Nursing Reports

Background/Objectives: Employment instability is increasingly recognized as an organizational stressor, yet its combined effect on nurse burnout, humanized care, and work engagement is poorly quantified. This study investigates those relationships and tests a serial mediation model linking contract instability, burnout, humanization, and engagement in Spanish hospital nurses. Methods: A nationwide cross-sectional survey was completed by 400 fixed-term nurses between February and May 2025. The data included demographics, number of contracts signed during 2024, and scores on the Maslach Burnout Inventory (MBI), Utrecht Work Engagement Scale (UWES), and Health Professionals’ Humanization Scale (HUMAS). Spearman coefficients described the bivariate relations. Results: Burnout correlated positively with both contract count (r = 0.42, p = 0.039) and years of experience (r = 0.74, p = 0.040). Work engagement was inversely associated with instability (r = –0.62, p = 0.018). Humanized care was strongly and negatively related to burnout (r = –0.61, p = 0.032), particularly in sociability and self-efficacy dimensions. Discussion: Contractual precarity elevates burnout, erodes perceptions of humanized care, and, through this erosion, suppresses nurse engagement. Stabilizing workforce arrangements and strengthening empathy-centered skills may mitigate these effects and foster a socially sustainable nursing workforce. Full article

Background: Unlike other chronic diseases, cancer patients undergo different types of treatments that affect their well-being, and as a result, they tend to have different experiences from those of other chronic disease sufferers. The purpose of this study was to assess the effects of cancer diagnosis and coping strategies on patients in Vhembe District hospitals in Limpopo Province. Methodology: The study design used was a quantitative descriptive cross-sectional survey. The target population included patients in the Vhembe District of Limpopo who had started treatment within the last year. Probability-stratified sampling was used to sample 207 patients from seven selected hospitals in Vhembe District. A self-administered questionnaire was used to collect data, and the data were analyzed using a software package for descriptive statistics (SPSS version 23). Tables were used to display the results visually, and chi-square tests were used to compare the variables. Ethical principles were considered for the participants’ privacy, anonymity, and informed consent. Findings: The findings revealed that the majority of patients 185 (89.4%) experienced a sense of psychosocial distress such as emotional pain; 142 (68.6%) participants experienced hopelessness and despair, 127 (61.3%) resorted to substance use, 160 (77.3%) did not have a positive attitude towards seeking the medical and other support resources available, only a minority resorted to spirituality, and 121 (63.2%) indicated seeking further clarity about the disease. The study recommends supporting cancer patients and their families through the cancer journey. Contributions: Clinicians should provide psychosocial support interventions to enhance mental health and quality of life in cancer patients, and decentralize oncology services by including primary care professionals in delivering chronic illness disease management strategies. Full article

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