Nurs. Rep., Volume 14, Issue 4 (December 2024) – 33 articles

Background and Objectives: Despite the robustness of evidence-based practice in increasing efficiency in nursing care and improving patient safety, using evidence in practice is still rare in mental health nursing. This correlational descriptive research aimed to explore the factors and examine the relationship between attitudes, knowledge/skills, organizational culture, mentorship, and demographic factors to evidence-based practices among mental health nurses working in psychiatric hospitals in Thailand. Methods: The sample consisted of 255 nurses working in psychiatric hospitals under the Thai Department of Mental Health, located in service units across the country’s four regions. The data collection tools included (1) a demographic questionnaire, (2) the Evidence-Based Practice Questionnaire: EBPQ, (3) Organizational Culture & Readiness for System-wide Integration of Evidence-Based Practice: OCRSIEP, and (4) the Evidence-Based Practice Mentorship Scale. Descriptive statistics and Spearman’s correlation coefficient were used for data analysis. Results: The findings revealed that the factors positively correlated with evidence-based practice among mental health nurses in Thailand were attitude with a mean score of 4.90 (r = 0.39, p-value < 0.001), knowledge/skills with a mean score of 4.69 (r = 0.61, p-value < 0.001), organizational culture with a mean score of 3.94 (r = 0.26, p-value < 0.001), and mentorship with a mean score of 2.77 (r = 0.16, p-value = 0.011). Demographic factors such as educational level (r = 0.21, p-value < 0.001) and work experience in psychiatric and mental health nursing (r = 0.14, p-value = 0.031) were also positively correlated. Conclusions: This research revealed that EBP knowledge and skills are the most significant factors related to evidence-based practice among Thai mental health nurses. Therefore, EBP knowledge and skills should be enhanced in the curriculum during the nursing study and through continuing education once nurses graduate. Organizational culture and mentorship also need to be promoted to strengthen the use of EBP in Thailand. Full article

Patient safety is fundamental to healthcare. Adverse events, particularly medication errors, cause harm to patients, especially the paediatric population in the emergency department. Aim: To explore paediatric emergency nurses’ perceptions of medication administration errors. Method: A qualitative, ethnomethodological, descriptive study. The participants were nurses working in the paediatric emergency department. Data were collected through in-depth individual interviews with paediatric emergency nurses. The study excluded nurses employed for less than six months. Ten individual interviews were carried out. All interviews were face-to-face and audio-recorded with the participant’s consent. Interviews took between 52 min and 1 h 25 min. A questions guide was followed during the interviews. The analysis of the data was carried out according to the scheme proposed by Taylor and Bogdan. Results: The participants’ discourse revealed three main categories: Safety culture, transmitted by supervisors and safety groups. Teamwork, with good communication and a positive relationship. Error management, the lack of formal support and negative feelings despite an understanding of the multifactorial nature of errors. The study identifies several challenges in the healthcare system. Emphasis was placed on the perception of errors in terms of patient harm, while near misses or dose delays or omissions are not treated as errors. Conclusions: Although institutions have implemented safety culture strategies, nurses have not fully embraced them. There is a need to promote a positive safety culture and a safe working environment that encourages communication within the team. The hospital should provide training in safe management and patient safety and develop effective protocols. This study was not registered. Full article

Background/Objectives: In recent years, research has increasingly highlighted the significance of nursing practice environments, linking positive settings with enhanced job satisfaction, professional autonomy, and care quality. Such environments can decrease turnover, stress, and costs while improving patient safety. Despite this extensive literature, there is limited consensus on defining a ‘positive nursing practice environment’, highlighting the need for a systematic analysis to advance understanding and application. This study aims to explore and clarify the concept of a ‘Positive Nursing Practice Environment’. Methods: This study applied Walker and Avant’s approach for concept analysis, conducting a comprehensive database search to gather relevant evidence. To review the available evidence on the concept of nursing practice environments, we followed the methodology proposed by JBI for scoping reviews. Results: The inclusion of 166 studies meeting the criteria provided a broad understanding of the topic, revealing 10 key attributes of a ‘positive nursing practice environment’ and identifying various antecedents and consequences affecting clients, nurses, and institutions. Conclusions: The concept analysis of a ‘Positive Nursing Practice Environment’ offers valuable insights into nurses’ working conditions, systematically identifying characteristics that impact professionals, patients, and institutions. This analysis lays the groundwork for future research and practical improvements in nursing practice environments. This study was not registered. Full article

Background: In the transition to a professional learning environment, healthcare professionals in their first year of specialized postgraduate clinical training (known as residents in Spain) are suddenly required to handle confidential information with little or no prior training in the safe and appropriate use of digital media with respect to confidentiality issues. The aims of this study were: (1) to explore the usefulness of an advanced clinical simulation program for educating residents from different healthcare disciplines about confidentiality and the dissemination of clinical data or patient images; (2) to explore the use of social networks in healthcare settings; and (3) to explore participants’ knowledge and attitudes on current regulations regarding confidentiality, image dissemination, and the use of social networks; Methods: This was a cross-sectional study. Data were collected from all 49 first-year residents of different health professions at a Spanish hospital between June and August 2022. High-fidelity clinical simulation sessions designed to address confidentiality and health information dissemination issues in hospital settings, including the use of social networks, were developed and implemented. Data were assessed using a 12-item ad hoc questionnaire on confidentiality and the use of social media in the healthcare setting. Descriptive of general data and chi-square test or Fisher’s exact test were performed using the SPSS 25.0 software; Results: All the participants reported using the messaging application WhatsApp regularly during their working day. A total of 20.4% of the participants stated that they had taken photos of clinical data (radiographs, analyses, etc.) without permission, with 40.8% claiming that they were unaware of the legal consequences of improper access to clinical records. After the course, the participants reported intending to modify their behavior when sharing patient data without their consent and with respect to how patients are informed; Conclusions: The use of advanced simulation in the training of interprofessional teams of residents is as an effective tool for initiating attitudinal change and increasing knowledge related to patient privacy and confidentiality. Further follow-up studies are needed to see how these attitudes are incorporated into clinical practice. Full article

(1) Background: Pain is a common symptom in patients with Amyotrophic Lateral Sclerosis (ALS). There are no evidence-based pharmacological treatments for pain in ALS; recommendations are based on guidelines for chronic non-oncological pain and clinical experience. The aim is to map the literature on how people with ALS experience pain, and how this affects their daily activities and social relationships. (2) Methods: This scoping review included studies concerning patients with spinal/bulbar ALS aged ≥ 18 years who experience pain, focusing on perception, characteristics, treatment, and impact on quality of life. Temporal and linguistic criteria were applied when searching the MEDLINE, CINAHL, and SCOPUS databases. (3) Results: The management of pain in these patients is complex and involves the use of anti-inflammatory drugs, analgesics, and opioids. Pain is associated with other conditions such as depression and anxiety, which contribute to a deterioration in the quality of life. Moreover, pain may also negatively influence patient compliance with prescribed treatment regimens and the quality of care they perceive themselves to be receiving. (4) Conclusions: It is of the most importance to identify effective ways to assess and treat this issue, with health care professionals taking an active role in this process. Full article

Background: Delirium or an acute confusional state (ACS) is characterised as being a frequent and complex hospital complication in older adult patients, which can affect their level of independence and increase patient morbidity and mortality. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium, leading to longer hospital and ICU stays, increased mortality and long-term impairment. Objectives: This review aims to assess existing evidence of interventions that can be considered effective for the management and prevention of delirium in ICUs, reducing short-term morbidity and mortality, ICU and hospital admission times and the occurrence of other long-term complications. Methodology: For this systematic review, we searched Medline, PubMed, Cochrane Library, CINHAL, LILACS, SciELO and Dialnet from January 2018 to August 2024, in English, Spanish and French. MeSH descriptors were adjusted to search the different databases. We also checked Prospero for ongoing systematic reviews. Main results: The electronic search yielded a total of 2656 studies, of which 14 trials met the eligibility criteria, with a total of 14,711 participants. We included eight randomised clinical trial (RCTs), four cohort analyses, one systematic review and one observational trial, including participants over 65 years admitted to the ICU. Ten of these studies were based on pharmacological interventions, three of them examined non-pharmacological interventions and the remaining study examined mixed (pharmacological and non-pharmacological) interventions. Six placebo RCTs were included, plus four reported comparisons between different drugs. Regarding non-pharmacological interventions, nursing programmes focused on optimising modifiable risk factors or the use of therapies such as bright light are emerging. Regarding mixed interventions, we found the combination of invasive techniques and with sedoanalgesia. Conclusions: Due to its satisfactory level of sedation, dexmedetomidine is presented as a viable option because, although olanzapine offers safer results, postoperative administration angiotensin inhibitor systems significantly reduced the incidence of delirium. As for propofol, no significant differences were found. Among the non-pharmacological and mixed therapies, bright light therapy was able to reduce the incidence of delirium, and the combination of epidural/general anaesthesia was effective in all subtypes of delirium. Concerning the remaining interventions, the scientific evidence is still insufficient to provide a definitive recommendation. Full article

Background: Nurse education plays an essential role in preparing future nurses to engage with quality improvement (QI) initiatives in their organisations and improve patient care. However, frontline nurses continue to report that a lack of QI knowledge hinders their abilities to engage in improvement work. In the UK, student nurses are now trained in QI within their degree to enable them to contribute to improvements once qualified. Objectives: This qualitative follow-up study investigated the sustainability of QI engagement in nurses who undertook QI training and a QI project during their degree and explored the factors influencing their engagement in QI once qualified. Methods: This paper followed the COREQ criteria to report upon 10 semi-structured interviews undertaken with registered nurses and focuses on their experiences of QI engagement post-registration. The data were investigated using an inductive thematic analysis and Nvivo 14. Findings: Five themes emerged: transition to a newly qualified nurse, QI knowledge decline, influencing factors (hierarchy, leadership, COVID-19 pandemic, data access and location), and skill transferability. Conclusions: This study showed that qualified nurses can sustain their QI knowledge and remain engaged with QI where they experience positive QI leadership and were exposed to ongoing QI activity in their preceptorship year. However, a lack of QI opportunities and a culture which does not consider QI a responsibility of new nurses is seen to hinder engagement. Educational institutions and practice partners require careful collaboration to assess and develop ongoing QI learning activities that support new nurses to engage in QI. Full article

Introduction: Clinical simulation has been used as a teaching strategy for students in health programmes, fostering greater preparedness and confidence in performing procedures. Objective: This study aimed to analyse the perception of fourth-semester nursing students and teachers regarding the simulated practice methodology implemented in a private university in Cali, Colombia. Method: A robust mixed-methods approach was used, incorporating quantitative surveys and qualitative interviews with 41 students and 5 teaching nursing faculty members. Data triangulation was applied to ensure the robustness of the results. Results: Both students and teachers reported a positive perception of simulated practice, which contributes to knowledge acquisition and contextual learning. Students emphasised that simulation improved their prior knowledge and motivated them to explore new topics. Lecturers emphasised the importance of well-trained instructors in simulation environments. However, participants identified challenges affecting performance, including simulation duration, group size, realism, and resource constraints. Conclusions: Students and teachers recommend strategic changes to the curriculum to optimise simulation practices. Full article

Background: Stigma education for nursing students has focused solely on stigma reduction, with studies showing temporary improvements in attitudes. However, nursing education research should also emphasize the importance of critical reflection and self-reflection to enhance attitudes, beliefs, topic comprehension, and learning satisfaction. This study aimed to evaluate the effectiveness of the “This is me” intervention regarding knowledge, attitudes, and communication skills of senior undergraduate nursing students in responding to mental illness-related stigma. Methods: This study employed a psychoeducational intervention for reducing mental illness stigma, using a questionnaire survey to assess pre- and post-intervention effects, with 37 eligible nursing students undergoing clinical training in psychiatric services between 16 May and 15 July 2022. Instruments included sociodemographic and health questions, the MICA-4 scale to evaluate students’ attitudes toward mental illness, the MAKS to measure mental health knowledge, the Empathy Scale (JSPE-S), the Intergroup Anxiety Scale (SS-12), and the Attribution Questionnaire (AQ-27). Results: Most students were female (73.0%) and single (70.3%), with a mean age of around 29 years. After implementing the psychoeducational program, there was a statistically significant increase in overall stigma-related knowledge (MAKS: Z = −1.99, p < 0.05), a decrease in intergroup anxiety (IAS: Z = −3.42, p < 0.05), and reductions in the perceptions of patients as dangerous (AQ27—Dangerousness: Z = −2.399, p < 0.05) and fear (AQ27—Fear: Z = −2.415, p < 0.05). Additionally, there was an improvement in empathy, specifically in Perspective Taking (JSPE: Z = −2.555, p < 0.05). Conclusions: This program may contribute to mental health literacy related to stigma, positively impacting therapeutic relationships and communication with people with mental illness and resulting in more effective care practices. Full article

Background/Objectives: The World Health Organization recommends skin-to-skin contact immediately after birth, yet the practice rate remains low in Saudi Arabia, impacting the health and well-being of mother–baby dyads. No previous studies have explored Saudi women’s attitudes toward skin-to-skin contact, a critical factor in developing strategies to increase its adoption. This study aimed to develop and evaluate an instrument to assess attitudes toward skin-to-skin contact among women in Saudi Arabia. Methods: An instrument was developed by modifying the validated “Mother–Newborn Skin-to-Skin Contact Questionnaire”. Psychometric testing was conducted to validate the instrument through a cross-cultural survey involving 383 participants recruited from two hospitals in Saudi Arabia using a convenience sampling method. The Kaiser–Meyer–Olkin measure of sampling adequacy was 0.885, indicating that the sample size was suitable for performing exploratory factor analysis. Results: The overall Cronbach’s alpha value was 0.85, reflecting adequate internal consistency of the questionnaire. The criteria of the two-factor confirmatory factor analysis were also met. The majority of women (85.6%) demonstrated a positive attitude towards skin-to-skin contact. A positive correlation was observed between higher educational levels and the total attitude score (r = 0.161, p = 0.002). Conclusions: The developed questionnaire is a reliable tool for measuring attitudes towards skin-to-skin contact among women in Saudi Arabia. The findings highlight the importance of educational interventions to improve the uptake of this practice. Full article

Background/Objectives: Cerebellar strokes account for only 2–3% of all strokes occurring annually in the United States but represent a disproportionally higher share of morbidity and mortality. Evidence examining the effect of inpatient rehabilitation on functional outcomes following a cerebellar stroke is limited. This study aimed to examine the effects of inpatient rehabilitation on balance and walking speed in individuals with cerebellar stroke. A secondary purpose of this study was to examine the length of inpatient rehabilitation stay of the included patients. Methods: A retrospective analysis was conducted using review of patient records during their inpatient rehabilitation stay from January 2021 to February 2022 at a large hospital system in the southeast United States. Balance and gait outcomes were examined on admission and discharge from inpatient rehabilitation that included physical therapy interventions. A paired t-test examined for changes in outcomes from admission to discharge. Pearson correlation examined for the association between length of stay and outcomes. Results: A total of 15 records were reviewed. There were significant improvements in the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), and the 10-Meter Walk Test (10MWT) (p’s < 0.01) from admission to discharge with large effect sizes (range d = 0.70–1.67) following inpatient rehabilitation. The average length of stay was 12.67 days (SD = 6.5) and the mean total hours of combined occupational, physical, and speech therapy was 27.33 (SD = 6.52) h. There was a moderate association between length of stay and PASS (r = 0.525, p = 0.04) and BBS (r = 0.546, p = 0.04) outcomes. Conclusions: Patients who underwent inpatient rehabilitation following acute cerebellar strokes demonstrated improvements in balance and gait speed. Study results could assist clinicians designing interventions for patients with cerebellar strokes in the inpatient rehabilitation setting. Full article

Background/Objectives: The complexity of care requires systematic documentation to fully understand its relationship with medical complexity and its impact on patient outcomes. The Nursing Minimum Data Set (NMDS) plays a crucial role by capturing essential nursing data, enabling a detailed analysis of care and its impact on outcomes, such as length of stay (LOS). However, despite its potential, the use of NMDS in paediatric care remains limited. This study aims to explore the association between nursing and medical complexities and LOS in paediatric patients. Methods: A descriptive, retrospective, monocentric study will be conducted. The data will be collected through a nursing information system (Professional Assessment Instrument (PAIped)) and the hospital discharge register of patients admitted to the paediatric department in 2022 in an Italian university hospital. Conclusions and Expected Results: The use of PAIped will allow for the description of the complexity of care and enable an analysis of its relationship with medical complexity and LOS. Full article

Background: Assessing the elements of nursing practice environments is crucial, as investing in their improvement will enhance outcomes for nurses, patients, and organizations. Moreover, comparing practice environments from different countries improves the definition of cross-cutting guidelines that can be applied in various contexts. Thus, this study aims to evaluate nursing practice environments in hospitals in Portugal and Brazil. Methods: A multicenter and cross-sectional study was conducted in eight Portuguese and eight Brazilian hospitals. Five hundred eighty-two nurses completed a survey regarding their sociodemographic and professional attributes, as well as the Scale for the Environments Evaluation of Professional Nursing Practice. The data were subjected to comparative analyses between the two countries. We adhered to ethical requirements in both participating countries. Results: In Brazil, the Structure, Process, and Outcome components were considered favorable to the quality of care and well-being of nurses. In Portugal, nurses considered the Structure and Outcome components favorable and the Process component very favorable. Statistically significant differences were found between the two countries in several dimensions of the three subscales. The Structure and Outcome components scored significantly better in hospitals in Brazil, and the Process component scored better in Portuguese hospitals. Conclusions: These conclusions underscore the urgent need for investment in continuous training and a culture of evaluation that promotes continuous improvement. Additionally, promoting the involvement and participation of nurses could simultaneously contribute to the development of more sustainable health systems. Full article

Background: Quality indicators in healthcare are essential to raising awareness about the appropriateness of nursing care. However, identifying the key indicators continues to pose a challenge, above all if one wants to include users and professionals. Aim: Identify which aspects of nursing care should be measured to assess the results of nursing care and how to do so. Methodology: Interpretive qualitative exploratory study. The participants were users and professionals of an autonomous regional health service in Spain. The information was collected by means of two focus groups and eight semi-structured interviews conducted between November 2022 and March 2024. The data were analysed thematically using the Braun and Clarke process. Results: The users and professionals agreed on the need to measure emotional skills and attitudes such as empathy, respect, and warmth when dealing with patients. The professionals highlighted workload and inefficiency of the current record system as barriers to adequately reflecting their work. They proposed improvements in the recording tool and the need for more human resources, as well as leadership that is more focused on quality. Conclusions: It is crucial to develop indicators that reflect both the emotional and technical aspects of nursing care. The participation by patients and professionals alike in this design and selection will make it possible to improve the quality of care and advances in the nursing profession. This study was not registered. Full article

Introduction: The healthcare sector significantly contributes to environmental degradation, highlighting the need for sustainable practices. Green Lean Six Sigma (GLSS) offers a relevant and impactful approach to reduce healthcare’s environmental footprint while improving efficiency. By incorporating environmental considerations into Lean Six Sigma, GLSS has the potential to mitigate healthcare’s environmental impact and promote environmental sustainability. This study aims to gain insight into healthcare professionals’ experiences with GLSS at their workplace. Materials and Methods: This qualitative exploratory study employed semi-structured surveys based on theory of training evaluation from Kirkpatrick with Dutch healthcare professionals in the first six to eight months after completing GLSS training. Results: Even though 76% (N = 16) of trained healthcare professionals applied GLSS at their workplace and 43% of them (N = 9) completed a project within the first six to eight months after training, they all experienced one or more barriers. The most frequently reported barriers were lack of time, difficulties with project selection and a lack of management support. GLSS project results included reduction of products, energy, costs and travel, green choices in procurement and sustainable food choices. GLSS also helped to create awareness on the environmental impact of healthcare and to optimize processes by reducing costs, waiting time, workload and defects. Discussion: This is the first study to report experiences from applying GLSS in healthcare. Furthermore, it is the first study presenting GLSS training evaluation results in terms of participant behaviour and organizational outcomes. Conclusions: Results of this study can be used to enhance GLSS deployment programs and to optimize organizational settings for successful GLSS implementation in healthcare. Full article

Background: As early as 1995, the Institute of Medicine suggested that nurses were inadequately prepared for and educated about climate change and its health consequences. The aim of this systematic review is to identify the most reliable, robust, and valid instruments for measuring nurses’ knowledge and awareness of climate change and climate-associated diseases. Methods: Included studies were appraised using the Mixed-Methods Appraisal Tool and the Appraisal tool for Cross-Sectional Studies. The psychometrics and clinimetrics of the instruments were evaluated using the COSMIN Risk of Bias checklist and the COSMIN methodology for assessing content validity. Results: Medline, PubMed, Embase, CINAHL Ebesco, Cochrane Library Wiley, Web of Science Core Collection, Trip Database, JBI OVID SP, GreenFILE EBSCO, Google Scholar, ProQuest Dissertations and Theses Global, and DART-EU were consulted. The 14 studies retained identified eight different instruments evaluating attitudes, perceptions, environmental awareness, environmental sensitivity, environmental attitudes, behaviours, motivation, concern, optimism, and experience. This review is reported according to the PRISMA guidelines. Conclusions: The New Ecological Paradigm Scale (NEPS) and the Climate, Health, and Nursing Tool (CHANT) are the most reliable, robust, and valid instruments for measuring nurses’ knowledge and awareness of climate change and climate-associated diseases. Full article

Socio-emotional competencies (SECs) are essential for the quality of nursing practice. This study aimed to understand the pedagogical strategies provided by universities for the development of SECs in Brazil, as perceived by nursing students. This is a descriptive, exploratory study with a qualitative approach involving 57 nursing students from a public Higher Education Institution in Brazil. Data collection was conducted through focus groups, and interpretation was carried out using inductive thematic analysis. The pedagogical strategies identified were categorized as follows: those offered by the curriculum matrix, those provided by the Nursing course department, those made available by the university as a whole (involving all courses and students), and the challenges related to the development of socio-emotional competencies. This study revealed a deficit in the integration of SECs in the curriculum, highlighting the need for curricular restructuring and discussions on this topic. Equipping students with socio-emotional competencies during their training can help address these gaps, fostering greater resilience and self-care capabilities among nursing professionals. Full article

(1) Background: Fibromyalgia (FM) is a syndrome marked by chronic widespread pain, fatigue, sleep issues, and other symptoms. Interventions like physical exercise can potentially enhance physical function in individuals with FM. This study aimed to assess physical function, perceived physical fitness, balance confidence, and fear of falling in women with FM based on their levels of pain, depression, fatigue, and sleep problems. (2) Methods: Participants underwent a series of tests and questionnaires to evaluate physical and perceptual aspects. These included the Time Up and Go, Four Step Square Test, 6-Minute Walking Test, Maximum Handgrip Strength, Back Scratch, International Fitness Scale, Activities-Specific Balance Confidence Scale, and Fall Efficacy Scale—International. Participants were categorised by the severity of their pain, depression, fatigue, and sleep problems (mild, moderate, severe). A Kruskal–Wallis test assessed intergroup differences, while Spearman’s rho evaluated correlations between the study variables and symptom levels. (3) Results: Perceived physical condition varied significantly with symptom severity. Symptoms and sleep problems were notably linked to fear of falling, though no significant differences emerged in the physical tests. (4) Conclusions: In women with fibromyalgia, symptom severity was primarily related to perceptual and subjective aspects of physical condition and fall safety. Full article

Background: Informational overload hinders the recognition of quality information and influences a population’s health-related decisions. In this context, media health literacy aims to promote citizens’ critical analysis skills, contributing to informed decision-making. This study aims to identify the instruments used to measure the level of media health literacy and their psychometric properties. Methods: A systematic review of the scientific literature was performed in 2023. The articles were extracted from the electronic databases “Pubmed”, “Web of Science”, “Dialnet”, and “Scopus”. The search languages were limited to English, Spanish, and Portuguese. Results: Twelve articles were selected for further analysis. The described measurement instruments included five original scales and seven cross-cultural adaptations of three of them. Four scales (the Sugar-Sweetened Beverages Media Literacy scale adapted to Turkish and Chinese, along with the Media Health Literacy (MeHLit) scale and its adaptation to the Chinese language) exhibited high quality in the assessment of psychometric properties. Conclusions: These instruments allow for the measurement of an individual’s level of skill when consuming specific health information, enabling an analysis to understand the risk they are exposed to. Further research is recommended to strengthen the existing evidence and apply these tools to broader and more diverse populations. Full article

Introduction: The recovery room (RR) is a hospital area where patients are monitored in the early postoperative period before being transferred to the surgical ward or other specialized units. The utilization of scores in the RR context facilitates the assignment of patients to the appropriate ward and directs necessary monitoring. Some scoring systems allow nurses to select patients who can be discharged directly to their homes. Aim and methods: The aim of this narrative review was to describe and compare the scoring systems employed to discharge postoperative patients from RR, with a focus on item characteristics. Results: Nine scoring systems were identified and discussed: the “Aldrete Score System” and its modified version, the “Respiration, Energy, Alertness, Circulation, Temperature Score”, the “Post Anesthetic Discharge Scoring System”, the “White and Song Score”, the “Readiness for Discharge Assessment Tool”, the “Anesthesia and Perioperative Medicine Service Checklist”, the “Post-Anesthetic Care Tool”, the “Post-operative Quality Recovery Scale”, and the “Discerning Post Anesthesia Readiness for Transition” instrument. Discussion and conclusions: To obtain a comprehensive overview, the items included in the scoring systems were compared. Despite the availability of guidelines for patients’ discharge readiness from the RR, there is no universally recommended scoring system. Next-generation scores must be improved to ease their use, minimize errors, and increase safety. The main goals of the scores included in this narrative review were to be simple to use, feasible, intuitive, comprehensive, and flexible. However, these goals frequently conflict because patient assessment takes time, and a smart and comprehensive score may not consider some clinical parameters that may be crucial for the discharge decision. Therefore, further research should be conducted on this topic. Full article

Background: Nursing, as an essential component of contemporary healthcare systems, has undergone significant changes in recent decades, resulting in an increase in research across various fields, such as mental health, well-being, and the development of the discipline itself. Currently, gender stereotypes persist, impacting the social image of the profession and influencing the professional identity of nurses and consequently, their work performance and the quality of care provided. Both public and internal perceptions of the profession are critical factors in these dynamics. Objective: to adapt and validate the Nursing Attitude Questionnaire in a Spanish sample, as it has only been validated in two languages to date. Methods: This study presents descriptive and validity analyses of several measures utilized, such as Nursing Image (NIS), Medical Empathy (JSE-HP), Professional Values (NPVS) and Communication Skills (HP-CSS). Results: Confirmatory factor model analyses indicated that a 21-item hierarchical model provided a superior fit (χ²(df = 1.65, NFI = 0.954, SRMR = 0.065), suggesting the presence of a general factor accounting for five first-order factors. Internal consistency was deemed adequate for the total measures (α = 0.789), though variable for the subscales. Correlations among measures provided evidence of convergent and discriminant validity, highlighting consistent correlation patterns between Attitude toward Nursing and other variables. In addition, significant differences were observed in the Professionalism subscale according to sex, albeit with a medium-low effect size. Scales are presented to facilitate future interpretation of the results in similar samples. Conclusions: The scale validated in this study exhibited overall good psychometric performance, although certain limitations were identified within the subscales. The established scales represent a novel contribution, providing a valuable tool for the comparison of similar samples. Full article

Background: “DeepFakes” are synthetic performances created by AI, using neural networks to exchange faces in images and modify voices. Objective: Due to the novelty and limited literature on its risks/benefits, this paper aims to determine how young nursing students perceive DeepFake technology, its ethical implications, and its potential benefits in nursing. Methods: This qualitative study used thematic content analysis (the Braun and Clarke method) with videos recorded by 50 third-year nursing students, who answered three questions about DeepFake technology. The data were analyzed using ATLAS.ti (version 22), and the project was approved by the Ethics Committee (code UCV/2021–2022/116). Results: Data analysis identified 21 descriptive codes, classified into four main themes: advantages, disadvantages, health applications, and ethical dilemmas. Benefits noted by students include use in diagnosis, patient accompaniment, training, and learning. Perceived risks include cyberbullying, loss of identity, and negative psychological impacts from unreal memories. Conclusions: Nursing students see both pros and cons in DeepFake technology and are aware of the ethical dilemmas it poses. They also identified promising healthcare applications that could enhance nurses’ leadership in digital health, stressing the importance of regulation and education to fully leverage its potential. Full article

Background: The integration of artificial intelligence (AI) in the organization of nursing care has continually evolved, driven by the need for innovative solutions to ensure quality of care. The aim is to synthesize the evidence on the use of artificial intelligence in the organization of nursing care. Methods: A scoping review was carried out based on the Joanna Briggs Institute methodology, following the PRISMA-ScR guidelines, in the MEDLINE, CINAHL Complete, Business Source Ultimate and Scopus^® databases. We used ProQuest—Dissertations and Theses to search gray literature. Results: Ten studies were evaluated, identifying AI-mediated tools used in the organization of nursing care, and synthesized into three tool models, namely monitoring and prediction, decision support, and interaction and communication technologies. The contributions of using these tools in the organization of nursing care include improvements in operational efficiency, decision support and diagnostic accuracy, advanced interaction and efficient communication, logistical support, workload relief, and ongoing professional development. Conclusions: AI tools such as automated alert systems, predictive algorithms, and decision support transform nursing by increasing efficiency, accuracy, and patient-centered care, improving communication, reducing errors, and enabling earlier interventions with safer and more efficient quality care. Full article

Objective: The aim of this study was to explore Sámi healthcare staff experiences in encounters with Sámi patients and their expectations for non-Sámi healthcare staff. Methods: Focus groups and individual interviews with 14 participants were conducted, and the participants’ experiences were subjected to a thematic analysis approach. Results: The findings show that the Sámi healthcare staff expect non-Sámi healthcare staff to enhance their knowledge about Sámi language and culture. The Sámi healthcare staff also expect non-Sámi healthcare staff to gain knowledge of diversities within the Sámi cultures. Additionally, the results show that the participants felt that the encounters were more authentic when the patients had the same background as themselves. Conclusion: These results were also based on the participants’ experience of resistance from non-Sámi healthcare staff, which can be addressed by the non-Sámi healthcare staff and healthcare institutions enhancing their knowledge of Sámi history, culture, and language. This can be conducted by making efforts to meet the participants’ expectations and experiences, enhancing their knowledge of Sámi history, culture, and language, and showing respect to provide culturally safe care. Further, tacit knowledge and what can be seen as “two-eyed seeing”, as demonstrated by the participants, are not necessarily transferable to non-Sámi healthcare staff. Despite this, all healthcare staff, through experience, recognition, and reflections on encounters with Sámi patients and Sámi healthcare staff, can develop awareness in what is addressed as “two-eyed seeing” by the participants in this study. Full article

Doll therapy is a psychosocial intervention that has been commonly used within dementia care for many decades. The practice of doll therapy involves supporting people with dementia to engage with a therapeutic doll and this has been associated with positive changes in a person’s wellbeing and behavior. While there have been several systematic reviews that have focused on behavioral outcomes, limited reviews have explored the broader psychosocial outcomes associated with doll therapy in care home settings. A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Four electronic databases were searched systematically (CINAHL Plus, Medline, PsycINFO, and PubMed). Twelve primary research studies from the past ten years (2013–2023) were included in this review. Primary data were synthesized using a narrative synthesis methodology. The three main themes from this review relate to a reduction in levels of behavioral and psychological symptoms of dementia (BPSD), increased communication skills, and a reduction in caregiver distress. Doll therapy has the potential to be an effective person-centered intervention that can enhance quality of life for people living with dementia in care home settings. Full article

Background/Objectives: This study aimed to identify the P-bottle feeding techniques systematically organized by Ms. Kumagai, an expert in nursing care for children with a cleft lip and/or palate (CLP), which were developed as she gained expertise in feeding affected children. Methods: We recruited three nurses who had mastered the Kumagai method for feeding with a P-bottle. Through analysis of participants’ voices and videos during interviews, we focused on aspects such as dealing with a closed mouth, inserting the nipple in cases of unilateral and bilateral CLP, dealing with the child’s movements after insertion, and key considerations when squeezing the bottle. Results: The interview analyses revealed numerous techniques used by nurses to manage the difficulties encountered while feeding children, ensuring successful provision of nourishment. Specifically, the nurses employed techniques such as placing the nipple along the midline of the child’s tongue and varying the application of force on the nipple depending on the cleft type. The nurses reported that the objectives of these techniques were to prevent ulcer formation and encourage the use of the tongue, simulating original feeding movements. Conclusions: We explored feeding techniques and the management of associated challenges. Our results suggest that the “Kumagai Method” could be valuable in improving feeding practices. Full article

Background: Telenursing could improve continuity of care in patients with cancer. This study aims to explore the expectations and perceptions of patients with lung cancer and melanoma toward telenursing. Methods: A descriptive qualitative study using a phenomenological approach was conducted on a convenience sampling of twenty patients aged 18 years or over from a Cancer Center. With the consent of patients and the relevant Ethics Committee, in-depth open-ended face-to-face interviews were conducted until data saturation. The phenomenon’s essence was achieved through themes emerging from the qualitative data analysis. Results: Patients’ perceptions and expectations were related to areas explored by a general theme on the nurse–patient relationship’s importance. Four themes and eleven sub-themes were focused on misconceptions about lack of use, patients’ potential and fears, the home as a place of care, and the caring relationship. Fifteen patients perceived the internet as a chaotic “bubble”. Conclusions: Despite the lack of previous use, patients consider telenursing positively as “a bridge between home and care”, especially in the advanced stages of the disease. They highlighted strengths and weaknesses of telenursing, such as having “someone for you”, connection, fear of psychological addiction, loss of privacy, and lack of empathy. This study was not registered. Full article

Background: Central line-associated bloodstream infections (CLABSIs) are critical infectious complications among pediatric hematology-oncology patients, and the management of central venous catheters (CVCs) by healthcare personnel can significantly influence the incidence of these infections. This study evaluates the impact of nurse-led changes in CVC management on the incidence of CLABSIs. Methods: This single-center, retrospective observational study was conducted at an urban, tertiary referral, and academic center serving pediatric patients. Results: The study cohort comprised 239 patients and 323 CVCs seen between 2012 and 2022. CLABSI was defined according to the Centers for Disease Control and Prevention definitions. Oncology nurse leaders developed CVC-specific educational modules for CLABSI prevention. All the relevant information during the CVC maintenance period was noted in the patient’s CVC logbook. A total of 24 (7%) cases of confirmed CLABSI were identified. The incidence of CVC-related infections was 0.32 cases per 1000 catheter days (95%CI: 0.19–0.45). The incidence decreased by 40% between the first and second three-year study period. Documented exit-site infection was reported in 32 (10%) cases. The correlation between exit-site infection and CLABSI was found in 9 (28%) cases. Our CVC-related infection rates are significantly lower than the incidence reported by the Italian Association of Pediatric Hematology and Oncology, which settles at 3–5 cases per 1000 catheter days. Conclusions: Our data confirm the effectiveness of local CVC management guidelines in preventing CVC-related infectious complications. Full article

Background: Hospitals are complex environments that bring together diverse aspects of technology, society, medicine, and architecture. The aim of this qualitative study was to examine how a hospital design with originally only single bedrooms and technological innovations affect nursing. Methods: Twelve interviews were conducted with registered nurses working in a hospital in Norway. Data were analyzed using conventional content analysis. Results: Results show that a layout with single bedrooms allows nurses to be present and improve patient care, but also complicates patient monitoring, leading to adverse events and patient isolation. Nurses may struggle to find colleagues, experiencing loneliness at work. Additionally, the use of technology, long corridors, and poorly positioned clinical support spaces can contribute to nurses’ mental and physical absence. Conclusions: This study provides knowledge that nurses working in a hospital environment designed with single bedrooms must modify their workflow and communication strategies. Technological advancements are necessary to support nurses’ presence and patient safety, and systems and clinical support spaces must be adequately adapted. Technologically advanced hospitals with only single bedrooms can make nurses feel both present and absent in patient care. This understanding holds significance in practical terms, offering insights to guide future hospital design and nursing practices. Full article

Digitalization in healthcare education has shifted simulation learning methods to distanced implementations. Successful transition to distance education requires effective communication and the teacher’s good ability to use digital learning methods, as well as students’ active interaction and motivation throughout the entire educational process. This study explores participants’ experiences of online large group simulations as an approach for learning about interprofessional collaboration. A mixed method design was used in this study. Data from health and social care students and qualified professionals were collected using a questionnaire which contained statements presented on a five-point Likert scale and open-ended questions. The questionnaire was filled online by 100 students and professionals. The quantitative data were analyzed using descriptive statistical methods, and the open-ended questions were analyzed with inductive content analysis. As a result, the participants were satisfied with the large group simulation intended for learning interprofessional collaboration (mean = 4.42, SD = 0.759). The majority viewed it as a good learning method (95%) that is suitable for interprofessional collaboration learning (90%) and for promoting working together (82%). Digitally activated communication tools promoted interactive discussion and activated joint learning. However, only one activation tool was preferred instead of using two methods simultaneously. In conclusion, distanced large group simulations were evaluated to be a good method for learning interprofessional collaboration. This study was not registered. Full article