Search Results (106)

Background/Objectives: The transformation of nursing and midwifery education through digital technologies has gained momentum worldwide, with algorithm-based video instruction and virtual reality (VR) emerging as promising tools for improving clinical learning. This quasi-experimental study explores the impact of an enhanced flipped classroom model on Bulgarian nursing and midwifery students’ self-perceived competence. Methods: A total of 228 participants were divided into a control group receiving traditional instruction (lectures and simulations with manikins) and an experimental group engaged in a digitally enhanced preparatory phase. The latter included pre-class video algorithms, VR, and clinical problem-solving tasks for learning and improving nursing skills. A 25-item self-report questionnaire was administered before and after the intervention to measure perceived competence in injection techniques, hygiene care, midwifery skills, and digital readiness. Results: Statistical analysis using Welch’s t-test revealed significant improvements in the experimental group in all domains (p < 0.001). Qualitative data from focus group interviews further confirmed increased student engagement, motivation, and receptiveness to digital learning tools. Conclusions: The findings highlight the pedagogical value of integrating structured video learning, VR components, and case-based learning within flipped classrooms. The study advocates for the wider adoption of blended learning models to foster clinical confidence and digital competence in healthcare education. The results of the study may be useful for curriculum developers aiming to improve clinical readiness through technology-enhanced learning. Full article

This study aims to understand the meaning nursing professionals attribute to their lived experiences of providing humanized care within a public hospital setting. Grounded in Jean Watson’s theory of human caring, the research adopts a qualitative, descriptive phenomenological design to capture the perceptions and emotions of nurses regarding humanized care. Data were collected through semi-structured interviews with nine experienced nurses, selected through purposive sampling. The interviews, conducted virtually between July and December 2024, were analyzed using Colaizzi’s method and supported by Atlas.ti software. Four main thematic categories emerged: institutional health policies, professional image and identity, strengths and challenges in care, and essential competencies for humanized care. The findings highlight the critical role of empathy, cultural sensitivity, ethical commitment, and emotional presence in delivering compassionate care. Participants emphasized that, beyond clinical procedures, humanized care requires relational and contextual sensitivity, often hindered by institutional limitations and excessive administrative burdens. The study concludes that nursing professionals are key agents in promoting ethical, empathetic, and culturally respectful practices that humanize health services. These insights offer valuable contributions for designing policies and training strategies aimed at strengthening humanized care as a cornerstone of quality healthcare systems. Full article

Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and complications and lower mortality rates. Based on this background, the objective of this study is to analyze the perception of non-technical skills and immediate learning outcomes in interprofessional simulation settings based on E-CRM items. Methods: A cross-sectional observational study was conducted involving participants from the official postgraduate Medicine and Nursing programs at the Catholic University of Murcia (UCAM) during the 2024–2025 academic year. Four interprofessional E-CRM simulation sessions were planned, involving randomly assigned groups with proportional representation of medical and nursing students. Teams worked consistently throughout the training and participated in clinical scenarios observed via video transmission by their peers. Post-scenario debriefings followed INACSL guidelines and employed the PEARLS method. Results: Findings indicate that 48.3% of participants had no difficulty identifying the team leader, while 51.7% reported minor difficulty. Role assignment posed moderate-to-high difficulty for 24.1% of respondents. Communication, situation awareness, and early help-seeking were generally managed with ease, though mobilizing resources remained a challenge for 27.5% of participants. Conclusions: This study supports the value of interprofessional education in developing essential competencies for handling urgent, emergency, and high-complexity clinical situations. Strengthening interdisciplinary collaboration contributes to safer, more effective patient care. Full article

Background/Objectives: Clinical Research Nurses (CRNs) have emerged as pivotal actors in the conduct, coordination, and oversight of clinical trials globally. Over the past three decades, the role of the CRN has evolved in response to the increasing complexity of research protocols, ethical standards, and regulatory frameworks. Originating as task-oriented support figures, CRNs have progressively assumed broader responsibilities that include patient advocacy, protocol integrity, ethical vigilance, and interprofessional coordination. By mapping the global literature on CRNs, this review will examine how their role has been defined, implemented, and evaluated over the past three decades. Methods: A scoping review was conducted using JBI methodology and PRISMA-ScR guidelines. The search covered the peer-reviewed and gray literature from 1990 to 2024 across major databases. Data analysis combined traditional extraction with topic modeling, Multiple Correspondence Analysis, and k-means clustering to identify key themes. Results: From the 128 included studies, four major themes emerged: clinical trial management, role perception and team integration, professional competencies and development, and systemic barriers. Despite formal competency frameworks, CRNs face inconsistencies in role recognition, unstable contracts, and limited career pathways. Emotional strain and professional isolation are recurrent. Over time, their functions have evolved from task execution to broader responsibilities, including advocacy and ethical oversight. However, no studies reported patient-level outcomes, revealing a critical gap in the evidence base. Conclusions: CRNs play a vital but undervalued role in clinical research. Persistent structural challenges hinder their development and visibility. Enhancing institutional support and generating outcome-based evidence are necessary steps toward fully integrating CRNs into research infrastructures. 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: Disasters pose significant challenges to public health by disrupting essential services, especially during mass gatherings such as the Hajj pilgrimage. These complex events demand swifts coordinated action from healthcare professionals. However, many remain insufficiently equipped for large-scale emergencies due to gaps in triage training, disaster knowledge, and established response protocols—issues that are particularly critical in high-risk settings. Aim: This systematic literature review aims to explore the clinical insights of registered nurses and other healthcare professionals in disaster preparedness and response during the Hajj pilgrimage in Saudi Arabia. Methods: A systematic literature review was conducted following PRISMA guidelines. A comprehensive database search was performed across CINAHL, Scopus, Medline, Embase, and APA PsycINFO, focusing on studies published between 2012 and 2025. Eligible studies addressed disaster nursing education, preparedness, and response. The Mixed Methods Appraisal Tool (MMAT) was used for quality assessment. Results: Twenty-three studies met the inclusion criteria. Three main themes emerged: disaster preparedness, experiences and challenges in disaster response, and education and training. The review revealed lack in nurses’ readiness, policy awareness, and real-world disaster experience. Training and curriculum improvements are essential to enhance disaster response capabilities. Conclusions: This review highlights the urgent need for standardized disaster nursing curricula to enhance preparedness and response competencies. Incorporating structured disaster training into nursing education will strengthen healthcare system resilience. Future research should adopt qualitative methods to capture healthcare professionals lived experiences during the Hajj. Including diverse participants and focusing on the unique cultural context can enhance disaster preparedness and response strategies. Full article

Background: Nurses play a crucial role in health promotion (HP) policy and in encouraging healthy behaviors. However, challenges persist in effectively integrating HP as a core component of healthcare systems and nursing practice. Therefore, it is essential to develop specialized and advanced competencies in nursing students, incorporate HP into nursing academic curricula, and better understand the factors influencing nursing students’ development of these competencies—an area that remains underexplored. Accordingly, this study explores and describes the factors nursing students perceive as essential in developing competencies in HP and in fulfilling their role as health promoters. Methods: A qualitative study was conducted using Reflexive Thematic Analysis. Data were collected through semi-structured interviews with 19 nursing students. Results: Five main themes emerged: (1) Training Needs of Future Health Promoters, (2) Navigating Time Constraints in Health Promotion, (3) Nurses’ Awareness of Their Role in HP, (4) Perceived Need to Adopt Healthier Lifestyles, and (5) Challenges of Lifestyle Management. Key facilitators included strong mentorship and well-structured educational programs; barriers included insufficient clinical exposure and time constraints. Additionally, students emphasized the need for HP to be a core aspect of nursing curricula. While acknowledging existing obstacles, participants also identified practical solutions that could be integrated into training and practice to enhance the impact of HP in nursing care. Conclusions: The study highlights significant gaps in HP education for nursing students and the need for curriculum reforms to better prepare them as health promoters. Future research should consider the perspectives of clinical mentors and evaluate the effectiveness of innovative teaching methods—such as simulation-based training—in strengthening students’ HP competencies. 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: Endometriosis, a chronic and debilitating gynecological disorder, exacts a heavy clinical and socioeconomic toll on women’s lives. Despite its prevalence, its timely diagnosis and effective management are hindered by pervasive knowledge gaps among frontline nursing professionals, and these are especially pronounced in under-researched regions such as Al-Jouf, Saudi Arabia. Aim: Guided by the Knowledge–Attitude–Practice model, this study aimed to assess the level of endometriosis-related knowledge among nurses in the Al-Jouf region of Saudi Arabia and to identify the sociodemographic and professional determinants of knowledge levels. Methods: A cross-sectional, descriptive-analytical design was employed between January and July 2024, enrolling 215 nurses from a principal maternity and children’s hospital and two primary healthcare centers in Sakaka. A rigorously validated, bilingual 20-item questionnaire assessing four domains (definition, risk factors, clinical manifestations, and treatment goals) was administered. Data were analyzed using descriptive statistics, multiple linear regression, and binary logistic regression to elucidate predictors of knowledge. Results: A concerning picture emerged: 61% of participants scored below 60% (indicative of low knowledge), with only 6% achieving high scores. Higher educational attainment proved the strongest predictor (β = 0.415, p < 0.001), followed by age (β = 0.232, p < 0.001), years of experience (β = 0.149, p = 0.041), and direct patient care exposure (β = 0.168, p = 0.021). Collectively, these factors explained 37.6% of the variance in knowledge scores, underscoring a critical deficit in endometriosis management preparedness. Conclusions: The stark deficiencies in endometriosis knowledge among nurses in Al-Jouf call for immediate, tailored educational and policy interventions. Strengthening clinical competencies is essential for fostering early diagnosis and improving care outcomes for women burdened by this complex condition. Full article

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

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that leads to severe functional decline and death, imposing significant physical, emotional, and ethical burdens on patients and healthcare providers. With no curative treatment, ALS care depends on the early and sustained integration of palliative care to address complex and evolving needs. Nurses play a pivotal role in this process, yet their lived experiences remain underexplored. This study aimed to synthesize qualitative evidence on nurses’ experiences in ALS care, with a focus on emotional, ethical, and palliative dimensions. Methods: A meta-synthesis of qualitative studies was conducted using Sandelowski and Barroso’s four-step method. A systematic search across five databases identified eight studies exploring nurses’ experiences with ALS care. Thematic synthesis was applied to extract overarching patterns. Results: Three core themes emerged: (1) Relational Dimension: From challenges to empathy and Trust and mistrust—emphasizing communication barriers and the value of relational trust; (2) Care Dimension: Competence, Palliative care needs, and Rewarding complexity—highlighting the emotional demands of care, the need for timely palliative integration, and the professional meaning derived from ALS care; (3) Ethical Dimension: Medical interventionism and Patient-centered values—exploring dilemmas around life-sustaining treatments, patient autonomy, and end-of-life decisions. Conclusion: Nurses in ALS care face complex emotional and ethical challenges that call for strong institutional support and palliative training. Enhancing palliative care integration from diagnosis, alongside targeted education and psychological support, is crucial to improving care quality and sustaining the well-being of both patients and nurses. Full article

Background: Resilience is a cornerstone attribute for nursing students, enabling them to adapt to stressful situations encountered during their educational journey and subsequent healthcare career. Objective: This qualitative study aimed to explore nursing instructors’ experiences promoting resilience among nursing students during clinical education. Methods: Focus groups were conducted with 27 instructors from four nursing colleges in Thailand. Data were analyzed using Braun and Clarke’s inductive thematic analysis approach, guided by the Unitary Caring Science Resilience-Building Model. Results: Two main themes emerged: (1) Challenges to Nursing Students’ Resilience and (2) Support Strategies for Enhancing Resilience. Challenges included bridging theory and practice, upholding confidence in clinical skills, adapting to new clinical environments, and managing expectations. Support strategies encompassed providing comprehensive preparation, fostering open communication, implementing peer support systems, and utilizing reflective practice. Conclusions: The findings highlight the complex interplay of factors affecting nursing students’ resilience and the multifaceted approaches instructors use to support it. This study underscores the need for a holistic approach to nursing education that addresses clinical competence and psychological well-being. Implications include curriculum redesign to bridge the theory–practice gap, enhanced instructor training in mentorship and resilience-building, implementation of comprehensive student support systems, and technology integration to support learning and resilience. Full article

Objective: To assess the experience and educational needs of hospital staff who care for pediatric patients with tracheostomies. Study Design: Staff were surveyed and participated in semi-structured, facilitated focus groups regarding their experiences caring for children with tracheostomies and their educational needs. Survey data were analyzed using descriptive statistics and Kruskal–Wallis nonparametric tests. Focus groups were transcribed verbatim and coded for thematic analysis. Results: Pediatric advanced practice providers, nurses, physicians, and respiratory therapists (152/353, 43%) completed the survey. Within the last year, 76% of staff had worked with a tracheostomy-dependent child. However, up to 59% of staff had not performed at least one tracheostomy skill (e.g., tracheostomy site assessment, tube change, etc.). Staff reported the least confidence in changing tracheostomy tubes and using home ventilators and rated these skills as most important for additional education. Forty-three staff members participated in 1 of 10 focus groups. Three themes were identified: building staff competencies in tracheostomy care, promoting the caregiver development of tracheostomy skills, and building caregiver preparedness for home life. Staff emphasized the need for participating in emergency simulations and developing their skills to better prepare caregivers for home life. They indicated a need to streamline the discharge process, gain knowledge of community resources, and develop a standardized team to provide discharge teaching. Conclusions: Hospital staff responsible for providing care to tracheostomy-dependent pediatric patients had limited opportunities to learn and maintain their skills. Survey and focus group findings can guide development of continuing education to optimize the care of tracheostomy-dependent children. Full article

Background: Care plans are a critical tool in nursing education because they enhance clinical competence; however, undergraduate students often face challenges in writing them effectively, which can impact their readiness for clinical practice. While existing research predominantly focuses on care plans within specific clinical contexts, little is known about how students experience the learning process and how these experiences shape their professional development. Objectives: This study aimed to explore the experiences of undergraduate nursing students in writing care plans to understand the impact on their clinical competence and identify strategies for improvement. Design: A qualitative phenomenological study utilizing focus group interviews was conducted. Methods: Semi-structured interviews with open-ended questions were conducted with 15 undergraduate nursing students in six focus groups. Data were analyzed using Colaizzi’s method to identify key themes. Results: Four main themes emerged: (1) enhancement and integration of knowledge and skills, (2) initiative learning and motivation, (3) adequate support and feedback from tutors, and (4) difficulties in transitioning from classroom learning to clinical practice. The findings highlight that care plan writing enhances students’ competence in patient care, with positive learning attitudes and tutor feedback playing crucial roles. However, students encounter difficulties in applying theoretical knowledge to complex clinical scenarios, particularly in prioritizing interventions and managing time effectively. Conclusions: Writing care plans not only fosters personal and professional development but also enhances students’ clinical competence, preparing them for real-world practice. Nurse tutors are encouraged to promote consistent practice in care plan writing, provide timely feedback, and share clinical experiences to support students’ learning. These findings underscore the need to reframe care plans as developmental tools rather than mere tasks for clinical transition, ultimately enhancing the quality of patient care. Full article

This descriptive cross-sectional study investigated the relationship between grit, emergency nursing competency, positive nursing organisational culture, and burnout among emergency department nurses and identified the factors influencing burnout. The study participants were 176 nurses from one tertiary and six general hospitals in Chungcheong-do, South Korea. Data were collected from 18 July to 10 August 2024 and analysed using hierarchical multiple regression. Burnout was negatively correlated with grit (r = −0.57, p < 0.001), emergency nursing competency (r = −0.41, p < 0.001), and positive nursing organisational culture (r = −0.60, p < 0.001). It was also negatively correlated with the subdomains of positive nursing organisational culture: active leadership of nurse managers (r = −0.46, p < 0.001), pursuit of shared values (r = −0.55, p < 0.001), trust-based organisational relationship formation (r = −0.62, p < 0.001), and fair management systems (r = −0.55, p < 0.001). The regression analysis showed two variables that significantly affected burnout—trust-based organisational relationship formation in positive nursing organisational culture (β = −0.31, p = 0.012) and grit (β = −0.29, p < 0.001); their explanatory power was 44.0% (F = 18.19, p < 0.001). Thus, positive nursing organisational culture and grit were major factors affecting burnout. Therefore, to prevent and effectively manage burnout among emergency department nurses, nursing organisations must create a positive organisational atmosphere based on mutual respect and trust, promoting active participation in work, decision-making, and collaboration. Full article