Search Results (1,822)

Introduction: Nursing informatics aims to improve patient care through rapid access to patient data, systematic assessment, a reduction in clinical errors, evidence-based practice, cost-effectiveness, and improved patient outcomes and safety. Background: Despite being the largest workforce in healthcare, nurses are not being adequately prepared to use nursing informatics, and this has been attributed to poor digital literacy, limited professional development, and a lack of undergraduate informatics education. Objectives: This scoping review aims to review contemporary published literature on the benefits, barriers, and enablers for embedding nursing informatics into undergraduate nursing education with a focus on the Australian healthcare context. Methods: A scoping review was conducted using the PRISMA-ScR checklist and the JBI Manual for evidence synthesis in adherence with an a priori scoping review protocol. A comprehensive search of JBI, Cochrane, CINAHL, Ovid, ProQuest, PubMed, and Scopus databases was performed. Two reviewers independently screened the results via Covidence, with discrepancies resolved via a third reviewer. Results: Two searches were conducted for this scoping review. In the first search, a total of 3227 articles were identified through database searches, with an additional 76 articles identified through bibliographic and grey literature searches. Following duplicate removal and screening, 46 articles met the inclusion criteria. In the second search, a total of 1555 articles were identified, and after duplicate removal and screening, 16 articles met the inclusion criteria. Duplicate removal during the second search round included those articles identified in the first search. The combined searches resulted in a total of 62 sources for this review. Conclusions: Despite the early adoption of nursing informatics in Australia in the 1980s, barriers remain to effective nursing informatics engagement and proficiency, including a lack of understanding of nursing informatics, limited infrastructure and resources, inadequate digital literacy of students and faculty, and the evolving nature of nursing informatics. Definitions of nursing informatics and associated fields, development of university faculty competency, access to digital health technologies, competency standards, digital literacy of the student cohort, faculty digital proficiency, and leadership from professional nursing bodies are all viewed as integral foundations for the development of student competency in nursing informatics. Full article

Background/Objectives: In recent years, quiet quitting has attracted increasing attention in nursing research and is conceptualized as a phenomenon in which nurses perform their professional duties at a minimal level without physically leaving their jobs. This study aimed to adapt the Quiet Quitting Scale into Turkish, evaluate its psychometric properties, and examine the relationships between stress of conscience, compassion fatigue, and quiet quitting among nurses. Methods: This is a descriptive, correlational, and methodological study. This study was conducted between 20 February and March 2025 with the participation of 205 nurses working in a university hospital in Turkey. The data were collected using the Nurse Descriptive Information Form, Stress of Conscience Questionnaire, Compassion Fatigue-Short Scale, and Quiet Quitting Scale. Results: The results indicated positive associations between stress of conscience, compassion fatigue, and quiet quitting. Mediation analysis revealed that compassion fatigue had a significant indirect effect on the association between stress of conscience and quiet quitting, while the direct relationship remained significant, suggesting partial mediation. Conclusions: These findings highlight the importance of supportive work environments where nurses can address ethical concerns and access interventions aimed at preventing compassion fatigue. Organizational strategies that promote psychological well-being may help sustain nurses’ work engagement and reduce quiet quitting. Full article

Background/Objectives: Early turnover among new graduate nurses remains challenging in South Korea. This study examined how socialisation factors—based on Scott et al.’s transition model and Herzberg’s motivation-hygiene theory—are associated with early retention at the first hospital of employment among new graduate nurses. Methods: This retrospective cross-sectional study analysed secondary data from the Graduate Occupational Mobility Survey (GOMS), a nationally representative dataset of college and university graduates in Korea, collected using a stratified multi-stage sampling method. The study included 602 new graduate nurses from the 2017–2019 datasets who had worked as nurses at their first hospital of employment. Anticipatory socialisation factors included personal and educational characteristics. Organisational socialisation factors referred to workplace-related characteristics of the first hospital, including motivational factors and hygiene factors. The outcome variable was early retention. Multiple logistic regression analyses were performed to identify factors associated with early retention. Results: A total of 68.6% of nurses remained in their first hospital employment. Retention was more likely among nurses whose high school, nursing school, and first hospital were in the same region (p = 0.019), those employed in Seoul (p < 0.001), and those working in larger hospitals (p < 0.001). Retention was also associated with satisfaction with autonomy and authority (p = 0.013). Conversely, lower retention was observed among nurses who were dissatisfied with interpersonal relationships (p < 0.001) and those who reported satisfaction with growth opportunities (p < 0.001). Conclusions: Targeted strategies that support new graduate nurses during their transition are essential. Aligning education-to-employment regions and strengthening workplace conditions may enhance early retention. Full article

Background/Objectives: Self-care is a cornerstone of healthy aging and chronic disease management; however, evidence on the most effective intervention models for improving quality of life in older adults with chronic non-communicable diseases (NCDs) remains fragmented. This review aimed to evaluate the effectiveness of self-care interventions in promoting quality of life and health outcomes in older adults with NCDs. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251040613). Randomized and non-randomized clinical trials published between 2019 and 2024 were retrieved from Scopus, Web of Science, and EBSCOhost. Eligible studies included adults aged ≥60 years with NCDs receiving self-care interventions. Data extraction and risk of bias assessment were independently performed using Joanna Briggs Institute tools. Results: Twenty-nine studies involving 7241 older adults were included. Self-care interventions comprised nurse-led educational programs, digital health strategies, community- and peer-based approaches, and person-centered care models. Multicomponent and continuous interventions demonstrated consistent improvements in physical and psychological domains of quality of life, self-efficacy, autonomy, symptom management, and treatment adherence. Digital interventions enhanced monitoring and engagement, although their effectiveness varied according to sensory and health literacy limitations. Conclusions: Structured, person-centered, and nurse-led self-care interventions are effective in improving quality of life and autonomy among older adults with NCDs. These findings support their integration into primary and community-based care, reinforcing their relevance for clinical practice, care planning, and the development of assistive and educational strategies in aging care. Full article

Background/Objectives: Frailty and functional decline represent major challenges for aging populations, particularly among institutionalized older adults. Preserving functional capacity is essential to maintain autonomy, mobility, and quality of life. This study aimed to compare the effects of two strength training interventions—functional electromechanical dynamometer (FEMD) training and weighted vest training—on peak concentric and eccentric force during the sit-to-stand task, as well as on functional performance and body composition in frail nursing home residents. Methods: A pilot quasi-experimental study with a non-randomized control group was conducted in 19 older adults (mean age: 86.3 ± 5.8 years). Participants were allocated to FEMD training (EG1, n = 6), weighted vest training (EG2, n = 6), or a control group (CG, n = 7). Training was performed twice weekly for eight weeks. Assessments included body composition, handgrip strength, 30 s chair stand test, 3 m walking speed, and peak concentric and eccentric force during the sit-to-stand movement. Data were analyzed using mixed-model ANOVA and complementary within-group analyses. Results: No significant group × moment interactions were observed. However, EG1 demonstrated significant within-group improvements in chair stand performance (+4.8 repetitions, p = 0.006), walking speed (+0.1 m·s⁻¹, p = 0.030), concentric peak force (+46.5%, p = 0.008), and eccentric peak force (+34%, p = 0.047). EG2 showed a smaller but significant increase in eccentric peak force (+6.1%, p = 0.019), without functional improvements. Body composition changes were modest, with EG1 showing increases in weight and BMI without concomitant fat mass gains. Conclusions: In this pilot quasi-experimental study, functional electromechanical dynamometer-based training was associated with improvements in neuromuscular performance, particularly concentric peak force. However, no significant group × moment interactions were observed, indicating that differential effects between interventions cannot be established. Functional improvements should be interpreted cautiously. The present results should therefore be considered exploratory and hypothesis-generating. These findings suggest that FEMD-based training may be a feasible and potentially beneficial functional strength training strategy for frail institutionalized older adults, which should be confirmed in adequately powered randomized controlled trials. Full article

Nail clipping can cause fear, anxiety, and stress (FAS) in dogs and cats and possibly long-term aversion to veterinary care. We conducted an anonymous, online, mixed-methods survey to characterise the knowledge, attitudes, and practices of Australian veterinary nurses, technicians, and other veterinary staff regarding nail clipping in dogs and cats. Among 242 valid responses, 71.9% (n = 174/242) performed nail clipping multiple times per week. Dogs (72.4%, n = 165/228) and cats (59%, n = 134/227) frequently displayed FAS (score > 2/5) during nail clipping. Most respondents (79.8%, n = 193/242) reported being injured while performing nail clipping. Respondents reporting a negative attitude towards nail clipping were 5.5 times (95% CI = 1.7–17.8) more likely to report being injured during a nail clip compared to those with a positive attitude. Respondents reported feeling pressure to persevere with nail clipping when it was unnecessary or when animals exhibited severe FAS. Where used, pre-visit pharmaceuticals and sedation were reported to effectively reduce FAS (dog: p = 0.015; cat: p = 0.152), along with non-pharmaceutical interventions such as gentle handling and counter-conditioning. Respondents perceived nail-clipping to be a difficult, undervalued task. Increased training of veterinary team members regarding nail clipping could improve animal welfare and the safety of veterinary team members. Full article

Background/Objectives: Children in paediatric palliative care often face school attendance barriers due to complex health needs. This study describes post-training perceptions of a training program by a pediatric hospice team to prepare school care assistants to safely include children with complex conditions, focusing on procedural skills, knowledge of the child, and family partnership. Methods: Care assistants who completed a structured course at the Paediatric Palliative Care Centre, University Hospital of Padua (2023–2024), were surveyed immediately after training. The program combined classroom instruction with hands-on simulation using high-fidelity mannequins and standard devices, including suction, pulse oximetry, ventilation, enteral feeding, and tracheostomy care. It also covered modules on urgent and emergency management, as well as family communication. An anonymous online questionnaire gathered socio-demographic data, prior training, clinical tasks performed, self-efficacy levels, and open-ended feedback. Quantitative results were analyzed descriptively, while qualitative comments were subjected to thematic analysis. Results: Of 130 invited assistants, 105 participated (81%). Participants reported strong perceived confidence: 85% selected the upper end of the 5-point scale (“very” or “extremely”) for routine-management ability, and 60% selected these same response options for emergency-management ability. In the most severe events recalled, 60.5% of incidents were resolved autonomously, 7.6% involved contacting emergency services, and 3.8% involved community or hospice nurses. Seventy-five percent judged the course comprehensive; thematic analysis of 102 comments identified satisfaction, requests for regular refreshers, stronger practical components, and requests for targeted topics. Conclusions: Immediately after the session, participants tended to select the upper end of the self-assurance item for both routine and emergency tasks. Combining core emergency procedures with personalized, child-specific modules and family-partnership training may support safety, trust, and inclusion. Regular refreshers and skills checks are advised. Full article

Postoperative delirium (POD) is a frequent and serious complication among elderly surgical patients. Despite its clinical relevance, reliable biomarkers for early identification and pathophysiological insight remain limited. Recent evidence implicates systemic immune activation and complements dysregulation as contributors to cognitive decline after surgery. This study investigated the association between perioperative levels of selected complement pathway proteins and both the incidence and severity of POD. Methods: We performed a secondary analysis of 22 patients aged ≥ 60 years from the prospective CONFESS cohort undergoing elective spine surgery. Complement proteins (C1q, C2, C4), mannose-binding lectin (MBL), Factor D [FD], Factor B [FB], Factor I [FI] were quantified from blood samples collected at baseline, preoperatively, and on postoperative days 1 and 2. POD was assessed using the Nursing Delirium Screening Scale (Nu-DESC) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Delirium severity was rated with the Confusion Assessment Method–Severity (CAM-S) scale. Associations were tested using univariate and multivariate regression analyses. Preoperative levels of FD and C2 were significantly elevated in patients who developed POD (FD: p = 0.023; C2: p = 0.044), while C4 levels trended lower. FD remained an independent predictor of POD in multivariate regression (p = 0.049), although cognitive performance was the only significant predictor when adjusted for surgery duration. Delirium severity was associated with perioperative reductions in C1q, FI, and FB and with increased MBL levels, explaining up to 43% of CAM-S score variance. These findings highlight the role of complement activation—particularly FD, C2, MBL—in the development and clinical expression of POD. Complement profiling may offer a novel approach for risk stratification and therapeutic targeting in perioperative neurocognitive disorders. Full article

Background/Objectives: Medical device-related pressure injury (MDRPI) is a significant patient safety issue associated with increased morbidity, prolonged hospitalization, and healthcare costs. Although evidence-based guidelines for MDRPI prevention exist, nurses’ prevention performance remains suboptimal, and the mechanisms linking workload to preventive practice remain insufficiently elucidated. Within a patient safety and quality improvement framework, this study aimed to examine whether occupational coping self-efficacy (OCSE) is statistically consistent with an indirect association linking nurses’ workload and MDRPI prevention performance across the nursing practice continuum. Methods: This descriptive correlational study used a mediation model with data from 181 registered nurses working in intensive care units, general wards, and integrated nursing care wards in South Korea. Workload, OCSE, and MDRPI prevention performance were measured using validated instruments. Mediation was tested using hierarchical regression and bootstrapped analysis (PROCESS macro Model 4, 5000 resamples), controlling for demographic and work-related variables. Results: Higher workload was associated with lower OCSE, while higher OCSE was associated with better MDRPI prevention performance. When OCSE was included in the model, the direct association between workload and prevention performance was no longer significant. Bootstrapping confirmed a significant indirect association through OCSE, consistent with a full mediation pattern. Conclusions: Nurses’ workload appears to be indirectly associated with MDRPI prevention performance through OCSE. These findings suggest that strengthening nurses’ coping self-efficacy, alongside organizational strategies, may be essential for sustainable MDRPI prevention and patient safety improvement. Full article

Background: Turnover intention among healthcare workers represents a growing challenge for chronic care institutions, particularly in resource-constrained healthcare systems. Organizational and ethical factors have been increasingly recognized as relevant correlates of workforce retention. Methods: This exploratory cross-sectional study was conducted in a Romanian chronic care hospital between January 2023 and September 2024. A total of 62 healthcare workers were included using a census-based recruitment approach. Organizational climate, ethical work environment, job satisfaction, and turnover intention were assessed using adapted and composite self-report measures. Correlation, multivariate regression, and exploratory mediation analyses were performed. Results: Job satisfaction and ethical work environment were inversely associated with turnover intention in both correlation and multivariate analyses. Organizational climate did not retain an independent association with turnover intention after adjustment. Exploratory mediation analysis suggested that job satisfaction may partially account for the association between an ethical work environment and turnover intention. Higher turnover intention and less favorable organizational perceptions were observed among nursing and auxiliary healthcare staff compared to physicians. Conclusions: The findings suggest that organizational and ethical conditions, particularly those influencing job satisfaction, are relevant correlates of turnover intention in chronic care settings. Given the exploratory design and limited sample size, these results should be interpreted cautiously. Organizational strategies targeting ethical practices and everyday work satisfaction may represent feasible approaches to workforce retention in similar healthcare contexts. Full article

Background/Objectives: Acute health events in institutionalized older adults often lead to avoidable hospital referrals, requiring rapid, accurate remote decision-making. Telemedicine has become a key tool to improve assessment and care continuity in nursing homes. This study aimed to evaluate outcomes associated with telemedicine-supported management of acute events in residential care facilities for older adults and to develop a deep learning model to classify episodes and predict hospital referrals. Methods: A quasi-experimental study analyzed 5202 acute events managed via a 24/7 telemedicine system in Vitalia nursing homes (January–October 2024). The dataset included demographics, comorbidities, vital signs, event characteristics, and outcomes. Data preprocessing involved imputation, normalization, encoding, and dimensionality reduction via Truncated SVD (200 components). Given the imbalance in referral outcomes (~10%), several resampling techniques (SMOTE, SMOTEENN, SMOTETomek) were applied. A deep feedforward neural network (256–128–64 units with Batch Normalization, LeakyReLU, Dropout, AdamW) was trained using stratified splits (70/10/20) and optimized via cross-validation. Results: Telemedicine enabled the resolution of approximately 90% of acute events within the residential setting, reducing reliance on emergency services. The deep learning model outperformed traditional algorithms, achieving its best performance with SMOTEENN preprocessing (AUC = 0.91, accuracy = 0.88). The proposed model achieved higher overall performance than baseline classifiers, providing a more balanced precision–specificity trade-off for hospital referral prediction, with an F1-score of 0.63. Conclusions: Telemedicine-enabled acute care, strengthened by a robust deep learning classifier, offers a reliable strategy to enhance triage accuracy, reduce unnecessary transfers, and optimize clinical decision-making in nursing homes. These findings support the integration of AI-assisted telemedicine systems into long-term care workflows. Full article

Background/Objectives: Vast amounts of textual data are generated by healthcare organizations every year. Traditional content analysis is time-intensive, error-prone, and potentially biased. This study demonstrates how freely available large language model (LLM) artificial intelligence (AI) tools can efficiently and effectively analyze qualitative healthcare data and uncover insights missed by traditional manual analysis. Interview data from chief nursing officers (CNOs) at top-performing academic medical centers were analyzed to identify factors contributing to their operational and patient quality success. Methods: Semi-structured interviews were conducted with CNOs from top-performing academic medical centers that achieved top-decile quality measures while using resources most efficiently. Interview transcripts were analyzed using a mix of traditional text mining in LSA and Gemini 2.5. The capability of four freely available AI platforms—Gemini 2.5, Scholar AI 5.1, Copilot’s Chat, and Claude’s Sonnet 4.5—was also reviewed. Results: LLM AI analysis identified ten primary factors, comprising twenty-four subtopics, that characterized successful hospital performance. Notably, AI analysis identified a theoretical connection that manual analysis had missed, revealing how the identified framework aligned with Donabedian’s seminal structure, process, outcomes quality model. The AI analysis reduced the required time from weeks to nearly instantaneous. Conclusions: LLM AI tools offer a transformative approach to unlocking insight from the analysis of qualitative textual data in healthcare settings. These tools can provide rapid insight that is accessible to personnel with minimal text-mining expertise and offer a practical solution for healthcare organizations to unlock insight hidden in the vast amounts of textual data they hold. Full article

Background/Objectives: The iBreast Exam (iBE) electronically palpates the breast to identify possible abnormalities. The purpose of this study was to assess iBE feasibility and compare it to Clinical Breast Exam (CBE) for breast lesion detection. Methods: Prospective evaluation of 300 asymptomatic women, ≥18 years old, with CBE, iBE, and mammography was performed. Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of iBE and CBE for detecting suspicious breast lesions were calculated using breast imaging as the reference standard. For women with one year follow up, the sensitivity, specificity, PPV, and NPV for cancer detection were calculated. Results: 300 women (mean age 58.9 years) underwent CBE, iBE, and mammography. In 2/300 (0.7%), CBE was positive; in 1/300 (0.3%), iBE was positive; and in 24/300 (8%), screening mammograms were positive. Nine had suspicious imaging findings with biopsy (three malignant and six benign). Of three cancers, all visualized mammographically, CBE and iBE detected an ipsilateral breast abnormality in one woman and missed two cancers (<2 cm). Sensitivity, specificity, NPV, and PPV of iBE and CBE were similar, with no statistically significant difference in NPV or PPV for detection of suspicious breast findings or breast cancer (p > 0.05). Conclusions: Mammography detected all breast cancers in our cohort and remains the standard of care. iBE is feasible to perform. Our pilot data demonstrates iBE performed similarly to CBE by trained nurse practitioners. Given our small study population, further investigation is warranted into the potential use of iBE where trained healthcare practitioners are not readily available. Full article

Background: Teamwork and effective communication are widely recognized as essential pillars for the safety and quality of healthcare. However, in Portugal, no validated instrument had previously been available to assess healthcare professionals’ attitudes toward teamwork. This study aimed to translate, culturally adapt, and validate the TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) for the Portuguese context, resulting in the Portuguese version of the instrument. Methods: A methodological study with a quantitative approach was developed. The translation and cultural adaptation process followed internationally recognized guidelines. The sample consisted of 162 healthcare professionals (136 nurses and 26 physicians) from a hospital in Lisbon. Exploratory and confirmatory factor analysis techniques were used to assess construct validity. The internal consistency of the scale was analyzed using Cronbach’s alpha coefficient. Results: The Portuguese version comprises 30 items distributed across five dimensions: Effective Leadership Support, Team Functional Performance, Teamwork Coordination, Willingness to Engage in Teamwork, and Team Functioning Supervision. The scale demonstrated a total explained variance of 53.9% and an overall internal consistency coefficient (α) of 0.86, indicating good reliability. Confirmatory factor analysis supported the five-factor structure of the scale (χ²/df = 1.461; CFI = 0.900; GFI = 0.821; RMSEA = 0.054; MECVI = 4.731). Conclusions: The T-TAQ-PT proved to be a valid, reliable, and robust instrument for assessing healthcare professionals’ individual attitudes toward teamwork, contributing to the development of research and clinical practice in the Portuguese context. Full article

The global rise in nursing home (NH) populations presents substantial challenges, as residents frequently experience physical and cognitive decline, low physical activity, and high fall risk. This study evaluates the effectiveness of the BeSt Age App, a tablet-based, staff-supported mHealth intervention designed to promote physical activity and prevent falls among NH residents. Primary outcomes were fall incidence and fall risk (assessed using Berg Balance Scale [BBS] and Timed Up and Go [TUG]); fear of falling was a secondary outcome. In a cluster-randomized controlled trial across 19 German NHs, 229 residents (mean age = 85.4 ± 7.4 years; 74.7% female) were assigned to an intervention group (IG) or control group (CG). The 12-week intervention comprised twice-weekly, tablet-guided exercise sessions implemented by NH staff. Mixed models and generalized estimating equations were used under an intention-to-treat framework. The IG showed significantly greater improvement in BBS scores than the CG (group × time: F(1, 190.81) = 8.25, p = 0.005, d = 0.22), while group × time changes in TUG performance, fear of falling, and fall incidence were nonsignificant. These findings demonstrate the feasibility of a staff-mediated mHealth approach to fall prevention in NH residents, showing significant improvements in BBS scores as one functional indicator of fall risk, while TUG, fall incidence and fear of falling showed no change. Full article