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To explore implementation patterns and perceived value of the SEXIT (SEXual health Identification Tool) method in the school health care (SHC) setting in Sweden.
Mixed method survey using an online questionnaire with closed and free-text response options.
115 SHC professionals who had completed SEXIT training responded to an online questionnaire (response rate 26%), between March and May 2024. Closed questions were answered on a five-point Likert scale, and responses trichotomised. Quantitative data were analysed using descriptive statistics, qualitative data with a deductive qualitative content analysis. CROSS guideline was used.
70 of 115 SHC professionals used SEXIT in their work. Findings suggest that SEXIT is appropriate and useful, supporting communication about topics such as sexual health and violence that both pupils and professionals may avoid addressing. Implementation patterns showed that 61% of those who had completed training also used SEXIT. 63% of those used SEXIT during regular health dialogues, but some did not use it with all pupils. The perceived value was that most SHC professionals felt that SEXIT helped them get a better understanding of the pupil's situation, an objection that it was too time-consuming.
Most SHC professionals who had completed SEXIT training used the method regularly and perceived the method as valuable and facilitating discussions about sexual ill health and experiences of violence with pupils. There are indications that SHC services fail to identify particularly at-risk young people. Sexual health inequity persists, as some structurally marginalised and vulnerable youths are excluded from the SEXIT dialogues. A follow-up study will focus on pupils' experiences.
This study validates SEXIT in a new setting, SHC, and is relevant for the promotion of sexual and reproductive health for all, and for preventing violence and sexual ill health among young people.
To combine, synthesise, and interpret qualitative evidence from studies exploring the causes, immediate responses, and preventive measures of needle stick injuries from the perspective of healthcare workers.
In this qualitative evidence synthesis, the qualitative data from the included studies were synthesised to identify overarching themes. The Preferred Reporting Items for Systematic Reviews and Meta-analysis flowchart, Joanna Briggs Institute tool, and Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist were used in the meta-synthesis process.
The MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, ProQuest, ClinicalKey and Scopus databases were searched between December 14 and December 31, 2024 for studies published between January 2000 and December 2024.
Nine primary research studies were included and the following themes were identified: unpredicted patient movement, casual attitude, recapping, excessive workload, scarcity of article or safety equipment, inadequate training or experience, vigilance, ongoing training, nurturing workplace culture, emotional response, re-living the injury and fear of reprimand.
Needle stick injuries result from a complex interplay of individual, administrative, engineering, and environmental factors, but there are potential solutions to address these issues.
Policymakers in healthcare settings would benefit greatly from an understanding of the causes, immediate responses, and preventive aspects of needle stick injuries. These findings can direct the creation of focused interventions and safety procedures by identifying important risk variables and useful coping mechanisms.
The causes, immediate responses, and preventive measures of needle stick injuries were explored. Findings can help develop protocols to lower needle stick injury rates and increase worker safety.
ENTREQ guidelines.
This research is a systematic review of published peer-reviewed studies.
PROSPERO registration number: CRD42024620673.
To synthesise the available evidence on the effect of artificial intelligence in promoting positive nursing practice environments, exploring outcomes for professionals, clients, and institutions.
Artificial intelligence has undergone significant advancements and shows great potential to transform nursing practice. However, this technological evolution is not without challenges, which must be identified and addressed.
A systematic mixed-methods review following the PRISMA 2020 guidelines and the methodology proposed by JBI. The search strategy was conducted in PubMed, CINAHL, Scopus, and Web of Science, including grey literature. Quantitative, qualitative, and mixed-methods studies were included, and the selection process involved screening by two independent reviewers, who assessed all studies, their methodological quality and extracted their data.
From the conducted search, 11 studies were included, addressing how artificial intelligence has transformed nursing practice by optimising decision-making, task execution, and patient safety. Artificial intelligence, through predictive models and assistants such as ChatGPT, can enhance nursing management. However, challenges such as privacy concerns, resistance to change, and the need for professional training must be addressed to maximise its effectiveness.
Artificial intelligence has the potential to positively transform the nursing practice environment, optimising decision-making, enhancing patient safety, and improving operational efficiency, with clear benefits for professionals, patients, and healthcare institutions.
This study analysed the impact of artificial intelligence on nursing, highlighting improvements in clinical decision-making, patient safety, and institutional efficiency. Despite the identified benefits, the implementation of artificial intelligence in nursing is not without challenges and risks, which must be identified and addressed to ensure safe and effective adoption.
The review followed the PRISMA 2020 checklist.
No.
To explore aspects of interpersonal relationships in palliative care nursing, focusing on confidential conversations between patients and registered nurses (RN).
A qualitative study employing focused ethnography.
Data were collected through unstructured participant observations, field notes and interviews with patients and RN in specialist palliative care. Data were analysed using reflective thematic analysis.
Confidential conversations in palliative care are founded on trust that is fragile and develops dynamically through consistent interactions. Small talk, presence and silence are essential for initiating and maintaining trust and the interpersonal relationship. The environment, patient condition and RN emotional presence and competence shape these conversations. As the relationship evolves, conversations adapt to the patient's changing needs. Missed signals or interruptions can disrupt flow, but the potential for repair remains, allowing for restoration and strengthening of trust and connection.
Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations.
Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.
This study explores key aspects of confidential conversations in palliative care, emphasising trust and emotional sensitivity. It addresses a research gap in palliative care using rare observational methods to deepen understanding of nursing relational aspects. The findings offer practical guidance for enhancing communication and relational skills, informing training and policy development and ultimately, improving emotional support and care.
Findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.
This study did not involve patient or public participation in its design, conduct or reporting.
To explore challenges parents of children with cancer encounter while providing complex medical care at home.
Design: Cross-sectional convergent mixed-methods study. Instruments: Questionnaire and open interviews that mirrored and complemented each other.
Parents (n = 32), with no prior medical training, were expected to remain constantly vigilant as they monitored and managed rapidly changing situations. Regardless of time from diagnosis, they detected a mean of 3.3 ± 1.4 (0–6) symptoms, reported administering up to 22 daily medications, including cytotoxics, narcotics and injections, and dealt with many related challenges. Parents described needing responsive communication channels, especially when dealing with bleeding and infection emergency situations during off-hours.
Findings highlight the constantly shifting demands when managing a child with cancer at home. Educational programmes that address parental needs throughout treatment, tailored to protocol changes and individual circumstances, should be expanded and further developed.
Parents need continual education regarding home management throughout their children's illness and treatment.
This study addresses challenges parents of children with cancer encounter while providing complex medical care at home. The findings demonstrated that parents, responsible for administering numerous medications via various routes and managing symptoms and side effects, did not feel confident performing these tasks regardless of time from diagnosis. Nurses should adapt ongoing parental education regarding complex medical tasks, symptoms, side effects, emergency detection and management for children with cancer at home. The study adhered to the Mixed Methods Appraisal Tool (MMAT) and STROBE reporting method.
Parents of children with cancer participated in the design and questionnaire validation.
This paper responds to the recently published article on nurses' turnover intentions and their lived experiences of disempowerment, moral distress and organisational neglect. While the study illuminates important workplace realities, it overlooks the perspectives of nurses who have left not only their institutions but also their countries of origin. From the vantage point of Filipino nurses in the diaspora, the decision to migrate mirrors the dynamic, cumulative processes described in the article. Migration is seldom the result of one critical incident; rather, it arises from entrenched systemic issues—understaffing, lack of respect and persistent undervaluing of nursing contributions—that transcend borders. Diaspora nurses bring with them narratives of resilience, yet their departure reflects health system fragility in their home countries and exposes new challenges in host nations. This commentary highlights the urgent need for global cooperation, stronger leadership and policy innovations that recognise migration as part of the retention equation, not apart from it.
To examine the associations among diabetes-related stress, treatment adherence, perceived social support, and health-related quality of life (HRQoL) in adults with type 1 diabetes mellitus (DM1), and to explore the mediating roles of support and adherence in this relationship.
A cross-sectional observational study using self-report standardised measures and mediation analysis.
A total of 772 Spanish adults with DM1 completed validated instruments measuring diabetes-related distress, perceived social support, treatment adherence, and HRQoL. Hierarchical multiple regression and serial mediation analysis (PROCESS Model 6, 10,000 bootstraps) were conducted, controlling for age, sex, and time since diagnosis.
Not applicable (primary data collection, not a review).
Diabetes-related stress was the strongest predictor of lower HRQoL. Perceived social support and treatment adherence also contributed significantly. Mediation analyses indicated that the impact of stress on HRQoL was partially mediated by perceived social support and, in sequence, by treatment adherence. The indirect path through social support alone and the sequential path involving both mediators were significant.
Stress and social support are critical in understanding and improving HRQoL in adults with DM1. Treatment adherence appears to be influenced by perceived support, highlighting an indirect mechanism linking stress to quality of life.
Healthcare professionals should integrate psychosocial assessments and interventions into routine diabetes care. Targeting stress reduction and enhancing social support may improve adherence and overall well-being in adults with DM1.
What problem did the study address? The study addressed the need to understand how psychosocial factors—specifically stress, perceived social support, and treatment adherence—contribute to HRQoL in adults with DM1. While prior research often focused on paediatric or clinical populations and rarely explored mediation models, this study sought to fill those gaps with data from a large community sample of adults.
What were the main findings? The main findings indicate that diabetes-related stress is the most significant predictor of reduced HRQoL. This relationship is partially mediated by perceived social support and, sequentially, by treatment adherence. While stress directly affects HRQoL, its negative impact is also channelled through diminished social support and decreased adherence. The indirect effect through treatment adherence alone was not significant.
Where and on whom will the research have an impact? The research has implications for adults living with DM1, particularly those in community settings outside of clinical supervision. It informs healthcare providers, diabetes educators, and policymakers on the importance of addressing emotional distress and strengthening support networks to improve both treatment adherence and overall quality of life.
This study adhered to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies. All methods and results are reported in alignment with EQUATOR Network recommendations for transparent and rigorous research reporting.
The study was conducted in collaboration with the Spanish Diabetes Federation (FEDE), which supported participant recruitment and dissemination through its affiliated associations. Patient input was incorporated throughout the study. A person with lived experience of type 1 diabetes contributed to the conceptual development of the research questions and the interpretation of findings. Their perspective helped ensure that the study design, choice of measures, and implications were relevant and meaningful to people living with the condition. This involvement supported a patient-centred approach to both the research and the manuscript preparation. Patients' participation as voluntary contributors was essential to the data collection process.
To describe the implementation determinants for care coordination interventions in a hospital context.
Systematic review.
This review was guided by the Consolidated Framework of Implementation Research (CFIR), assessed for quality using the Mixed Methods Appraisal Tool and reported with the PRISMA guidelines.
CINHAL Complete, EMBASE, MEDLINE Complete, PsychINFO (between January 1, 2013, and December 31, 2022, and updated May 09, 2024) and a manual reference list search of all included studies.
The search returned 5614 articles after duplicates were removed. After title and abstract screening, 264 articles underwent full-text review. Sixteen studies (15 care coordination models) met the inclusion criteria. The CFIR inner setting domain and the implementation process domain were the most prominent domains and ‘Partnerships & Connections’, ‘Work Infrastructure’, ‘Capability’ and ‘Reflecting and Evaluating’ subdomains emerged as important determinants across the included studies.
Inconsistent findings relating to care coordination outcomes are likely to be substantially influenced by the complexity and heterogeneity of the interventions and variations in implementation and contextual factors. Intra- and inter-organisational relationships were important to connect previously disconnected parts of the health system and were facilitated by experienced care coordinators. Continual improvement was also important to increase fit with contextual factors. More high-quality studies are needed to identify commonalities and provide generalisable principles and characteristics associated with high-performance implementation.
Review findings will provide practitioners, policymakers, and researchers with a comprehensive synthesis of evidence underpinning implementation of effective community care coordination from hospital settings.
These review findings will inform the effective implementation of care coordination interventions in a hospital context for patients with complex multimorbidity.
Preferred Reporting Items for Systematic reviews and Meta-Analysis.
PROSPERO Registration: CRD42022376642.
No patient or public Contribution.
Low-value care provides little or no benefit to patients, or its risk of harm outweighs the potential benefits. Non-nursing tasks refer to tasks performed by nurses below their scope of practice. With increasing pressure on the global nursing workforce, it is necessary to identify these concepts to deliver fundamental care.
To assess the prevalence, influencing factors and associations of low-value nursing care, and to identify non-nursing tasks and potential solutions in surgical hospital care settings.
The study followed a cross-sectional study design using a self-developed questionnaire.
A questionnaire on low-value care and non-nursing tasks was distributed to surgical wards in four hospitals in The Netherlands.
A total of 302 nurses responded to the survey. Five most prevalent low-value care practices were identified, including routine preoperative fasting (84.8%), taking over blood glucose monitoring (59.3%) and leaving in place any type of venous catheter (42.1%). These practices were mainly performed due to habitual practice, in accordance with an established protocol, or upon physicians' request. Most reported non-nursing tasks were administrative duties and cleaning patient rooms and equipment. Provided solutions included clearly defining responsibilities and taking personal responsibility.
Low-value care, provided by surgical nurses, is common in daily practice. This requires targeted de-implementation of each low-value care practice, based on influencing factors. Additionally, 85.8% of nurses perform non-nursing tasks daily or several times a day, underlining the need to re-organise nursing tasks.
De-implementing low-value care and reducing non-nursing tasks is necessary to ease pressure on the global nursing workforce and to improve fundamental care.
Low-value nursing care and non-nursing tasks persist when nurses lack leadership responsibility.
STROBE checklist.
No patient contribution.
To describe diagnostic categories and comorbidities associated with increased risk of readmission within 28 days among older adults.
Retrospective observational study of all hospital admissions following ED attendance by patients aged ≥ 60 years between July 2020 and June 2023. Index and subsequent 28-day readmission were identified using ED data and hospital discharge records. ED diagnosis, Australian Refined Diagnosis-Related Group (AR-DRG) discharge codes, and ICD-10-AM comorbidities were extracted. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with 28-day readmission. The study and findings have been reported against the STROBE-RECORD guideline.
Of the 28,730 initial patient visits, 7.9% re-presented within 28 days. The most common ED diagnoses at initial and readmission were chest pain (5.4% vs. 4.6%), falls (5.2% vs. 4.1%), dyspnoea (3.5% vs. 3.1%), abdominal pain (3.1% vs. 3.3%) and cerebrovascular accident (1.7% vs. 1.7%). The most frequent AR-DRGs were respiratory infections/inflammations, kidney and urinary signs/symptoms, and other digestive system disorders. Key ICD-10-AM codes associated with a higher likelihood of readmission within 28 days were obstructive/reflux uropathy (OR 2.66, 95% CI 1.78–3.96), urinary retention (OR 1.84, 95% CI 1.38–2.46), chronic ischaemic heart disease (OR 1.57, 95% CI 1.10–2.25), delirium (OR 1.35, 95% CI 1.07–1.71) and disorders of fluid, electrolyte, and acid–base balance (OR 1.29, 95% CI 1.09–1.54).
Nearly 8% of older adults are readmitted within 28 days. Our described approach offers a potential framework to identify at-risk groups and intervene to reduce avoidable representations and/or admissions.
The results reported here create the opportunity for clinicians to identify areas for improvement in clinical practice, care coordination, and service delivery. Our approach and methodology can be replicated in other health services.
No patient or public contribution.
To explore how public health nurses at child and family health clinics work to prevent maltreatment and the experiences of public health nurses in the maltreatment prevention efforts.
Child maltreatment is a serious societal issue with major consequences. Preventive efforts are increasing and have broad political support. A key objective of the child and family health clinic services is to prevent, identify, and stop maltreatment, abuse, and neglect. National clinical guidelines outline, in general terms, how such work should be conducted. However, limited research exists on how public health nurses prevent maltreatment and the effectiveness of their methods.
A qualitative and explorative design was used, based on semi-structured interviews with 14 public health nurses conducted as part of the project ‘Public Health Nurses in Child and Family Clinics' Role in Preventing and Detecting Child Maltreatment’ at Oslo Metropolitan University. The interviews were carried out between August and November 2021. We used qualitative content analysis with an inductive approach to analyse the data.
Three main categories were developed: 1. Structure and system: weaving prevention into daily practice; 2. To dare and endure: a negotiation of courage and understanding, and 3. To empower and uphold: the goal of strengthening and supporting parents. The results show the importance of early intervention, barriers to discussing maltreatment with parents, and the importance of building trust and empowering parents.
Preventing maltreatment is a key part of public health nurses' clinical work, focusing on early risk identification and parental guidance. While building trust with families is prioritised, structural, resource, and guideline-related challenges persist.
This study provides knowledge about Norwegian public health nurses clinical work with child maltreatment at the child and family health clinics, which can serve as a valuable foundation for further research as well as for collaborating services.
EQUATOR guidelines were followed, using the COREQ checklist.
No patient or public contribution.
To evaluate the predictive capacity of the Integrated Care for Older People screening tool for the risk of falls in older people receiving care at a healthcare service.
A cross-sectional study.
This study was conducted in a geriatric healthcare service in the southeast region of Brazil. The convenience sample included older people aged 60 and over living at home. The study used the Fall Risk Score to assess the risk of falls and the Integrated Care for Older People screening tool to track intrinsic capacity. The data was analysed using logistic regression to analyse the association between the six Intrinsic Capacity domains, for the early detection of impairment and risk of falls.
A total of 253 older adults participated in the study, most of whom were identified as having a high risk of falls. Logistic regression analysis across six association models revealed that the models including the Intrinsic Capacity domains of locomotion and hearing had a significant association with having a higher risk of falls. Care plans should prioritise the domains most strongly associated with fall risk, guiding targeted strategies to enhance older adults' safety.
The Integrated Care for Older People screening tool, in the locomotion and hearing domains, is associated with the risk of falls in older people from the community receiving care in a geriatric healthcare service. Future longitudinal studies could show whether other domains of intrinsic capacity can predict the occurrence of falls.
This study highlights the Integrated Care for Older People screening tool as essential in nursing practice, especially for assessing the locomotion and hearing domains of intrinsic capacity. Early detection of impairments helps identify increased fall risk in older adults, enabling nurses to implement targeted, person-centred interventions that enhance safety, autonomy and overall quality of life.
No patient or public contribution.
This study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.
To describe patient outcomes for patients at high risk of mortality (with a prognosis of three months or less to live) where a Palliative Care Nurse Consultant (PCNC) was embedded in a General Medicine team. To explore patients and/or their carers feedback and allied health, nursing professionals' perspectives on integrating a palliative care approach in the General Medicine ward.
Prospective exploratory study.
SQUIRE reporting guidelines was adopted for the study reporting. This study was conducted over six weeks in a general medicine ward at Monash Medical Centre in Melbourne, Australia. Participants were 20 patients aged > 65 years with non-malignant, chronic conditions at high risk of mortality within three months and had 18 nursing and allied health professionals involved in their care. Quantitative data were analysed descriptively and qualitative survey data were analysed thematically.
Twenty patients participated, with an average age of 87 years. 55% spoke a language other than English. PCNC interventions, focused on care coordination and family liaison, were found to facilitate timely referrals to other support services, improve communication and better address end-of-life care needs. Healthcare professionals recognised the benefits of PCNC involvement; however, a key qualitative theme was staff reluctance to raise palliative care needs due to perceived role boundaries and limited confidence. While PCNC presence improved communication and advocacy, barriers included time constraints and patient/family resistance.
Embedding a PCNC in a general medicine team appears to enhance care coordination and support timely palliative care integration. Addressing barriers and optimising workflow can improve patient, carer and clinician experience as well as improve resource utilisation.
The model has the potential to enhance patient-centred care and clinician support in acute general medicine settings.
The research will have an impact on acute care settings, particularly general medicine units, by informing models of integrated palliative care for patients with complex needs and enhancing staff capability and confidence in providing timely, person-centred care.
Patients or members of the public were not involved in the design, conduct, analysis or manuscript preparation of this study. The project was a prospective observational study with limited scope and resources, which did not include a formal patient or public involvement component.
To develop and psychometrically test a comprehensive Cancer Nurse Self-Assessment Tool (CaN-SAT).
Modified Delphi to assess content validity and cross-sectional survey to assess reliability and validity.
Phase 1: An expert group developed the tool structure and item content. Phase 2: Through a modified Delphi, cancer nursing experts rated the importance of each element of practice and assessed the relevance and clarity of each item. Content Validation Indexes (CVI) were calculated, and a CVI of ≥ 0.78 was required for items to be included. Phase 3: Cancer nurses participated in a survey to test internal consistency (using Cronbach's alpha coefficients) and known-group validity (through Mann–Whitney U tests). This study was reported using the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) checklist.
The CaN-SAT underwent two rounds of Delphi with 24 then 15 cancer nursing experts. All elements of practice were rated as important. Only three items achieved a CVI < 0.78 after round one; however, based on open-ended comments, 26 items were revised and one new item added. After round two, all items received a CVI above 0.78. The final tool consisted of 93 items across 15 elements of practice. Cronbach's alpha coefficients were between 0.92 and 0.98 indicating good reliability. Mann–Whitney U tests demonstrated significant differences between clinical nurses and advanced practice nurses across 13 out of 15 elements of practice.
The CaN-SAT is a comprehensive, valid and reliable tool that can be used for cancer nurses to self-assess current skill levels, identify their learning needs and inform decisions about educational opportunities to optimise cancer care provision.
The research team included three patient advocates from Cancer Voices NSW, who were actively involved in all aspects of the study and are listed as authors.
To examine individual variations in mental health trajectories and identify associated risk factors among patients with lung cancer.
A longitudinal study.
Participants recruited from outpatient clinics at five time points: 1, 3, 6, 9 and 12 months after a diagnosis. Data collected included demographic and disease-related characteristics, symptom distress, and mental health. Hierarchical Linear Modelling (HLM) was used to analyse changes in mental health trajectories and identify significant predictors. The study is reported using the STROBE checklist.
In total, 130 patients with lung cancer were included in the study. Mental health demonstrated a significant improvement over time, with notable individual variations in patterns of improvement. Male patients and those experiencing high levels of symptom distress exhibited slower improvements in mental health over time.
Patients with lung cancer showed overall improvement in mental health within 1 year following a diagnosis; however, the pattern of improvement varied among individuals. Male patients and those with high levels of symptom distress constituted a vulnerable group, exhibiting poorer mental health outcomes over time.
Early assessments of and individualised interventions for symptoms distress to improve mental health should be considered essential components of care to enhance the overall well-being of patients with lung cancer.
These findings highlight the need for healthcare professionals implementing person-centred interventions aimed at improving mental health that might be beneficial for patients with lung cancer.
Study methods and results reported in adherence to the STROBE checklist.
Patients contributed their consent, time, and data to the study.
To identify the pain assessment scales with the best psychometric properties to be used by nurses in an inpatient setting.
Umbrella review.
A comprehensive search of four databases was conducted for systematic reviews published from July 2013 to November 2024, focusing on psychometric properties of pain scales used in inpatient settings. Inclusion criteria required scales to assess subjective or behavioural pain and be nurse-administered, while reviews without detailed psychometric data were excluded. Screening, quality appraisal (JBI checklist), and data extraction were performed independently by two researchers. Data synthesis combined qualitative and quantitative approaches, with psychometric properties evaluated using the COSMIN checklist. The study was reported in accordance with the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement.
Seventeen articles met the inclusion criteria, identifying 41 scales used across various patient populations, including critical care, paediatric, postoperative, cancer, cerebral palsy, disorders of consciousness, low back and neck pain, stroke and verbal communication disorders. The Paediatric Pain Profile, the Breakthrough Pain Assessment Tool and the Questionnaire on Pain caused by Spasticity demonstrated adequate psychometric properties, although the positive findings for the latter two should be confirmed by at least one additional study. Most of the scales (n = 36) require further studies to validate their use in clinical practice. For two scales, their clinical use remains questionable.
The Paediatric Pain Profile, the Breakthrough Pain Assessment Tool, and the Questionnaire on Pain caused by Spasticity can be recommended for use. Unidimensional scales should complement, rather than replace, multidimensional scales to ensure a comprehensive pain assessment. Standardising documentation with validated scales enhances clinical decision-making, care quality, research usability, and reduces documentation burden.
Develop and simulate test a digital alert dashboard drawing from existing data to support nurses, care workers and managers in residential aged care.
Participatory action research, co-designing for an Australian 64-bed residential site.
Qualitative data were collected through focus groups and analysed using reflective thematic analysis.
Nursing-theory and evidence-based Nursing Data Domain Standards (NDDS) were developed to support internal triaging of fundamental and clinical care in a non-clinical environment. A co-designed retrospective digital alert dashboard (Aged Care Electronic Dashboard Information Tool—ACED-IT) representing the Standards was created and tested. Twenty aged care nurses, care workers and managers found it had promise in enhancing quality of care, improving resident health and reducing adverse events.
Maximising efficient use of resident-level data with a system that empowers nurse decision-makers is crucial to support effective care design and harm prevention.
ACED-IT has the potential to improve visibility of resident needs, support staff to adjust their workflow based on in-house triage, enhance supervision of staff and quality of care and reduce preventable complications.
Digital systems that enable nursing care escalation and triaging for early intervention are needed in residential aged care settings. The co-designed system was perceived by registered nurses, care workers and managers to have the potential to improve care quality and efficiency. Using an evidence-informed nursing framework to identify day-to-day care indicators can be widely implemented by government regulators, software providers and residential care providers on an international scale to improve resident experience.
This study adhered to the relevant EQUATOR guidelines, specifically the COREQ (Consolidated Criteria for Reporting Qualitative Research) Checklist.
A member of the public participated in the Advisory Group, observed and contributed to the co-design process and reviewed the manuscript.
Signs of clinical deterioration may appear differently in children with dark-coloured skin. How to assess children in this cohort is currently poorly defined.
To explore available information on the assessment of clinical deterioration in children with dark-coloured skin and identify research deficits.
A scoping review following Arksey and O'Malley and PRISMA-ScR frameworks. Five online databases, grey literature and reference lists of eligible documents were searched. Source titles, abstracts and full texts were screened. Included documents were assessed for level of evidence according to the Joanna Briggs Institute. Data were charted on a pre-defined data collection tool and analysed through descriptive and content analysis.
Out of 2382 documents screened, 37 were included. Document types included 16 quantitative studies, 14 opinion papers, five reviews and two reports. Most sources (21) were low-level evidence. Sixty-six unique terms were used to describe dark-coloured skin. Eighteen documents reported use of a skin classification system, including race/ethnicity, established colour scales, cosmetic references and observer opinion. Twelve focused on newborn hyperbilirubinaemia. Considerations for assessing jaundice, pallor, cyanosis, pulse oximetry, petechiae and signs of shock were reported. Techniques to improve assessment included optimising the environment, identifying baseline skin colour, and involving families and patients in assessment. No documents reported on assessment of mottling or capillary refill time for children with dark-coloured skin.
Assessment of clinical deterioration for children with dark-coloured skin is highly relevant to health professional practice. There is an overall deficit in high-quality research. Specific information gaps in assessment are considerations for mottling, capillary refill time, APGAR scoring, and clinical implications of device overestimation of bilirubin and oxygen saturations in children with dark-coloured skin. Health professionals are encouraged to use devices cautiously. Greater accuracy and objectivity are necessary to fill these gaps and support effective detection of signs of clinical deterioration.
In response to global outcries of poor healthcare, organisational interventions have been implemented with the aim of promoting compassionate care. An overall synthesis of qualitative data, including the perspectives of healthcare staff who have attended interventions, can establish ‘what works’ and inform future interventions.
To synthesise existing research exploring how healthcare staff experience organisational interventions for compassionate care.
Qualitative evidence synthesis.
A qualitative evidence synthesis was conducted in August 2023. Five databases were searched: MEDLINE, Academic Search Premier, CINAHL, APA PsycInfo and APA PsycArticles. Articles met the following criteria: (a) reported on the experiences of healthcare staff who had participated in organisational interventions for compassionate care, (b) taken place in a healthcare setting, (c) use of a qualitative or mixed-methods methodology, (d) published in English and (e) published since 2010. A thematic synthesis was conducted using NVivo software to synthesise findings. Data from the complete ‘findings/results’ sections were included in the synthesis. The final search protocol and search strategy were registered on PROSPERO (ID: CRD42023472404) and are reported using the PRISMA guidelines.
Eighteen qualitative or mixed-methods studies were included in the review, encapsulating the experiences of healthcare staff across eight countries. Four themes were identified: (1) holding back, (2) humanising healthcare, (3) values are instilled and (4) sustainability is important.
Organisational interventions for compassionate health care are valued and appreciated by healthcare staff and foster reflection and connection. Interventions facilitate clinical creativity, improve staff well-being and strengthen communication between staff.
The implementation of organisational interventions for compassionate care should be encouraged in healthcare settings. Interventions that consider organisational cultures are driven by organisational values and are embedded with sustainability in mind can improve staff well-being and positively impact the provision of patient care.
PRISMA guidelines were followed in the reporting of this review.
FreshRSS 