Search Results (466)

Background/Objectives: Evidence-based nursing practice (EBNP) is essential in high-acuity settings such as intensive care units (ICUs) and emergency departments (EDs), where nurses are frequently required to make time-critical, high-stakes clinical decisions that directly influence patient safety and outcomes. Despite its recognized importance, the implementation of EBNP remains inconsistent, with frontline nurses often facing barriers to accessing and applying current evidence. Methods: This descriptive, cross-sectional study systematically mapped and prioritized clinical questions generated by ICU and ED nurses at a tertiary hospital in South Korea. Using open-ended questionnaires, 204 clinical questions were collected from 112 nurses. Each question was coded and classified according to the Nursing Interventions Classification (NIC) taxonomy (8th edition) through a structured cross-mapping methodology. Inter-rater reliability was assessed using Cohen’s kappa coefficient. Results: The majority of clinical questions (56.9%) were mapped to the Physiological: Complex domain, with infection control, ventilator management, and tissue perfusion management identified as the most frequent areas of inquiry. Patient safety was the second most common domain (21.6%). Notably, no clinical questions were mapped to the Family or Community domains, highlighting a gap in holistic and transitional care considerations. The mapping process demonstrated high inter-rater reliability (κ = 0.85, 95% CI: 0.80–0.89). Conclusions: Frontline nurses in high-acuity environments predominantly seek evidence related to complex physiological interventions and patient safety, while holistic and community-oriented care remain underrepresented in clinical inquiry. Utilizing the NIC taxonomy for systematic mapping establishes a reliable framework to identify evidence gaps and support targeted interventions in nursing practice. Regular protocol evaluation, alignment of continuing education with empirically identified priorities, and the integration of concise evidence summaries into clinical workflows are recommended to enhance EBNP implementation. Future research should expand to multicenter and interdisciplinary settings, incorporate advanced technologies such as artificial intelligence for automated mapping, and assess the long-term impact of evidence-based interventions on patient outcomes. Full article

Background and Objectives: Specialized nurses play an essential role in managing pulmonary fibrosis. While tele-nursing has the potential to optimize disease management, current evidence regarding its impact remains limited. This study aimed to evaluate a tele-nursing intervention that provided unscheduled access to a specialized nurse via phone or email for both patients and caregivers. Materials and Methods: This was a prospective, single-center, open-label, and pre–post pilot study. Participants and their caregivers were provided with direct access to a specialized nurse, by phone and email, for unscheduled consultations. Patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) were collected at baseline and after three months of tele-nursing access. PREMs were assessed using a 10-point Likert scale questionnaire, and PROMs were evaluated using the King’s Brief Interstitial Lung Disease (K-BILD) and the Living with Pulmonary Fibrosis (L-PF) questionnaires. Results: A total of 47 patients with pulmonary fibrosis receiving antifibrotic drugs were enrolled. At three months, 44 patients and 34 caregivers completed the questionnaires. Four patients did not complete the study due to death, lung transplantation, or transition to end-of-life care. No significant changes were observed in PROMs. However, PREMs showed significant improvements, with most scores exceeding 9/10. Patient satisfaction increased by 28% (p < 0.001), and caregiver satisfaction by 30% (p < 0.001). Caregivers of patients who did not complete the study also reported high satisfaction, comparable to that of other caregivers. Conclusions: A pragmatic and affordable tele-nursing program, based on direct phone and email consultations, may enhance patient and caregiver satisfaction in the management of pulmonary fibrosis. Full article

Background/Objectives: Emotional intelligence has emerged as a key factor in shaping nursing performance and care quality, yet its specific mechanisms and impact within the Greek public healthcare context remain underexplored. This study aimed to investigate the role of emotional intelligence in ethical behavior, crisis management, and the perceived quality of care among nurses working in Greek public hospitals. Methods: A cross-sectional survey was conducted among practicing nurses using validated instruments to assess emotional intelligence, ethical compliance, crisis management skills, and care quality. Data were analyzed using covariance-based structural equation modeling (CB SEM) to examine both direct and indirect relationships among variables. Results: The results indicated that emotional intelligence training had a strong and significant effect on nurses’ ethical behavior and their ability to manage critical situations. However, the direct effect of emotional intelligence on the perceived quality of care was not significant; instead, its influence was mediated through improvements in ethics and crisis management. Conclusions: These findings suggest that the benefits of emotional intelligence in nursing are most evident when integrated with supportive organizational practices and ongoing professional development. Overall, this study highlights the need for comprehensive emotional intelligence training and a supportive workplace culture to enhance ethical standards, resilience, and patient care quality in Greek healthcare settings. Full article

Background/Objectives: Falls are recognized as a leading cause of injury, with approximately one in ten incidents resulting in physical injury. Although virtual reality (VR)-based interventions have been explored for fall prevention, systematic reviews and meta-analyses remain limited. This study aimed to assess research trends and evaluate the effectiveness of VR-based fall prevention through a systematic review and meta-analysis. Methods: This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was carried out in PubMed, EBMASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Korean databases from their inception through 31 December 2024. A total of 49 studies met the inclusion criteria, and a meta-analysis was conducted on 37 studies with available data using “R” 4.4.1 software. Effect sizes (ESs) and 95% confidence intervals (CIs) were calculated for key outcomes. Results: The VR-based interventions showed a statistically significant positive effect on falls self-efficacy, as measured by the Falls Efficacy Scale (FES) (ES = 0.28, 95% CI: 0.17–0.39, p < 0.001). However, no significant reduction was observed in the number of falls (ES = −0.31, 95% CI: −0.80–0.17, p = 0.20). Subgroup analysis by participant medical condition for the FES revealed the largest effects in the Parkinson’s disease (PD) group (ES = 0.61), followed by the multiple sclerosis (MS) (ES = 0.34), the “other” group (ES = 0.25), and “healthy” participants (ES = 0.24). A statistically significant reduction in the number of falls was observed only in the MS group (ES = −0.56). Conclusions: VR-based interventions are effective in improving falls self-efficacy, particularly among individuals with neurological conditions, such as Parkinson’s disease and multiple sclerosis. However, evidence for a reduction in actual fall incidence remains limited. Further large-scale, long-term studies are needed to evaluate the sustained impact of VR interventions on fall prevention outcomes. Full article

Tetrabromobisphenol A (TBBPA) is a brominated flame retardant widely used in consumer products. TBBPA is often detected in soil, water, organisms, and even in human blood and breast milk. Hence, it is accessible to developing fetuses and nursing offspring after maternal exposure. The reported evidence for the endocrine disruption of TBBPA in the brain has raised concerns regarding its effects on neurodevelopmental and behavioral functions. This study investigated the effects of TBBPA exposure on neurodevelopment. A cell-based developmental neurotoxicity assay was performed to determine whether TBBPA is a developmental neurotoxicant. The assay revealed TBBPA to be a developmental neurotoxicant. C57BL/6N maternal mice were administered TBBPA at 0, 0.24, and 2.4 mg/kg during pregnancy and lactation, and their offspring underwent behavioral testing. The behavioral experiments revealed sex-specific effects. In females, only a deterioration of the motor ability was observed. In contrast, deteriorations in motor function, memory, and social interaction were noted in males. Furthermore, we validated changes in the expression of genes associated with behavioral abnormalities, confirming that perinatal exposure to TBBPA, at the administered doses, can affect neurodevelopment and behavior in offspring. These findings highlight the need for more in-depth and multifaceted research on the toxicity of TBBPA. Full article

In recent studies, public health has been considered a key stakeholder in climate mitigation and adaptation in cities since they are more exposed to the impact of climate change. Nurses represent a vast majority of public health professionals, playing a key role in health promotion that allows them to influence individuals, families, and communities in adopting healthier behaviours and decarbonized lifestyles. Therefore, the purpose of this study is to map the existing evidence on nursing interventions, which are being led or implemented to reduce the health risks related to climate change in urban areas. The present review follows the JBI methodological framework, including a search on PubMed, MEDLINE complete, CINAHL Complete, Scopus, Web of Science, SciELO (Scientific Electronic Library Online), BASE (Bielefeld Academic Search Engine), and RCAAP. Hand searched references were also considered, including quantitative, qualitative, and mixed-methods studies between January 2014 and October 2024, for a more contemporary perspective. A three-step search strategy and data extraction tool were used by two independent reviewers. Twenty-seven studies in English and Portuguese were eligible for inclusion, all targeting a population of professionals with nursing-related roles: two case studies, one Delphi panel, one descriptive study, one historical research paper, two using a methodological design format, four narrative reviews, one observational study, nine review articles, three scoping reviews, and three systematic reviews. Eight categories of nursing interventions that contribute to decarbonized lifestyles, reducing health risks in relation to climate change, were acknowledged. Nurses play a key role in empowering individuals, families, and communities, promoting climate awareness and literacy, supporting health policy change, advocating for the most vulnerable and engaging in environmental activism, using evidence-based research, and taking advantage of marketing strategies and social media. 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

Background/Objectives: Evidence-based practice (EBP) has been widely adopted in clinical nursing practice, with nursing education efforts consistently emphasizing its importance in strengthening implementation efforts. Despite these efforts to promote translational research, the level of implementation of evidence-based practice (EBP) in clinical nursing practice remains unsatisfactory. This study aimed to identify specific organizational, individual, and research-related barriers to the utilization of research in clinical practice among nurses in Sabah, Malaysia, to determine factors associated with these perceived barriers and to assess nurses’ awareness and understanding of the implementation of evidence-based practice. Methods: A cross-sectional study was conducted in 2019 using the BARRIERS scale, a validated tool that measures perceived barriers to the utilization of research across four domains: organizational barriers, nurses’ research awareness and values, quality of research, and research communication. This study involved nurses from five tertiary hospitals in Sabah, Malaysia. Results: A total of 562 nurses participated in the study, with a mean age of 34.3 years (SD = 7.96) and mean duration of clinical practice of 10.0 years (SD = 7.58). While 66.5% of the nurses had heard of EBP, only 7.3% reported understanding it very well. The top three barriers to the utilization of research were ‘the nurse does not feel she/he has enough authority to change patient care procedures’ (35.9%), ‘the nurse does not have time to read research’ (27.8%), and ‘research reports/articles are not published fast enough’ (25.8%). Among the four domains, organizational barriers scored highest (mean = 2.7, SD = 0.72), followed by research communication (mean = 2.6, SD = 0.73). Conclusions: The study findings emphasize the challenges nurses encounter in integrating research into clinical practice and highlight the need for ongoing efforts to promote the utilization of evidence-based practice and research among nurses in Sabah, while addressing the identified gaps. 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/Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with rural populations experiencing higher prevalence and worse outcomes. This paper explores the transformative potential of nurse-led palliative care models in addressing the unique challenges faced by rural patients with COPD and their informal caregivers and synthesizes current evidence on nurse-led palliative care interventions, highlighting their impact on symptom management, advance care planning, and psychosocial support. Methods: This is a comprehensive synthesis of nurse-led palliative care programs, focusing on home-based care, telehealth, community outreach, and primary care integration. Results: Nurse-led interventions significantly improve patient satisfaction, reduce symptom burden, and enhance the likelihood of advance care planning discussions. Home-based care models and telehealth are particularly effective in rural settings, offering accessible and continuous support. Conclusions: Nurses have a critical role in bridging the palliative care gap for rural patients with COPD and their informal caregivers. Expanding nurse-led palliative care services can improve quality of life, reduce healthcare utilization, and promote health equity. Future research should focus on long-term outcomes, cost-effectiveness, and strategies for scaling nurse-led palliative care programs in rural contexts. Full article

Background/Objectives: This study protocol outlines the implementation of a professional development programme (ProDeveloP) designed to support newly graduated nurses (NGNs). NGNs often experience inadequacy and face challenges in developing their professional competence. Healthcare organisations can ease this transition through introduction programmes. However, effective implementation strategies in local healthcare settings remain unclear. This study aims to develop, implement, and evaluate a programme that enhances role clarity, task mastery, social acceptance, stress reduction, and recovery, contributing to increased job satisfaction and retention. Methods: ProDeveloP will be implemented at a regional hospital in mid-Sweden. This study will include a convenience sample of 110 NGNs from both the previous and the new introduction programmes, 20 dialogue facilitators involved in the programme, and 10 managers responsible for NGNs participating in the programme. Data will be collected throughout the ProDeveloP using questionnaires, individual interviews, and focus groups. The data will be analysed using both qualitative and quantitative analyses. Conclusions: This study has the potential to improve NGNs’ work-related health, job satisfaction, and retention while contributing to competence development. By offering structured reflection, mentorship, and organisational support, this research project addresses knowledge gaps in understanding the long-term impacts of introduction programmes and structured reflection, contributing to evidence-based improvements in nursing practice and healthcare leadership. Clinical trial number: NCT06742047. Registered in ClinicalTrials.gov, 19 December 2024. Full article

Background: Sexual assault affects millions globally each year, yet research on survivors’ resilience remains limited and methodologically inconsistent. Resilience after sexual assault is a multidimensional and deeply personal process shaped by psychological, social, and systemic influences. Understanding this complexity requires research methodologies that can capture both measurable patterns and lived experiences. Objectives: This integrative review explores how mixed-methods research (MMR) has been used to study resilience and healing following sexual assault. Methods: Using the framework by Whittemore and Knafl, four databases (PubMed, CINAHL, PsychInfo, and EMBASE) were searched for peer-reviewed primary research articles published between 2014 and 2024. Studies were screened and appraised independently by two reviewers using predefined inclusion and exclusion criteria and a modified Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) tool. Results: Six studies met the inclusion criteria, revealing substantial variation in how mixed-methods approaches were applied. Half of the studies cited a “completeness” rationale for integrating qualitative and quantitative strands, while others emphasized enhancement, triangulation, or discovery of new insights. Integration strategies included connecting datasets sequentially, merging findings at the interpretation stage, or building new frameworks from combined results. However, only one study used a joint display to visually represent integration, highlighting an ongoing underutilization of visual synthesis tools in trauma research. Measures of resilience and associated outcomes also varied widely across studies, underscoring the complex and multidimensional nature of resilience following sexual assault. Conclusions: This review suggests that MMR can offer a deeper, more nuanced understanding of resilience among sexual assault survivors and calls attention to the need for intentional integration strategies to maximize insight. Full article

Background: The concept of evidence-based practice (EBP) is globally relevant in current healthcare climates. However, nursing students and teachers often struggle with integrating EBP effectively into a curriculum. This has implications for the way students learn to use evidence for their nursing practice. A new undergraduate EBP module was co-designed with current nursing students and university staff throughout 2023. Underpinning the module was a UDL (universal design for learning) pedagogy consisting of flexible approaches to learning for nursing students which included co-developed videos, co-developed audio podcasts, and co-developed serious games to complement traditional flipped classroom learning. The module commenced in September 2023, running in Year 1 one of a 3-year undergraduate nursing program, and was co-taught by staff and senior students. Methods: A pre/post-test design was used to collect data on student attitude, knowledge, and utilization of EBP. A total of 430 students completed two validated questionnaires, the EBP Beliefs Scale© and EBP Implementation Scale©, before and after the module. Following the post-test, six focus group interviews were also conducted with 58 students to explore how the module informed student nursing practice whilst attending clinical placement during Year 1. A convergent mixed-methods design was employed. Sample attrition occurred (~25%). Effect sizes and 95% confidence intervals were calculated for primary outcomes. Results: Quantitative data was analyzed using paired t-tests and this highlighted statistically significant improvements in attitude, knowledge and utilization of evidence-based practice after learning (p < 0.001). Qualitative data was transcribed verbatim, thematically analyzed, and highlighted three main findings; EBP is my business, EBP positively influenced the care of my patients and EBP has positively impacted my professional development. Conclusions: Partnership with current nursing students in the co-design and implementation of a module about EBP was associated with improvements in student knowledge, attitude and utilization of evidence in practice. These factors are likely to also improve professional competence and ultimately patient care. Full article

Background/Objectives: Cardiovascular diseases (CVDs) are a leading cause of mortality globally. Growing studies have been conducted to examine the diet–CVD association to alleviate the health and economic burdens associated with CVDs, but beneficial dietary factors may vary by study region and cohort. There was a need to identify the trends in diet–CVD research by study region and current emerging dietary exposures of interest, which could inform areas for future research and the regions where evidence is relatively limited. Methods: A comprehensive search of multiple databases was performed to identify eligible prospective cohorts examining diet–CVD associations published between 2019 and 2024. Trends in dietary exposure, including dietary patterns, food groups, and nutrients, were analyzed by publication year and geographical distribution. Results: A total of 298 studies were included in the review. While the United States continued to lead in the number of CVD–diet cohort studies, China has significantly increased its contributions over the past five years, increasing from 2.1% to 14.3%. The cohorts that contributed the most to the literature included the Nurses’ Health Study and the Danish Diet, Cancer, and Health cohort. Although food groups accounted for the highest number with respect to dietary exposure overall, there was a notable shift in diet–CVD cohort studies from a focus on nutrients to dietary patterns. Plant-based and Mediterranean diets were the most frequently investigated, while ultra-processed foods and country-specific dietary indices also gained prominence. Conclusions: This systematic review highlighted the shift towards dietary patterns in nutritional epidemiology, emphasizing the importance of understanding the role of nutrition in health through holistic dietary approaches. The observed trends in dietary exposure research suggested the need for future studies to delve deeper into the complexities of dietary patterns, including how cultural and socioeconomic elements defined the nuances of country-specific dietary patterns. Full article

Background/Objectives: Aortic stenosis is a common heart disease, particularly among elderly patients. Transcatheter aortic valve implantation (TAVI) offers a minimally invasive alternative method to surgical valve replacement for high-risk patients. Although clinical guidelines for TAVI are well established, standardized nursing care pathways are lacking. This systematic review aims to clarify the nursing role in the pre-, peri-, and postoperative phases of TAVI. Methods: This review was conducted in accordance with the PRISMA guidelines. After applying the eligibility criteria, ten studies were selected from five databases: PubMed, Scopus, CINAHL, Web of Science, and the Cochrane Library. The work was registered in the PROSPERO database with the ID number CRD420251061863. Results: The analysis revealed the following: (1) a strong emphasis on preoperative patient education, often led by nurse coordinators; (2) perioperative nursing roles in conscious sedation protocols and early mobilization; (3) a lack of standardized rehabilitative protocols, especially in the preoperative phase; and (4) an emerging but insufficiently evaluated role of the TAVI nurse coordinator in multidisciplinary care. Most studies concentrated on postoperative care, outcomes, follow-up, and rehabilitation, but the small sample sizes limited the strength of the conclusions. Conclusions: Nurses play a vital role in multidisciplinary TAVI teams. There is an urgent need for evidence-based nursing guidelines to standardize care, improve clinical outcomes, and address the needs of TAVI patients. This review highlights the pivotal contribution of nursing to the success of TAVI. Full article