Conectar
Physicians’ preferences for financial and non-financial incentives significantly influence their job satisfaction and career choices. A comprehensive understanding of these preferences can aid in the optimisation of incentive policies. While prior studies have examined these preferences using discrete choice experiments (DCEs), the effects of intrinsic motivations, such as altruism and job satisfaction, on incentive responsiveness remain poorly understood. Understanding this heterogeneity is essential for designing incentive policies that are effective and tailored to the healthcare context in China. This study aimed to assess how physicians’ altruism and job satisfaction shape their preferences for financial and non-financial incentives.
This study employed a DCE methodology and surveyed 886 physicians from urban tertiary hospitals. The DCE design was based on a comprehensive literature review and focus group interviews, assessing physicians’ preferences regarding attributes such as work environment, workload, career development opportunities and career identity. Mixed logit models were used to estimate the willingness to pay for each attribute and analyse heterogeneity across subgroups based on levels of altruism and job satisfaction.
Financial incentives were the most important factor for physicians, followed by attributes such as work atmosphere and workload. On average, physicians expressed a willingness to sacrifice 4859.035 ¥ for an improved work atmosphere and 4335.008 ¥ in exchange for reduced workload. Subgroup analysis showed that physicians with low- and medium-altruism prioritised improvements related to working conditions, while those with high-altruism placed greater emphasis on intrinsic career development and career identity. Furthermore, physicians reporting low-job satisfaction demonstrated heightened sensitivity to both financial and non-financial incentives, whereas those with high-job satisfaction showed weaker preference for financial incentives and greater preference for improvements in work atmosphere (β=1.002) and work environment (β=0.876).
The findings highlight the need to align incentive policies with physicians’ intrinsic motivations and current job satisfaction. Financial incentives remain a key driver of job preferences. Non-financial factors, including improvements in the work atmosphere, work environment, workload, career development and professional identity, also play an important role in supporting physicians’ job satisfaction and retention. Considering differences in altruism and job satisfaction can help healthcare institutions and policymakers develop more targeted and context-specific incentive strategies.
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
Glaucoma is an optic neuropathy caused by the gradual degeneration of retinal ganglion cells. This study aimed to investigate the knowledge, attitude and practice (KAP) towards glaucoma among ophthalmic inpatients.
A web-based questionnaire.
Local hospital.
Ophthalmic inpatients (n=1238).
The primary outcome was the patients’ KAP.
Multivariable logistic regression analysis showed that rural residence (OR=0.488, 95% CI 0.313 to 0.762, p=0.002), college education or above (OR=4.996, 95% CI 2.942 to 8.483, p
Ophthalmic inpatients might have moderate knowledge and attitude, but a proactive practice towards glaucoma. A history of glaucoma, previous glaucoma surgery, education level, residency and alcohol consumption were potentially associated with knowledge and attitudes towards glaucoma among ophthalmic inpatients.
The overuse of antibiotics for respiratory tract infections in primary healthcare in rural China is a particular challenge and is highly related to antibiotic resistance. Our research team designed a multi-component intervention focusing predominantly on health practitioners to reduce antibiotic prescriptions in rural communities of China. The effects of the intervention were evaluated through a randomised controlled trial. This study was conducted alongside the trial to develop a contextualised understanding of the implementation of the intervention and related influencing factors.
Qualitative process study nested in a randomised controlled trial, including observation and semi-structured interviews.
Primary healthcare in rural China.
27 health practitioners from township health centres assigned to the intervention arm.
A complex intervention to reduce antibiotic prescriptions in rural communities of China, which includes the following components: training for health practitioners, a public letter of commitment, patient leaflets, a decision support system and a peer support group.
Not applicable.
Data were analysed using thematic analysis.
The overall multi-component intervention was described as useful in reducing antibiotic prescribing, with a particularly high acceptance and use of patient leaflets and the public letter of commitment among health practitioners. There were mixed views on the decision support system and peer support group. Practitioners reported usability-related barriers to using the decision support system during consultations. Practitioners did not understand the role or benefits of the peer support group and found it difficult to initiate group discussions, due to the lack of any existing clinical team at the primary care level.
The multi-component intervention appears to be acceptable and useful in primary healthcare in rural China. Successful implementation requires a comprehensive understanding of the contextual characteristics of the setting. Interventions to reduce antibiotic prescribing in China in the future could consider wider stakeholders including patients, retail pharmacies and health authorities.
ISRCTN30652037 (01/12/2020).
Patient-reported experience measures (PREMs) are measures of patients’ perceptions of care they receive. PREMs are critical in developing and evaluating programmes that aim to improve patient healthcare experiences and quality of care (QoC) according to patient-defined needs. This review aims to map key domains of PREMs across distinct healthcare technical areas and life stages from globally available literature.
A scoping review adapting Arksey and O’Malley’s framework and Joanna Briggs Institute’s guidelines for the conduct of scoping reviews.
Google Scholar, PubMed, WHO, US Academy of Medicine and USAID Momentum.
PREMs literature from electronic repositories of grey and peer-reviewed publications, published in English historically up to September 2023.
Two lead reviewers with support from the technical working group co-created a review framework of healthcare technical areas, life stages and PREMs domains. We screened eligible articles, prioritising reviews except for technical areas with no reviews, where we then selected individual studies. We charted, analysed and synthesised data from 52 eligible articles.
PREMs literature has recently increased, especially in low-income and middle-income countries (LMICs), although studies in high-income countries (HICs) dominate in proportion (n=38; 73.1%). Out of 52 eligible articles, technical areas with most publications were sexual and reproductive health (n=21; 40.4%) and general outpatient care (n=11; 21.2%). Studies in adulthood (n=24; 46.2%) and from pregnancy and birth to postnatal (n=16; 30.8%) were most represented. PREMs studies reported mostly on communication and rapport (n=33; 63.5%) and respect and dignity (n=42; 80.8%) domains. Nearly a quarter (n=12; 23.1%) of the articles included only validated tools; the rest included a combination of validated and unvalidated measures. Of the tools relating to life stages of babies, younger children and older adults, the majority (n=17; 94.4%) included patient proxies.
PREMs, as an important component of QoC measurement, are increasing across several healthcare technical areas and life stages with commonalities and notable distinctions in measurement domains and tools. Evidence on PREMs largely comes from HICs. Evidence on critical, yet sometimes overlooked domains, highlights key QoC implementation gaps. The adaptation and utilisation of PREMs in programmes, especially in LMICs and under-represented technical areas, present opportunities to close the QoC disparities in those settings. Strategic, concerted efforts towards the harmonisation of PREMs tools across multiple life course stages and technical areas are critically needed in high-level quality improvement efforts.
To compare the power styles that nurses perceive and expect from nurse managers at two time points. The study aims to investigate any changes in nurses' perceptions and expectations regarding the power styles of nurse managers over a six-year period.
Repeated cross-sectional desing.
The study was conducted with 158 nurses at Time-1 and 103 nurses at Time-2. Data were collected using the Personal Information Form and the Perceived Leadership Power Questionnaire. For data analysis, frequency and percentage distribution, arithmetic mean, t-test, and Cronbach's Alpha were applied.
It was determined that the power style most perceived by nurses in their nurse managers was Referent Power at Time-1 and Expert Power at Time-2, while the expected power style was Expert Power at both Time-1 and Time-2.
It was observed that the perceived power styles of nurse managers changed over the course of the study. The power styles perceived by the nurses were consistent with the power styles they expected.
The perceived power styles of nurse managers may change over time. Identifying this change could facilitate the determination of effective leadership and communication styles.
The study examined changes in nurses' perceptions of nurse managers' power styles over time. Nurses perceived Referent Power in Time-1 and Expert Power in Time-2, while expecting Expert Power in both periods. This research contributes to enhancing leadership in nursing, understanding power dynamics in nurse-manager relationships, and improving nursing care quality.
STROBE statement selected as EQUATOR checklist.
No Patient or Public Contribution.
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.
To examine practical, ethical, and organisational implications of the use of a key technology deployed in the care of hospitalised people with dementia—visual identifiers—through a comparative analysis with parallel interventions in other spheres of healthcare and social activity.
Discursive paper.
We contrast visual identification systems used for hospitalised patients with dementia with other, ostensibly similar, systems to understand how they differ in key characteristics: what they disclose, to whom and with what intended consequence.
Certain distinctive features of the ways identifier systems are used to improve dementia care appear particularly consequential for their impact. Given how much is expected of such identifiers, they are likely to fail at least a proportion of patients.
We argue that it is important to critically evaluate the interests served by visual identifiers, identifying the dimensions of quality they can enhance and those that may be negatively impacted.
Visual identifiers for people with dementia can contribute to the ‘taskification’ of nursing care, implying that achieving person-centred care is a matter of following defined protocols rather than an emergent, relational, time-consuming process. Staff may end up prioritising risk avoidance and hospital routines (tasks that are measurable and auditable) rather than embracing the unpredictability of developing relationships with patients.
Visual identifiers are a part of well-established strategies to improve hospital care for those with cognitive impairment. While these identifiers aim to prompt healthcare professionals to deliver individually tailored care, research suggests that they are unable to consistently ensure the desirable quality of care. Understanding influences on how they are deployed can help reshape the expectations placed on such low-tech interventions and inform more reflective use.
Patients and public were not directly involved in the development of this discursive paper.
To explore how practical nurses perceive telehomecare in relation to sustainability.
This study had a qualitative exploratory design.
Ten practical nurses working with telehomecare were interviewed in February–April 2024. The interviews were individual, semi-structured and were analysed through Braun and Clarke's reflexive thematic analysis.
The overarching theme of this study was ‘Telehomecare: A catalyst for a multifaceted transformation towards sustainable practices in homecare nursing’, with three main themes and seven subthemes. The three main themes were ‘Reshaped delivery of care’, ‘Reformed work environment’ and ‘Reallocated resources'. The findings reveal that nurses have multifaceted perspectives on telehomecare in relation to sustainability, recognising both its positive and negative impacts on healthcare organisations, nurses and clients while also acknowledging that more sustainable practices demand significant changes in the healthcare environment.
Telehomecare has significant impacts on multiple dimensions of sustainability within healthcare and notable drawbacks. These findings emphasise the critical need for comprehensive education and training in sustainable digital work practices to enhance healthcare professionals' awareness of environmental impacts. This underscores the importance of transformative leadership that drives organisational change towards sustainable healthcare practices and implements effective sustainability policies.
The findings present some aspects of telehomecare that contribute to a lesser environmental impact from a nursing care perspective, encouraging healthcare leaders to make conscious and effective strategic decisions towards more sustainable healthcare. The findings strengthen nurses, leaders and policymakers' knowledge and awareness of sustainable nursing activities in the digital milieu, highlighting the urgent need for transformation of healthcare practices to decrease the environmental impact.
The study followed the consolidated criteria for reporting qualitative studies (COREQ).
This study did not include patient or public involvement in its design, conduct or reporting.
To describe obstacles and ideas for improvement for the delivery of cardiopulmonary resuscitation and basic life support to wheelchair users.
A descriptive qualitative study underpinned by constructivism was conducted.
Semi structured interviews were completed with 26 participants from three cohorts: formal and informal carers, wheelchair users and healthcare professionals. Data were collected via online and in person interviews between February and June 2024. All participants were located in Australia, with the exception of one who was located in the United Kingdom. Data were analysed using thematic analysis.
Two major themes were identified: (1) obstacles to providing cardiopulmonary resuscitation and basic life support to a wheelchair user and (2) aspirations for improving cardiopulmonary resuscitation and basic life support for wheelchair users.
Participants shared ideas for how to improve emergency care for wheelchair users, highlighting a need for further research, testing and development of an education intervention.
Improving knowledge about providing emergency care to a wheelchair user could improve outcomes, save lives and reduce the life expectancy gap experienced by people with disability.
Approximately 2% of the global population use a wheelchair. Wheelchair use complicates the delivery of cardiopulmonary resuscitation and basic life support. There are currently no guidelines informing emergency care for wheelchair users available globally. Recognition of common symptoms of distress exhibited by wheelchair users, and options for the delivery of practical emergency care are required for wheelchair users.
The paper adheres to the EQUATOR reporting guidelines utilising the SRQR checklist.
Patients and the public were the driving force in recognising the gap in knowledge regarding the delivery of CPR to wheelchair users. Questions from patients and the public shaped the aims and methodological choices for this study.
To explore the experiences of and reasons for midwives leaving practice.
A qualitative approach applying a social constructivism interpretative framework.
Twenty participants were selected for interviews based on reasons for leaving midwifery practice between October 2022 and April 2023. Thematic analysis was used to identify themes, and results were checked for trustworthiness through a third coder, community engagement and member checking with two participants.
One overarching theme with six subthemes characterised the experience of leaving midwifery practice. All participants reported the overarching theme: Caring for myself and my close community became incompatible with the work of midwifery. Five subthemes reflected negative aspects of midwifery work: value incongruence; racism in midwifery; not feeling respected/valued (+compensation); high workload leading to low quality of care; negative practice climate and psychosocial safety climate. The theme of strong professional commitment and identity weighed into their decision to leave. Negative experiences working in birth centres were prominent across themes.
Participants reported leaving the profession of midwifery when they reached an unsustainable balance between the demands of work life and personal life. The decision to leave midwifery was emotional; participants maintained a strong connection to midwifery. The leaving process supports a theoretical premise for midwifery turnover behaviour. The work life of midwives is a complex composite of challenges that are reflective of identified problems with maternity care in the United States.
Midwives are not leaving practice because they want to leave midwifery but because they are unable to meet non-work-related caring demands. Family-friendly policies, such as flexible schedules and leave policies, could help retain the midwifery workforce.
Based on recommendations from representatives of historically marginalised groups within the midwifery community, we offered participants to be interviewed by a midwife of colour.
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 explore the concurrent trajectories of depressive symptoms and insomnia among adolescents and to analyse the individual, familial and social predictors of the concurrent trajectories.
This study tracked depressive symptoms and insomnia in eight secondary schools annually from 2021 to 2023. We also collected data on individual, familial and social factors that may influence these conditions. Group-based multi-trajectory (GBMT) modelling was used to categorise adolescents into depressive–insomnia severity subgroups.
This study included 2822 adolescents, who were categorised into four groups, including the no symptom group, mild symptom group, symptom relief group and symptom increase group. Compared with the no symptom group, predictors of the mild symptom group were gender (OR = 1.30), academic performance (OR = 1.57), subjective well-being (OR = 0.78), anxiety (OR = 1.14), economic status (OR = 1.23) and relationship with teachers (OR = 1.46). Predictors of the symptom relief group were personality (OR = 1.75), academic performance (OR = 2.28), subjective well-being (OR = 0.69) and anxiety (OR = 1.25). Predictors of the symptom-increasing group were personality (OR = 2.45), academic performance (OR = 1.96), subjective well-being (OR = 0.69), anxiety (OR = 1.20), maternal education level (OR = 1.58), family function (OR = 0.93), parental relationship (OR = 2.07) and relationship with teachers (OR = 1.54).
This study provided a comprehensive understanding of the concurrent trajectories of depressive symptoms and insomnia among adolescents, revealing distinct subgroups and identifying predictors across individual, familial and social levels.
This study emphasises the importance of a multi-faceted approach involving family, school and society to promote adolescent mental health and also highlights the need for conducting precise interventions according to adolescents' features.
The identification of four distinct symptom trajectories and their predictors advances the understanding of adolescent mental health development, informing precision prevention strategies.
STROBE checklist.
None.
This systematic review and meta-analysis evaluated the efficacy of infrared (IR) devices versus the traditional palpation technique for first-attempt success of peripheral intravenous catheter (PIVC) insertion in adults.
Systematic review and meta-analysis of randomised controlled trials (RCTs).
A comprehensive search of PubMed, Embase, Cochrane Library, Scopus and CINAHL was conducted on 28 May 2024 and included articles in English or French published from 1st January 2000 onwards.
Eligible studies included RCTs comparing IR devices with the traditional palpation method for PIVC insertion in adults. The primary outcome was first-attempt success. Secondary outcomes included overall success, number of attempts, cannulation time and patient pain. The risk of bias was assessed using the RoB2 tool, and a random-effects model was applied for meta-analysis.
Five RCTs were included, involving 690 patients and 704 catheters, including 289 PIVCs in patients with Difficult Intravascular Access (DIVA) criteria. First attempt insertion success was similar when using infrared devices (139/331, 42%) and traditional palpation (143/373, 38%) with Risk Ratio (RR) 1.08 (95% CI, 0.69 to 1.70). No significant statistical differences were noted in secondary outcomes: overall insertion success, number of attempts, time to cannulate and patient pain. Clinical and statistical heterogeneity were substantial (primary analysis I 2 = 83%).
Current evidence does not support the systematic use of infrared devices to improve PIVC insertion success, reduce the number of attempts or alleviate patient pain compared with traditional palpation in adults. Further high-quality studies with suitable sample sizes and varied populations are needed to better establish the potential place of infrared devices.
This study highlights the limited benefit of IR devices in routine clinical practice and underscores the need for further research into their use in specialised settings.
No Patient or Public Involvement. This study did not include patient or public involvement in its design, conduct or reporting.
To examine the relationship among leadership, clinical teaching competencies, and structural empowerment of nursing clinical instructors in China.
A cross-sectional study.
A total of 152 nurses who come from three Grade A tertiary hospitals located in Beijing, Kunming, and Liaoning Province, China, completed an online questionnaire that included general information, clinical teaching information, the Conditions of Work Effectiveness Questionnaire-II, nurse leadership, and structural empowerment. SPSS 26.0 and AMOS 26.0 were used for normality test, descriptive statistics, correlation analysis, regression analysis, and structural equation model.
The study revealed that nurse leadership (r = 0.402) and structural empowerment (r = 0.568) both positively correlated with clinical teaching competencies. Specifically, the level of nurse leadership exhibited a low but direct positive effect on these competencies (β = 0.22), while the level of structural empowerment demonstrated a moderate direct positive effect (β = 0.56).
Enhancing nurse leadership and structural empowerment positively influence the clinical teaching competencies of nursing instructors.
Constructing a structural equation model to describe the relationship between leadership, structural empowerment, and teaching ability can provide the most intuitive direction for future research, so as to better improve the teaching ability of clinical nursing teachers.
No patient or public contribution.
To explore nurses' experiences with power structures in hospital care and to develop policy recommendations for transforming disempowering structures.
A three-phased critical ethnographic design.
Data were collected in a general teaching hospital in the Netherlands between December 2022 and June 2024 through (1) ethnographic diaries kept by nurses, (2) semi-structured interviews, (3) partial participant observations, (4) one focus group discussion with only nurses and (5) one multistakeholder focus group. Thematic analysis was used to identify themes.
Twenty-eight nurses of thirteen different departments and nine stakeholders participated. Four themes emerged from the analysis: (1) power in cooperation, (2) hierarchical relationships, (3) aggression and (4) insufficient decision-making power in hospital policies. The first theme was experienced as an empowering structural condition, while the last three were identified as disempowering structures.
Job satisfaction and quality of care among nurses are at risk and elicit feelings of burnout because of nurse–doctor hierarchies, aggression and insufficient decision-making power in hospital policies. Therefore, improving interprofessional cooperation and including nurses in decision-making is crucial to structurally empower nurses.
Hospital administrators need to create empowering conditions for nurses by furthering inclusion in policy making and setting department goals, implementing interprofessional education for effective collaboration, increasing nurse representation throughout hospital management layers and ensuring strong support systems. These interventions are important in addressing aggression, hierarchies, nurse turnover and burnout.
COREQ guidelines were used for reporting qualitative studies.
None.
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 analyse the dimensions of the omission of nursing care in emergency departments, including its attributes, antecedents, and consequences, using Walker & Avant's concept analysis method.
Methods: Walker and Avant's eight-step method defined attributes, antecedents, and consequences of the omission of nursing care in emergency departments.
A comprehensive literature review was conducted using CINAHL, MEDLINE, Embase, Health Management Database, and Cochrane Library, covering publications from 2001 to 2024. The search was conducted in August 2024.
Key attributes were delayed, incomplete, or interrupted care, mostly due to insufficient staffing or unpredictable patient volumes. Antecedents included high workloads, inadequate skill mixes, and understaffing. Consequences were increased patient morbidity and mortality, nurse burnout, and job dissatisfaction. A research gap exists in paediatric-specific measurement tools.
Identifying dimensions of omitted nursing care in emergency departments informs interventions to improve patient safety and care quality. Developing paediatric-specific measurement tools is essential.
The findings emphasise the need for improved staffing and resource allocation policies, reducing risks to patients and enhancing nurse satisfaction.
This study addressed the gap in understanding omitted nursing care specifically in emergency departments. Findings highlight systemic issues impacting patient outcomes and nurse well-being. The results will guide organisational improvements and future research globally.
This study adhered to EQUATOR guidelines, following Walker and Avant's method for concept analysis.
This study did not include patient or public involvement.
This study underscores the critical impact of the omission of nursing care (ONC) in emergency departments (EDs) on patient safety, nurse well-being, and healthcare efficiency. ONC contributes to increased morbidity, mortality, and adverse events, highlighting the urgent need for improved staffing models and resource allocation. Training programmes should equip emergency nurses with prioritisation strategies to mitigate care omissions. Policymakers must recognise ONC as a key quality indicator, ensuring adequate workforce support. Additionally, this study identifies a gap in measuring ONC in paediatric EDs, calling for the development of tailored assessment tools and further research on intervention strategies.
FreshRSS 