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☐ ☆ ✇ Journal of Clinical Nursing

Assessing Clinical Deterioration in Children With Dark‐Coloured Skin: A Scoping Review

Por: Chelsea Kelly · Gavin D. Leslie · Pamela Laird · Scott Stokes · Fenella J. Gill — Agosto 13th 2025 at 09:00

ABSTRACT

Background

Signs of clinical deterioration may appear differently in children with dark-coloured skin. How to assess children in this cohort is currently poorly defined.

Aim

To explore available information on the assessment of clinical deterioration in children with dark-coloured skin and identify research deficits.

Methods

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.

Results

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.

Linking Evidence to Action

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.

☐ ☆ ✇ BMJ Open

Scope of practice of primary care nurses: a protocol for an umbrella review of international literature

Por: Lukewich · J. · Mathews · M. · Myles · S. · Dufour · E. · Asghari · S. · Rioux-Dubois · A. · Martin-Misener · R. · Halcomb · E. J. · Chiu · P. · Poitras · M.-E. · Leslie · K. · McGraw · M. · Ryan · D. · Curnew · D. · Meredith · L. · Morin · A. · Swab · M. · Braithwaite · S. · Macdonald · D. — Julio 25th 2025 at 10:04
Introduction

Primary care nurses (PCNs) are the second largest workforce in primary care and play a critical role in facilitating access to coordinated care and reducing health disparities. There is renewed interest in team-based primary care as a solution for health workforce challenges. Some team models enable PCNs (ie, nurse practitioners, registered nurses, licensed/registered practical nurses) to leverage one another’s expertise to work to optimal scope; the extent to which this happens depends on multiple context-dependent factors. We will conduct an umbrella review to synthesise and compare international knowledge syntheses focused on scope of practice enactment (ie., roles and activities) of PCNs in primary care.

Methods and analysis

We will conduct the umbrella review according to the Joanna Briggs Institute methodology, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines, and using the Nursing Care Organization Framework as guidance. We will search a wide range of scientific electronic databases and grey literature sources, and consider articles published in English and French by the Organization for Economic Cooperation and Development and designated key partner countries for inclusion, with no publication date limits. Two independent reviewers will screen titles, abstracts and full-text articles, and any disagreements will be resolved through discussion or by a third reviewer. We will use the Risk of Bias Assessment Tool for Systematic Reviews to assess the quality and risk of bias in the included systematic and scoping reviews.

Ethics and dissemination

Results will be presented in a PRISMA Scoping Review flow diagram. We will synthesise data from included studies in a detailed literature review table and develop visual aids to communicate the shared and unique roles and activities of PCN scope of practice. We will disseminate the results of the review through peer-reviewed publications and conferences related to this field. Ethics approval is not required.

☐ ☆ ✇ BMJ Open

Clinical evaluation of adults undergoing elective surgery utilizing intraoperative incisional wound irrigation (CLEAN Wound): protocol for a randomised controlled trial

Por: Roke · R. · Lillie · E. · Daneman · N. · Mason · S. A. · Tomlinson · G. · Jiang · Y. · Shiroky · J. · Puran · S. · Smith · D. E. · Abou Khalil · J. · Kayssi · A. · Serrano · P. E. · Pinchuk · B. · Apte · S. S. · Lamb · T. · Ma · G. · Vogt · K. · Leslie · K. · Mutabdzic · D. · Gomez · D. · Ladh — Julio 17th 2025 at 10:43
Introduction

In moderate to high-risk surgical procedures, 15–25% of patients develop a postoperative surgical site infection. Intraoperative incisional wound irrigation has the potential to reduce surgical site infections, and additional randomised controlled trials are required to provide evidence of effectiveness.

Methods and analysis

This protocol describes a pragmatic, adaptive, participant and adjudicator-blinded trial at 13 sites in Canada in up to 2500 participants. Participants planned for surgery with an abdominal or groin incision, who are eligible and provide verbal consent through an integrated consent model, are randomised to receive intraoperative incisional wound irrigation with povidone-iodine, saline or no irrigation. The primary outcome is surgical site infection within 30 days postoperatively. Secondary outcomes include quality of life measured 30 days postoperatively and morbidity, mortality and healthcare utilisation within 90 days postoperatively.

Ethics and dissemination

This trial has been approved by the research ethics board at the participating centres and stopped enrolling participants on May 23, 2025. All participants will provide verbal consent. Results will be disseminated via presentation at conferences, publication and posted on clinicaltrials.gov.

Trial registration number

The study is registered with http://clinicaltrial.gov (NCT04548661; 14 September 2020).

☐ ☆ ✇ CIN: Computers, Informatics, Nursing

Achieving a Legacy and Moving On

Por: Nicoll · Leslie H. — Julio 1st 2025 at 02:00
No abstract available
☐ ☆ ✇ Journal of Clinical Nursing

How Do Spouses Experience Living Alone After Their Partner With Dementia Moves Into a Care Home?

Por: Barbara Pope · Leslie Gelling · Sharon Holland · Chantel Cox — Junio 2nd 2025 at 13:45

ABSTRACT

Aims

This systematic review aims to explore spouses' lives after their partner with dementia moves to a care home facility. It will review existing peer-reviewed papers written between 2002 and 2022 from English-speaking parts of the world. It will investigate what is already established and underline where there are information gaps.

Background

According to statistics, approximately 311,730 people with dementia currently reside in a care home. Many of these people will have a living spouse who will have to acclimatise to living alone and may experience anxiety and distress after this change.

Design

A systematic search found that all the research papers met pre-defined inclusion and exclusion criteria and were published between 2002 and 2022. Papers were identified and reviewed using the Critical Appraisal and Skills Programme (CASP) to evaluate the papers.

Method

Databases searched included APA PsycINFO, MEDLINE Complete, Complementary Index, CINAHL Complete and Academic Search Ultimate Directory of Open Access. In total, 1390 papers were found; eight papers were identified; five were qualitative, and three were quantitative and analysed thematically. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used to support the presentation of this systematic review.

Results

Detailed thematic analysis of the eight research studies included in this review identified three broad themes: (a) loss of a shared life, (b) visiting their partner in a care home and (c) grief, depression and ‘unable to move on’. These aspects have been shown to adversely impact the physical and mental health of the community-dwelling spouse, which increases their exposure to depression.

Conclusions

The selected papers showed persuasive evidence of the state of the community-dwelling spouse's social, mental and physical health, which became a barrier to them moving forward with their lives. The needs of the community-dwelling spouse have been under-researched once their partner with dementia enters a care home. Further research is needed to understand how and when interventions should be offered to this group of people and which interventions might be most effective.

Relevance to Clinical Practice

This research will help to disseminate clinical knowledge to nursing and other professionals, who will be able to appreciate the effect of moving a lifelong partner with dementia into a care home and be able to appreciate the uncertainties the community-dwelling spouse feels at this time. With this information, they could identify spouses who are more vulnerable to the risk of not managing this phase of their lives and suggest appropriate support networks.

Trial Registration: This Systematic Review is registered in PROSPERO: 309784

☐ ☆ ✇ Journal of Advanced Nursing

Using the Hospital Anxiety and Depression Scale in Patients 80 Years‐Old and Older: A Systematic Review

ABSTRACT

Aims

To identify and report results from studies of anxiety and depression, as measured by The Hospital Anxiety and Depression Scale (HADS) in patients ≥ 80 years admitted to hospital settings, and to inform nurses, researchers and educators in nursing about these findings.

Design

Systematic review.

Data Sources

MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane, Epistemonikos, Scopus and Web of Science Core Collection of studies published until October 2023.

Methods

A search strategy was developed with a university librarian. Four independent reviewers screened titles and abstracts based on predefined inclusion criteria. Data were systematically extracted, descriptively analysed, and Critical Appraisal Skills Programme checklists were used to assess studies.

Results

Out of 7076 identified studies, three met the eligibility criteria. Data from 420 participants aged ≥ 80 years were analysed, revealing anxiety prevalence rates between 6% and 18% and mean scores below 4. Depression prevalence rates ranged from 7% to 17%, with a mean score below 4. Most patients with depression were not previously recognised as being depressed.

Conclusions

Few publications reported on anxiety and/or depression in hospitalised patients aged ≥ 80 years using HADS. A gap in the knowledge base has been identified.

Implications

Anxiety and depression are mental health conditions that can lead to adverse events and strongly affect aging. Increased understanding of the role that these conditions have on hospitalised patients ≥ 80 years is important for nurses when in contact with this patient group.

Impact

There is a need for more studies to generate evidence regarding anxiety and depression in an increasingly common and challenging hospital population by building upon evidence that is based on validated instruments such as the Hospital Anxiety and Depression Scale.

Reporting Method

The PRISMA guideline was followed, and the review registered in PROSPERO (Registration number CRD 42022380943).

Patient Contribution

No patient or public contribution.

Trial Registration

CRD 42022380943

☐ ☆ ✇ Journal of Nursing Scholarship

An examination of retracted articles in nursing literature

Abstract

Introduction

The output of scholarly publications in scientific literature has increased exponentially in recent years. This increase in literature has been accompanied by an increase in retractions. Although some of these may be attributed to publishing errors, many are the result of unsavory research practices. The purposes of this study were to identify the number of retracted articles in nursing and reasons for the retractions, analyze the retraction notices, and determine the length of time for an article in nursing to be retracted.

Design

This was an exploratory study.

Methods

A search of PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, and Retraction Watch databases was conducted to identify retracted articles in nursing and their retraction notices.

Results

Between 1997 and 2022, 123 articles published in the nursing literature were retracted. Ten different reasons for retraction were used to categorize these articles with one-third of the retractions (n = 37, 30.1%) not specifying a reason. Sixty-eight percent (n = 77) were retracted because of an actual or a potential ethical concern: duplicate publication, data issues, plagiarism, authorship issues, and copyright.

Conclusion

Nurses rely on nursing-specific scholarly literature as evidence for clinical decisions. The findings demonstrated that retractions are increasing within published nursing literature. In addition, it was evident that retraction notices do not prevent previously published work from being cited. This study addressed a gap in knowledge about article retractions specific to nursing.

☐ ☆ ✇ Journal of Clinical Nursing

The choice for colostomy following spinal cord injury: A grounded theory study

Por: Michelle Louise Boucher · Leslie Gelling · Desiree Tait — Septiembre 22nd 2023 at 14:38

Abstract

Aim

Explore experiences and choices related to bowel management following spinal cord injury.

Background

In one UK spinal centre, more are choosing a colostomy soon after injury in contravention of professional guidelines. Reasons for this were unknown.

Methods

Grounded theory study using semi-structured interviews with 12 individuals living with spinal cord injury.

Results

All ‘Experienced Loss’ related to bowel function. Those who chose colostomy later ‘Progressed into Suffering’. Colostomy transformed lives and was likened to ‘Being Alive Again’. ‘Failures of Care’ contributed to experiences and decision-making.

Conclusion

Possessing information and choice emerge as key in transforming lives following spinal cord injury. They allow individuals to make choices from a lifeworld perspective, which may differ from those professionals assume. Present neurogenic bowel management guidelines fail to account for the wider lifeworlds of those they are designed for.

Implications for the Profession and Patient Care

An imperative emerges to make information and choice available and involve patients in the reconstruction of guidelines.

Impact

Unique knowledge emerges about patient experiences and motivations, and points to a patient-led revolution in how bowel management following spinal cord injury is understood and managed. The imperative for adequate access to information and choice is demonstrated.

Reporting Method

EQUATOR Standards for Reporting Qualitative Research (SRQR) were adhered to.

Patient or Public Contribution

The methodology facilitated discussion of areas important to patients and made them co-constructors of theory.

☐ ☆ ✇ Index de Enfermería

Riesgo suicida e Inteligencia emocional de rasgo en el retorno presencial estudiantil

Objetivo: Describir la relación de la Inteligencia Emocional de rasgo con el Riesgo Suicida en los estudiantes de Enfermería luego del retorno estudiantil a la presencialidad en una universidad pública de Chile. Metodología: Enfoque cuantitativo, correlacional, transversal, no experimental. Resultados principales: Se presentó una prevalencia de 19,3% de la muestra con riesgo suicida, y ambas variables se correlacionaron negativamente a nivel estadísticamente significativo (r= -,502; p<,000). Conclusión principal: Existe una relación fuerte y de dirección negativa entre la inteligencia emocional de rasgo y el riesgo suicida en estudiantes de enfermería luego del retorno a la presencialidad. Se observa un aumento del riesgo suicida en comparación con la referencia prepandémica. Además, los estudiantes de primeros años presentaron niveles más altos de riesgo suicida. La inteligencia emocional se considera un factor protector, por lo que las universidades deben ser fuente de formación en la gestión emocional, dado que el riesgo suicida suele estar presente en este estudiantado.

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