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The aim of this integrative review is to critically appraise and synthesise empirical evidence on the clinical applications, outcomes, and implications of generative artificial intelligence in nursing practice.
Integrative review following Whittemore and Knafl's five-stage framework.
Systematic searches were performed for peer-reviewed articles and book chapters published between 1 January 2018 and 30 June 2025. Two reviewers independently screened titles/abstracts and full texts against predefined inclusion/exclusion criteria focused on generative artificial intelligence tools embedded in nursing clinical workflow (excluding nursing education-only applications). Data were extracted into a standardised matrix and appraised for quality using design-appropriate checklists. Guided by Whittemore and Knafl's integrative review framework, a constant comparative analysis was applied to derive the main themes and subthemes.
CINAHL, MEDLINE, and Embase.
Included literature was a representative mix of single-group quality improvement pilots, mixed-method usability and feasibility studies, randomised controlled trials, qualitative descriptive and phenomenological studies, as well as preliminary and proof-of-concept observational research. Four overarching themes emerged: (1) Workflow Integration and Efficiency, (2) AI-Augmented Clinical Reasoning, (3) Patient-Facing Communication and Education, and (4) Role Boundaries, Ethics and Trust.
Generative artificial intelligence holds promise for enhancing nursing efficiency, supporting clinical decision making, and extending patient communication. However, consistent human validation, ethical boundary setting, and more rigorous, longitudinal outcome and equity evaluations are essential before widespread clinical adoption.
Although generative artificial intelligence could reduce nurses' documentation workload and routine decision-making burden, these gains cannot be assumed. Safe and effective integration will require rigorous nurse training, robust governance, transparent labelling of AI-generated content, and ongoing evaluation of both clinical outcomes and equity impacts. Without these safeguards, generative artificial intelligence risks introducing new errors and undermining patient safety and trust.
PRISMA 2020.
by Evelyn Aboagye Addae, Moses Adjei, Uchechi Shirley Anaduaka, David Kyetuo Wuollah-Dire, Regobert Bondong
Though the impact of COVID-19 pandemic’s effects on individuals’ life domains and quality of life has been widely researched, there remains unanswered questions on the mechanisms that explain the impact of fear of COVID-19 on different measurements of adolescents’ subjective well-being (SWB) particularly in the sub-Saharan African context. In a mediation model, we employed data collected during the pandemic to examine the mediating mechanisms that links fear of COVID-19 and COVID-19-induced changes in multiple life domains (subjective feelings of unsafety, positive affect and peer relationships) to different measurements of adolescents’ SWB (overall life satisfaction, overall happiness, subjective happiness, and composite SWB). Findings revealed significant negative correlations between fear of COVID-19 and all employed measurements of SWB as well as between the proposed mediating variables – changes in peer relationship, positive affect, subjective feelings of unsafety and the different measurements of SWB. Adolescents who reported negative changes in peer relationship, positive affect and subjective feelings of unsafety were more likely to report poorer SWB including lower life satisfaction and happiness. For instance, adolescents who experienced increase in peer relationship were more likely to experience higher overall life satisfaction (B = .169, p B = .172, p B = .056, p B = .416, p B = .381, p B = −1.350, pTo report organisational factors known to positively contribute to nurses' well-being in the workplace.
Integrative literature review.
Peer-reviewed journal articles using various methodological approaches, and theoretical works, published in English with a focus on organisational factors and nurses' well-being were included. Papers reporting on other healthcare professional groups and/or nursing students were excluded. Data were synthesised into an integrative review, with findings organised theoretically, according to the PERMA model (Positive emotions, Engagement, Relationships, Meaning, Accomplishment), otherwise known as The Well-being Model.
Relevant papers published between May 2020 and April 2025 were identified using CINAHL and PsycINFO electronic databases. Search date, April 24, 2025.
The review included 18 articles, mostly from Europe and the United States, examining workplace factors that contribute to the health and well-being of nurses. Mapping findings to the PERMA domains showed that organisational support and individual strategies together foster flourishing among nurses.
This review highlights both individual factors (such as self-care, strength use and adaptive coping) and organisational structures (including supportive environments, professional development and recognition) that are essential for nurses' well-being and flourishing. However, effective interventions require systemic change, with leadership and education playing key roles in supporting nurses to flourish in the workplace.
This review addressed the need to go beyond deficit models of nurses' well-being to pinpoint specific organisational factors that can help nurses to flourish. Prioritising nurse well-being is vital for high-quality, safe and sustainable healthcare systems. Investing in environments where nurses can flourish benefits both individuals and the broader healthcare system.
This integrative review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
To report the current state of nurses' engagement in professional and organisational citizenship behaviours worldwide and identify the factors that enable or hinder these discretionary, value-adding actions.
Integrative literature review.
Peer-reviewed empirical studies, theoretical works and editorials published in English between January 2015 and April 2025 were eligible. Reports had to examine nurses' engagement in professional citizenship behaviours or organisational citizenship behaviours. Conference abstracts, dissertations and studies centred on non-nursing workforces were excluded. Quality was appraised with the mixed methods appraisal tool; data were synthesised narratively using constant-comparison techniques.
CINAHL Complete and MEDLINE were searched on 30 April 2025.
Nineteen articles met the inclusion criteria: seventeen empirical studies (sixteen cross-sectional surveys; one randomised controlled trial) and two editorials. Research emerged across eight countries, including Asia, the Middle East, Europe and North America. For organisational citizenship, six inter-locking themes emerged: (1) psychological resources and personality, (2) attitudinal and affective mediators, (3) leadership effects, (4) ethical, fair and supportive climate, (5) outcomes (patient safety, job satisfaction, retention) of organisational citizenship and (6) sparse intervention evidence (one neurolinguistic programming RCT). No empirical studies directly measured professional citizenship; evidence is limited to two conceptual papers calling for civic, policy and professional association engagement. Thus, the main theme was (7) professional citizenship as a nascent (i.e., emerging) field. Overall, citizenship flourished when nurses felt psychologically resourced, fairly treated and supported by transformational or ethical leaders. Burnout, incivility and destructive leadership suppressed organisational citizenship behaviours.
Nurses' organisational citizenship behaviours yield important benefits for patients, staff and healthcare organisations, including improved safety, satisfaction and retention. In contrast, professional citizenship behaviours remain largely conceptual, highlighting the need for foundational research to define and operationalise this construct. Advancing both organisational and professional citizenship should be a strategic priority for health systems worldwide to sustain the nursing workforce and strengthen care quality.
Embedding citizenship behaviours in education, leadership development and policy can strengthen workforce retention, enhance patient-safety culture and drive professional advocacy. Priority actions include routine assessment of organisational citizenship behaviours, leadership coaching and instrument development, plus intervention trials targeting professional citizenship behaviours.
To explore healthcare professionals' experiences of providing compassionate care and identify care situations considered challenging, with attention to the factors that contribute to these challenges.
A cross-sectional qualitative study was conducted involving 878 healthcare professionals in New Zealand who completed an anonymous online survey between February and May 2022. Of these, 115 participants provided detailed narrative responses describing patient care situations that challenged the provision of compassionate care. These qualitative responses were analysed using content analysis, guided by the Transactional Model of Physician Compassion and reported following the COREQ qualitative reporting guidelines.
Three major themes emerged: (1) fragmented services, resource constraints, and compartmentalisation of care; (2) clinician compassion needs and motivations; and (3) patient-related challenges impacting compassionate care. Over 90% of narratives described barriers to compassionate care that were linked to interconnected patient, clinician, clinical, and systemic factors—rather than being focused on individual patient influences alone.
Challenges to compassionate care are rarely attributable to individual patient characteristics alone. Instead, they reflect complex interactions among patient, provider, clinical, and systemic factors, underscoring the need for multilevel interventions to foster equitable, compassionate care.
This study highlights that barriers to compassionate care are embedded in complex systemic, clinician, and patient domains. Findings underscore the need for interprofessional collaboration, resilience-building strategies, and integrated approaches to enhance compassionate and equitable healthcare delivery.
None.
Despite increasing proportions of underrepresented minority (URM) medical school graduates, their progression into surgical training and leadership remains disproportionately low. Barriers such as financial constraints, limited mentorship and implicit bias contribute to this disparity, creating a disconnect between the diversity of patient populations and those providing care. While interventions such as mentorship programmes and pipeline initiatives have been implemented, their overall effectiveness has not been systematically evaluated. The primary aim of this scoping review is to map the current landscape of interventions, programmes and policies designed to enhance access to surgical careers for URM learners.
Searches will be conducted on EMBASE, Web of Science and OVID MEDLINE. Three independent reviewers will screen references, extract data and perform analyses with disagreements adjudicated by a fourth reviewer. This review will include studies conducted across all levels of training: secondary (high school or secondary school), postsecondary (undergraduate, medical school) and postgraduate (residency, fellowship), with no geographical restrictions. The definition of URM will be accepted as reported within each individual study, allowing for variability in racial, ethnic, gender, socioeconomic or other criteria. The review will include any structured interventions, programmes or policies aimed at increasing URM representation in surgical education. Data on the nature, duration and target population of each intervention will be extracted. The primary outcome will be the reported impact of interventions on URM representation or participation in surgical education. Secondary outcomes will include characteristics of the study participants, definitions of URM status and any qualitative or quantitative evaluations of intervention effectiveness.
Research ethics approval is not required under University of Toronto policy. Study results will be reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Results will be disseminated to relevant stakeholders at conference presentation(s) and submitted for publication in a peer-reviewed journal.
To determine the association between rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection following home, community and work-related exposures, to assess real-world relative vaccine effectiveness, and to determine whether anti-receptor-binding domain (RBD) IgG levels were associated with the rates of subsequent infection.
Prospective cohort of 34 months’ duration (February 2021 to December 2023).
Teachers and education workers working ≥8 hours per week in the Canadian province of Ontario.
3155 education workers were eligible for the risk factor analysis; 2977 for the serological analysis.
Rate of SARS-CoV-2 infection.
1909 SARS-CoV-2 infections were reported (0.93 per 1000 participant-days); the highest incidence occurred during the period dominated by the Omicron BA.2 variant (2.01 per 1000 participant-days). Rates of infection were significantly higher following the repeal of the mask mandate. Compared with participants without known contact with an infected person, those in close contact with infected adult or child household members (adjusted HR (aHR) 1.43; 95% CI 1.24 to 1.65 and 1.39; 95% CI 1.17 to 1.65, respectively), coworkers (aHR 1.28; 95% CI 1.10 to 1.50), or individuals from more than one setting (aHR 1.44; 95% CI 1.27 to 1.64) had higher rates of infection. Participants with three or more doses of vaccine were 79%–87% less likely to develop SARS-CoV-2 than participants who had two or fewer vaccine doses. Blood samples with anti-RBD antibody levels in the highest quintile (≥5850 binding antibody unit/mL) were associated with a lower rate of subsequent infection (aHR 0.40; 95% CI 0.23 to 0.72) compared with samples with RBD levels below the threshold of detection.
Risk of SARS-CoV-2 infection in education workers occurred at home as well as the workplace, indicating the need to practise multiple intervention strategies whenever the potential for transmission of respiratory diseases is high. COVID-19 vaccines provided protection through December 2023.
by Mostafa Bondok, Moses Kasadhakawo, John Onyango, Oscar Turya, Khumbo Kalua
PurposeTo determine the prevalence and causes of blindness and vision impairment (VI) among adults aged ≥50 years in Western Uganda.
MethodsA population-based cross-sectional survey was conducted in Western Uganda (July-August 2023) using RAAB7. Adults aged ≥50 years who had resided in the study districts for at least six months in the past year were eligible. Participants were identified through door-to-door household visits using a two-stage cluster sampling approach. Primary outcomes include prevalence of blindness and VI and its causes. Secondary outcomes include cataract surgical coverage (CSC), effective CSC (eCSC), refractive error coverage (REC), and effective REC (eREC).
ResultsA total of 3,125 participants were examined (54.1% female). The adjusted prevalence of blindness (presenting visual acuity (PVA) Conclusion
Blindness and vision impairment remain major public health issues in Western Uganda, primarily due to untreated cataract and uncorrected refractive error. Poor post-operative outcomes highlight the urgent need to improve surgical quality. These findings may guide targeted interventions and policy to strengthen eye care services.
To integrate the quantitative and qualitative data collected as part of the PEACH (Procalcitonin: Evaluation of Antibiotic use in COVID-19 Hospitalised patients) study, which evaluated whether procalcitonin (PCT) testing should be used to guide antibiotic prescribing and safely reduce antibiotic use among patients admitted to acute UK National Health Service (NHS) hospitals.
Triangulation to integrate quantitative and qualitative data.
Four data sources in 148 NHS hospitals in England and Wales including data from 6089 patients.
A triangulation protocol was used to integrate three quantitative data sources (survey, organisation-level data and patient-level data: data sources 1, 2 and 3) and one qualitative data source (clinician interviews: data source 4) collected as part of the PEACH study. Analysis of data sources initially took place independently, and then, key findings for each data source were added to a matrix. A series of interactive discussion meetings took place with quantitative, qualitative and clinical researchers, together with patient and public involvement (PPI) representatives, to group the key findings and produce seven statements relating to the study objectives. Each statement and the key findings related to that statement were considered alongside an assessment of whether there was agreement, partial agreement, dissonance or silence across all four data sources (convergence coding). The matrix was then interpreted to produce a narrative for each statement.
To explore whether PCT testing safely reduced antibiotic use during the first wave of the COVID-19 pandemic.
Seven statements were produced relating to the PEACH study objective. There was agreement across all four data sources for our first key statement, ‘During the first wave of the pandemic (01/02/2020-30/06/2020), PCT testing reduced antibiotic prescribing’. The second statement was related to this key statement, ‘During the first wave of the pandemic (01/02/2020-30/06/2020), PCT testing safely reduced antibiotic prescribing’. Partial agreement was found between data sources 3 (quantitative patient-level data) and 4 (qualitative clinician interviews). There were no data regarding safety from data sources 1 or 2 (quantitative survey and organisational-level data) to contribute to this statement. For statements three and four, ‘PCT was not used as a central factor influencing antibiotic prescribing’, and ‘PCT testing reduced antibiotic prescribing in the emergency department (ED)/acute medical unit (AMU),’ there was agreement between data source 2 (organisational-level data) and data source 4 (interviews with clinicians). The remaining two data sources (survey and patient-level data) contributed no data on this statement. For statement five, ‘PCT testing reduced antibiotic prescribing in the intensive care unit (ICU)’, there was disagreement between data sources 2 and 3 (organisational-level data and patient-level data) and data source 4 (clinician interviews). Data source 1 (survey) did not provide data on this statement. We therefore assigned dissonance to this statement. For statement six, ‘There were many barriers to implementing PCT testing during the first wave of COVID-19’, there was partial agreement between data source 1 (survey) and data source 4 (clinician interviews) and no data provided by the two remaining data sources (organisational-level data and patient-level data). For statement seven, ‘Local PCT guidelines/protocols were perceived to be valuable’, only data source 4 (clinician interviews) provided data. The clinicians expressed that guidelines were valuable, but as there was no data from the other three data sources, we assigned silence to this statement.
There was agreement between all four data sources on our key finding ‘during the first wave of the pandemic (01/02/2020-30/06/2020), PCT testing reduced antibiotic prescribing’. Data, methodological and investigator triangulation, and a transparent triangulation protocol give validity to this finding.
FreshRSS 