Conectar
To investigate the impact of a workplace leadership development programme on nurse manager leadership capability, knowledge, skills and confidence.
Quasi-experimental repeated-measures design without a control group.
Associate Nurse Unit Managers at a large tertiary hospital in Melbourne, Australia, were invited to engage in a clinical leadership programme involving education and subsequent peer group reflective practice. A longitudinal survey with multiple pre- and post-programme timepoints was conducted. Measures included the Leader Efficacy Questionnaire, researcher-developed Likert-scale items to evaluate programme learning outcomes and free response items. Quantitative items were analysed using descriptive statistics and repeated measures analyses; free response items were explored using content analysis.
At baseline (T1), 103 Associate Nurse Unit Managers pooled from three cohorts consented to participate, of whom 98 provided sufficient data for analysis. Data were collected across 5 timepoints (T1–T5); T2 was used primarily to assess baseline comparability with T1; longitudinal analyses focused on T1, T3, T4 and T5. Sixteen participants provided data at all relevant follow-up timepoints and were included in the main longitudinal analyses. Following the leadership programme scores on the Leadership Efficacy Scale increased significantly. There were no significant changes in perceptions of organisational support or confidence in giving and receiving feedback. Participants reported positive experiences of the programme and identified future opportunities to refine topics, teaching and learning approaches and opportunities for peer networking.
A workplace clinical leadership programme for Associate Nurse Unit Managers demonstrated sustained increased leadership efficacy. Embedding coaching, mentoring and peer networks within leadership development may be an effective strategy to translate learning to practice and foster a sustainable healthy work environment. Further evaluation of education translation to practice and long-term organisational outcomes are important next steps.
For Associate Nurse Unit Managers, supporting leadership education by establishing organisation-wide peer groups and structured coaching and mentoring may help consolidate and embed leadership knowledge and skills into practice. Future leadership education programmes should intentionally combine workplace learning with mentoring, organisational supports and peer networks to provide ongoing feedback and protected time, maximising long-term benefits for staff wellbeing, retention and patient outcomes.
Effective clinical leadership is essential to nurse wellbeing and retention; however, the role preparation of these clinical leaders is variable and at times absent. A workplace leadership programme integrating education and peer-group reflective practice for Associate Nurse Unit Managers produced measurable increases in leadership efficacy, strengthening frontline leadership capability. Embedding coaching, mentoring and peer networks into these programmes underpins future translation of learning into practice to build health work environments that promote staff wellbeing and patient safety.
Transparent Reporting of Evaluations with Non-randomised Designs (TREND).
No patients, service users, caregivers or members of the public were involved in this study. Instead, this study was focused on the experiences and perceptions of nurses.
This study explores nursing educators' perspectives on the challenges and benefits of integrating generative artificial intelligence (AI) into nursing education. There is little empirical evidence on how educators perceive these technologies and how such perceptions influence their integration into curriculum design, teaching practices, assessment, and student research and learning.
Exploratory-descriptive qualitative study underpinned by the Actor–Network Theory.
Four focus group sessions were conducted with ten nursing educators across Australia, New Zealand, Austria and Hong Kong. Data were collected via Zoom, transcribed verbatim, and analysed thematically using Braun and Clarke's six-step reflexive framework.
The nurse educators included five women and five men. Ages ranged between 25 and 64 years and a mean 8.75 [SD ±6.36] years of experience as an educator. Three main themes were constructed based on focus group discussions: (1) The AI Dilemma, revealing tensions surrounding academic integrity, policy ambiguity and ethical concerns; (2) The AI Toolkit, identifying pedagogical benefits alongside challenges to critical thinking development; and (3) Educator's AI Odyssey, exposing disparities in institutional preparedness and educator competence. Whilst AI was recognised for enhancing engagement and efficiency, substantive concerns persisted regarding equity, ethical implementation and organisational readiness.
Generative AI presents a paradox in nursing education. Whilst it enables innovation and personalised learning, it poses risks to academic integrity and deep learning when implementation lacks ethical consideration and pedagogical rigour.
AI-enhanced nursing education must safeguard fundamental nursing values, critical thinking capabilities, ethical reasoning and clinical judgement to ensure the delivery of safe, competent patient care.
Educational and institutional policies must facilitate balanced, ethical and equitable integration of AI in nursing education.
The Consolidated Criteria for Reporting Qualitative Research (COREQ).
No patient or public contribution.
To review how statistically non-significant indirect treatment comparison (ITC) results are interpreted within National Institute for Health and Care Excellence (NICE) cost-comparison evaluations (CCEs) and develop a framework to support interpretations of these results from Bayesian network meta-analyses (NMAs).
A systematic review of CCEs between 2017 (first introduced) and April 2025. A framework (point-and-density plots) was developed to better interpret statistically non-significant NMA results for CCEs.
CCEs were identified through NICE website searches, references of similar reviews and communications with NICE.
NICE technology appraisals (from 2017) that followed a CCE approach ab initio, had final guidance available and used non-statistically significant ITC results were included.
A single reviewer performed screening and data extraction with validation by a second reviewer. Narrative syntheses were performed separately for company, External Assessment Group (EAG) and committee perspectives. Point-and-density plots combine elements of forest plots and density plots alongside reporting the probability that a treatment is non-inferior relative to a comparator. These were applied to a recent CCE (TA1019) for crovalimab for patients with paroxysmal nocturnal haemoglobinuria.
Among 41 CCEs, EAGs raised concerns about statistically non-significant ITC results while companies relied heavily on them. Only ~32% of CCEs applied formal methods to explore ITC result uncertainty.
For the example framework analysis, comparisons of crovalimab to eculizumab (mean difference (MD): 0.018; 95% CIs –0.22 to 0.25) and ravulizumab (MD: 0.079; 95% CIs –0.25 to 0.41) were statistically non-significant, with non-inferiority not demonstrated. However, point-and-density plots indicated a 95.9% and 86.3% probability of non-inferiority of crovalimab versus eculizumab and ravulizumab.
Interpretations of statistically non-significant ITC results are inconsistent within individual CCEs and across appraisals. Implementation of the presented recommendations and framework would improve the consistency and robustness of CCEs.
CRD420251034143.
Psychotic disorders account for significant morbidity and healthcare costs and yet their pathophysiology remains poorly understood. The National Institute for Health and Care Research (NIHR) Severe Mental Illness Longitudinal Evaluation (SMILE) BioResource is a collaborative project that aims to collect clinical data and biological samples from people with psychosis for long-term storage, future projects and recontact for targeted trials.
The NIHR SMILE BioResource cohort will initially include up to 2000 UK-based patients with a recorded diagnosis of psychosis. Clinical symptoms will be captured using self-report and clinician ratings. Biosamples will enable genotyping and wider omics as further funding allows. Study data will be analysed to facilitate development of discovery science for underlying mechanisms of psychotic disorders and recall of participants for targeted interventional studies.
This study is sponsored by the University of Oxford and received full ethical approval from Wales REC 2. SMILE BioResource biosamples and data will be stored long-term by the NIHR BioResource. Researchers who are interested in applying to use these biosamples and data, and/or recontacting SMILE participants can find further information on the website of the NIHR BioResource.
To explore the extent and range of published research on the nature of moral distress in emergency nurses.
Scoping review.
The review followed the Joanna Briggs Institute methodology for scoping reviews and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Searches were undertaken with a date limit of 2015–2025. Reference lists of included papers were also screened. Two reviewers independently screened and extracted data, with disagreements resolved through discussion or third-party review.
Searches were undertaken in August 2025 in CINAHL, MEDLINE, Scopus, and PsycINFO.
Included studies were across diverse international settings with sample sizes ranging from 169 and 390. Thematic analysis identified four overarching themes: factors contributing to moral distress; situational triggers; the impact of moral distress; and interventions and support strategies.
The scoping review identified moral distress as a complex phenomenon that undermines nurse well-being, reduces professional satisfaction, and compromises care delivery. Common causes include organisational constraints and the depersonalisation of care, with demographic and contextual factors shaping experiences. Most studies focused on describing the experience of moral distress. Few studies considered evaluating interventions or organisational supports. No longitudinal studies were identified, and variation in tools limited comparability. Future research should focus on interventions and longitudinal designs to investigate how moral distress evolves in the emergency nurse population over time and across various stages of practice.
Establishing evidence-based strategies to mitigate moral distress is essential for supporting emergency nurses and reducing attrition.
This study mapped the literature on moral distress in emergency nurses over the last 10 years. It found that most research focuses on measuring moral distress rather than on interventions to prevent or mitigate it. The review will inform nurse leaders, researchers, educators, and policymakers seeking strategies to further support their staff.
This review adhered to the Joanna Briggs Institute guidelines for scoping reviews.
No patient or public contribution.
The protocol is registered with Open Science Framework and will be publicly accessible following embargo release in January.
Many older people experience Mild Cognitive Impairment (MCI), which may compromise the effectiveness of health promotion programmes.
We explored engagement with behaviour change among participants scoring 18-25 on the Montreal Cognitive Assessment receiving HomeHealth, a health promotion intervention supporting older adults with mild frailty to maintain independence in England ().
Of the 46 semistructured process evaluation interviews, 29 participants scored in the MCI range, purposively selected for demographic characteristics and degrees of cognitive impairment and the seven support workers.
Thematic analysis resulted in three themes: Navigating the impact of MCI; Addressing memory as a goal in the intervention; and Adapting Behaviour Change Interventions for MCI. Participants had varied opinions about whether their memory was problematic and whether anything could be done to help. Many reported not discussing memory concerns with support workers. Barriers to engagement in behaviour change included limited social support and not acknowledging memory problems. Facilitators included setting goals which increased or were linked to existing health behaviours, using reminders/prompts and actively involving family members.
Implementing these facilitators into existing and new health promotion interventions delivered to older adults, with suspected but unacknowledged MCI, could overcome the current barriers people with MCI face when trying to engage and benefit from interventions.
Codes of ethics are, for many, important documents that define the key values and behaviours expected of healthcare professionals. They are also documents that have been widely criticised. These criticisms range from being vague to failing to provide guidance on many important issues. Codes, however, vary substantially in their scope, content and the guidance they provide.
This scoping review sought, in the context of comparative studies of codes, to examine the form (i.e., the structure of the code, its contents, principles or rules for example) and function (what the code says it does, either explicitly or implicitly) of codes, along with their points of con/divergence.
A systematic search was carried out using Scopus, PsycInfo, CINAHL and Medline.
Thirty-one papers met inclusion criteria and were included in this review. Results suggest that while there were a number of similarities seen across codes, there were also substantial points of divergence related to the content of codes and structure. These differences were seen across professions, countries and time, suggesting that culture, history, politics and perhaps even geography influence the content of codes.
These findings are discussed in light of the broader literature that examines and critiques codes.
FreshRSS 