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This paper outlines key developments, innovations, and milestones in the field of spirituality and spiritual care in nursing.
A discursive paper.
Nursing scholars have significantly influenced the profession and contributed to the development of nursing knowledge, particularly in the field of spirituality and spiritual care. Key research has focused on nurses' perceptions and attitudes toward spirituality, clarifying foundational spiritual concepts, and establishing a framework of core spiritual care competencies for the profession.
Despite these advancements, significant gaps remain in nurses' knowledge, understanding, and experience in providing spiritual care. The development of agreed-upon spiritual care competencies at the European level offers important guidance for the profession, and educational initiatives are underway to support their integration. However, the field remains in an early stage of development, and further research is needed to embed spiritual care competencies into national and international nursing policy and practice. Moreover, continued research is also essential to inform and evaluate current educational programmes and nursing interventions, and to support the translation of evidence-based knowledge into effective spiritual care delivery.
Spiritual support is proven to be an important consideration for many patients and families globally. Imbedding spiritual care education into both undergraduate and postgraduate nursing curricula is essential to prepare nurses to address the spiritual needs of patients in healthcare settings. Structured curricula that provide clear instructions on how to recognise, assess, and respond to spiritual concerns in clinical practice can enhance nurses' competence and confidence. Embedding spiritual care into education and training helps normalise spiritual care as a component of holistic nursing, supporting its inclusion in everyday care rather than treating it as an optional or marginal practice. Such educational integration has the potential to improve the consistency and quality of spiritual care across healthcare settings.
Internationally there are evident gaps in the consistent provision of spiritual care to patients and their families. These are being addressed through conceptual clarity, the agreed-upon competencies, and enhanced educational initiatives. It is essential to continue to increase awareness among the nursing profession on the necessity of addressing spiritual care needs, within the context of cultural perspectives to ensure that value is placed on the significance of these issues on a global scale.
There was no patient or publication contribution in this specific commentary.
To explore the identity and body experiences of emerging adults with congenital heart disease.
Qualitative descriptive study.
Narratives from 152 emerging adults about living with congenital heart disease and its impact on their identity and body experiences were analysed using template analysis. An inductive and deductive approach was combined, and the frameworks of illness identity and experience of embodiment were used as a starting point.
The template analysis generated two primary themes: (1) identity and (2) body, each containing several subthemes. For identity, the subthemes were (1.1) illness identity and (1.2) acknowledgement. For body, the subthemes were (2.1) the dimensions of embodiment and (2.2) the process of embodiment. In addition, the related themes (3) self in light of the other and (4) lack of impact were included.
This study highlights the unique challenges emerging adults with congenital heart disease can encounter regarding their identity and body experiences.
Patient care would benefit from adopting a more holistic and person-centred approach that fosters positive identity and body experiences in emerging adults with congenital heart disease.
This study deepens our understanding of how congenital heart disease affects identity and body experiences in emerging adults. Recognising these aspects as crucial to psychological care can facilitate patients in sharing identity and body-related challenges and receiving tailored support.
This study adheres to the EQUATOR guidelines and used SRQR as the reporting method.
Emergency Departments face increasing pressure due to rising patient demand, complex presentations, and resource constraints, resulting in long waits and extended stays. Nurse-initiated protocols enable nurses to commence investigations and treatments based on clinical guidelines, improving care and efficiency. Despite evidence supporting their effectiveness, few nurse-initiated protocol implementation strategies are grounded in behaviour change theory. This gap may contribute to limited uptake, as many initiatives fail to address the complex factors influencing clinician behaviour.
To develop a behaviour change theory-informed implementation strategy to enhance the uptake of nurse-initiated protocols in the emergency department.
A framework-based intervention design was used.
The Behaviour Change Wheel and Theoretical Domains Framework guided the development of the implementation strategy. Barriers and enablers identified through prior research in 2023 using surveys and focus groups were mapped to relevant intervention functions. Behaviour change techniques were selected based on their potential to address barriers or strengthen enablers. The APEASE criteria (Affordability, Practicability, Effectiveness, Acceptability, Side effects, and Equity) were applied to optimise feasibility.
Nine barriers and ten enablers to nurse-initiated protocols use were identified and categorised using the COM-B (Capability, Opportunity and Motivation) framework and mapped to the Theoretical Domains Framework. Eight intervention functions were selected and mapped to 24 behaviour change techniques and 23 delivery modes. The key implementation strategies are education, clinical champions, documentation changes, audit and feedback, and leadership engagement. Stakeholders confirmed the feasibility of the selected strategies.
Theory-informed, context-specific strategies are essential for implementing nurse-initiated protocols in emergency departments. This approach enables the design of targeted, feasible interventions that directly respond to identified barriers and enablers. Future research should test context-specific implementation strategies, assess their long-term impact on healthcare outcomes, and evaluate their scalability across diverse healthcare settings.
By targeting the behavioural determinants of clinician practice, this study fills a critical gap in implementation science within emergency nursing. This study identified 24 behaviour change techniques across eight intervention functions to support nurse-initiated protocol uptake. Strategies such as education, clinical champions, and audit provide a practical, replicable framework to overcome barriers, enhance autonomy, and reduce care delays. Findings support sustainable implementation in emergency settings, with future research needed on long-term impact and scalability.
There is no EQUATOR guideline available for this study.
This study did not include patient or public involvement in its design, conduct, or reporting.
Dynamic and complex health systems require innovative and adaptive solutions to support patient safety and achieve equitable health outcomes for Indigenous populations. Understanding the ways by which Indigenous (and specifically Māori) nurse practitioners (NPs) practice patient safety is key to enhancing Indigenous health outcomes in predominantly westernized healthcare systems.
To describe Māori NPs perspectives on patient safety when caring for Māori and understand how Māori NPs deliver safe health care.
A group of five Māori NPs worked alongside a Māori nurse researcher to explore their perceptions of patient safety. Together, they held an online hui (focus group) in early 2024. Data were analysed collectively, informed by kaupapa Māori principles, using reflexive thematic analysis.
Māori NP experiences, expressions and understandings of patient safety envelop cultural safety and have many facets that are specific to the needs of Māori populations. The three themes showed: (1) Te hanga a te mahi: the intersection of cultural and clinical expertise; (2) Mātauranga tuku iho: the knowledge from within, where safe practice was strongly informed by traditional knowledge and cultural practice; (3) Te Ao hurihuri: walking in two worlds, where Māori NPs navigated the westernized health system's policies and practices while acting autonomously to advocate for and deliver culturally safe care.
The Māori NP lens on patient safety is vital for promoting culturally responsive and effective health care. By recognizing the unique needs of Māori patients and families and incorporating cultural perspectives into practice, Māori NPs contribute to a more comprehensive and inclusive approach to patient safety that goes beyond westernized principles and practices.
No patient or public contribution.
To analyse research publication performance of Australian and New Zealand professors and associate professors of nursing and midwifery, and compare with 2016 data.
A search of university websites was conducted to identify all nursing and midwifery professoriate in Australia and New Zealand. Each individual was then searched in the Scopus database to identify individual total citations, h-index, number of publications, first author Field Weighted Citation Impact (FWCI) and overall FWCI. Comparisons with 2016 data were also undertaken.
A total of 304 academics were included, comprising 270 from Australia and 34 from New Zealand, and 169 full professors and 135 associate professors. Overall, total publications and citations had increased. Maximum h-index had increased; however, median only changed slightly.
The study provides contemporary data that can support cases for academic promotion along with other benchmarking activities.
Findings reflect the current research publication performance of the Australian and New Zealand professoriate and provide invaluable data for academic benchmarking in those countries and also in many others.
No patient or public contribution.
To identify and synthesise the ethical, feasibility and acceptability challenges associated with implementing eye-tracking research with clinicians in acute care settings and to explore strategies to address these concerns.
Scoping review using the Joanna Briggs Institute methodology.
Six databases (MEDLINE, CINAHL, EMBASE, Web of Science, APA PsycInfo and ProQuest Dissertations & Theses Global) were searched for peer-reviewed articles. Reference lists of included studies were also hand-searched.
Eligible studies involved clinicians using or interacting with eye-tracking devices in acute care environments and addressed at least one ethical, feasibility, or acceptability consideration. Data were extracted and thematically analysed. Knowledge users, including clinicians, ethicists and a patient partner, were engaged during protocol development and findings synthesis.
Twenty-five studies published from 2010 to 2024 were included. Seven challenges were identified: obtaining ethical approval, managing consent, privacy and confidentiality concerns, collecting data in unpredictable environments, interference with care, participant comfort and data loss or unreliability. Knowledge users highlighted the importance of early institutional engagement, clear protocols, continuous consent and context-sensitive ethical reflection.
Eye-tracking offers valuable insights into clinician behaviour and cognition, but its implementation in acute care raises complex ethical and methodological issues. Responsible use requires anticipatory planning, stakeholder engagement and flexible yet rigorous protocols.
By informing the development of ethically sound study protocols and consent practices, this work contributes to safer, more transparent and patient-centred research that respects participant autonomy and protects clinical workflows.
The protocol was registered with the Open Science Framework (https://osf.io/jn4yx).
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Page et al., 2021) and its Extension for Scoping Reviews (Tricco et al., 2018).
A patient partner was involved in protocol development, interpretation of findings and development of study recommendations. Their contributions included participating in advisory groups and providing feedback alongside clinicians and ethicists during focus groups. This input helped ensure the research addressed patient-relevant priorities and informed the development of ethically responsible practices for conducting eye-tracking research in clinical care settings.
To discuss inter-organisational collaboration in the context of the successful COVID-19 vaccination programme in North Central London (NCL).
An action research study in 2023–2024.
Six action research cycles used mixed qualitative methods.
Four findings are presented which illustrate inter-organisational collaboration across professional and organisational boundaries: working in the action research group, learning to work as an action research group, working collaboratively in new ways, working outside professional, occupational and organisational silos. These themes are discussed in relation to the literature on interprofessional and inter-organisational collaboration.
The COVID-19 vaccination programme offered a way out of the pandemic. Between December 2020 and February 2022, 2.8 M people were vaccinated by the NCL Vaccination team in an example of inter-organisational collaboration between science, health and community. Staff on the vaccination programme worked inter-organisationally in new ways to achieve this. In NCL several thousand local residents joined the NHS to work with healthcare professionals including nurses, nursing associates and students to deliver the programme in new ways which are illustrative of inter-organisational collaboration.
No PPI within this study.
The implications for the profession and for healthcare organisations of the findings are that, in contrast to traditional ways of working which have been entrenched in silos of professional knowledge and expertise, health professionals are able to work in new ways and find inter-organisational work satisfying. This has implications for patients as it has the potential to improve communication between very different organisations and as the vaccination programme shows, results in successful public health vaccination rates.
This study set out to create a public resource for learning (for future pandemics or other works of national effort) to commemorate the collaborative efforts of the diverse vaccination workforce and volunteers involved in the programme. Participation in the COVID-19 vaccination programme had a profound effect on NHS clinical and professional staff, on partners across business and volunteer organisation in North Central London and on volunteers from the public in North Central London. Inter-organisation collaboration has been sustained after the delivery of the vaccination programme in North Central London; innovative ways of working have been introduced in the local community to deliver ongoing vaccinations and wider prevention activities and the partnership between academia and clinical practice. The research findings have had an impact on the research participants and the wider public through the website created as a public resource to commemorate the COVID-19 vaccination programme in North Central London.
The consolidated criteria for reporting qualitative studies (COREQ) was used as a guide throughout data collection and analysis.
The public were involved as participants in this study. They did not participate in the study design.
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