Nurs. Rep., Volume 15, Issue 6 (June 2025) – 31 articles

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

Background: The ageing of the population and the progressive increase in chronic diseases represent a major challenge for healthcare systems. The community nurse case manager (CNCM) is emerging as a key figure to provide comprehensive and continued care for complex and pluripathological chronic patients (CPCPs), especially after hospital discharge. Objective: The aim of this study is to pilot CNCMs in assisting CPCPs and assess their effects on functional capacity, cognitive performance, quality of life, readmissions, clinical parameters, satisfaction with home care, and caregiver overload. Methods: A comparative study will be carried out at two health centres in Salamanca (Spain). In both centres, CPCPs will continue to receive the interventions included in the Castilla y León Health System Portfolio from their primary care (PC) nurses. In the intervention centre, case management provided by a CNCM will be added. We will recruit 212 CPCPs with cardiac or respiratory disease and/or diabetes mellitus who are dependent for basic activities of daily living and have a programmed hospital discharge. An initial assessment will be performed at home after discharge, followed by assessments at 3, 6, and 12 months. Expected results: The intervention is anticipated to improve all study outcomes. Discussion: CNCMs may contribute to more proactive and individualised follow-up care for CPCPs and their caregivers, improving care coordination. Conclusions: This study will help to evaluate the feasibility and clinical relevance of incorporating the CNCM’s role into PC. This study was registered at ClinicalTrials.gov with the identifier NCT06155591. The date of trial registration was 24 November 2023. Full article

Background: Educational requirements in healthcare are constantly evolving, and understanding nurses’ motivations toward continuing education is critical to designing nursing programs, developing workforce strategies, and ensuring better healthcare outcomes. Objectives: This study aimed to examine the relationships among nurses’ personal factors, motivations, and attitudes toward further education. Methods: We conducted a cross-sectional study involving 526 employed nurses. Based on their intention to enroll in studies, the nurses were divided into two groups: those who intended to enroll (n = 276) and those who did not intend to enroll (n = 250). We used the Work Preferences Inventory and the Attitudes and Educational Intentions Scale to assess motivations and attitudes toward further education. The multivariate analysis included linear and logistic regression to assess associations between variables. Results: Nurses who intended to enroll in nursing studies had higher intrinsic motivation than nurses who did not. Strong negative associations were found between job challenges and older age (β = −0.68), while length of service was positively correlated (β = 0.46). A lower level of education had a negative effect on overall work motivation (β = −0.15) and attitudes toward future education (β = −0.09). Nurses with higher intrinsic challenge motivation (OR = 1.07) and a positive attitude toward further education (OR = 1.17) were more likely to study nursing. Conclusions: Intrinsic motivation, experience, and a positive attitude toward career advancement influence nurses’ intentions to continue their education. To further motivate nurses, it is crucial to improve working conditions, offer advancement opportunities, and foster a culture that values their contributions and growth. Full article

Gender-based violence is a social problem that affects the health of women in all countries, cultures, ages and economic status; its complexity requires a transdisciplinary approach. However, this study will emphasize the care provided by nursing in emergency services. Objectives: To explore the experiences of nursing professionals in the emergency area in relation to the approach to gender-based violence considering care management skills. Methods: A qualitative study with semi-structure interviews was conducted; the saturation was reached with the participation of 20 nursing professionals from emergency rooms. The study employed qualitative content analysis and the software QCAmap for organization and extraction of analysis. Results: The category called “Specific Approaches to Risk and Vulnerability” was characterized by its comprehensiveness, evident in its association with experiences in screening, follow-up, measures to prevent re-victimization, and ensuring privacy. The most relevant subcategories, based on the redundancy, were empathy, which encompasses affective aspects; education on forms of abuse not recognized by the victim; and multidisciplinary and multisectoral action to address patients’ needs effectively. Conclusions: Nursing professionals valued both the psychological and physical aspects of patients, highlighting the importance of multidisciplinary coordination and the protection of integrity. Awareness and offering help are key interventions during the activation of protocols for addressing gender-based violence. Full article

Background: Diabetes is common among nursing home residents, with approximately one in four affected, a figure expected to rise. Despite the complexity of care required, educational support for nursing home staff remains limited. This study will aim to co-design and evaluate a digital intervention to improve staff knowledge, confidence, and practices in diabetes care. Methods: The study will follow a logic model across three workstreams. Workstream 1 (WS1) will inform the model inputs through three phases: (1) a scoping review will be conducted to summarise existing diabetes education initiatives in nursing home settings; (2) approximately 20 semi-structured interviews will be carried out with nursing home staff to explore perceived barriers and supports in delivering diabetes care; and (3) a modified Delphi process involving 50–70 diverse stakeholders will be used to establish educational priorities. Workstream 2 (WS2) will involve co-designing a digital diabetes education intervention, informed by WS1 findings. Co-design participants will include nursing home staff, diabetes professionals, and people living with diabetes or their carers. Workstream 3 (WS3) will consist of a mixed-methods evaluation of the intervention. Pre- and post-intervention questionnaires will assess staff knowledge, confidence, and attitudes. The usability of the intervention will also be measured. Following implementation, focus groups with approximately 32 staff members will be conducted to explore user experiences and perceived impact on resident care. Discussion: This study will address an important gap in staff education and support, aiming to improve diabetes care within nursing home settings through a digitally delivered, co-designed intervention. Full article

Background/Objectives: Gender bias in healthcare remains a persistent challenge, partly due to gaps in gender-related knowledge among professionals. While existing instruments assess gender sensitivity and gender-role ideology, there is a lack of generalizable tools specifically designed to evaluate gender-related health knowledge. This study aimed to develop and validate the Gender Knowledge Scale in a sample of 591 nursing students from the University of the Basque Country (Spain). Methods: The 10-item multiple-choice instrument was created using the Nominal Group Technique with a multidisciplinary panel of experts. Results: Psychometric analyses supported a unidimensional structure with acceptable fit indices (CFI = 0.928, RMSEA = 0.025), and items displayed a diverse range of difficulty levels. Knowledge scores were moderately correlated with gender sensitivity but not with gender-role ideology, suggesting that knowledge may influence attitudes but is insufficient to challenge entrenched stereotypes. Knowledge differences emerged across academic years, though not by gender. Misconceptions, particularly regarding menstruation, cardiovascular risk, and pain, were prevalent. Conclusions: The Gender Knowledge Scale is a practical and psychometrically sound tool for assessing gender-related health knowledge among nursing students. While further validation is needed in other populations, the scale may support educational interventions aimed at reducing gender bias in clinical care. Full article

Background/Objectives: Nursing diagnosis is a complex process that requires clinical judgment, time, and resources and whose implementation is hindered by factors such as workload, lack of time, and resistance to computerized systems. This study aimed to compare the quality and efficiency of care plans generated by nursing professionals versus those produced by an artificial intelligence (AI) model, using the NANDA, NOC, and NIC taxonomies as criteria. Methods: An observational study was carried out with three simulated clinical cases. Thirty experts, fifty-four nursing professionals, and the ChatGPT model (GPT-4) were included. The experts established the referral plans using the Delphi technique. Responses were evaluated with a validated rubric (EADE-2) and analyzed using nonparametric tests. Professionals’ perceptions on the use of computer systems were also collected. Results: ChatGPT scored significantly higher on several dimensions (p < 0.001) and resolved all three cases in 35 s, compared to an average of 30 min for practitioners. Professionals expressed dissatisfaction with current diagnostic documentation systems. Conclusions: AI demonstrates high potential in optimizing the diagnostic process in nursing, although for its implementation human supervision, ethical aspects and improvements in current systems must be considered to achieve effective integration. Full article

Background: Eye tracking technology, when used in nursing, helps to reduce medication errors by analyzing eye movements. In education, it provides insights into student learning, cognitive load, and instructional design, allowing for more personalized learning. Despite challenges such as the need for technical expertise, privacy concerns, and cost, eye tracking offers real-time feedback that enhances both teaching and learning effectiveness. Objectives: To explore the current evidence on the application of eye tracking technology in training nursing students for drug administration. Methods: Eligible studies included peer-reviewed empirical papers, both qualitative and quantitative, and reports published in English. Excluded were studies involving Non-Eye Glass Tracking, non-nursing students, or non-English articles. Searches were conducted in nine databases. The risk of bias was assessed using the JBI SUMARI tool, and the results were synthesized narratively, presented with the PRISMA-P flow diagram. Results: From 739 studies, 10 focusing on medication training were identified. Eye tracking helped to reveal differences in visual focus between novice and expert nurses, with certain interventions shown to improve attention and concentration. Conclusions: Eye tracking has strong potential in nursing education, especially for improving attention and enhancing situational awareness in medication administration. However, limitations such as small sample sizes, technical barriers, and a lack of long-term data remain. Future research should address these gaps with larger, more diverse samples and extended follow-ups. Full article

Background/Objectives: Technological advancements are revolutionizing nursing education by improving precision, patient outcomes, and learning experiences. There is an urgent need for systematic frameworks to help nurse educators effectively integrate advanced technologies into their teaching methods. This manuscript introduces the Artificial Intelligence-Driven Technology Adoption in Nursing Education (AID-TANE) framework and operationalizes its use through a pilot study with undergraduate nursing students. Methods: The framework was tested through a convergent mixed-methods pre/post-test study design involving 160 senior-level community health nursing students who participated in an AI-driven educational intervention. Quantitative data were collected using the Facts on Aging quiz, while qualitative data were gathered from a reflective survey. Statistical analyses included paired-sample t-tests and a qualitative content analysis. Results: The study revealed a statistically significant increase in learners’ knowledge about older adults, with mean scores improving from 33.29 (SD = 5.33) to 36.04 (SD = 6.76) post-intervention (t = 5.05, p < 0.001). The qualitative analysis identified four key themes: communication and understanding, patience and empathy, respect for independence, and challenging stereotypes. Conclusions: This study found that AI-driven educational tools significantly improved nursing students’ knowledge about older adults and positively influenced their learning experiences. The findings highlight the need for targeted frameworks like AID-TANE to effectively integrate AI into nursing education, ensuring that students are ready for a technologically advanced practice setting. Full article

Background/Objectives: Understanding environmental experiences in residential dementia care is crucial for enhancing care practices, training, and policy. The environment’s role in dementia care is complex. Allied health and nursing professionals must consider environmental aspects concerning care for individuals with dementia. This study investigates how employed caregivers experience and perceive environmental influences in residential dementia care. Methods: In September 2024, we systematically searched PubMed, CINAHL, and PsycINFO for qualitative studies, adhering to SRQR guidelines. The CASP tool was used to assess study quality, ensuring rigor and reliability in selection. The meta-synthesis is registered with Prospero: CRD42024598962. A template analysis was conducted to structure emerging themes. Results: Fifteen studies met the inclusion criteria. Key themes included: 1. Working Environment: Informed understandings—capturing caregivers’ perceptions of organisational structures and support. 2. Lived Environment: Stability and Clarity—highlighting the impact of relational and social dynamics on caregiving; and 3. Physical and Built Environment: Impact on Overall Care Experience—looking at the role of space and design in facilitating effective dementia care. Following this, more subthemes emerged, resulting in the final template. Conclusions: The key gaps included understanding the existing strengths of practice, differences in job roles, funding, the role of Employed Caregivers, and Employed Caregivers’ personhood. Emphasising evidence-based practice and clearly defining job roles may improve decision-making and collaboration. It is essential to identify funding gaps and provide clear guidelines and training to ensure equitable care and maximise the contributions of Employed Caregivers working with nurses and allied health professionals. Recognising Employed Caregivers’ personhood could enhance job satisfaction and reduce burnout. Policies should address these gaps by providing training to clarify roles and enhance skills. A supportive, person-centred workplace may improve satisfaction and care outcomes. Future research should evaluate these aspects and continue to identify the best practices. Full article

Background/Objectives: High-quality healthcare delivery relies on a on a sustainable nursing workforce. However, rising attrition rates and declining enrollment in nursing programs pose a significant challenge. A comprehensive synthesis of these factors for student attrition alongside effective retention strategies is needed to guide interventions. The aim of this scoping review is to map and synthesize existing evidence on the factors contributing to attrition among bachelor’s nursing students and to identify strategies that have been implemented or proposed to improve student retention in undergraduate nursing programs. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) Checklist and Joanna Briggs Institute (JBI) guidelines, a systematic search was conducted in the following databases: MEDLINE/PubMed, Embase, Web of Science, PsycInfo, CINAHL, and Ovid. This review included peer-reviewed, English-language empirical studies (2010–December 2024) on attrition, dropout, or retention among bachelor-level nursing students, excluding non-nursing, non-bachelor programs, and unpublished studies or studies without primary data. A structured content analysis approach was used to synthesize findings from both qualitative and quantitative studies. Results: After screening titles, abstracts, and full texts, 19 articles were found eligible for inclusion. Analyses of the included studies revealed four key themes contributing to nursing student attrition: academic factors, institutional and social support, personal factors, and economic challenges. Retention strategies were categorized into two overarching themes: academic and non-academic approaches. Conclusions: Bachelor’s nursing programs should adopt retention strategies that enhance institutional and social support to reduce attrition. Strengthening supportive environments alongside curricular reform is key to building a resilient nursing workforce and ensuring quality care. Full article