This study aimed to describe the types of psychological and physical symptoms experienced by healthcare professionals who became second victims after a patient safety incident and the impact of the incident on their social and professional lives.
Scoping review.
JBI methodology for scoping reviews and PRISMA-ScR for reporting were followed.
The search was conducted on June 13, 2024, using the CINAHL (EBSCO), Scopus, PubMed (Medline), Medic and PsycInfo (EBSCO) databases. A grey literature search was also conducted.
A total of 96 papers were included. Healthcare professionals experienced psychological symptoms such as anger, sadness and guilt after a safety incident. Physical symptoms were reported, including symptoms related to sleep and gastrointestinal symptoms. At the professional and social levels, the incident affected their work, relationships and well-being. Positive impacts were also noted.
This study provides a comprehensive overview of healthcare professionals' experiences after safety incidents. In addition, this study also captured the positive impacts of safety incidents, such as learning from mistakes.
By recognising the symptoms and impacts associated with the second victim syndrome, appropriate support can be provided for healthcare professionals.
The findings of this study can be used to identify the relevant harm to professionals after a safety incident, which could help to improve the well-being of these workers.
No patient or public contribution.
Open Science Framework, https://archive.org/details/osf-registrations-5cdmu-v1
To (1) analyse managers' experiences with handling patient safety incident reports in an incident reporting software, identifying key challenges; (2) analyse the incident report processes from the managers' perspective; (3) examine managers' perceptions of ways to support and improve health professionals' experiences of report-handling processes; and (4) investigate how, from their point of view, incident reporting software should be developed in the future.
A descriptive qualitative study.
Interviews and focus group discussions on Microsoft Teams from 11/2024 to 3/2025, including 16 participants, analysis with deductive and inductive content analysis.
Of 16 participants, 15 were managers and one was a patient safety expert. Most were nurse managers (n = 9). Four discussion themes were divided into 30 categories. Participants highlighted the need to improve the reporting software's terminology, classification and analysis tools. The use of artificial intelligence was desired but not currently integrated into the software. Participants were unsure of their skills to use all the software features. Clear and transparent handling processes, feedback, managers' behaviour and communication methods were seen as key to improving staff's experience with report processes. A real-time warning system was considered beneficial for various incident types. Specific questions must be answered before further developing such systems.
This study deepened the understanding of reporting software's challenges regarding its handling features. The handling processes of incident reports had multiple shortcomings, which may negatively affect health professionals' experiences in report handling. Real-time warning systems could assist healthcare managers in processing reports.
Organisational-level guidance for incident report processing is needed. Improvements to report processing and reporting software can improve shared learning and understanding of the status of patient safety.
No patient or public contribution.
COnsolidated criteria for REporting Qualitative research Checklist.
To explore the lived experiences of intensive care nurses caring for patients with limited English proficiency.
A hermeneutic, interpretive phenomenological design was used.
Semi-structured interviews were conducted with intensive care nurses recruited through purposive sampling. Data collection included Qualtrics screening surveys and semi-structured Zoom interviews. The research team, comprising linguistically diverse faculty and undergraduate research assistants, employed reflexivity techniques to minimise bias and enhance interpretive rigour. Data were analysed via inductive analysis using the hermeneutic circle.
Five main themes emerged organically from the data: Complications of Care Relating to Verbal Communication Challenges. Benefits and Barriers of Nursing Informatics in Linguistic Care. The Universal Language: Nursing Effort Builds Trust. The Ripple Effect: Chronological Considerations for Patient Care. Moving Forward: Where Do We Go From Here?
Based on these findings, a four-phase model was developed to guide individual and system-level interventions to reduce nurse moral distress and improve language equity in critical care.
Language barriers in the intensive care unit hinder communication, increase stress for patients and nurses, and impact care quality. While nurses' efforts to bridge these gaps are valued, systemic changes (such as expanded interpreter availability and improved cultural safety training) are necessary to support culturally, linguistically, and medically appropriate care.
Findings highlight the need for increased institutional support, additional resources for night-shift staff, and the integration of cultural humility education into intensive care training. The Limited English Proficiency Moral Distress Action Cycle for Critical Care Nursing, developed from this study, offers a flexible framework to guide the implementation of these improvements and reduce nurse moral distress. Future research should explore interventions to promote cultural and linguistic competence in multilingual patient populations.
Q: What problem did the study address?
A: The nurse-identified clinical, ethical, and workflow risks created when interpreters or translation tools are inadequate for critical care.
Q: What were the main findings?
A: Language barriers jeopardise teaching, informed consent, and symptom reporting. Video and phone interpreters or translation apps are vital but are often scarce, unreliable, or impersonal, particularly during night shifts. Nurses bridge these gaps by building trust through empathy, non-verbal communication, and learning key phrases. Yet, effective care for patients with limited English proficiency requires extra time, increasing workloads and fuelling moral distress related to language-discordant care. Nurses consistently called for 24/7 interpreter coverage; more reliable devices and cultural humility training must be implemented system-wide.
Q: Where and on whom will the research have an impact?
A: Findings can guide nurses, managers, leaders, and administrators to improve both language concordant and discordant nursing care and train nurses in cultural and linguistic competencies for a multilingual patient population. Ultimately, these efforts have been shown to improve the quality, outcomes, and cost-effectiveness of patient care. The study also identifies moral-distress triggers and introduces the Limited English Proficiency Moral Distress Action Cycle (LEP-MDAC). This model is proposed for use in other high-acuity settings worldwide that seek to provide language-concordant or language-discordant care effectively.
SRQR.
None.
To examine the evolution of intensive care nurses’ roles in pharmacological haemodynamic management from 1975 to 2025 and to explore projected responsibilities through 2075.
A scholarly commentary.
A critical synthesis of literature, historical accounts and clinical guidelines spanning 1975–2025, focussing on nursing practice, technology, workforce dynamics and patient safety in critical care pharmacology.
CINAHL, PubMed, EBSCO, Embase, Cochrane, Google Scholar and major pharmacological guideline repositories were searched for sources between 1975 and 2025, including clinical trials, systematic reviews, position papers and qualitative studies.
Nurses have progressed from unstandardised vasoactive medication titration to advanced, protocol-driven multimodal vasopressor strategies. Milestones include the early catecholamine era, nurse-led sepsis protocols and contemporary adoption of peripheral vasopressor practices supported by technology. Looking ahead, intensive care nurses will increasingly supervise technologically driven titration, manage multimodal regimens, address drug shortages and sustain resilience amid workforce pressures.
Over the past five decades, nurses have transformed vasopressor management and remain essential in bridging innovation with ethical, patient-centred care. The next 50 years will require advanced decision-making, technological fluency and improved support for the nursing workforce.
Investment in simulation-based education, workforce supports and ethical frameworks is vital to prepare nurses for expanding responsibilities and ensure patient safety.
Historical variability and future challenges in nursing roles for vasopressor management.
Nurses have driven safety and innovation and will face increasing technological, ethical and workforce demands.
Relevant to critical care nurses, nurse educators, nurse leaders and policy-makers worldwide shaping the future of critical care practice.
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.
The COVID-19 pandemic prompted a significant increase in the use of remote consultations—by telephone or video—in both primary and secondary healthcare. The reported advantages of remote consulting for both patients and clinicians include greater efficiency, flexibility and convenience. However, disadvantages, such as the uncertainty created by a loss of face-to-face contact, have also been highlighted. The aim of this study was to explore, explain and interpret patients’ and clinicians’ perceptions and experiences of remote consultations and assist decision-making about their future use.
A qualitative study based on semistructured online interviews.
Primary mental healthcare or secondary care cardiology services, London, UK, February–March 2022.
Primary care mental health patients (n=5), primary care clinicians (general practitioners) (n=15), secondary care cardiology patients (n=9) and secondary care cardiology clinicians (n=5).
The results demonstrate that a range of factors have influenced the experiences of both clinicians and patients and indicate shifts in the norms of professional practice and clinician–patient relationships.
Patients and clinicians demonstrated pragmatic acceptance of remote consultations and, looking forward, a preference for a balanced ‘hybrid model’ of remote and face-to-face appointments. The study also highlights a need to consolidate and build on the informal learning and adaptation to remote consulting that has already taken place.
This study aims to determine key workforce variables (demographic, health and occupational) that predicted National Health Service (NHS) staff’s absence due to illness and expressed intention to leave their current profession.
Staff from 18 NHS Trusts were surveyed between April 2020 and January 2021, and again approximately 12 months later.
Logistic and linear regression were used to explore relationships between baseline exposures and four 12-month outcomes: absence due to COVID-19, absence due to non-COVID-19 illness, actively seeking employment outside current profession and regularly thinking about leaving current profession.
22 555 participants (out of a possible 152 286 employees; 15%) completed the baseline questionnaire. 10 831 participants completed the short follow-up questionnaire at 12 months and 5868 also completed the long questionnaire; these participants were included in the analyses of sickness absence and intention to leave, respectively. 20% of participants took 5+ days of work absence for non-COVID-19 sickness in the 12 months between baseline and 12-month questionnaire; 14% took 5+ days of COVID-19-related sickness absence. At 12 months, 20% agreed or strongly agreed they were actively seeking employment outside their current profession; 24% thought about leaving their profession at least several times per week. Sickness absence (COVID-19 and non-COVID-19 related) and intention to leave the profession (actively seeking another role and thinking about leaving) were all more common among NHS staff who were younger, in a COVID-19 risk group, had a probable mental health disorder, and who did not feel supported by colleagues and managers.
Several factors affected both workforce retention and sickness absence. Of particular interest are the impact of colleague and manager support because they are modifiable. The NHS workforce is likely to benefit from training managers to speak with and support staff, especially those experiencing mental health difficulties. Further, staff should be given sufficient opportunities to form and foster social connections. Selection bias may have affected the presented results.
The COVID-19 pandemic disrupted healthcare delivery for patients with breast cancer. eHealth solutions enable remote care and may improve patient activation, which is defined as having the knowledge, skills and confidence to manage one’s health. Thus, we developed the Breast Cancer Treatment Application (app) for patients and practitioners to use throughout the cancer care continuum. The app facilitates virtual assistance, delivers educational resources, collects patient-reported outcome measures and provides individualised support via volunteer e-coaches. Among newly diagnosed patients with breast cancer, we will compare changes in patient activation, other patient-reported outcomes and health service outcomes over 1 year between those using the app and Fitbit, and those receiving standard care and Fitbit only.
This randomised controlled trial will include 200 patients with breast cancer seen at a tertiary care cancer centre in Ontario, Canada. The intervention group (n=100) will use the app in addition to standard care and Fitbit for 13 months following diagnosis. The control group (n=100) will receive standard care and Fitbit only. Patients will complete questionnaires at enrolment, 6 and 12 months post-diagnosis to measure patient activation (Patient Activation Measure-13 score), distress, anxiety, quality of life and experiences with their care and information received. All patients will also receive Fitbits to measure activity and heart rate. We will also measure wait times and number of visits to ambulatory care services to understand the impact of the app on the use of in-person services.
Ethics approval was obtained on 6 January 2023. Protocol version 2.0 was approved on 6 January 2023. The trial is registered with ClinicalTrials.gov. Study findings will be disseminated via publication in a peer-reviewed journal and shared with participants, patient programmes and cancer awareness groups. The app has also been approved as a secure communication method at our trial institution, thus we are well-positioned to support future integration of the app into standard care through collaboration with our hospital network.
Haemodialysis is a life-sustaining treatment for patients suffering from advanced chronic kidney disease that persists without respite. Adherence to complex haemodialysis regimens demands rigorous self-management. Current literature has suggested the potential of novel telehealth technologies in supporting the self-management of haemodialysis patients, but this remains inconclusive.
To synthesise available evidence to determine the effectiveness of telehealth self-management interventions on the health outcomes of adults undergoing haemodialysis.
A systematic review and meta-analysis (reported according to the PRISMA Guidelines).
Nine electronic databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science and ProQuest Dissertations & Theses Global), trial registries and grey literature were searched from inception till 1 December 2023 for randomised controlled trials on the effectiveness of telehealth self-management interventions for haemodialysis patients. Two independent reviewers performed screening, data extraction and risk-of-bias appraisal using Cochrane RoB tool-1. Meta-analyses using Review Manager Web synthesised the interventional effects. Cochrane GRADE assessed the overall quality of evidence.
Fifteen randomised controlled trials (involving 1003 participants) were included. Telehealth self-management interventions had a medium statistically significant effect on improving self-efficacy (SMD = 0.54, 95% CI [0.25, 0.83], Z = 3.69, p = 0.0002). Additional meta-analyses for the outcomes of knowledge, treatment adherence, health-related quality of life, inter-dialytic weight gain and serum electrolyte levels were non-statistically significant but appeared promising to be improved by telehealth self-management. The overall certainty of evidence for all outcomes was very low.
This review provided insights into the clinical importance of telehealth self-management interventions in self-efficacy enhancement among haemodialysis patients. Future researchers are encouraged to optimise telehealth components relevant to the worldwide needs and cultural diversity of adults undergoing haemodialysis.
Adoption of technological healthcare delivery is vital in establishing positive health outcomes and sustainability of routine patient care pathways.
None.
Registration: PROSPERO CRD42024438860
To identify and describe nursing practices on the sexual health of people with neurological disorders.
Narrative review.
Data were extracted from 1 January 2002, to 20 May 2021. Inclusion criteria were nursing practices, sexual health and people with neurological disorders. The main outcome measures were: context of nursing practice implementation (assumptions, knowledge, strategies and skills), facilitators of and barriers to addressing and treating the sexual health of people with neurological disorders, and benefits of nursing practices in sexual health. PRISMA reporting guidelines were used.
PubMed, Embase, ScienceDirect and CINAHL.
In total, 926 articles were identified and nine were included. The involvement of nurses was recommended in most studies. Assumptions about the impact of neurology on sexuality and nurse's role in sexual healthcare, biopsychosocial knowledge, and skills (ethical, interpersonal, and technical) were highlighted. We found that the modes of knowledge proposed by Carper were mobilized in an unequal way. Sexual difficulties were the key focus and eroticization concerns were not addressed in any of the articles.
Several studies advocate nursing intervention; however, few accurately present, detail and evaluate sexual health nursing practices of patients with neurological pathologies. Literature describes practices structured around disorders rather than the potentials, fails to address the brake of eroticism and provides little information on the results of interventions.
Developing teaching programs on sexual health in nursing programs may be necessary if nurses are to support a diverse range of patients in an inclusive and positive manner. These programs should highlight the domain-specific knowledge that is mobilized.
Sexual health is a fundamental human right. Alterations in the nervous system have shown to affect sexual health, however, it is not often discussed among patients with neurological disorders, who are rarely provided with sexual health counselling. Our findings may impact healthcare professionals engaged in care with these patients.
PRISMA.
No patient or public contribution.
Nurses, assuming a wide range of clinical and patient care responsibilities in a healthcare team, are highly susceptible to direct and indirect exposure to traumatic experiences. However, literature has shown that nurses with certain traits developed a new sense of personal strength in the face of adversity, known as post-traumatic growth (PTG). This review aimed to synthesize the best available evidence to evaluate personal and work-related factors associated with PTG among nurses.
Mixed studies systematic review.
Studies examining factors influencing PTG on certified nurses from all healthcare facilities were included. Published and unpublished studies were identified by searching 12 databases from their inception until 4th February 2023. Two reviewers independently screened, appraised, piloted a data collection form, and extracted relevant data. Meta-summary, meta-synthesis, meta-analysis, as well as subgroup and sensitivity analyses were performed. Integration of results followed result-based convergent design.
A total of 98 studies with 29,706 nurses from 18 countries were included. These included 49 quantitative, 42 qualitative, and seven mixed-methods studies. Forty-six influencing factors were meta-analyzed, whereas nine facilitating factors were meta-summarized. A PTG conceptual map was created. Four constructs emerged from the integration synthesis: (a) personal system, (b) work-related system, (c) event-related factors, and (d) cognitive transformation.
The review findings highlighted areas healthcare organizations could do to facilitate PTG in nurses. Practical implications include developing intervention programs based on PTG facilitators. Further research should examine the trend of PTG and its dynamic response to different nursing factors.
Research on trauma-focused therapies targeting nurses' mental health is lacking. Therefore, findings from this review could inform healthcare organizations on the PTG phenomenon and developing support measures for nurses through healthcare policies and clinical practice.