewardship into daily nursing practice. Findings from this review highlight the measurable environmental benefits of nurse-led sustainability interventions, such as waste reduction and energy conservation in ICUs. The evidence supports updating nursing curricula, clinical guidelines, and hospital policies to equip nurses with the knowledge and tools needed to lead sustainability efforts, thereby reducing healthcare's carbon footprint without compromising care quality.
FreshRSS 