Conectar
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-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
To explore the experiences of student nurses with dyslexia in clinical practice in the United Kingdom.
A systematic literature review of qualitative research.
Three databases—CINAHL, MEDLINE and the British Education Index, were searched for original articles, using keywords to find peer-reviewed papers published between 1995 and 2024. Two reviewers independently evaluated the studies for inclusion, and the selected studies were critically appraised using the CASP tools. The extracted data were thematically analysed and synthesised.
Six studies were identified. Thematic analysis revealed four themes: Disclosing dyslexia, patient safety, compensatory coping strategies and support from practice assessors/supervisors.
Student nurses with dyslexia have a variety of difficulties in clinical practice that call for continual assistance from their practice supervisors and assessors, including ward managers. Students must reveal their dyslexia to receive support, which can be a difficult and complicated process. Students should capitalise on their skills and employ compensating coping mechanisms to maintain patient safety. Further research is required to explore appropriate adjustments and the current level of help needed to support student nurses with dyslexia.
This study did not include patient or public involvement in its design, conduct or reporting.
Frailty affects over 35% of maintenance haemodialysis (MHD) patients globally—2–3 times higher than the general elderly—and is strongly linked to higher mortality, hospitalisation, and functional decline. Despite its clinical impact, frailty is often underdiagnosed in dialysis settings due to inconsistent assessments and limited resources. Existing prediction models vary widely in predictors and methods, requiring systematic review to guide clinical use and improve risk-stratified care.
To systematically identify, describe, and evaluate the existing risk prediction models for frailty in patients undergoing MHD.
Systematic review and Methodological appraisal.
A comprehensive search was conducted across multiple databases—PubMed, Web of Science Core Collection, Embase, Cochrane Library, CINAHL, China Biomedical Literature Database (CBM), Wanfang Database, VIP Database—covering studies up to November 1, 2024.
Two researchers independently conducted literature searches, screening, and data extraction. They used the Prediction Model Risk of Bias Assessment Tool (PROBAST) to evaluate the risk of bias and the applicability of the included models.
Fifteen studies (21 models) were analysed, with sample sizes 141–786 and frailty incidence 11.00%–59.57%. Model AUCs ranged 0.720–0.998 (potential overfitting at extreme values). Key predictors included age, serum albumin, gender, Charlson comorbidity index, and activities of daily living scores. Methodological appraisal using PROBAST revealed moderate applicability but high bias risks: 53% of studies used retrospective designs, 95% lacked external validation, and limitations included small samples, non-standard variable selection, and inadequate handling of missing data.
While models demonstrate initial predictive utility, widespread bias and developmental-stage limitations hinder clinical application. Future research must prioritise TRIPOD-guided model development, emphasising large prospective cohorts, rigorous validation, and transparent reporting to enhance reliability and clinical utility in frailty risk stratification for MHD patients.
To examine how patients experience day surgery.
Systematic review using Thomas and Harden's framework for synthesis and analysed through Ricoeur's theory of interpretation.
Systematic searches in MEDLINE, CINAHL and EMBASE (September 2023) identified qualitative studies focusing on patients' lived experiences with day surgery (defined as < 24-h hospital stay). Studies were required to provide qualitative data on patient experiences and be published in English or Scandinavian languages. Forward and backward citation searches were also conducted in Scopus.
Thirty-four studies met the inclusion criteria. The analysis revealed four key themes: (1) ‘Perceptions of the day surgery concept shape patient expectations’; (2) ‘Navigating expectation and reality: Surprises and challenges in day surgery’; (3) ‘Navigating through postoperative recovery: Feelings of responsibility and insecurity following day surgery’; and (4) ‘The vital role of support from both family and professionals during recovery after day surgery’.
Patients' expectations of day surgery strongly influence their overall experience, while the complex self-care demands of postoperative recovery underscore the need for robust support systems involving families and healthcare professionals.
This review highlights the importance of thorough preoperative counselling and ongoing support for patients' complex postoperative self-care. These findings suggest that improved patient-centred care and targeted support could enhance recovery outcomes in day surgery pathways.
Problem addressed: The study explores the often-overlooked challenges that patients face with postoperative self-care following day surgery. Main findings: Expectations of day surgery as ‘minor’ often conflict with patients' emotional and physical self-care needs, revealing a need for comprehensive support. Research impact: Insights from this review can inform patient-centred care practices in day surgery settings globally, underscoring the critical role of family and professional support.
No patient or public contribution.
Registered with PROSPERO: CRD42023414310
To explore the persistent changes in working conditions and nursing practices in high acuity settings in the post COVID-19 pandemic era.
A qualitative systematic review using the meta-aggregation design of the Joanna Briggs Institute.
After screening by two authors based on the inclusion and exclusion criteria, 36 studies were included. Quality was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data were then extracted and synthesised. Confidence of findings was assessed using the ConQual approach.
The electronic databases: MEDLINE, CINAHL, Embase, and Scopus were searched in November 2023. Additional searches were conducted using the preprint servers: medRxiv, Open Science Foundation, Social Science Research Network, and Journal of Medical Internet Research.
Synthesised findings of ‘unfavourable working conditions and changed nursing practices’ and ‘health concerns caused by the nursing practices’ with eight categories were identified. Significant findings included increased workloads; overwhelming use and insufficient supply of personal protective equipment; decreased communication between nurses and patients, families, and other healthcare workers; lack of knowledge of the disease; and adequate support from coworkers, but inadequate support from nurse managers and physicians.
This study synthesised existing knowledge and offered insight into the nursing practices and working conditions of high acuity nurses during the COVID-19 pandemic. Clinical nurses and managers need to actively take action on those modifiable aspects of their practices in a future similar crisis. This review did not identify any studies focusing on high acuity nurses' working conditions and practices in the post-pandemic era. This kind of research is urgently needed.
Nurse managers and policy makers can use the findings of this review to help construct better working conditions for their high-acuity nursing staff in a future similar crisis. Frontline high-acuity clinical staff may use the findings of this review to help better guide their nursing practices and mitigate negative effects of a future similar crisis on their practice and health.
The study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement.
No patient or public contribution.
International Prospective Register of Systematic Reviews: CRD42023473414
To summarise the incidence rate and identify the risk factors for oral endotracheal tube-related mucous membrane pressure injury (OETMMPI) in critically ill patients.
This systematic review and meta-analysis followed the PRISMA 2020 requirements. We searched the databases PubMed, Embase, Web of Science, the Cochrane Library, WanFang, China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure (CNKI) and China Biomedical Literature Database (SinoMed) from conception to July 3, 2025. Two independent researchers read the publications, assessed them and extracted data. Stata 18.0 software was used to conduct the analyses.
This meta-analysis comprised 16 observational studies. Two studies recorded the number of days of tracheal intubation rather than the number of patients who required it, which totaled 274 days. The remaining 14 trials included a total of 6768 adult patients. The incidence rate of OETMMPI was 28.9% (95% CI = 0.177–0.417). Risk factors include tracheal catheter indwelling time (OR = 1.13), APACHE II score (OR = 1.39), use of hard bite blocks (OR = 1.88), prone ventilation (OR = 3.95), diabetes history (OR = 4.86), vasoconstrictor medication use (OR = 2.11) and albumin level (OR = 0.50).
The incidence rate of OETMMPI is relatively high in critically ill patients, and there are many influencing factors. Nursing staff should enhance their awareness of OETMMPI, accurately identify high-risk groups and risk factors, and formulate early, full-course, meticulous and personalised intervention measures for critically ill patients to prevent OETMMPI.
OETMMPI in critically ill patients brings pain to the patients, increases the risk of infection and affects the prognosis of the disease. Therefore, medical staff should regularly assess and address it. This study also identified specific related factors, and these results provided valuable insights for the ICU medical team to identify high-risk patients and offer personalised intervention measures to reduce their occurrence.
To offer a comprehensive overview of the individual and organisational factors related to inclusive leadership among healthcare professionals.
Systematic review and meta-analysis.
The review was conducted following the Joanna Briggs Institute methodology for systematic reviews of effectiveness. Findings were synthesised using meta-analysis, a random effects model and narrative synthesis.
In January 2025, a systematic search was conducted with no time or geographical limits in the CINAHL, MEDLINE (PubMed), Mednar, ProQuest and Scopus databases. Studies in English, Swedish and Finnish were included.
A total of 34 studies were included. The meta-analysis revealed a statistically significant positive relationship between inclusive leadership and psychological safety among healthcare professionals (n = 10). The narrative synthesis further identified individual and organisational factors related to inclusive leadership. Individual factors consisted of well-being at work, performance and productivity, social behaviour, innovativeness and creativity and psychological capacity. Organisational factors revealed work community cohesion and citizenship, as well as organisational fairness and appreciation.
Inclusive leadership is a promising leadership behaviour, with positive outcomes for healthcare professionals and organisations. By enhancing psychological safety, inclusive leadership offers broader benefits for individuals and organisations. As such, it could improve the retention of professionals and the attractiveness of organisations in the healthcare sector.
To strengthen the functioning of healthcare organisations, leaders should be educated in inclusive leadership and its practical benefits. Training should focus on developing inclusive leadership behaviours that foster belonging, value individual uniqueness and encourage participation across all professional groups, creating an environment where both individuals and organisations can thrive.
The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were used to report the results.
No patient or public contribution.
The protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO (ID: CRD42024503861)
This study aims to synthesise evidence on users' experiences of telephone cancer information and support services (CISS) to identify important service features and inform service development.
A qualitative evidence synthesis.
OVID MEDLINE, EMBASE, CINAHL, PsycINFO and SocINDEX databases were searched for peer-reviewed qualitative literature fitting the inclusion criteria from database inception to 30 March 2023. The included articles were double-screened, and quality appraised using the CASP checklist. GRADE-CERQual was used as a tool to assess the confidence of review findings. Content synthesis combined the qualitative data with the Loiselle cancer experience measurement framework guiding analysis. This paper is reported as per the equator network recommended SRQR checklist.
Of the 607 articles screened, seven studies were included. Four main themes and 14 sub-themes about CISS aspects were identified: psychological well-being (managing emotions/coping, hope/reassurance, supporting close others and a reluctance to call the CISS); knowledge is power (information seeking, the burden of knowledge and empowerment); truth and clarity (adjunct support, credible source and improved understanding and confidence); and service adequacy (operators' ability to connect with users, convenience, service provision and awareness, and the cancer journey).
Findings suggest people with cancer and their carers accessing a CISS value emotional support combined with trusted information, topic expertise and a connection with the service operator. future service provision should address the lack of awareness regarding the range of services and the convenience extended operating hours may offer.
The results add to our understanding of CISS service provision. However, knowledge gaps remain regarding preferences among service features and the hierarchy of CISS characteristics to be prioritised to enhance services.
Focused CISS awareness campaigns will inform communities and healthcare professionals of the available resources to improve the lives of those affected by cancer. Ongoing service review will enable resources to be tailored to callers' needs, potentially easing the burden on existing services that are overwhelmed and under-resourced.
This qualitative evidence synthesis did not directly involve patient or public contribution to the manuscript.
Systematic Review Registration Number (PROSPERO): CRD42023413897
To systematically examine how structural vulnerability has been defined and operationalised in United States-based health research, identify conceptual consistencies and methodological gaps, and propose core dimensions of structural vulnerability along with implications for future application in health research.
A systematic mixed-studies review using a parallel-results convergent synthesis design.
PubMed, Embase, Scopus and CINAHL were searched from first publication through 2024 using the terms ‘structural* vulnerab*’ AND health.
Peer-reviewed English-language empirical studies conducted in the United States that applied the concept of structural vulnerability were identified. The Mixed Methods Appraisal Tool was used to assess study quality. Study content was analysed to identify how structural vulnerability was defined and operationalised.
Thirty-seven predominantly high-quality studies published between 2011 and 2024 met inclusion criteria. Structural vulnerability was consistently defined through two interrelated dimensions: as a social positionality (characterised by constrained resilience, limited agency and imposed risks rooted in systemic discrimination and social hierarchies) and as a critical analytic framework for examining structural determinants of health. Quantitative studies predominantly used individual-level indicators (e.g., income, housing) and cross-sectional designs. Qualitative studies focused on experiences of structural vulnerability in relation to health outcomes and infrequently translated findings into structural interventions. The most frequently studied outcomes were infectious disease, substance use and mental health.
Structural vulnerability, as a conceptual and empirical lens, reveals how systems produce—and can potentially reduce—health risks. Findings underscore the need for geographically diverse and longitudinal studies, as well as multidimensional measures. Advancing health equity demands critiquing systemic causes of inequities and pursuing justice-oriented interventions.
Nursing, positioned at the intersection of public health, social sciences and policy, is uniquely equipped to engage structural vulnerability as a critical analytic tool to address health inequities, design interventions and advocate for policy reform.
What problem did the study address? This study addressed a lack of clarity in the definition and operationalization of structural vulnerability in health research.
What were the main findings? The definition of structural vulnerability is consistent across quantitative and qualitative studies, but there are marked variations in its operationalization. Quantitative studies predominantly rely on individual-level indicators, while qualitative studies use it as a theoretical framework to guide analysis, interpret findings and examine structural determinants of health.
Where and on whom will the research have an impact? This review offers a clear framing for integrating structural vulnerability in health research in efforts to advance health equity.
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guideline.
This study did not include patient or public involvement in its design, conduct or reporting.
The use of technology to support nurses' decision-making is increasing in response to growing healthcare demands. AI, a global trend, holds great potential to enhance nurses' daily work if implemented systematically, paving the way for a promising future in healthcare.
To identify and describe AI technologies for nurses' clinical decision-making in healthcare settings.
A systematic literature review.
CINAHL, PubMed, Scopus, ProQuest, and Medic were searched for studies with experimental design published between 2005 and 2024.
JBI guidelines guided the review. At least two researchers independently assessed the eligibility of the studies based on title, abstract, and full text, as well as the methodological quality of the studies. Narrative analysis of the study findings was performed.
Eight studies showed AI tools improved decision-making, patient care, and staff performance. A discharge support system reduced 30-day readmissions from 22.2% to 9.4% (p = 0.015); a deterioration algorithm cut time to contact senior staff (p = 0.040) and order tests (p = 0.049). Neonatal resuscitation accuracy rose to 94%–95% versus 55%–80% (p < 0.001); seizure assessment confidence improved (p = 0.01); pressure ulcer prevention (p = 0.002) and visual differentiation (p < 0.001) improved. Documentation quality increased (p < 0.001).
AI integration in nursing has the potential to optimise decision-making, improve patient care quality, and enhance workflow efficiency. Ethical considerations must address transparency, bias mitigation, data privacy, and accountability in AI-driven decisions, ensuring patient safety and trust while supporting equitable, evidence-based care delivery.
The findings underline the transformative role of AI in addressing pressing nursing challenges such as staffing shortages, workload management, and error reduction. By supporting clinical decision-making and workflow efficiency, AI can enhance patient safety, care quality, and nurses' capacity to focus on direct patient care. A stronger emphasis on research and implementation will help bridge usability and scalability gaps, ensuring sustainable integration of AI across diverse healthcare settings.
Limited literature has focused on people with cancers' preference for care providers in scenarios where trade-offs may have to be made.
To report the results of a comprehensive search and synthesis of discrete choice experiments or best-worst scaling studies (± willingness to pay estimates) in scenarios involving cancer nurses, with a focus on: (1) preferred care provider; and (2) relative importance of attributes of care provision for people with cancer.
A search was conducted across: CINAHL, Cochrane Central Register of Controlled Trials, EconLit, Medline, PsycINFO, Scopus, Web of Science Core Collection, and Google Scholar for discrete choice experiments published between January and July 2025. Data were extracted and appraised by two authors. Results were narratively synthesised.
Of 461 studies screened, 11 were included, published in Australia (n = 3), UK (n = 3), and China (n = 5) including people with breast (n = 4), gastric (n = 4), prostate (n = 1), or mixed cancers (n = 2). In six studies exploring scenarios of follow-up care (i.e., survivorship/surveillance), cancer medical specialists were the preferred care provider, followed by cancer nurses, and then general practitioners. In four of the five studies of supportive care scenarios (i.e., diet and exercise advice, anxiety and depression screening), cancer nurses were the preferred care provider, followed by allied health professionals, then cancer medical specialists. The highest WTP estimate was $US226.15 for a medical specialist to provide follow-up care. For supportive care, the highest WTP was $US137.52 for a cancer nurse to provide diet-based lifestyle advice post-treatment for breast cancer.
Cancer nurses are highly valued by people with cancer, particularly for supportive care provision. Opportunities exist for an increase in cancer nurse specialists with expanded scope of practice, to support the preference of people with cancer to have cancer medical specialists, or cancer nurse specialists provide expert cancer follow-up care.
Employees of a cancer patient advocacy group were involved in the design of the study, interpretation of the data, and the preparation of the manuscript. No patients were involved in this work. However, this systematic review prioritized patient voices by including studies that reported on the preferences of people with cancer.
Nurses are pivotal in EBHC implementation; however, its adoption remains limited, highlighting the need to investigate nurses' experiences and perceptions of their EBHC competence.
To critically appraise and synthesise qualitative evidence of nurses' experiences and perceptions of EBHC competence.
A qualitative systematic review.
The review followed the JBI methodology for qualitative systematic reviews. Inclusion criteria were qualitative studies published in Finnish, Swedish or English that explored nurses' experiences and perceptions of EBHC competence. Data were synthesised using JBI's meta-aggregation method and the findings were graded with the ConQual approach.
CINAHL, Medic, PubMed, Scopus and grey literature from EBSCO Open Dissertations and MedNar, searched in December 2023.
Seventeen qualitative studies were included. The study findings were generated from four synthesised findings with low confidence scores. The synthesised findings were: (1) Nurses' competence in Global Health, (2) Nurses' competence in enhancing Evidence generation, (3) Nurses' competence in optimising Evidence Transfer and (4) Nurses' competence in effective implementation of evidence. A new finding of this systematic review was that nurses did not express their experiences or perceptions on evidence synthesis.
Nurses' experiences of EBHC competence focus mainly on evidence implementation and global health. The lack of findings to evidence synthesis suggests that core principles of the EBHC model are not yet fully embedded in nursing practice. Nurses emphasised the need for greater support for developing EBHC competence.
Integration of EBHC into education, mentoring and adequate resources enhances nurses' competence, motivation and commitment to EBHC sub-dimensions, while also strengthening their professional confidence and development.
Strengthening nurses' EBHC competencies contributes to supporting the delivery of high-quality, effective and sustainable healthcare services.
PRISMA guidelines followed.
None.
PROSPERO-registered: CRD42021285179
The utilisation of artificial intelligence in the context of nursing education has become increasingly extensive. However, various studies show differing perspectives and attitudes among nursing students, and the findings have not been systematically synthesised.
To systematically review the perceptions and attitudes of nursing students on the application of artificial intelligence in nursing education.
Mixed-methods systematic review.
A comprehensive literature search was conducted across 10 databases, including PubMed, Cochrane, Embase, Web of Science, CINAHL, Scopus, China Science and Technology Journal Database, SinoMed, China National Knowledge Internet, and WanFang database, the inclusive years of articles searched were from 1969 to 2025. Two researchers independently screened the literature and extracted the data. The mixed methods assessment tool was used to evaluate the risk of bias in the included literature. The relevant data were extracted and synthesised according to the Joanna Briggs Institute's convergence synthesis method, ensuring the comprehensive integration of qualitative and quantitative results. These results were then integrated into the Technology Acceptance Model.
A total of 28 articles were included, including 13 qualitative studies, 13 quantitative studies, and 2 mixed-method studies. According to the Technology Acceptance Model, the perceptions and attitudes of nursing students on the nursing education's adoption of artificial intelligence were integrated into 10 categories of three comprehensive themes: (i) Nursing students' perceptions and attitudes of the ease of use of artificial intelligence in nursing education, including 3 categories; (ii) nursing students' perceptions and attitudes on the usefulness of artificial intelligence in nursing education, including 4 categories; (iii) nursing students' behavioural intention, including 3 categories.
Overall, our study demonstrated that nursing students had an active willingness to utilise artificial intelligence. However, they acknowledged that certain issues persist regarding the ease and practicality of artificial intelligence in nursing education.
No patients or members of the public were directly involved in this systematic review, as the study synthesised existing literature.
Improving global access to pain management medications for cancer patients remains a critical priority. Nurses are now understood to play an essential role in cancer pain medication management, yet the barriers and facilitators they encounter require urgent identification.
This systematic review aimed to identify the barriers and facilitators for nurses in managing cancer pain medication.
This systematic review followed the Joanna Briggs Institute (JBI)'s guidelines for qualitative systematic reviews.
Eleven databases (PubMed, Web of Science, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Scopus, OPENGREY.EU, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP) and SinoMed) were searched from their inception to 9th July 2025. Articles were evaluated for quality using JBI critical appraisal tools. Data extraction was performed according to JBI standardised protocols, and evidence synthesis was conducted using JBI meta-aggregation, which involved extracting findings, categorising them into thematic groups and synthesising them into comprehensive statements.
Twenty-four qualitative studies were reviewed in the present study. Two synthesised findings regarding the barriers and facilitators for nurses in managing cancer pain medication were integrated: (1) Barriers for nurses to manage cancer pain medication were summarised into five categories: systemic barriers, resource barriers, knowledge and skills barriers, financial and cultural barriers and communication and psychological barriers; (2) Facilitators for nurses to manage cancer pain medication were summarised into three categories: nursing capacity building, supportive care environments and collaborative support systems.
Multilevel barriers impede nurse-led cancer pain management, necessitating policy reforms (e.g., tiered prescribing), investments in telehealth/training and culturally responsive interprofessional collaboration. Prioritising facilitators, capacity building, supportive environments and collaboration is vital to empower nurses in delivering equitable, evidence-based pain relief.
This review equips clinical managers and policymakers with evidence to implement policy and practice reforms, such as tiered prescribing and interprofessional collaboration, which are critical to empower nurses in delivering effective cancer pain management.
This systematic review was prospectively registered in PROSPERO prior to the initiation of the search (Registration ID: CRD42024570807).
There was no patient or public contribution.
To systematically compare nurse-led versus traditional rehabilitation in improving clinical outcomes for stroke survivors.
Systematic review and meta-analysis.
Data were extracted from Cochrane, PubMed, Embase, and Web of Science (searched up to July 2024). Analyses with standardized mean differences (SMDs) and risk ratios (RRs) as the estimates were performed in Review Manager 5.4 and Stata 15.0. Randomized controlled trials investigating nurse-led stroke rehabilitation with outcomes such as mental component summary (MCS) and physical component summary (PCS) of quality of life, self-efficacy, National Institutes of Health Stroke Scale (NIHSS), stroke-specific quality of life (SS-QOL), Barthel Index (BI), Geriatric Depression Scale-15 (GDS-15), and pain were included. Sensitivity analyses and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were performed.
A total of 12 articles were included. The quality assessment indicated that most studies did not have a serious risk of bias. Nurse-led rehabilitation showed significant improvements in SS-QOL (SMD: 3.33, 95% CI: 1.26, 5.40; very low-quality evidence), depressive symptoms (GDS-15, SMD: −2.21; 95% CI: −2.80, −1.63; high-quality evidence), pain (SMD: −1.61; 95% CI: −2.14, −1.08; high-quality evidence), and BI (SMD: 0.24, 95% CI: 0.01, 0.48; low-quality evidence). However, there were no significant differences in MCS, PCS, self-efficacy, or NIHSS between the two groups. Sensitivity analysis showed that the results for SS-QOL and BI were unstable and should be interpreted with caution.
Nurse-led rehabilitation is effective in improving psychological outcomes, particularly depression (GDS-15) and pain, although this high-quality evidence is based on a single study. Functional independence (BI) and SS-QOL are also improved, but the evidence for these outcomes is of low quality and highly unstable in sensitivity analyses. No significant benefits are found for other outcomes. The evidence quality varies, and future high-quality studies are needed to confirm these findings.
Incorporating nurse-led rehabilitation into stroke guidelines and implementing standardized depression screening programs and non-pharmacological pain interventions in community rehabilitation could be beneficial for populations with depressive symptoms and chronic pain.
This study adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for transparent reporting of systematic reviews.
This study did not include patient or public involvement in its design, conduct, or reporting.
To identify and synthesise nursing interventions directed at family caregivers of patients with end-stage renal disease undergoing haemodialysis.
A convergent-integrated mixed-methods systematic review.
A comprehensive search was conducted in EBSCOHost databases (Academic Search Complete, CINAHL Complete, MEDLINE with Full Text, MedicLatina, ERIC) and the PubMed database. Studies were appraised using the Mixed-Methods Appraisal Tool (MMAT), and interventions were classified using the Cochrane Effective Practice and Organisation of Care taxonomy.
Quantitative data were narratively synthesised and transformed into textual descriptions to enable integration with qualitative findings. A thematic synthesis was conducted to group similar concepts.
Twenty-three studies met the inclusion criteria. Most were quantitative or mixed methods with moderate-to-high methodological quality. Interventions were primarily classified as disease management (n = 10) or self-management support (n = 9). Common components included education, coping strategies, empowerment, and psychosocial support. Positive effects were observed on caregiver quality of life, anxiety, depression, and self-efficacy. Caregiver burden outcomes were mixed, potentially influenced by time and intervention intensity. Additional benefits were noted from relaxation techniques and intradialytic exercise. Qualitative data revealed culturally embedded coping strategies such as spiritual practices, time management and seeking social support.
Educational and empowerment-based nursing interventions—particularly those supporting dyadic coping and family-centred care—can improve caregiver outcomes. Frameworks such as the Roy Adaptation Model and the ‘Timing it Right’ approach enhance intervention design and relevance.
By addressing caregiver needs through structured education, psychosocial support and contextually sensitive approaches, nurses can mitigate caregiver burden and promote long-term caregiver well-being and patient adherence to treatment.
Although patients and caregivers were not directly involved, this review contributes to improving nursing care for family caregivers of individuals with ESRD, aiming to enhance their quality of life.
To synthesise evidence on the self-perceived consequences of workplace violence (WPV) among male nurses in hospital care settings.
Mixed-methods systematic review (PROSPERO: CRD420251041864).
Systematic searches were performed in PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, and China Biomedical Database. Quantitative, qualitative, and mixed-methods studies on registered male nurses were included. Methodological quality was assessed using the Mixed Methods Assessment Tool 2018. Data synthesis followed the Joanna Briggs Institute convergent integrated approach.
Six databases were searched from their inception to April 30, 2025.
Twenty six studies (18 quantitative, 6 qualitative, and 2 mixed-methods) from 12 countries (n = 2354 male nurses; 7 in psychiatric departments, 4 in emergency departments, 2 in psychiatric hospitals, 1 in an ICU, 1 in an operating room, and 11 unspecified department studies in hospital nursing settings) were included. Six themes emerged: (1) Physical health damage; (2) Mental health trauma; (3) Impediments to Career Advancement; (4) Deterioration of working environment and social relations; (5) Impaired Quality of Patient Care; and (6) Deficiencies in Violence Coping Mechanisms and Potential Risks.
WPV inflicts multidimensional harm on male nurses, spanning their health, career, social well-being, and care quality, compounded by systemic underreporting.
Urgent interventions are needed, including gender-sensitive training, improved reporting systems, mental health support, and safe workplaces. Addressing WPV is vital for nurse retention and patient safety.
This review highlights under-studied WPV toward male nurses, revealing profound personal and professional impacts. It informs healthcare policymakers, administrators, and clinicians, urging gender-inclusive prevention strategies to protect nurses and enhance global care quality.
This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.
No patient or public contribution was involved in this systematic review.
To summarise the effect of mentoring within mentoring programmes on the retention and turnover of newly graduated nurses in healthcare settings.
An umbrella review.
Two independent reviewers screened the titles, abstracts and full texts for eligibility and critically appraised the included reviews using the JBI critical appraisal. The findings were tabulated and synthesised.
The search was conducted in five electronic databases (CINAHL, OvidMedline, ProQuest, Scopus, Cochrane and Medic) in November 2023.
Out of 450 Papers, 13 systematic and integrative reviews were included. Thirteen mentoring programmes were identified and categorised into three groups based on their content: didactic mentoring programmes, interaction-based mentoring programmes and combined mentoring programmes. Across these programme types, retention among newly graduated nurses ranged from 72% to 100% at the 1-year mark and 70% to 98% at 2 years. Turnover rates showed consistent reductions, with post-intervention rates ranging from 3.5% to 20% compared to pre-intervention rates of up to 50%. Several studies reported statistically significant improvements in retention and turnover, particularly in programmes integrating structured education and preceptorship models.
Several different mentoring programmes have been developed to support the transition of newly graduated nurses. Mentoring programmes that provide ongoing support and structured guidance increase retention and reduce turnover among newly graduated nurses.
Effective mentoring programmes are key to ensuring high-quality patient care and a sufficient supply of qualified nurses in the future.
The findings can provide information for developing transition support and mentoring programmes for newly graduated nurses.
This umbrella review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
No patient or public contribution.
The umbrella review protocol was registered in PROSPERO: CRD42023478044.
To identify barriers and facilitators to nurse prescribing implementation through a synthesis of qualitative studies.
The roles of healthcare professionals are expanding in response to the growing demand for access to high-quality healthcare services. Advanced practice nurses are a global trend, and nurse prescribing is a crucial feature of advanced practice nurses that can meet the needs of growing healthcare services. The development and promotion of nurse prescribing varies significantly across countries, and it is essential to identify the factors influencing the implementation of nurse prescribing.
A systematic search of PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wan Fang and Weipu database was conducted to retrieve literature on barriers and facilitators related to the implementation of nurse prescribing. We searched records from inception to 29 March 2025. Two researchers independently performed literature screening, literature evaluation, data extraction and synthesis. Literature screening and data extraction adhered to the predefined inclusion and exclusion criteria. Literature quality was evaluated using the JBI Checklist for Qualitative Research. The results were synthesised using the thematic synthesis approach. Information was extracted using the Consolidated Framework for Implementation Research (CFIR) in a deductive way, and barriers and facilitators to the implementation were categorised based on the CFIR. Report rigour assessed via ENTREQ.
The synthesis of 14 included papers identified 18 thematic categories, yielding two key findings. The main barriers identified included failure to anticipate the cost of nurse prescribing, legal constraints, social pressures, poor organisational structure, insufficient prescribing education, lack of competence of nurses leading to psychological changes, opposition and lack of cooperation of team members, and insufficient planning of nurse prescribing. Facilitating factors included prescribing experience, resource and labor conservation, cost reduction, resources, nurses' prescribing training, leadership support, patients' needs, nursing professional development, nurses' competence, and team cooperation and support.
Identifying barriers and facilitators to nurse prescribing is critical for informing policy-making and clinical prescribing practices. The results offers practical guidance to develop strategic plans that enhance implementation and adoption of nurse prescribing.
Nurse prescribing improves patient access while mitigating healthcare strain. By streamlining medication delivery and optimising resource use in overburdened systems, this model strengthens patient-centered care while allowing physician specialisation in complex cases. This workforce innovation enhances team-based care and ensures continuity for vulnerable populations.
This paper identifies barriers and facilitators, offering policymakers, healthcare administrators, and educators actionable insights to enable nurse role expansion, reduce physician workload, and enhance outcomes through holistic care.
No patient or public contribution.
FreshRSS 