Nurs. Rep., Volume 15, Issue 6 (June 2025) – 41 articles

Background: Although there is recent evidence from a range of sources that demonstrates the usefulness of assessing satisfaction with healthcare, there is still a lack of evidence regarding the satisfaction with healthcare received by adult individuals at the EOL in Portugal. Methods: This systematic review aims to examine and synthesize the evidence published through 2024 regarding satisfaction with care received by adult individuals at the EOL in Portugal. Results: Seven studies were included in this review. Six out of the seven studies were quantitative descriptive cross-sectional studies. The majority of them used family caregivers as the source of information. Most studies had small samples that characterized the satisfaction with care received in a palliative care context in a specific region of the country. Sixteen different variables were studied to understand the factors that influence satisfaction with care. The majority of them were related to the personal characteristics of the patient or the family caregiver. No evidence was found regarding the study of variables related to the patient’s trajectory, location of care provision, or place of death. Conclusions: The different instruments used in the data collection in all of the included studies made it difficult to compare the results and draw definite conclusions regarding satisfaction with care received by adult individuals at the EOL in Portugal. Although different levels of satisfaction with the care were found, it can be concluded that the results tend to be positive in the palliative care context. Full article

Background/Objectives: Organizing nurses’ work is crucial for ensuring patient care quality and efficiency. Nurses’ work methods directly influence patient safety and healthcare outcomes, making them vital for effective health services. Assessing these methods helps identify effective practices, enhance work organization, and improve both professional satisfaction and patient safety. This study aims to translate, adapt, and validate the Nurse Work Method Assessment Scale (NWMAS) for Turkish. Methods: Methodological study with a non-probabilistic sample of 209 hospital nurses, conducted between June and July 2024. The linguistic adaptation involved translation and back-translation with the participation of bilingual experts. Statistical analyses included exploratory and confirmatory factor analyses, item-total correlation tests, test-retest reliability, and internal consistency assessment using Cronbach’s alpha. Results: One item was removed due to cultural incompatibility, resulting in a 24-item Turkish version of the NWMAS. During the adaptation process, expert evaluations led to the removal of one item from the original scale, as it referenced nursing practices that are either not widely implemented or considered culturally incompatible with the structure of the Turkish healthcare system. Content Validity Index values ranged from 0.85 to 0.95. Exploratory factor analysis confirmed a five-factor structure explaining 55.65% of total variance. Confirmatory factor analysis supported this structure with acceptable fit indices (χ²/df = 1.89; RMSEA = 0.06; GFI = 0.86). Cronbach’s alpha for the overall scale was 0.87, with subscale alphas ranging from 0.52 to 0.82. Test-retest reliability coefficients ranged from 0.95 to 0.98, indicating high stability over time. Conclusions: The Turkish version of the NWMAS demonstrated adequate validity and reliability and can be used to evaluate nurses’ work methods in Turkish hospital settings. The study highlights the importance of cultural adaptation in scale development to ensure conceptual relevance in local healthcare systems. Full article

Introduction: Psychomotor agitation represents a complex medical emergency, particularly challenging in prehospital settings. Since March 2020, the incidence of psychomotor agitation has significantly increased. Rationale: Emergency Medical Services (EMS) frequently serve as the first point of contact, bearing the critical responsibility of effectively managing these situations. Objective: This was to assess the feasibility and suitability of the intranasal route for administering pharmacological therapy in the prehospital management of patients experiencing psychomotor agitation. Materials and Methods: An integrative review of the literature was conducted to evaluate the use of the intranasal route for drug administration in patients with psychomotor agitation in prehospital settings. The review was carried out between September 2022 and July 2024. A total of 454 articles were identified, 15 of which met the inclusion criteria. These were supplemented by an additional 10 records, resulting in the analysis of 25 studies. Results: Seventeen studies outlined protocols for managing agitated patients, five described the correct technique for intranasal drug administration, and eleven identified drugs suitable for this route. Conclusions: The intranasal route is a safe, rapid, and accessible method for the pharmacological containment of agitated patients in prehospital settings, particularly for individuals who are uncooperative. Full article

Background: As artificial intelligence (AI) continues to advance in healthcare, limited research has explored how nursing professionals perceive its integration into clinical practice and education—particularly among those directly involved in AI-driven initiatives. This qualitative study aimed to investigate the perceptions, experiences, and expectations of nursing educators and clinical practitioners regarding the application of AI in nursing and to provide insights for the advancement of AI-driven nursing science. Methods: A descriptive qualitative design was employed. Between September and December 2024, semi-structured interviews were conducted with 12 nursing professionals from universities and hospitals in Shanghai, Suzhou, and Chengdu, China. Participants were selected using maximum variation sampling, and data were analyzed using content analysis. Results: Three major themes and eleven sub-themes were identified: (1) The potential of multi-perspective development of AI-driven nursing science and practice, including aiding in decision-making, assisting with writing nursing documents, helping in care practices with high exposure risks and heavy physical exertion, and supporting the development of nursing activities. (2) A multi-dimensional response to the wave of intelligent nursing research and practice: education and scientific research come first, then we fully explore the application scenarios, and then conduct deep interdisciplinary integration. (3) Obstacles for intelligent nursing research and practice: interaction factors of “human–technology–machine” for application, transformation, and promotion; financial support and continuous investment; the controversy behind the intelligent maturity level; and application risk and fault tolerance. Conclusions: Participants emphasized the importance of evidence-based, cautious, and context-sensitive application of AI technologies to ensure that intelligent nursing evolves in alignment with clinical realities. The findings suggest a need for strengthened policy, education, and resource allocation to support the sustainable integration of AI in nursing. Full article

Introduction: The health education curricula should explicitly recognize, define, and address the unique needs and health disparities faced by Black and LGBTQIA+ populations, as a means of ensuring that healthcare for these populations is both comprehensive and inclusive. Aim: To map scientific evidence and identify knowledge gaps regarding the health of Black and LGBTQIA+ populations within the global context of health education. Methods: A scoping review will be conducted following the JBI methodology. The articles will be retrieved from Scopus, Web of Science, PubMed, Embase, MEDLINE, BVS, CINAHL, ERIC, Cochrane, BDTD, PQDT, EBSCO, and NDLTD. The search will be conducted without language or time restrictions. Two independent reviewers will screen the studies and extract data using a form specifically developed for this purpose. The concepts, definitions, structures, results, and applications of professional health education worldwide for the healthcare of Black and LGBTQIA+ populations will be summarized and discussed. Inclusion Criteria: Studies related to professional health training at both undergraduate and graduate levels, as well as other educational modalities that address the provision of healthcare for these populations, will be included. The results will be presented in both tabular and graphical formats, accompanied by a narrative summary. Protocol registered in the Open Science Framework (OSF). Full article

Antimicrobial resistance (AMR) is a pressing global health challenge, driving the need for effective antimicrobial stewardship (AMS) programmes. Despite nurses’ critical role in care delivery, their involvement in AMS remains under-recognized. Objectives: This mapping review aims to identify barriers and facilitators influencing nurses’ engagement in AMS programmes and examine nursing-sensitive outcomes associated with their participation, using Irvine’s Nursing Role Effectiveness Model (NREM) as a guiding framework. Methods: A systematic mapping review was conducted following Joanna Briggs Institute (JBI) guidance and reported using the PRISMA-ScR checklist. The protocol was registered on the Open Science Framework. Searches were conducted in MEDLINE, CI-NAHL, Scopus, LILACS, Scielo, and grey literature sources. Data were extracted and categorized according to the NREM domains: structure, process, and outcomes. Results: Thirty-two studies were included. Key barriers included limited AMS knowledge, role ambiguity, hierarchical dynamics, communication gaps, and lack of standardized nursing outcomes. Facilitators encompassed targeted AMS education, participation in multidisciplinary discussions, managerial support, and defined nursing roles. Nurse-led interventions showed potential to improve infection control and antibiotic administration, although standardized outcome reporting remains scarce. Conclusions: Framed by the NREM, this review underscores the essential contribution of nurses to AMS. Addressing structural barriers, enhancing role clarity, and fostering interdisciplinary collaboration are critical to enabling nurses’ full participation. Strengthening nursing engagement in AMS not only supports effective antimicrobial use and patient safety but also reinforces health system resilience and sustainability. Full article

Background/Objectives: Leadership in nursing plays a pivotal role in the provision of high-quality healthcare. It is, therefore, of paramount importance to understand the challenges encountered by newly qualified nurses when assuming leadership responsibilities. This scoping review protocol aims to identify and map these challenges, thereby facilitating the development of more effective interventions and support programmes. The data collection and analysis were conducted from January 2024 to March 2024. Methods: The review was conducted in accordance with the Joanna Briggs Institute (JBI) guidelines for scoping reviews and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) recommendations. A comprehensive search was undertaken across MEDLINE, CINAHL, Web of Science, Scopus, LILACS, and SciELO databases, in addition to a search for the grey literature. Study selection was performed by two independent reviewers, applying pre-defined inclusion and exclusion criteria. The data were extracted using a standardised form and analysed descriptively. Results: The review identified several key challenges faced by newly qualified nurses in leadership roles, including conflict management, decision-making under pressure, and effective communication. These findings highlight the complexity of transitioning from academic training to professional practice. The results provide a comprehensive overview of these challenges, enabling the identification of gaps in the existing knowledge base and informing the direction of future research and interventions. Conclusions: The findings of this review will contribute to the enhancement of healthcare quality and the promotion of the professional development of newly qualified nurses. This research underscores the importance of developing targeted interventions and support systems to address the specific challenges identified, thereby influencing nursing practice and policy. Full article

Background: Healthcare is a dynamic environment for nurses, with early career nurses (ECNs) needing to adapt and learn while also meeting care demands. Effective support systems, mentorship, and continuous professional development are vital in facilitating their transition while navigating competing demands. The aim of this study is to interpret and understand the meaning of ECNs’ professional experiences four years after completing their bachelor’s degree in Australia. Method: A qualitative descriptive design using a hermeneutic phenomenological approach was used as part of a longitudinal study. Follow-up semi-structured interviews were conducted among twenty-five ECNs between 2022 and 2024 using purposive sampling to recruit ECNs who had graduated four years ago. Thematic analysis was used to analyse data while adhering to the consolidated criteria for reporting qualitative research (COREQ) guidelines. Results: Four themes emerged among participants, which encompassed professional growth and unwavering commitment, ongoing professional adaptability, feeling stuck with limited choices, and continual learning amid career challenges and personal life demands. Conclusions: Change is needed to ensure professional learning becomes a shared responsibility among policy makers and healthcare leaders and to ensure that professional learning leads to more nurses taking up further study, thus increasing the safety and quality of care delivered in the healthcare environment. Full article

Background/Objectives: All countries face a shortage of qualified nurses. Based on the social cognitive career theory (SCCT), it is assumed that individual and environmental aspects are interlinked and determinants in career choice and vocational behaviors. This study aims to determine if nursing students differ in their perceptions of nursing as a career. Furthermore, this study wants to determine if the students in a cluster differed in their outcome expectations, job satisfaction, and informal workplace learning. Methods: This study employed a mixed-methods design consisting of two phases: the first involving a pre-study with experts (N = 10) and the second comprising a cross-sectional questionnaire survey. The goal of the pre-study was to find relevant characteristics of the nursing profession. In a cross-sectional study with an online questionnaire, 230 nursing students (N = 230) participated. An inclusion criterion was that participants were enrolled in vocational training to become a nurse. In the questionnaire validated scales were used to ask participants about the characteristics of the nursing profession, their perceptions of nursing as a career, outcome expectations, informal workplace learning, and job satisfaction. Analysis: Data analysis included descriptive statistics (e.g., percentage distributions), hierarchical cluster analysis, and analysis of variance (ANOVA). Results: The LCA results based on Schwarz’s BIC showed a two-cluster solution (Akaike Information Criterion (AIC) 251.984, Bayesian information criterion (BIC) 265.296, and adjusted Bayesian information criterion (aBIC) 252.622). The results of the ANOVA showed significant differences regarding outcome expectations (F = 22.738; <0.001), the perception of nursing as a career (F = 36.231; <0.001), and the engagement in informal workplace learning activities (F = 20.62; <0.001). For job satisfaction, no significant differences were found. Conclusions: Nursing vocational education and training is a vital socialization process in which supervisors can arrange a positive learning climate. Full article

Objective: The aim of this study is to investigate uterine prolapse (UP) among women attending a semi-urban health center for routine gynecological examinations. Specifically, the study explores the potential association between UP and various established or suspected risk factors, including age, menopausal status, number and mode of deliveries, birth weight, smoking habits, and body mass index (BMI). Furthermore, it examines the relationship between the presence or severity of UP and the scores of specific questionnaires and their subscales. Finally, the study seeks to develop a predictive model for the likelihood of UP based on questionnaire responses. Methods: A quantitative study was conducted at the gynecological department of a health center in Greece from January 2021 to October 2022. A total of 134 women were recruited using convenience sampling during routine gynecological visits. The degree of prolapse was classified according to the International Continence Society (ICS) Pelvic Organ Prolapse Quantification (POP-Q) classification system. Data collection also included the use of validated instruments: the Australian Pelvic Floor Questionnaire (APFQ), the Urogenital Distress Inventory-6 (UDI-6), the Pelvic Floor Distress Inventory-20 (PFDI-20), and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). The data were processed with the Statistical Package for the Social Sciences (SPSS) v25. Results: Of the 134 participants, 21 (15.7%) aged 21 to 82 showed signs of UP, while 113 women (84.3%) did not. The average age of the women with UP was 55 years. Fourteen (10.4%) of these women were diagnosed with UP stage I, three of them (2.2%) with stage II, and four of them (3%) with stage III UP. There were no stage IV UP incidents. The risk factors associated with the disease include age, mode of delivery, parity, and duration of menopause. Regarding parity, every subsequent birth after the first one increases the likelihood of a UP incident by approximately 125%. Conclusions: Most women with UP did not exhibit severe symptoms, as UP typically does not manifest symptoms until it reaches a final stage. Considering the population aging and the increase in morbidity, a regular pelvic organ prolapse (POP) checkup should be established to facilitate early recognition, prevention, and treatment of symptoms. This study offers a potential tool for non-invasive screening to facilitate identifying UP in women early, which has not been previously reported. Full article

Background/Objectives: The use of standardized assessment tools within the nursing care process is a globally established practice, widely recognized as a foundation for evidence-based evaluation. Accurate translation is essential to ensure their correct and consistent clinical use. While effective, traditional procedures are time-consuming and resource-intensive, leading to increasing interest in whether artificial intelligence can assist or streamline this process for nursing researchers. Therefore, this study aimed to assess the translation’s quality of nursing assessment scales performed by ChatGPT 4.0. Methods: A total of 31 nursing rating scales with 772 items were translated from English to Italian using two different prompts, and then underwent a deep lexicometric analysis. To assess the semantic accuracy of the translations the Sentence-BERT, Jaccard similarity, TF-IDF cosine similarity, and Overlap ratio were used. Sensitivity, specificity, AUC, and AUROC were calculated to assess the quality of the translation classification. Paired-sample t-tests were conducted to compare the similarity scores. Results: The Maastricht prompt produced translations that are marginally but consistently more semantically and lexically faithful to the original. While all differences were found to be statistically significant, the corresponding effect sizes indicate that the advantage of the Maastricht prompt is slight but consistent across all measures. The sensitivity of the prompts was 0.929 (92.9%) for York and 0.932 (93.2%) for Maastricht. Specificity and precision remained for both at 1.000. Conclusions: Findings highlight the potential of prompt engineering as a low-cost, effective method to enhance translation outcomes. Nonetheless, as translation represents only a preliminary step in the full validation process, further studies should investigate the integration of AI-assisted translation within the broader framework of instrument adaptation and validation. Full article

Background/Objectives: Healthcare-associated infections (HAIs) are a major global public health concern, significantly impacting patient safety and healthcare quality. These infections are associated with high morbidity and mortality rates, prolonged hospital stays, and increased healthcare costs. Nurses play a critical role in infection prevention, implementing evidence-based interventions to reduce infection risks. This systematic review aims to identify and synthesize the most effective nursing interventions to prevent HAIs in hospitalized adults, analyzing their variability across different clinical settings and populations. Methods: This systematic review follows the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness and is reported according to PRISMA guidelines. The protocol is registered in the PROSPERO database (CRD42024582820). This review includes randomized controlled trials, quasi-experimental studies, and observational studies (cohort, case-control, and cross-sectional) assessing the effectiveness of nursing interventions in reducing HAIs. A comprehensive search is conducted in the PubMed, CINAHL, Scopus, Web of Science, and Cochrane databases. Study selection, data extraction, and quality assessment are performed by two independent reviewers, with disagreements resolved by a third reviewer. Results: The primary outcomes include reductions in HAI incidence rate, increased adherence to preventive interventions, decreased hospital length of stay, reduced readmission rates due to infections, and overall patient safety improvements. A meta-analysis is conducted when feasible; otherwise, results are synthesized narratively. Conclusions: The findings of this review contribute to the standardization of evidence-based nursing practices for HAI prevention, promoting safer healthcare environments. By identifying the most effective interventions, this study aims to support healthcare professionals and policymakers in implementing targeted infection control strategies. Full article

Background: Patients who undergo cardiac surgery and procedures often experience functional impairments. However, few studies have compared changes in physical function, cognitive function, mental health, and sleep quality before and after the interventions. Methods: Intensive care unit (ICU) nurses visited the ward and conducted the assessments. The Japanese version of the Cardiovascular Health Study (J-CHS) and the Barthel index for physical function, mini-mental state examination (MMSE) for cognitive function, hospital anxiety and depression scale for anxiety (HADS-A) and depression (HADS-D) for mental health, and a 5-point Likert scale for sleep quality were used. Results: Of the 210 cases, 156 were included. Cardiac surgeries and procedures included valve replacement or valvuloplasty (43%), coronary artery bypass graft (9%), and transcatheter aortic valve implantation (39%). At a median of 7 (4–9) days after ICU discharge, the J-CHS score worsened from 2 (1–3) to 3 (2–3) (p < 0.01), and the Barthel index worsened from 95 (85–100) to 75 (55–85) (p < 0.01). The HADS-A score improved from 3 (1–6) to 1 (0–4) (p < 0.01), and the HADS-D score improved from 4 (1–7) to 2 (1–6) (p < 0.01). The MMSE score remained unchanged at 26 (24–29; p = 0.91). Sleep quality worsened from 4 (3–5) to 3 (2–4) (p < 0.01). In the multivariate analysis, sleep quality deterioration was associated with open thoracotomy. Conclusions: After cardiac surgeries and procedures, physical function and sleep quality worsened, whereas anxiety and depression improved, and cognitive function remained unchanged. Full article

Aim: This study aimed to explore the relationships between burnout, emotional intelligence (EI), and work engagement (WE) among hospital nurses. Specifically, it examined the mediating role of burnout in the relationship between EI and WE. Background: Nurses are frequently exposed to emotionally and physically demanding environments, which may lead to sustained occupational stress. Prolonged exposure to such conditions can contribute to burnout, adversely affecting both personal well-being and professional performance. EI is increasingly recognised as a protective factor that may alleviate burnout and enhance WE. Methods: A quantitative, cross-sectional correlational design was employed. A quota sampling technique was used to select 336 nurses working in public healthcare facilities in Ha’il, Saudi Arabia. Data were collected using standardised self-report instruments: the 14-item Shirom–Melamed Burnout Questionnaire (SMBM), the short-form Genos Emotional Intelligence Inventory (Genos EI), and the 9-item Utrecht Work Engagement Scale (UWES-9). Structural equation modelling examined associations and the mediating role of burnout between EI and WE. Results: EI was positively associated with WE and negatively with burnout. Burnout, in turn, was negatively associated with WE. Mediation analysis confirmed that burnout partially mediated the effect of EI on WE, indicating that EI nurses were less likely to experience burnout and more likely to remain engaged in their roles. Discussion: The results emphasise the role of EI in reducing burnout and enhancing WE among nurses. Burnout partially mediates this relationship, suggesting that EI influences WE both directly and indirectly. Conclusions and Implications for Nursing: Integrating EI training into professional development and implementing measures to reduce burnout may improve WE and retention. Policy efforts should ensure supportive work environments and adequate staffing to sustain nurse well-being. Full article

Background/Objectives: To examine shifts and challenges in transitional care practices during COVID-19 and the adaptive strategies developed by Transitional Care Nurses (TCNs) in response. Methods: A qualitative descriptive study was conducted using semi-structured interviews with 15 TCNs from acute care hospitals in Japan. Data were collected from October 2021 to October 2022 and analyzed using qualitative thematic analysis. The study is reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: Three main themes emerged: (1) disrupted connections in transitional care with patients and families, among hospital staff, and with community services; (2) professional pressures in pandemic care, including the mental and physical burden on TCNs and navigating unexpected changes to transitional care plans; and (3) adaptive strategies through digital solutions and community partnerships. TCNs implemented hybrid approaches combining selective face-to-face interactions for complex procedures and strategic use of digital tools for routine communication. Conclusions: This study provides the first detailed examination of how TCNs in Japan adapted to transitional care during COVID-19. TCNs maintained essential care principles while implementing digital tools and strengthening community partnerships using hybrid approaches. These findings offer practical guidance for healthcare organizations to enhance transitional care practices during future healthcare crises. Full article

Background/Objectives: Ostomy creation surgery is a common intervention for patients with conditions such as colorectal cancer, ulcerative colitis, Crohn’s disease, or acute events like trauma and gastrointestinal perforation. Individuals with an ileostomy face unique challenges when managing their new ostomies due to the liquid caustic nature of the effluent, increasing the likelihood of leakage and peristomal skin complications (PSCs). This sub-analysis evaluates the prevalence of leakage and PSCs in a cohort of individuals with a new ileostomy and examines the risk of leakage of different ostomy pouching systems and their impact on leakage and PSCs. Methods: This sub-analysis examined a cohort of 98 patients from a previously published retrospective chart review of stoma-creation surgeries at the University of Pittsburgh Medical Center. Data on pouching system selection, leakage, and PSCs were collected from electronic medical records and evaluated across 479 pouch changes. Two main barrier pouching systems were analyzed: elastic tapeless border (ETB) and ceramide-infused tape-border (CIB) barriers. Statistical analyses using generalized linear mixed models assessed the risk of leakage for each barrier type and controlled for significant differences in the sub-groups. Results: The prevalence of leakage in the ileostomy cohort was 19%, with the prevalence of leakage increasing over successive pouch changes. The ETB sub-group experienced a significantly lower risk of leakage (13.7%) compared to CIB (29.3%), reflecting a 53.2% lower risk of leakage with ETB (p = 0.03; OR 2.45). Conclusions: This sub-analysis of ileostomy patients confirms that ETB significantly reduces the risk of leakage in this more difficult to manage population compared to CIB, a clinically important consideration in PSC development and overall ostomy management. Evidence-based selection of ostomy barriers can improve patient outcomes, enhance quality of life, and reduce healthcare resource utilization. Full article

Background and Objective: Delirium, a prevalent neurocognitive disorder, frequently affects critically ill patients hospitalized in intensive care units (ICUs), leading to increased mortality, prolonged hospital stays, and higher healthcare costs. This quasi-experimental study assessed the effect of an educational program relating to ICU nurses’ knowledge of delirium in a university hospital in Nablus, Palestinian Authority. Methods: A pre-test–post-test design was employed, utilizing a 25-item questionnaire for 114 ICU nurses. The educational intervention included a presentation on delirium, the distribution of educational materials, and follow-up video sessions. Our study aim was to evaluate nurses’ understanding of ICU delirium and the impact of the educational program on their ability to identify and evaluate the delirium. Results: Pre-intervention assessments indicated limited awareness among nurses regarding delirium diagnosis and management tools, i.e., the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist. Post-intervention results showed a significant improvement in knowledge; median scores increased from 6 (range: 3–13) to 15 (range: 12–20) (p < 0.001). Nurses also reported greater confidence in identifying and managing delirium, and 50% found CAM-ICU easy to use. However, knowledge gaps remained concerning mixed delirium types and modifiable risk factors. Conclusions: Continuous educational programs are essential for ensuring long-term knowledge retention. We recommend integrating routine delirium education with hospital policies and emphasizing the use of delirium assessment tools during each shift. Findings show that targeted education can enhance ICU nurses’ competencies and thereby improve patient outcomes through more effective delirium management. Full article

Background: Nursing students’ readiness for clinical practicums is critical to nursing education. Concerns about students’ preparedness for clinical courses have emerged due to increased student-to-educator ratios and limited hands-on practice time. Moreover, feedback from clinical instructors reveals that many student nurses lack the necessary knowledge and skills for patient care, thereby raising questions about their readiness for clinical practicum. Purpose: This study investigates undergraduate nursing students’ readiness for clinical practicum in the UAE by examining their perspectives, the variation in clinical study plans across different contexts, and the evidence gathered from clinical evaluations. Methodology: A case study design was adopted, utilizing semi-structured interviews with 13 nursing students from a UAE nursing college. Additionally, two types of document analysis were conducted. First, 11 nursing curricula from high-ranking universities were analyzed to compare whether students received adequate laboratory courses for their clinical practicum. Second, 217 clinical evaluation reports from third- and fourth-year nursing students across 4 campuses of the UAE nursing college were reviewed. Findings: The study identified two key themes from the interviews: incomplete readiness for clinical practicum and the factors contributing to this incomplete readiness. Document analysis revealed that, unlike many American and Australian institutions, most universities lacked co-requisite laboratory courses. Clinical evaluation reports highlighted that some students, particularly in their fourth year, were inadequately prepared for clinical practice due to deficiencies in both clinical skills and theoretical knowledge. Conclusions: The findings indicate that many nursing students felt only partially prepared for their practicum, negatively impacting their confidence and competency. Moreover, adopting the American and Australian approach of pairing practicum courses with laboratory courses may better prepare students for clinical practicum. Recommendations for future research have been outlined. Full article

Background/Objectives: Comparative analysis of work ability factors between German nurses without a migration background and Kosovar nurses working in Germany as nurses with a migration background. Methods: This is an observational cross-sectional study. We surveyed 814 nurses from hospitals in Kosovo and Germany using self-administered questionnaires. We used the Nurses Working Capability (WiN) Screening Manual to analyze work ability factors. Data analysis involved descriptive statistics, ANCOVA, and Bonferroni multiple comparison tests. Results: Of the 40 target factors, 17 showed significant differences. There were notable distinctions between German and Kosovar nurses in Germany. Concerning health and personal resources, Kosovar nurses in Germany reported poorer physical (M = 3.71) and social health (M = 3.83) but better mental health (M = 3.53) and fewer cognitive stress symptoms (M = 3.60) than German nurses (M = 3.97, M = 4.05, M = 3.40, and M = 4.00, respectively). As to the work-related factors, Kosovar nurses in Germany faced higher emotional demands (M = 3.33), felt greater time pressure (M = 3.43), and had a more negative view of the organizational structure (M = 2.09) but rated supervisor feedback more positively (M = 3.24) and faced fewer patient-related stressors (M = 2.16) relative to German nurses (M = 2.64, M = 2.64, M = 2.82, M = 2.76, and M = 3.09, respectively). Conclusions: Kosovar immigrant nurses in Germany face distinct challenges related to physical and social health, higher emotional demands, and time constraints; they also have a more negative view of organizational structure than native German nurses. The possible causes of these differences may be attributed to migration-related stress, cultural and environmental adaptations, varying job expectations, or organizational experiences. Full article

Background/Objectives: Hospital discharge of pediatric hematopoietic stem cell transplant (HSCT) patients is complex and requires multidisciplinary efforts to ensure patients/caregivers are prepared for transition to the outpatient setting. This period is tenuous as patients are medically complex, immunocompromised, and required to take several medications requiring dose titration. Miscommunication or decreased preparedness for discharge can place patients at risk for life-threatening complications. An integrative review was performed to evaluate the current literature on discharge coordination best practices for pediatric HSCT, revealing a scarcity of data. Taking into account this minimal literature and the lack of an established process at our center, this article details the development and implementation of a multidisciplinary care coordination program for pediatric HSCT patients following hospital discharge, aiming to establish a standardized approach and thus improve caregiver readiness for discharge. Methods: A group of physicians, advanced practice nurses, registered nurses, and pharmacists developed a comprehensive approach to pediatric HSCT discharge coordination. Interventions included standardized education, checklist integrated into the electronic medical record, 24 h rooming-in period, and personalized pharmacist follow-up. Surveys were provided to caregivers to assess discharge readiness and ongoing medication adherence. Results: This quality improvement project demonstrated feasibility via successful implementation for 12 patients. Compared to a nine-patient pre-implementation group, there was no statistically significant difference in perceived readiness. Medication adherence was unable to be evaluated. Clinical significance was anecdotally appreciated by the medical care team, with improved organization, collaboration, and communication. Conclusions: A new pediatric HSCT discharge coordination program was created and successfully implemented. More literature on best practices is needed. Full article

Background: Type 2 diabetes (T2D) is a chronic disease that significantly impacts individuals’ quality of life, affecting their physical, psychological, social, and environmental well-being. Objectives: This study investigates how self-care habits influence quality of life and key health indicators, such as glycated hemoglobin (HbA1c), blood sugar levels, and body mass index (BMI), among newly diagnosed diabetic individuals in Vlore, Albania. Methods: In this cross-sectional study, 332 individuals recently diagnosed with diabetes were surveyed between April and July 2024. Data were collected using the World Health Organization Quality of Life Assessment (WHOQOL-BREF) and the Summary Diabetes Self-Care Activity (SDSCA) surveys. Sociodemographic and clinical information, including age, education, occupation, duration of diabetes, HbA1c, and BMI, were collected through structured interviews and medical records. Descriptive and multivariate analyses were conducted to examine the relationships between self-care behaviors, sociodemographic factors, and quality of life. Results: The findings reveal a low quality of life, with a mean quality of life (QoL) score of 35.33 ± 8.25. Environmental domains were most affected, registering a low QoL score of 30.93 ± 9.04. Significant relationships between QoL, self-care practices, and sociodemographic factors and pathologic factors were found. The analysis indicated that distinct factors influenced various domains of quality of life. Physical health was associated with residence, comorbidities, BMI, and HbA1c, follow-up visits, dietary self-care and physical activity self-care. Psychological health correlated with residence, educational level, BMI, and HbA1c, follow-up visits, dietary, physical activity and foot self-care. Age, occupation, BMI, and physical activity self-care were linked to social relationships. Finally, environmental well-being was influenced by gender, residence, BMI, HbA1c, follow-up visits, and dietary and physical activity self-care. Conclusions: This study emphasizes the impact of sociodemographic and clinical factors on the quality of life of patients with T2D. Older age, lower education levels, comorbidities, increase in BMI and HbA1c levels, and inadequate self-care were associated with reduced quality of life. These findings highlight the need for targeted interventions and policies that promote self-care and support for at-risk groups. Full article

Background: Ensuring the safety of patients in the operating room, through the monitoring and prevention of adverse events is a central priority of healthcare delivery. In the professionalization of operating room nurses, the processes of identifying, assessing, developing, monitoring, and certifying transversal competencies are crucial. While national and international frameworks have attempted to define such competencies, they often vary in scope and remain inconsistently integrated into education and clinical practice. There is, therefore, a need for a comprehensive and structured identification of transversal competencies relevant to both perioperative and perianesthesiological nursing roles. Objectives: To formulate a validated and structured repertoire of transversal competencies demonstrated by operating room nurses in both perioperative and perianesthesiological contexts. Methods: A qualitative descriptive design was adopted, combining shadowed observation with Hierarchical Task Analysis (HTA). A convenience sample of 46 participants was recruited from a university and a public hospital in Italy. Data were collected between September 2021 and June 2023 and analyzed using content analysis and data triangulation. Results: Through a qualitative, inductive and iterative approach the study identified 15 transversal competencies, 50 sub-competencies, and 153 specific tasks and activities. Specifically, operating room nurses working in perioperative and perianesthesiological roles presented the following transversal competencies: communication and interpersonal relationships, situation awareness, teamwork, problem solving and decision-making, self-awareness, coping with stressors, resilience and fatigue management, leadership, coping with emotions, task and time management, ethical and sustainable thinking, adaptation to the context, critical thinking, learning through experiences, and data, information and digital content management. Each competency was associated with specific tasks observed. Conclusions: This framework complements the existing repertoire of technical-specialist competencies by integrating essential transversal competencies. It serves as a valuable tool for the assessment, validation, and certification of competencies related to patient and professional safety, emotional well-being, relational dynamics, and social competencies. The findings underscore the need for academic institutions to revise traditional training models and embed transversal competencies in both undergraduate and postgraduate nursing education. Full article

Background/Objectives: Clinical incivility is a persistent issue in nursing education and practice, with negative impacts on students, educators, and clinicians. Uncivil behaviors—such as belittling, exclusion, and dismissiveness—compromise communication, teamwork, and patient safety. Although various interventions have been implemented, their effectiveness remains inconsistent. This systematic review aimed to evaluate the effectiveness of interventions addressing clinical incivility in nursing and to identify common trends, gaps, and implications for future practice and research. Methods: Following PRISMA 2020 guidelines, a systematic search was conducted in PubMed, Web of Science, and EBSCOhost (CINAHL) for peer-reviewed empirical studies published between 2014 and 2024. Search terms included “clinical incivility” and (“intervention” or “program” or “training”) and “nursing”. Studies were eligible if they evaluated interventions aimed at reducing incivility among nursing students, faculty, or practicing nurses. Seventeen studies met the inclusion criteria and were analyzed for intervention types, target populations, delivery methods, and outcomes. Results: The review identified five main intervention types: educational modules (n = 9), cognitive rehearsal (n = 5), simulation and role-play (n = 5), team-based strategies (n = 3), and feedback/communication strategies (n = 2). Many studies used multiple strategies. Fourteen studies reported positive outcomes such as improved awareness, communication, and self-efficacy. Eight studies demonstrated statistically significant reductions in perceived incivility, particularly those with simulation-based, multi-session, or institutionally supported formats. Three studies showed limited or mixed results due to insufficient follow-up or lack of leadership engagement. Conclusions: Experiential and multi-component interventions appear effective in reducing clinical incivility. Long-term success requires leadership engagement, institutional support, and integration into ongoing professional development. Full article

Background: Nursing decision-making is pivotal for patient safety and care quality. While artificial intelligence (AI) offers transformative potential in this field, a comprehensive analysis of global research trends is lacking. Methods: We conducted a bibliometric analysis of 238 publications (197 research papers, 41 reviews) from the Web of Science Core Collection (2003–2025) using CiteSpace and VOSviewer. Results: The results reveal growing interest (7.59% annually) in the field of AI in nursing decision-making, with contributions from 54 countries/regions. The USA leads in the number of publications, followed by China and Canada, while the United Kingdom stands out in terms of citation impact. Institutions such as Columbia University and Harvard Medical School dominate in both the publication volume and citation frequency. Journal analysis shows that the top three journals in terms of publication volume in this field are Cin-Computers Informatics Nursing, Journal of Nursing Management, and Applied Clinical Informatics. Keyword analysis highlights the significant potential of natural language processing technologies, particularly those based on large language models (e.g., ChatGPT), in nursing decision-making. Furthermore, emerging trends are evident, with the sudden appearance and rapid growth of keywords such as “patient safety” and “user acceptance”, indicating a shift in research focus from purely technology-driven studies to a greater emphasis on the practical impact of AI technologies on nursing systems and their clinical applications. Conclusions: This study delineates the current landscape and evolving trends of AI in nursing decision-making, emphasizing its progression from theoretical frameworks to clinical integration, thereby providing valuable references for future research. Full article

Background/Objectives: Although psychoeducation for relatives of individuals with a first episode psychosis is important for increasing understanding of psychosis, reducing relapse rates, decreasing hospitalization duration, and improving patient functionality, there is limited research on the specific experiences and needs of relatives of patients with a first episode psychosis. This study aims to explore the experiences and needs of relatives of young adults with first-episode psychosis regarding psychoeducation, with the goal of developing tailored psychoeducation (PE) that can be delivered by nurses. Methods: This qualitative study employed a descriptive, interpretative approach with a total sample of 23 participants, including semi-structured interviews (N = 16), two dyadic interviews (N = 4) and one triadic interview (N = 3). The dyadic interviews included two relatives and two patients, while the triadic interview involved two relatives and one patient. A topic list was utilized to guide the interviews. Thematic analysis was employed to analyse the data, supported by the use of ATLAS.ti. Results: During data analysis, five key themes were identified as relevant for the development of a psychoeducational program: experiences with first-episode psychosis and psychoeducation, the content of PE (what), timing (when), exchanging experiences (how) and joint PE versus separate groups (which format). Conclusions: This study highlights valuable insights and key components for an integrated psychoeducation program, focussing on the needs and experiences of relatives, for the development of the PE program. To optimize the benefits for both parties, future research should explore the potential of offering PE sessions that accommodate both individual and combined participant formats, allowing for a design tailored to the specific needs of the participants. Full article

Background/Objectives: The COVID-19 pandemic, caused by SARS-CoV-2, required the rapid development of diagnostic tests. SARS-CoV-2, part of the betacoronavirus genus, shares characteristics with SARS-CoV-1, including its ability to survive on surfaces, facilitating the spread of the infection. This study analyzes the technique of nasopharyngeal secretion collection for SARS-CoV-2 diagnosis and compares the accuracy of rapid antigen and molecular tests. Methods: This study had two components: study A assessed the healthcare personnel training in collecting nasopharyngeal secretions and the discomfort associated with applying a questionnaire. Study B compared rapid antigen test accuracy with RT-PCR among children, through a retrospective analysis. The data were statistically analyzed to assess compliance with the testing protocols. Results: In study A, 88 healthcare workers achieved an average compliance score of 7.60 out of 10 regarding the collection procedure. Over 70% of participants correctly followed the fundamental steps of the procedure. Many patients who underwent sample collection reported pain and symptoms such as coughing or sneezing. In study B, 198 pediatric patients were tested using rapid antigen tests, collected simultaneously with RT-PCR. The rapid tests showed a 50% sensitivity and 97.5% specificity. Conclusions: This study indicates that nasopharyngeal specimen collection techniques are based on international recommendations, but improvements could be made to reduce discomfort. Rapid antigen tests are helpful for screening due to their high specificity and negative predictive value. Continuous healthcare personnel training and the monitoring of diagnostic techniques remain essential in managing SARS-CoV-2 and other viral infections. Full article

Background: Nurses play a fundamental role in identifying the early symptoms of sepsis and thereby contribute to early diagnosis and prevention, which decreases complications and mortality rates and lowers the cost of care. This study aimed to evaluate nurses’ knowledge of sepsis and to analyze its relationship with attitude, self-assessment, and sociodemographic variables. Methods: A correlational, cross-sectional study was conducted. A total of 293 nurses in Poland using a validated tool, the Nurses’ Attitudes and Knowledge about Sepsis Scale (NAKSeS), which assesses both knowledge and attitudes toward sepsis. The instrument included two knowledge subscales (Factor 1: knowledge of pathogenesis, treatment, and prevention; Factor 2: knowledge of nursing actions), an attitude subscale, and a self-assessment item. Sociodemographic data included age, seniority, voluntary postgraduate education, current workplace, and place of residence. Results: Nurses demonstrated moderate levels of general knowledge, Factor 1, Factor 2, attitude toward sepsis, and self-assessed knowledge. Higher scores across all domains were observed among nurses who had completed postgraduate education, cited professional experience or books as key sources of knowledge, and worked in high-acuity settings such as intensive care units, emergency departments, or pediatric wards. Nurses working in larger cities scored significantly higher in general knowledge and Factor 1 compared to those in smaller towns or rural areas. Additionally, greater age and longer work experience were positively associated with more favorable attitudes and higher self-assessed knowledge, although negatively correlated with some knowledge scores. Conclusions: Nurses’ knowledge and attitudes toward sepsis were influenced by the source of education and clinical exposure, with significantly better outcomes observed among those with postgraduate training and experience in high-acuity settings. These findings underscore the need to strengthen sepsis education across all levels of nursing curricula and promote accessible, continuous professional development supported by validated assessment tools. Full article

Background/Objectives: Clinical debriefing is a learning tool that promotes reflection after critical incidents, improving patient safety and professional performance. TALK© is a debriefing technique designed to facilitate structured team self-reflection after any learning event in clinical settings. The aim of this study is to explore the experiences of fourth-year nursing students in clinical internships with clinical debriefing guided by the TALK© tool. Methods: A qualitative case study was conducted. Twenty-seven participants were recruited using purposeful sampling. The sample consisted of nursing students. Data were collected through in-depth interviews, focus groups, personal writings, and researcher field notes. An inductive thematic analysis process was applied. The data analysis was performed using ATLAS.ti 23 software, which facilitated the identification and organization of key themes and patterns within the qualitative data. Conclusions: Participants perceived TALK©-guided clinical debriefing as a valuable practice. Key factors influencing their experience included the reflexive process, the debriefing approach and technique, the timing and context, as well as its emotional sphere. Full article

Background: The development of the pediatric nursing specialty in Spain is uneven, with marked differences between Autonomous Communities in training and employment. This study analyzes its evolution, current situation, and existing disparities. Material and Methods: A narrative documentary review was carried out including quantitative and qualitative data obtained from academic databases, legislative sources, and professional associations. Results: In 1964, 2554 nurses obtained the title of specialist in pediatrics and childcare, validated in 2005 as pediatric nursing. From 2010 to 2024, 2312 places for pediatric nursing interns were offered, with an unequal distribution between communities. By the exceptional route, in 2015, 9875 nurses obtained the specialty, adding up to an estimated total of 13,978 specialists. The first public employment offer was announced in 2019 in Galicia, followed by Castilla y León, Madrid, and Murcia in 2023. A total of 245 vacancies were advertised, with reconversions of vacancies in some regions. Communities such as Galicia, Madrid, and Murcia have created the category, while others, such as Catalonia and the Basque Country, have not implemented it. Finally, only five regions have a specific employment exchange that is currently operating. Conclusions: Specialization in pediatric nursing presents inequalities in training and employment that influence the quality of care. To improve this situation, it is necessary to increase training places, create specific employment exchanges, and unify the recognition of the specialty at the national level to ensure equitable and quality specialized pediatric care throughout the country. Full article

Background: Roughly 18% of all patients discharged from hospitals in the United States experience an unplanned hospital readmission (UHR) within 30 days of discharge. This can be life-threatening for patients and costs the U.S. health care system billions of dollars. The Centers for Medicare and Medicaid Services is seeking continued research to identify factors contributing to UHR. Research has viewed the transition from hospital to home in three stages: the pre-discharge stage where the patient is being diagnosed and treated in the hospital, the bridging stage where the patient is being prepared for discharge, and the post-discharge stage where the patient is recovering at home. Objectives: Our aims were: (1) to identify factors perceived by patients to influence their recovery during at least one of the three stages of the hospital to home transition and (2) to identify factors perceived by patients as important across all three stages of the transition. Methods: To accomplish this, we analyzed information obtained from in-depth, home interviews with 62 participants who had been discharged from a regional hospital roughly 30 days prior to the interview. Our analysis included open-ended readings and the use of qualitative analysis software. Results: Factors reported to influence recovery at the pre-discharge stage include appropriate diagnosis, treatment, and financial resources. Factors at the bridging stage include access to health information and social supports. Factors perceived to influence recovery at post-discharge include personal characteristics, social supports, and the environment. Conclusions: Participants identified factors at the pre-discharge, bridging, and post-discharge stages believed to be influencing their ability to recover from a hospital stay. Four of these factors were perceived to influence their recovery across multiple stages of the hospital to home transition. These included financial resources, social supports, access to health services, and personal stress. Full article