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☐ ☆ ✇ Journal of Advanced Nursing

The Symptoms and Impacts Experienced by Healthcare Professionals as Second Victims After a Safety Incident: A Scoping Review

Por: Laura Jukarainen · Sanu Mahat · Saija Koskiniemi · Tiina Syyrilä · Albert W. Wu · Virpi Jylhä · Marja Härkänen — Octubre 1st 2025 at 07:08

ABSTRACT

Aim

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.

Design

Scoping review.

Methods

JBI methodology for scoping reviews and PRISMA-ScR for reporting were followed.

Data Sources

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.

Results

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.

Conclusions

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.

Implications for the Profession and/or Patient Care

By recognising the symptoms and impacts associated with the second victim syndrome, appropriate support can be provided for healthcare professionals.

Impact

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.

Patient or Public Contribution

No patient or public contribution.

Protocol Registration

Open Science Framework, https://archive.org/details/osf-registrations-5cdmu-v1

☐ ☆ ✇ Journal of Advanced Nursing

Nurse and Other Healthcare Managers' Experiences and Recommendations for Patient Incident Reporting Processes and Real‐Time Software Development: A Qualitative Study

ABSTRACT

Aims

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.

Design

A descriptive qualitative study.

Methods

Interviews and focus group discussions on Microsoft Teams from 11/2024 to 3/2025, including 16 participants, analysis with deductive and inductive content analysis.

Results

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.

Conclusion

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.

Implications for the Profession and/or Patient Care

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.

Patient or Public Contribution

No patient or public contribution.

Reporting Method

COnsolidated criteria for REporting Qualitative research Checklist.

☐ ☆ ✇ Journal of Advanced Nursing

When Words Fail: ICU Nurses' Experiences Caring for Patients With Limited English Proficiency in the United States

ABSTRACT

Aims

To explore the lived experiences of intensive care nurses caring for patients with limited English proficiency.

Design

A hermeneutic, interpretive phenomenological design was used.

Methods

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.

Results

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.

Conclusion

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.

Implications for the Profession and/or Patient 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.

Impact

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.

Reporting Method

SRQR.

Patient or Public Contribution

None.

☐ ☆ ✇ Journal of Advanced Nursing

Pharmacological Haemodynamic Management in the Intensive Care Unit: The Evolution of the Nurse's Role Over 50 Years

Por: Adrianna Lorraine Watson — Septiembre 2nd 2025 at 07:54

ABSTRACT

Aim

To examine the evolution of intensive care nurses’ roles in pharmacological haemodynamic management from 1975 to 2025 and to explore projected responsibilities through 2075.

Design

A scholarly commentary.

Methods

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.

Data Sources

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.

Results

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.

Conclusion

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.

Implications for the Profession and/or Patient Care

Investment in simulation-based education, workforce supports and ethical frameworks is vital to prepare nurses for expanding responsibilities and ensure patient safety.

Impact

Problem addressed

Historical variability and future challenges in nursing roles for vasopressor management.

Main findings

Nurses have driven safety and innovation and will face increasing technological, ethical and workforce demands.

Impact

Relevant to critical care nurses, nurse educators, nurse leaders and policy-makers worldwide shaping the future of critical care practice.

☐ ☆ ✇ Journal of Clinical Nursing

Development and Psychometric Testing of a Comprehensive Cancer Nurse Self‐Assessment Tool (CaN‐SAT) for Identifying Cancer Nursing Skills

ABSTRACT

Aim

To develop and psychometrically test a comprehensive Cancer Nurse Self-Assessment Tool (CaN-SAT).

Design

Modified Delphi to assess content validity and cross-sectional survey to assess reliability and validity.

Methods

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.

Results

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.

Conclusion

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.

Patient or Public Contribution

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.

☐ ☆ ✇ Journal of Advanced Nursing

Taking Back the Authentic Nurse

Por: Adrianna Lorraine Watson — Septiembre 25th 2025 at 07:02
Journal of Advanced Nursing, Volume 81, Issue 10, Page 6074-6075, October 2025.
☐ ☆ ✇ Journal of Clinical Nursing

The Effectiveness of Telehealth Self‐Management Interventions to Improve the Health Outcomes of Adults Undergoing Haemodialysis: A Systematic Review and Meta‐Analysis

Por: Si Xian Ng · Lian Kwang Tang · Hannele Turunen · Minna Pikkarainen · Yanhong Dong · Hong‐Gu He — Febrero 15th 2025 at 03:41

ABSTRACT

Background

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.

Aim

To synthesise available evidence to determine the effectiveness of telehealth self-management interventions on the health outcomes of adults undergoing haemodialysis.

Design

A systematic review and meta-analysis (reported according to the PRISMA Guidelines).

Methods

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.

Results

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.

Conclusions

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.

Implication for Professional Care

Adoption of technological healthcare delivery is vital in establishing positive health outcomes and sustainability of routine patient care pathways.

Patient or Public Contribution

None.

Registration: PROSPERO CRD42024438860

☐ ☆ ✇ Journal of Clinical Nursing

Nursing practices on sexual health for people with neurological disorders: A narrative review

Abstract

Aims

To identify and describe nursing practices on the sexual health of people with neurological disorders.

Design

Narrative review.

Methods

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.

Data Sources

PubMed, Embase, ScienceDirect and CINAHL.

Results

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.

Conclusion

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.

Implications for the Profession and/or Patient Care

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.

Impact

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.

Reporting Method

PRISMA.

No patient or public contribution.

☐ ☆ ✇ Journal of Nursing Scholarship

Personal and work‐related factors associated with post‐traumatic growth in nurses: A mixed studies systematic review

Abstract

Introduction

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.

Design

Mixed studies systematic review.

Methods

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.

Results

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.

Conclusion

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.

Clinical Relevance

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.

☐ ☆ ✇ Nursing Research

Happy Family, Healthy Kids: A Healthy Eating and Stress Management Program in Low-Income Parent–Preschooler Dyads

Por: Ling, Jiying · Chen, Sisi · Zhang, Nanhua · Robbins, Lorraine B. · Kerver, Jean M. — Septiembre 23rd 2023 at 02:00
imageBackground Substantial effort has been invested to combat childhood obesity, but overall effects are disappointing, especially in low-income racial minority children. One possible reason is a lack of focus on the important stress–eating connection. Stress can negatively influence eating behaviors, leading to an increased appetite for high-fat and energy-dense foods. Objective This study aimed to evaluate the preliminary effects of a healthy eating and stress management program targeting multiple theoretical variables on improving eating behavior (dyads’ fruit/vegetable intake, emotional eating), food insecurity, anthropometric characteristics (dyads’ body mass index, % body fat), cardiovascular health (dyads’ blood pressure), and mental well-being (parental stress). Methods A one-group, quasi-experimental pilot study was conducted among 107 low-income parent–preschooler dyads. The 14-week program included a parent component, a parent–preschooler learning component, and a day care-based preschooler component. Results The program had positive effects on improving dyads’ fruit/vegetable intake, food insecurity, body mass index, and blood pressure and parents’ nutrition knowledge, self-efficacy, support, food resource management behavior, problem-focused coping, and home eating environment. The overall satisfaction rate was 95.2%, and 88.1% stated that the program assisted their families with having a healthy lifestyle. Discussion Results support the preliminary effects of the program on improving health outcomes in rural and urban low-income families. Although warranting further investigation with a more rigorous randomized controlled trial, the healthy eating and stress management program provides a potential solution to the current coexistence of an obesity epidemic and mental health crisis.
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