Nursing Reports

Background: Due to the lack of curative treatments for inflammatory bowel disease (IBD), patients need lifelong follow-up care. Telehealth offers a valuable solution to balance routine visits with necessary monitoring. Objectives: To map what is known about the benefits and barriers encountered by nurses in their use of telehealth for the follow-up care of patients with IBD. Methods: Following the methodology from the Joanna Briggs Institute, we conducted a scoping review across four electronic databases from June 2024 to September 2025. Key search terms included “inflammatory bowel disease,” “nurse experience,” and “telehealth.” A content analysis was employed to summarize the key findings. Results: We screened 1551 records, ultimately including four original research articles from four countries. Benefits identified were as follows: (1) the vital contributions of IBD telenursing in empowering patients by bridging health literacy and self-care skills; (2) optimal use of staffing time supports patient-centred care; and (3) ease of use. Barriers included the following: (1) increased workload and task imbalances; (2) the need for customized interventions; (3) technical issues and concerns regarding the security of digital systems; (4) telehealth as a supplementary option or a standard procedure; and (5) concerns related to the patient–nurse relationship. Conclusions: Nurses view telehealth as a promising approach that enhances patients’ health literacy and self-care skills and improves patient outcomes through effective monitoring. To fully realize telehealth’s potential, implementing strategies like triage protocols, algorithmic alerts, electronic health record integration, and comprehensive nurse training to enhance patient care and engagement may be beneficial. This scoping review highlights the need for more research on nurses’ experiences with telehealth in IBD due to limited publications. Full article

Background/Objectives: The use of physical restraints in adult and pediatric intensive care units (ICUs) is common yet controversial. While restraints are intended to prevent treatment interference or self-harm, they pose significant physical, psychological, and ethical risks. Nurses in intensive care units play a key role in decisions about restraint application, but there is a global lack of validated tools to assess their knowledge, attitudes, and practices, particularly in non-English-speaking contexts. Aim of this study was to develop and validate a questionnaire for assessing knowledge, attitudes, and practices (KAP) of ICU nurses regarding restraint use in adult and pediatric settings. Materials and Methods: A multi-method psychometric validation study was conducted across both adult and pediatric ICU settings at two hospitals in northern Italy. Questionnaire development included literature review, expert consultation, and iterative content and face validity assessments. Reliability was tested using test–retest methods, and construct validity was explored through exploratory factor analysis. The study followed COSMIN guidelines. Results: The final CON-Ti-IT questionnaire comprised 29 items across three subscales: Practices, Attitudes, and Knowledge. It demonstrated strong content validity (CVI = 0.96) and good internal consistency for the Practices subscale (Cronbach’s α = 0.89). Internal consistency for the Attitudes (α = 0.51) and Knowledge (α = 0.47) subscales was lower, reflecting the broader conceptual variability of these domains. Exploratory factor analysis confirmed the structural validity of the tool and led to the removal of three items with low factor loadings. Conclusions: This study presents the first validated tool specifically designed to evaluate ICU nurses’ KAP on restraint in adult and pediatric settings. While developed and validated in Italy, it could undergo cross-cultural adaptation and translation for use in other languages and healthcare systems. Its strong psychometric properties support its application in future research, and the data collected through its use can serve both to improve patient care and to provide a foundation for targeted educational initiatives. Full article

Background: In recent years, interest has grown in the study of the role of the maximization trait in situations of high uncertainty and high stakes. However, although up to 13 different scales have been proposed for its measurement, none of them have been translated and validated in the Spanish language. This study addresses this gap by adapting and validating the Spanish version of the 7-item Maximization Tendency Scale, a concise instrument designed to assess the tendency to maximize, which may offer practical advantages in terms of brevity and ease of administration compared to longer scales. Objectives: We aimed to adapt and evaluate the psychometric properties of the Spanish version of the MTS-7, examining its internal consistency and factor structure when applied to a Spanish sample. Methods: A sample of 213 active nurses from the province of Cádiz (Spain) (83.5% female) completed the translated version of the MTS-7 and completed the retest two weeks later. Results: Both Exploratory and Confirmatory Factor Analyses confirmed the unidimensional nature of the scale. Cronbach’s alpha coefficient was 0.78; the 2-week test–retest reliability Pearson correlation coefficient was 0.89; ICC was 0.78. Conclusions: The Spanish version of the MTS-7 possesses satisfactory psychometric properties and proves to have adequate reliability and validity. This scale may serve as a useful tool for studying decision-making under uncertainty among Spanish-speaking nurses. Full article

Background: Population ageing and the growing prevalence of chronic diseases, particularly stroke, have negative repercussions on fine motor function, compromising the independence of older adults. The Specialist Nurse in Rehabilitation Nursing plays a central role in functional recovery and in improving quality of life. This study aims to describe the process of developing and validating the design of rehabilitation nursing care for older adults with impaired fine motor function. Methods: This paper is a three-phase methodological study conducted between January and July 2025: (1) initial development of the design of rehabilitation nursing care for older adults with impaired fine motor function; (2) validation of the content of the proposed design, using the modified e-Delphi technique; and (3) development of the final model of the care design. Results: The e-Delphi study, involving a panel of 15 experts, allowed the content validation of the design of rehabilitation nursing care for older adults with impaired fine motor function after two rounds. Following the suggestions, the final care design model, in relation to fine motor function, comprises five steps: (1) collection of relevant data, (2) identification of possible nursing diagnoses, (3) definition of objectives, (4) planning and implementation of interventions, and (5) evaluation of outcomes. As part of step 4, photographic records of exercises focused on the recovery of fine motor function were included. Conclusions: The final model of the design of rehabilitation nursing care for older adults with impaired fine motor function, developed and validated in this study, may serve as a guiding framework in the delivery of specialised care to this population. Full article

Background/Objectives: Workplace violence (WV) against healthcare workers (HCWs) is a major hazard all over the world. Prevention requires a reliable risk assessment. The rate of HCWs reporting a violent event varies considerably across multi-year retrospective studies compared to periodic surveys. We conducted a rapid observational study to demonstrate that data collection methods are more important than socio-cultural and healthcare organizational differences in determining the frequency of reported violence. Methods: In June 2025, in a cross-sectional observational comparison, we examined a total of 236 nurses divided into three groups: the first two were recruited online from Brescia (Italy) and Trollhättan (Sweden), while the third group was composed of Latium (Italy) nurses participating in a sleep health promotion program who answered the same questions on WV online. All the workers reported the frequency of violent incidents experienced in the previous 12 months using the Violent Incident Form (VIF), occupational stress using the Effort/Reward Imbalance questionnaire (ERI), and work ability via the Work Ability Score (WAS). Results: In the three samples, WV was correlated positively with stress and inversely with work ability (p < 0.01), while no significant difference was found between Italian and Swedish nurses in relation to the spot surveys. The nurses questioned directly about WV were significantly younger and reported significantly higher rates of physical aggression (28% vs. 5%, p < 0.001) and all forms of violence (73% vs. 20%, p < 0.001) than those questioned indirectly during the census of all the HCWs. In a multivariate linear regression model, the WV experienced and poor work ability were highly significant predictors of work-related stress (p < 0.001). Nurses who had experienced WV in the previous year had an increased odds ratio (OR = 8.94; Confidence Interval 95% = 4.43; 18.01) of reporting a state of distress. Conclusions: Experience has shown that specific questioning about violence—the commonest method used—encourages respondents to report violent events and may induce overreporting. This method also tends to involve younger workers who are more exposed to WV. On the other hand, prospective studies based on official reports may be influenced by underreporting. Monitoring WV during health promotion interventions included in occupational health surveillance could minimize both phenomena. Systematic studies and meta-analyses which rely mainly on “ad hoc” studies may be biased. Full article

Background: Malnutrition is common among older adults with cognitive impairment and contributes to frailty and poorer health outcomes. Many individuals with dementia require mealtime assistance, yet differences in caregiving practices across hospital and nursing home settings remain underexplored. Aim: The aim of this study was to compare eating encouragement practices, feeding skills, feeding difficulties, and nutritional status between family caregivers in hospitals and professional caregivers in nursing homes. Methods: A cross-sectional observational study was conducted between June 2020 and December 2023 in New South Wales, Australia. The study included 82 older adults (≥65 years) with cognitive impairment: 31 hospital patients supported by family caregivers and 51 nursing home residents supported by assistant nurses. Eating encouragement, feeding skills, and feeding difficulties were assessed using structured observation tools, and nutritional status was evaluated using the Mini Nutritional Assessment–Short Form (MNA-SF). Group differences were analysed using chi-square tests and independent t-tests (p < 0.05). Results: Family caregivers in hospitals demonstrated stronger relational and engagement-based practices, including consistent handwashing (χ² = 31.945, p < 0.001), encouraging self-feeding (χ² = 21.678, p < 0.001), verbal cueing (χ² = 12.083, p = 0.002), touch prompting (χ² = 51.817, p < 0.001), and sitting face to face (χ² = 38.697, p < 0.001). Nursing home caregivers showed more advanced technical skills, such as task simplification (χ² = 54.135, p < 0.001), mirroring (χ² = 78.456, p < 0.001), hand-over-hand guidance (χ² = 73.076, p < 0.001), mouth- and lip-opening techniques (both χ² = 81.000, p < 0.001), and stronger choking management (p < 0.001). Feeding difficulties also differed: refusal behaviours were more common in nursing homes, while distraction and oral–motor issues were more frequent in hospitals. Overall, nursing home residents had significantly poorer nutritional status (t = −12.592, p < 0.001). Conclusions: Family caregivers provide stronger relational support, whereas professional caregivers demonstrate superior technical competence. Integrating these complementary strengths may enhance mealtime care and reduce malnutrition among cognitively impaired older adults. Full article

Background/Objectives: Workplace violence in the healthcare sector is a growing global concern. Defined as incidents where staff are abused, threatened, or assaulted in work-related contexts, this issue affects over half of healthcare personnel worldwide, with nurses being particularly vulnerable. The consequences are far-reaching, leading to diminished service quality, workforce turnover, reduced healthcare access, and increased costs. Despite its physical and psychological impact, workplace violence remains underreported, especially in its psychological forms, which have historically been underestimated. Methods: This study applies Per Isdal’s typology of violence to analyze incident reports from a hospital setting. By doing so, it offers a structured framework for understanding the multifaceted nature of workplace violence. By categorizing and examining how different forms of violence co-occur and manifest in daily professional interactions, the study aims to contribute to more systematic documentation and theoretical understanding of the field. Results: In total, 247 incidents were analyzed. Physical violence was the most frequently reported type with 167 incidents, followed by psychological violence with 125 cases. Material violence accounted for 28 reports, sexual violence for 10, and latent violence for 4, indicating that physical and psychological aggression dominates the spectrum of workplace violence in this context. Conclusions: The prevalence and complexity of violent incidents targeting healthcare personnel highlight the pressing need for actionable policies and evidence-based interventions that prioritize staff safety and psychological well-being. Establishing clear definitions of violence, alongside fostering a culture of reporting, is essential to create safer and more resilient healthcare environments. Full article

Background: Many nurses and physicians report difficulties with breaking bad news to their patients due to the lack of adequate skills and training. This study aimed to explore the communication skills, knowledge, and self-perceived difficulties of healthcare professionals working in oncology and hematology settings in Italy, in relation to their self-perceived stress levels when communicating bad news. Methods: An “ad hoc” questionnaire and the Perceived Stress Scale were administered online to both physicians and nurses registered by two important professional associations between October 2023 and September 2024. Results: A total of 221 Italian physicians and nurses were enrolled in the study. Most participants reported learning how to conduct difficult conversations from a mentor (61.1%) or through specific courses (56.6%). However, many of the recruited subjects declared having difficulty in giving bad news to the patient and family members (84.2%), and many of them did not know the SPIKES method (63.8%). A moderate level of stress was perceived by the great majority of participants, and the stress level was significantly increased in healthcare professionals who had difficulties in using evidence-based tools (e.g., SPIKES) for bad news communication. Moderate stress was “often” experienced by participants when presenting themselves during the first approach (p = 0.006), when attempting to anticipate the patient’s reactions (p = 0.044), when the patient refused to receive information (p = 0.006), when they had to remain assertive and confident regardless of the patient’s response (p = 0.013), and when managing post-communication consequences (p = 0.012). Conclusion: The limited knowledge and application of specific tools for bad news communication could exacerbate stressful conditions at this sensitive time among healthcare providers. The present findings could be used by health institutions to develop ad hoc training programs for both physicians and nurses, as well as to strengthen their organizational culture. Full article

Background/Objectives: Shift-working healthcare professionals are exposed to high psychophysiological demands associated with occupational stress, anxiety, and depressive symptoms. Salivary chromogranin A (sCgA) and secretory immunoglobulin A (sIgA) are non-invasive biomarkers reflecting sympathetic nervous system activation and mucosal immune function, respectively, and are increasingly used to assess biological stress responses. This study examined changes in these biomarkers and their associations with anxiety and depression. Methods: This cross-sectional comparative observational study was conducted among healthcare professionals working 12-h shifts (n = 95) and non-shift-working controls (n = 95) and included a within-shift pre-post assessment, with saliva samples collected before and after the work shift. Salivary biomarkers were determined using ELISA methods. Anxiety and depression were assessed using the State–Trait Anxiety Inventory and the Zung Self-Rating Depression Scale. Data were analyzed with t-tests, correlation, and multiple linear regression. Statistical analyses included between- and within-group comparisons, correlation analyses, and multiple linear regression models to examine independent associations between salivary biomarkers and psychological outcomes. Results: After a 12-h shift, healthcare professionals showed increased sCgA (3.82 ± 0.95 vs. 4.68 ± 1.02 ng/mL; p < 0.001) and decreased sIgA (165.3 ± 32.4 vs. 142.6 ± 29.8 mg/dL; p < 0.001). Psychological scores were higher in healthcare professionals than in controls (p < 0.001). Salivary sCgA correlated positively with anxiety and depression (r = 0.41 to 0.45), while sIgA correlated negatively (r = −0.29 to −0.36). Regression analysis confirmed occupational group (healthcare professionals vs. controls) as the strongest predictor, with independent contributions of sCgA and sIgA to psychological scores. Conclusions: A 12-h work shift in healthcare professionals leads to increased salivary chromogranin A, indicating sympathetic activation, and decreased secretory IgA, reflecting reduced mucosal immune activity. The combined assessment of sCgA and sIgA provides a sensitive and non-invasive approach for monitoring occupational stress and identifying early risks of anxiety and depressive symptoms among shift-working healthcare professionals. Full article

Background/Objectives: The nursing profession is experiencing a global shortage of nurses. Early-Career Nurses (ECNs) assist in addressing the shortage; however, a significant number are leaving their workplaces and the profession. The aim of the review is to explore the factors that impact early-career nurses thriving at work, including their motivation and intention to stay in employment and the profession. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. The objectives, analysis, and inclusion and exclusion criteria were informed by PRISMA for Scoping Reviews (PRISMA-ScR) to ensure accurate and complete reporting of findings. The target population were ECNs who are in the first five years of practice. Databases including CINAHL, PubMed, PsycINFO, Scopus, and Web of Science were searched to identify the literature on ECN thriving between 1985 and 2025. Titles, abstracts, and full texts of the identified studies were screened by two independent reviewers, and thematic analysis was undertaken to analyse the data. Results: A total of 190 studies was initially identified, and after screening and review, a total of 16 articles met the inclusion criteria and explored factors related to thriving and retention. Key themes identified within the literature that contribute to ECNs thriving at work encompass the work environment, work–life balance, and education, where generational differences may also create unique nuances between ECNs. Conclusions: ECNs encounter many challenges in the early stages of their nursing career. Organisational support may be responsive and provide conducive work environments that nurture growth, career development, and thriving for ECNs. However, future research is needed to further confirm drivers of thriving, along with understanding the impact of targeted interventions to better support ECN thriving and retention. Future search will include stakeholders to validate the findings. Full article

Background/Objectives: This review aimed to explore the pathways of nursing and midwifery education in Tanzania and compare them with global perspectives. The goal was to identify similarities, differences, and areas for potential improvement to align with international standards. Methods: A narrative literature review was carried out through databases with published studies in nursing and gray literature. The database search included Medline, PubMed, Google Scholar, EBSCO, PsycINFO, clinical nursing, and gray literature from January 2014 up to December 2024. The search process was carried out by the authors with the following key words: admission, pathway to nursing profession, delivery mode, generative dynamic, and learning models. The search strategy included studies from selected countries in East Africa, Europe, North America, Australia, and Asia. The inclusion criteria were (1) published papers or reviews addressing the review topics; (2) studies published in the English language; (3) gray literature on the reviewed topics; (4) studies originating from Tanzania, East Africa, Europe, Asia, Australia, and North America. The selected countries served as a source for comparison of nursing and midwifery education in Tanzania with the globe. Results: A total of 758 articles were reviewed from the selected databases. Finally, 27 studies and 11 gray literature sources were included. In Tanzania, the overall duration of nursing education from primary education to a bachelor’s degree for diploma graduates is relatively long. Students complete approximately 14 years of schooling from primary education to the completion of a diploma, including three years at the diploma level. To enroll in a degree program, candidates are required to have two years of professional experience, followed by four years of academic training and a mandatory one-year internship. Globally, the duration of educational programs is generally decreasing due to generational shifts and advancements in technology. Conclusions: Whilst nursing and midwifery education is regulated in Tanzania, the current admission criteria and duration of the program do not align with the global standards. Future studies that provide the comparison of curriculums among universities in Tanzania with global standards would provide a deep understanding of the competencies, teaching models, learning environment, duration, and desired learning outcomes for nursing and midwifery education. Full article

Background: Hospital In The Home (HITH), also called Hospital at Home or Virtual Hospital, delivers hospital-level care in patients’ homes to enhance outcomes and reduce hospital bed occupancy. Despite widespread implementation, strategic guidance for managing HITH initiatives remains limited. Methods: Following PRISMA 2020 guidelines, we conducted a systematic review (protocol not registered) searching ScienceDirect and Scopus (inception to December 2023) using the terms “hospital in the home,” “HITH,” “hospital at home,” “virtual care” AND “lesson,” “management,” “governance.” Peer-reviewed studies reporting lessons learned, best practices, or governance strategies for HITH programs with sufficient implementation detail were included; we excluded studies focusing solely on clinical effectiveness without organizational aspects, conference abstracts, and editorials. Two researchers independently screened records, extracted data, and conducted thematic analysis. Quality assessment used the Mixed Methods Appraisal Tool (MMAT). Sixteen studies (12 high-quality, 3 moderate, 1 low) were included. The studies were moderate overall, based on predominantly observational program evaluations and case studies. Results: Forty-two lessons were identified and classified into nine categories: combining care modalities, technology integration, impact on patient outcomes, training and specialized knowledge, care coordination, governance structures, financial sustainability, cross-sector collaboration, and patient selection. These categories fall under four themes: care delivery models; staffing and team dynamics; governance and financial sustainability; and patient selection and safety. Conclusions: This framework provides healthcare executives and program managers with evidence-based guidance for implementing and enhancing HITH programs, addressing a critical gap in governance and management literature. Full article

Background/Objectives: Sex trafficking is a form of modern-day slavery still present in our societies. Health professionals are in a key position to identify and support victims, but adequate training is required. The aim of this study was to analyze the impact of a structured educational intervention on knowledge, perceived professional role, and attitudes toward sex trafficking of women among undergraduate nursing students at the University of Seville, Spain. Methods: A cluster randomized pilot educational trial with a pre-test–post-test control group design and one-year follow-up was conducted. A two-hour educational session addressed key concepts related to sex trafficking, health professionals’ responsibilities, and survivor support. Knowledge and attitudes were assessed at baseline, immediately after the intervention, and at one-year follow-up. Results: 199 students participated. Significant post-intervention improvements were observed in knowledge and attitudes, with sustained impact after one year despite some knowledge decay. Conclusions: This pilot educational intervention appears to improve knowledge and attitudes toward sex trafficking among undergraduate nursing students and may represent a useful strategy for sensitizing and training future health professionals in this area. Full article

Background/Objectives: Low-income compared to high-income women have a higher incidence of and mortality from cervical cancer (CC) due to lower screening rates (under/never-screened). Home-based screening for CC via mailed “self-collection” for human papillomavirus (HPV) testing is an alternative to traditional, provider-collected screening that may be more acceptable to low-income women. Theoretically, adoption of a recent technology, in this case, mailed return of self-collection, is related to the Diffusion of Innovations concepts of advantages and complexity. The purpose of this study was to develop and psychometrically test scales to measure advantages and complexity of self-collection in a low-income, under/never-screened population. Methods: Low-income women (n = 168) were recruited in person from food pantries and online using Facebook in the Midwest U.S. After a baseline survey, women were mailed a self-collection kit. We assessed reliability with item analysis and Cronbach’s α and evaluated validity with exploratory factor analysis and t-tests, using mailed kit return as the independent variable. Results: Two scales were developed: (1) advantages (Cronbach’s α = 0.84), item–total correlation = 0.51 to 0.69, and (2) complexity (Cronbach’s α = 0.82), item–total correlation = 0.45 to 0.64. Exploratory factor analysis supported items factoring on their respective scales, and t-tests supported a relationship between each scale and mailed return of kits. Conclusions: Both the advantages and complexity scales demonstrated reliability and validity among low-income women. Future studies should evaluate these scales in a larger, more diverse population. Nurses could use these scales to assess preferences and difficulties associated with self-collection and aid patients with CC screening decision-making. Full article

Background: Nurses have unique insights into health systems yet remain underrepresented in policy processes. Strengthening political competence is widely regarded as important for evidence-informed nursing leadership. Objectives: To assess self-perceived political competence and policy participation among nurses and nursing students in Croatia. Methods: We conducted a cross-sectional online survey using open, non-probability recruitment. Of 447 individuals who opened the survey link, 440 provided responses and 390 completed all 19 competence items measuring political competence across three domains (attitudes, knowledge/evidence, and skills). Open recruitment precluded calculation of a conventional response rate. A 19-item self-report questionnaire measured political competence across three domains (attitudes, knowledge/evidence and skills); internal consistency was α = 0.91, although the Croatian version has not been fully validated. Data were analyzed using descriptive statistics, binomial tests and ordinal logistic regression on the complete-case sample. Results: Most respondents endorsed nurses’ policy involvement, the importance of scientific evidence and nursing’s holistic perspective. Conclusions: Nurses and nursing students reported strong conceptual support for a policy role but only moderate confidence in influencing policy. These cross-sectional findings highlight a gap between conceptual support and personal confidence that may be addressable through structured educational and institutional support; the impact of such initiatives on policy influence should be examined in future longitudinal or interventional studies. Full article

Climate change poses a major global health threat, with healthcare systems contributing substantially to global greenhouse gas emissions. Health professionals and students play an essential role in advancing sustainable practice, yet many lack the knowledge, skills, and confidence needed to address the environmental impacts of healthcare. This study aims to co-design and evaluate a gamified e-resource that enhances pre-registration health profession students’ knowledge, self-efficacy, and attitudes towards healthcare decarbonisation, while encouraging sustainable behaviour change. A sequential explanatory design will be employed in three phases: (1) a scoping review of the literature; (2) four co-design workshops with students (n = 20) followed by post-workshop focus groups using focused ethnography to explore co-design experiences; and (3) pre- and post-test questionnaires (n = 200) assessing knowledge, attitudes, self-efficacy, behaviours, willingness to act, and usability, followed by focus groups (n = 30) exploring behavioural changes after using the e-resource. The study will generate evidence on how a co-designed, gamified e-resources influence student learning and engagement with healthcare decarbonisation. Findings will inform the integration of sustainability and decarbonisation principles within education and support efforts to equip future health professionals with the competencies required for a low-carbon healthcare system. Full article

Background/Objectives: The integration of Information Technologies has transformed interactions between healthcare professionals and the families of hospitalized patients, enabling more comprehensive, transparent, and patient-centered care. Artificial Intelligence is emerging as a transformative tool to further enhance these interactions; however, its implementation faces challenges associated with access to and availability of basic technological infrastructure. Methods: This cross-sectional pilot study, conducted at the Tamaulipas Children’s Hospital, Mexico, included 51 healthcare professionals from diverse specialties. It examined the use of digital technologies and perceptions of information systems aimed at optimizing communication with families. Results: Findings indicated that 58.8% reported consistent use of digital devices, whereas only 41.2% had regular internet access. Between 60.0% and 67.0% consistently provided information regarding patients’ health status, treatments, and medical procedures. With respect to a digital system, 37.3% considered its implementation necessary and 39.2% perceived potential benefits, although functions such as multimedia sharing and automated notifications were regarded with caution. The questionnaire demonstrated high reliability (α = 0.835) and acceptable construct validity (KMO = 0.705; Bartlett’s test p < 0.001). Conclusions: Preliminary results suggest that the integration of AI-based digital systems in hospital settings remains conditional. They also highlight the need to ensure equitable access to technological infrastructure as a prerequisite for achieving sustainable adoption. Full article

Background/Objectives: Clinical instruction and mentorship are essential components of nursing education and early professional development. In Greece, while nursing curricula align with EU directives mandating both theoretical and clinical training, significant gaps persist in the quality, coordination, and legislative support of mentorship. This work aims to (i) synthesise evidence on clinical instruction and mentorship in Greece and draw on selected European examples to provide contextual insight, and (ii) integrate national stakeholder perspectives to generate actionable recommendations for a Greek clinical mentorship framework. Methods: A narrative literature review was conducted, identifying 19 eligible articles examining mentorship, clinical instruction and preceptorship in European and Greek contexts. In addition, a national stakeholder focus group with 25 participants, including representatives from academia, healthcare institutions, regulatory bodies, and nursing associations, was held in Athens in 2024. Data from both sources were thematically analysed and integrated to identify gaps, best practices, and context-specific recommendations. Results: Findings revealed inconsistent collaboration between universities and clinical institutions, limited training and recognition for clinical instructors, and the absence of a unified national framework. Stakeholders highlighted structural barriers to clinical mentoring such as understaffing and lack of policy support and expressed strong interest in a mentorship reform. Comparative analysis with European models demonstrated feasible pathways for Greece, including structured training, certification, and non-financial incentives. During the national stakeholder focus group, a dual-pathway mentorship system tailored for nursing students and newly hired nurses was most recommended to ensure both continuity and quality in professional development of nurses. Conclusions: Despite alignment with EU directives, Greece lacks an integrated national mentorship framework that ensures consistent clinical learning and supports workforce development. Two priority policy actions emerge from this work: (1) establishing a legally supported national certification and training system for clinical mentorship, and (2) educational structures in the clinical setting to improve educational quality, workforce retention and patient care outcomes. Full article