Search Results (40)

This exploratory research investigates the perceived educational potential of visual, spatial, and auditory immersions as integral components of innovative healthcare simulation technologies. The study examines user experiences in learning health assessment concepts through purposefully designed 360° immersive virtual reality video (360° IVRV). Utilizing a case-study approach, insights were gathered from four subject-matter experts and four doctoral students regarding the perceived effectiveness of 360° IVRV for instructional activities focused on patient health assessment, commonly known as the Onset, Location, Duration, Characteristics, Aggravating/Alleviating factors, Related symptoms, Treatment, and Severity method (OLD CARTS). The research aimed to enhance the accessibility of learning materials by optimizing 360° IVRV content for personal phones and mobile devices, accommodating both online and traditional instructional formats. Interviews were transcribed and analyzed using qualitative data analysis software, with results categorized into subthemes, themes, and perspectives. The findings highlight the distinct perceived advantages of immersive technologies in advancing teaching methods for nursing practitioners. The discussion addresses concerns related to integrating 360° IVRV simulation technology in nursing education and the limitations of current instructional interventions. Practical implications for future research, design, and development of immersive learning materials and their integration with instructional design elements are emphasized. Full article

To identify the determinants, prevalence, and proposed solutions for potentially avoidable hospital transfers (PAHT) of residential aged care facility (RACF) residents in Australia, a scoping review was conducted using PubMed, CINAHL, Cochrane Library and Google Scholar, covering the period from 2015 to 2025. The database search identified 1350 articles, of which 43 studies met inclusion criteria. Prevalence of PAHT ranged from of 8.5% to 95.2% when defined as specific conditions manageable by an outreach service; from 2.2% to 55.6% when defined as potentially manageable with primary care; and from 11.6% to 53% when defined as an Emergency Department (ED) presentation not requiring a hospital admission. The most frequently reported determinant of PAHT pertained to the overarching theme of RACF clinical decision-making and systemic RACF practice-based factors. Establishment of, and access to, outreach services was the main proposed solution, alongside onsite General Practitioners (GP), Advance Care Planning (ACP), and capacity building for RACF nurses. Despite Australia’s diversity, our findings demonstrate patterns and similarities in prevalence, determinants and solutions. Consensus or standardisation of denominators would enhance comparability of outcomes across studies. These findings offer opportunities to reconsider solutions in response to the chronic challenge of avoidable nursing home patient transfers. Full article

Background: There are ongoing challenges in revascularizing patients with severe left ventricular (LV) dysfunction, with high rates of short- and long-term complications. Cardiac magnetic resonance (CMR) imaging is widely used for these patients; however, the prognostic value of the sum scar score and microvascular obstruction (MVO) remains unclear. Method: A retrospective study of data from King Abdullah Medical City (KAMC) between 2023 and 2025 was conducted to evaluate revascularization decisions made based on CMR studies. Patients who had normal LV function, no angiogram report, or incomplete CMR imaging were excluded. The primary outcome was hospitalization or death in patients with or without revascularization. Results: The cohort included 145 patients. The patients had a mean age of 56.7 ± 9.7 years and were predominantly male 131 (90.3%), with a high prevalence of cardiovascular risk factors: diabetes 102 (70.8%), hypertension 84 (58.7%), known dyslipidemia 46 (32%), and smoking 65 (45.5%). Most patients underwent a viability study within 7 days of a myocardial infarction (MI), 58 (40%), and a further 42 (28.9%) did so within 7–15 days. The CMR LVEF was 29.5 ± 8, and the sum scar score was 38.8 ± 21.9; MVO was observed in 34 patients (23.4%). The number of patients who underwent revascularization at the index admission was 66 (45.5%), of whom 48 (33%) received percutaneous intervention (PCI) and 18 (12.4%) underwent coronary artery bypass surgery (CABG). The patients lost to follow-up numbered 51 (35%). There were no significant differences between the two groups for the primary endpoints, including hospitalization (p-value: 0.61) and mortality (p-value: 0.31). Conclusion: In this retrospective study, CMR did not have an independent effect on hospitalization or mortality in patients who had revascularization compared to medical therapy groups. MVO and the LGE scar score were not significantly associated with cardiovascular outcomes. Our cohort was underpowered, with a high proportion of patients lost to follow-up, limiting the generalizability of the data. Full article

Background: Nurse Practitioners (NPs) are increasingly integrated into pediatric inpatient teams in response to evolving healthcare needs and workforce challenges. However, evidence describing how NP roles are operationalized, implemented, and sustained in general pediatric ward settings remain fragmented. Objective: This scoping review will synthesize international literature on NP roles in general pediatric inpatient settings, with a focus on determinants of role implementation. Guided by the Participatory, Evidence-based, Patient-focused Process for Advanced Practice Nursing (PEPPA) framework, this review will examine implementation strategies, outcomes, timelines, facilitators, barriers, and required resources to inform future integration and evaluation. Methods: This scoping review will be conducted in accordance with Joanna Briggs Institute (JBI) methodology and reported following PRISMA-ScR guidelines. A PRESS-reviewed search strategy will be applied to Scopus, MEDLINE, PsycInfo, CINAHL, Cochrane Central, ProQuest, grey literature, and reference lists for English and French language studies published from 2016 onward. Studies relating to NP roles in general pediatric wards internationally will be included. Data extraction and synthesis will be structured using the PEPPA framework’s implementation domain. Findings will be summarized descriptively and presented in tables and narrative synthesis. Conclusions: A targeted synthesis focused on determinants of NP role implementation in this context is needed. This review will clarify how NPs roles have been integrated in general pediatric wards, highlight enabling and constraining factors, and will identify gaps to guide future research, practice redesign, and policy development. Full article

Background/Objectives: Skilled labor migration of nurses from low- and middle-income to high-income countries is a growing global phenomenon. While Germany increasingly recruits internationally trained nurses to address severe nursing shortages, existing research has predominantly focused on post-migration experiences, leaving the pre-migration phase unexplored. Drawing on the case of Kerala, India, this study examines the motives driving Indian nurses to migrate to Germany during the preparatory phase of migration. Methods: The qualitative study draws on individual and group interviews with 22 Indian nurses from Kerala participating in a pre-migration preparatory course. Data were analyzed using qualitative content analysis, with Herzberg’s two-factor theory serving as a theoretical lens. Results: In total, the findings demonstrate that nurses’ decisions to migrate to Germany are shaped by a complex and interrelated set of motives encompassing personal fulfillment, socio-cultural aspirations and professional development. The intrinsic motivation to engage with a new language and culture emerged as a particularly salient finding, representing a dimension frequently overlooked in existing research. Applying Herzberg’s theory, migration decisions appear to result from an interplay of intrinsic motivators like career advancement and the perceived absence of fundamental extrinsic conditions such as adequate salary and social security in the country of origin. Conclusions: The findings have practical implications for practitioners, policymakers, employers and training providers. Preparatory programs could extend beyond language and professional training to include cultural preparation and realistic expectation management, while integration measures in Germany could be tailored to the actual needs and motives of internationally recruited nurses. Full article

Background: Rural and remote health systems are diverse; while many of these settings face persistent workforce shortages and access gaps, not all are underserved. Nurses play a critical role in improving access, continuity, and quality of care in these contexts. However, evidence on their roles, the challenges they face, and the outcomes associated with their contributions remains fragmented. Objective: To map the roles, challenges, and reported outcomes of nurses working in rural and remote healthcare settings, and to examine the quality and scope of the available evidence. Design: This study employed JBI scoping review methodology and is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Methods: Eligible studies involved registered nurses (RNs) and nurse practitioners (NPs) providing care in rural or remote settings and reporting at least one outcome related to patients, services, or health systems. Six bibliographic databases (PubMed/MEDLINE, CINAHL, Embase, Scopus, Web of Science, Cochrane Library) plus Google Scholar for supplementary grey literature retrieval and targeted grey literature were searched (from 1 January 2000 to 30 September 2025). The lead author conducted screening and data extraction, supported by a 10% calibration pilot and structured peer debriefing. Design-specific critical appraisal was undertaken descriptively to inform interpretation but did not determine inclusion. Results: From 22 primary empirical studies (plus 2 contextual-only entries; 24 total, nurses’ roles clustered into direct clinical care, care coordination/navigation, telehealth facilitation, and health promotion. Reported outcomes were predominantly in access/utilization (e.g., time-to-care), quality and safety indicators, and patient-reported outcomes/experiences; clinical endpoints were less common. Conclusions: Nurses in rural and remote settings enact broad, adaptive roles that appear to support healthcare access and service continuity. The evidence base is predominantly descriptive, and causal claims about effectiveness cannot be drawn from the available studies. Standardized outcome frameworks, multi-reviewer methodologies, and effectiveness-focused primary research are needed to advance this field. Full article

The organized integration of research competencies into nursing curricula is still a global challenge and is key for preparing professionals to respond to complex clinical contexts, technological advancements, and contemporary societal demands. At the School of Health of the Polytechnic Institute of Setúbal, a longitudinal research axis was implemented across the four years of the undergraduate nursing program, involving epistemological foundations, the research process, evidence-based practice, and applied practice. Objective: The objective of this study was to describe the design and implementation of the longitudinal axis of research, analyzing institutional indicators of academic success and the progressive development of students’ scientific competencies. Methods: A descriptive documentary study based on institutional data analysis (the number of enrolled students, pass rates, and mean grades in the four research-related curricular units) was conducted, complemented by a review of pedagogical materials produced (two published course booklets: “Research I—From the origin to the dissemination of knowledge” and “Research II—(De)Constructing the Research Process: A Critical and Practical Analysis”) and evidence of scientific dissemination (conference presentations and published articles). Results: A continuous progression in academic performance was observed across the research curricular units, accompanied by increased complexity of student work and enhanced scientific literacy. The sequential structure proved essential: the articulation of epistemology, methodology, critical appraisal, and scientific production demonstrated strong coherence and pedagogical efficiency. Conclusions: The longitudinal research axis constitutes a curricular innovation that strengthens essential scientific competencies in undergraduate nursing education. Longitudinal models that reflect both conceptual and practical progression can significantly contribute to the development of nurses who are critical thinkers, reflective practitioners, and capable of integrating evidence into clinical decision-making. Full article

Background: Mental health needs are rising globally, while workforce shortages constrain access to timely care. Israel launched formal training for Psychiatric–Mental Health Nurse Practitioners (PMHNPs) in 2023 as part of broader efforts to strengthen the public mental health system. This narrative review provides a focused synthesis of international and Israeli literature on PMHNP roles, models of practice, outcomes, and implementation considerations relevant to the Israeli context. Methods: We conducted a narrative, non-systematic literature review of international and Israeli literature on Psychiatric–Mental Health Nurse Practitioners (PMHNPs). Searches were conducted in PubMed/MEDLINE, CINAHL, PsycINFO, and Scopus (January 2000–December 2024), alongside targeted policy and regulatory documents. Eligible sources addressed NP/PMHNP roles, scope of practice, clinical and service outcomes, implementation processes, workforce implications, or policy considerations in high-income health systems. Findings were synthesized thematically. Results: Across the reviewed literature, particularly in primary care and community-based settings, PMHNP/NP-delivered care was generally associated with comparable outcomes on selected quality and safety indicators, alongside improved accessibility, continuity, and high patient satisfaction. Successful implementation depended on regulatory clarity, organizational readiness, interprofessional collaboration, and the development of a clear professional identity. In Israel, the role is emerging within a cautious regulatory framework and may face early barriers related to role ambiguity, variable organizational support, and limited stakeholder awareness. Conclusions: PMHNP implementation may offer an important strategy for strengthening mental health service capacity in Israel. However, the extent of its contribution will depend on regulatory clarity, organizational support, implementation quality, and future empirical evaluation in the Israeli context. Full article

Background: Digital transformation in healthcare has advanced rapidly in hospitals and primary care, while long-term care facilities have often lagged behind. In nursing homes, nurses play a central role in coordinating care and accessing medical expertise, yet digital tools to support these tasks remain inconsistently implemented. The CareConnect study, funded under the German Model Program for Telecare (§ 125a SGB XI), aimed to develop and implement a multiprofessional telecare system tailored to nursing home care. Objective: This implementation study examined the feasibility, acceptability, and early adoption of a multiprofessional telecare system in nursing homes, focusing on implementation processes, contextual influences, and facilitators and barriers to integration into routine nursing workflows. Methods: A participatory implementation design was employed over 15 months (June 2024–August 2025), involving a university hospital, two nursing homes (NHs), and four medical practices in an urban region in Germany. The telecare intervention consisted of scheduled video-based teleconsultations and interdisciplinary case discussions supported by diagnostic devices (e.g., otoscopes, dermatoscopes, ECGs). The implementation strategy followed the Standards for Reporting Implementation Studies (StaRI) and was informed by the Consolidated Framework for Implementation Research (CFIR). Data sources included telecare documentation, nurse surveys, researcher observations, and structured feedback discussions. Quantitative and qualitative data were analyzed descriptively and triangulated to assess implementation outcomes and mechanisms. Results: A total of 152 documented telecare contacts were conducted with 69 participating residents. Most interactions occurred with general practitioners (48.7%) and dermatologists (23%). Across all contacts, in 79% of cases, there was no need for an in-person visit or transportation. Physicians rated most cases as suitable for digital management, as indicated by a mean of 4.09 (SD = 1.00) on a 5-point Likert scale. Nurses reported improved communication, time savings, and enhanced technical and diagnostic skills. Key challenges included delayed technical integration, interoperability issues, and varying interpretations of data protection requirements across facilities. Conclusions: This pilot study suggests that telecare can be feasibly introduced and accepted in nursing home settings when implemented through context-sensitive, participatory strategies. Implementation science approaches are essential for understanding how telecare can be sustainably embedded into routine nursing home practice. Full article

Background/Objectives: The implementation of advanced practice nursing in Kazakhstan is aimed at improving the accessibility and quality of primary healthcare. One of the key indicators of the effectiveness of this model is patient satisfaction, which reflects the perceived quality of care and directly influences treatment adherence. The aim of the study was to assess patient satisfaction with nurse-led consultations in primary healthcare institutions in Kazakhstan. Methods: A cross-sectional study was conducted using a questionnaire developed on the basis of Karin Bergman’s instrument and adapted to the Kazakhstani context. A total of 621 patients who attended independent nursing consultations in polyclinics in Aktobe, Almaty, Astana, and the village of Merke participated in the survey. Descriptive statistics and Pearson’s χ² test were applied, with statistical significance set at p < 0.05. Results: The majority of respondents were women, with a median age of 61 years. Awareness of independent consultations was higher among patients who regularly visited nurses (97.1% vs. 86.9%; p < 0.006). High satisfaction levels were associated with service accessibility, quality of examination, and clarity of recommendations. Among regular visitors, 99.2% reported satisfaction with the nurse’s work, and 76.6% rated the service as “excellent”. In contrast, patients with irregular visits more often reported dissatisfaction due to insufficient attention and limited knowledge of nurses. Conclusions: The findings confirm a high level of patient satisfaction with advanced practice nursing services and highlight the importance of this model in strengthening primary healthcare in Kazakhstan. Full article

Background: The climate impacts of health professionals’ work are significant. The potential role and opportunities for regulators of health professionals’ work to drive behavioural and practice change have not been adequately explored in the literature. The objective of this research was to examine regulators’ perspectives on the potential role of health professions’ regulatory bodies in advancing the adoption of climate-conscious professional practice. Methods: Semi-structured interviews with 19 regulators overseeing the practice of health professionals in medicine, nursing, pharmacy, and dentistry in Canada were undertaken. Constant comparative data analysis using nVivo v15 was undertaken to identify common themes. The COREQ framework was applied to ensure the quality of the research processes used. Results: Participants highlighted their belief that there are only limited opportunities for health professions’ regulators to lead climate-positive practice change, despite their personal beliefs in the importance of the topic. The use of educational approaches, rather than legal or regulatory tools, was emphasized. Concerns were raised regarding regulatory overreach, practitioner blowback, and practical/logistical considerations. Coalition building across different facets of a profession (including educational institutions, unions, workplaces, and professional/advocacy groups) was identified as potentially most impactful. Conclusions: Previous research had highlighted practitioners’ beliefs that regulators had significant legal and practice-directed levers that could drive behavioural change towards more climate-friendly health care work. This research has highlighted regulators’ discomfort with assuming a legalistic role. Instead, they favoured persuasive techniques such as education and coalition building that may nudge, rather than compel, practitioners towards more climate-friendly practice. Full article

Half of all Canadians will develop cancer at some point in their lifetimes. These rates have increased substantially over the last decade alongside increasing effectiveness and complexity of treatment options. Therefore, the need for patients to receive both an early diagnosis and ongoing care has never been so important. In Alberta, referrals to oncology specialty care have increased 18% in the last 7 years with no commensurate increase in the number of oncology health care professionals. Challenges with oncologic care access and provider recruitment are not unique to Alberta. In 2004, Cancer Care Alberta, specifically the Cross Cancer Institute (CCI), embarked on an initiative focusing on nurse practitioner (NP) care provision, aiming to address these gaps. The purpose of this article is a description of four distinct NP care models: the Assigned model, Consultative model, Partner model, and Most Responsible Provider (MRP model) significantly contributing to enhanced and expanded cancer care delivery at CCI. To the best of our knowledge, we are the first to demonstrate how NPs can significantly address the rapidly expanding demands for specialist oncology care. This work highlights roles and exemplars of NP care to meet the evolving needs of cancer patients, the multidisciplinary care team and the health system. Full article

The adjuvant treatment landscape for hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) early breast cancer (EBC) is rapidly evolving, with a diverse range of therapeutic options—including endocrine therapies, bisphosphonates, ovarian function suppression, olaparib, CDK4/6 inhibitors, and emerging agents such as immunotherapy. While these advances have markedly improved patient outcomes, they also introduce challenges related to implementation, monitoring, and resource allocation. Notably, therapies like CDK4/6 inhibitors require particularly close monitoring, creating logistical and capacity challenges for medical oncologists, whose workloads are already stretched due to rising cancer incidence and treatment complexities. These challenges underscore the need for innovative care delivery solutions to ensure patients with EBC continue to receive optimal care. This paper offers a comprehensive guide—a playbook—of multidisciplinary-team-based care models designed to optimize adjuvant treatment delivery in EBC. Drawing on real-world evidence and successful applications across Canadian centers, we explore models led by nurses, nurse practitioners (NPs), general practitioners in oncology (GPO), and pharmacists. Each model leverages the unique expertise of its team to manage treatment toxicities, facilitate adherence, and enhance patient education, thereby promoting effective and sustainable care delivery. Importantly, these models are not intended to compete with one another, but rather to serve as a flexible recipe book from which breast cancer care teams can draw strategies tailored to their local resources and patient needs. By detailing implementation strategies, benefits, and challenges—in many instances supported by quantitative metrics and economic evaluations—this work aims to inspire care teams nationwide to optimize the adjuvant management of patients with HR+, HER2– EBC. 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

Background: Diabetes mellitus is a complex chronic condition requiring continuous healthcare. Consequently, various organisations recommend therapeutic education to enhance treatment adherence. This is often facilitated by Advanced Practice Nurses, who provide a range of advanced interventions that impact clinical health outcomes and deliver healthcare services to these patients. Objective: To analyse the effectiveness of interventions performed by Advanced Practice Nurses in patients with diabetes. Method: A peer-reviewed systematic review was conducted and registered in PROSPERO. The databases consulted included PubMed, Scopus, Web of Science, and CINAHL. Inclusion criteria comprised studies published between 2014 and 2024 on the effectiveness of interventions by Advanced Practice Nurses in diabetic patients. The review included qualitative, quantitative, and mixed methods designs. Various screenings were carried out, including the assessment of methodological quality. Results: A total of 600 studies were identified, of which 17 were selected for final review. Among these, 12 studies focused on diabetic education. Interventions were predominantly delivered in person in primary care settings, private clinics, and hospitals. Reported outcomes included reductions in HbA1c levels, improved patient self-knowledge and self-efficacy, and decreased rates of readmission and mortality. Conclusions: The sample consisted predominantly of women over 60 years of age. Diabetic education emerged as the most common intervention, primarily delivered in person by Advanced Practice Nurses across diverse settings. Nearly all interventions proved effective in improving health outcomes for diabetic patients. Full article