Pub Date : 2025-12-01DOI: 10.1016/j.ijnsa.2025.100454
Le Zhou , Yaofeng Zhu , Shuo Liu , Lisha Tang , Wenya He , Huihong Zhong , Min Tian , Ru Tian , Ping Li
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Pub Date : 2025-11-21DOI: 10.1016/j.ijnsa.2025.100459
Shahbaz Masih , Mohammad Nisar Khattak , Tariq Iqbal Khan
Background
Destructive leadership, particularly exploitative leadership (leaders benefiting themselves at the expense of followers), has received limited attention in nursing research. Moreover, the fundamental mechanisms and boundary conditions associated with exploitative leadership that trigger turnover intention have also been neglected.
Aim
Based on the conservation of resources theory, we explored how exploitative leadership was associated with nurses’ turnover intention through emotional exhaustion and further looked into the moderating effect of emotional intelligence on the relationship between emotional exhaustion and turnover intention.
Methods
This was a cross-sectional study, with a survey carried out between January and March 2024.
Setting(s)
Data were gathered at two intervals from nurses (N = 361) across 10 hospitals, both public and private, in five cities (four provincial capitals and one federal capital) in Pakistan. Structural equation modeling was carried out to evaluate the proposed mediation and moderation effects.
Results
We identified a statistically-significant positive association between exploitative leadership and both turnover intention and emotional exhaustion among nurses. Furthermore, emotional exhaustion partially mediated the relationship between exploitative leadership and turnover intention, and emotional intelligence weakened the relationship between emotional exhaustion and turnover intention.
Conclusions
Exploitative leadership was associated with adverse effects among nurses, manifested as emotional exhaustion and turnover intention; nevertheless, these detrimental events may be mitigated through nurses’ emotional intelligence.
Implications for Nursing Management
Training programs might be considered, arranged for nursing leaders with a focus on cultivating leadership abilities, and for nurses with a focus on emotional intelligence and stress management to equip them to combat emotional exhaustion.
{"title":"The association of leadership with nurses' turnover intention: A two-wave cross-sectional study","authors":"Shahbaz Masih , Mohammad Nisar Khattak , Tariq Iqbal Khan","doi":"10.1016/j.ijnsa.2025.100459","DOIUrl":"10.1016/j.ijnsa.2025.100459","url":null,"abstract":"<div><h3>Background</h3><div>Destructive leadership, particularly exploitative leadership (leaders benefiting themselves at the expense of followers), has received limited attention in nursing research. Moreover, the fundamental mechanisms and boundary conditions associated with exploitative leadership that trigger turnover intention have also been neglected.</div></div><div><h3>Aim</h3><div>Based on the conservation of resources theory, we explored how exploitative leadership was associated with nurses’ turnover intention through emotional exhaustion and further looked into the moderating effect of emotional intelligence on the relationship between emotional exhaustion and turnover intention.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study, with a survey carried out between January and March 2024.</div></div><div><h3>Setting(s)</h3><div>Data were gathered at two intervals from nurses (<em>N</em> = 361) across 10 hospitals, both public and private, in five cities (four provincial capitals and one federal capital) in Pakistan. Structural equation modeling was carried out to evaluate the proposed mediation and moderation effects.</div></div><div><h3>Results</h3><div>We identified a statistically-significant positive association between exploitative leadership and both turnover intention and emotional exhaustion among nurses. Furthermore, emotional exhaustion partially mediated the relationship between exploitative leadership and turnover intention, and emotional intelligence weakened the relationship between emotional exhaustion and turnover intention.</div></div><div><h3>Conclusions</h3><div>Exploitative leadership was associated with adverse effects among nurses, manifested as emotional exhaustion and turnover intention; nevertheless, these detrimental events may be mitigated through nurses’ emotional intelligence.</div></div><div><h3>Implications for Nursing Management</h3><div>Training programs might be considered, arranged for nursing leaders with a focus on cultivating leadership abilities, and for nurses with a focus on emotional intelligence and stress management to equip them to combat emotional exhaustion.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100459"},"PeriodicalIF":3.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-20DOI: 10.1016/j.ijnsa.2025.100458
Ella Hermie , Nicky Van Der Vekens , Hannelore Hofman , Annelies Van Damme , Alexander Verheggen , Ann Van Hecke , Dimitri Beeckman
<div><h3>Background</h3><div>Advances in surgical and anaesthetic techniques have enabled some outpatients to meet the criteria for discharge from the Post-Anaesthetic Care Unit while still in the operating room. These patients may benefit from being transferred directly from the operating room to a dedicated recovery area designed to expedite discharge home—a concept known as fast-tracking. Although this innovative approach to postoperative nursing care has already been implemented in clinical practice, its impact on patient outcomes and patient safety remains uncertain.</div></div><div><h3>Objective</h3><div>This systematic review aims to evaluate the effectiveness of a fast-track pathway compared to the standard recovery pathway after outpatient surgery.</div></div><div><h3>Information sources</h3><div>The databases MEDLINE, Embase, Web of Science, CINAHL, Cochrane and Scopus were searched until January 2025.</div></div><div><h3>Methods</h3><div>The review included randomised-controlled trials, case-control studies, prospective and retrospective cohort studies that reported on fast-tracking of adult patients undergoing outpatient surgical procedures. Two reviewers independently assessed the eligibility of the articles identified with the search strategy. The risk of bias was assessed with the Risk of Bias 2 tool for randomised-controlled trials and the Risk of Bias in Non-randomised studies of Interventions for non-randomised controlled trials. Due to the heterogeneity of the included studies, a narrative synthesis was conducted to systematically summarise and interpret the findings across studies.</div></div><div><h3>Results</h3><div>The literature search identified 5226 unique records, with 7 studies of low quality and high risk of bias included in this review. 5 of the 7 studies were published before 2005. Bypass rates varied from 30 % to 87 %. All included studies reported a shorter postoperative length of stay for the fast-track group compared to the standard recovery pathway. The studies indicated that fast-tracked patients had similar, or in some cases, even better outcomes regarding readmission rates and the incidence of postoperative adverse effects compared to the standard recovery pathway.</div></div><div><h3>Conclusions</h3><div>Not all patients require admission to the Post-Anaesthetic Care Unit after outpatient surgery. Fast-tracking certain patients may offer benefits, such as a shorter postoperative length of stay, without negatively impacting patient outcomes. By reducing length of stay, improving patient flow and optimising resource utilisation, fast-tracking has the potential to enhance the efficiency and organisation of care while maintaining the quality. However, high-quality studies are needed to evaluate the safety and effectiveness of fast-tracking. As fast-tracking combines the care environments of the Post-Anaesthetic Care Unit and phase II recovery units, tailored nursing care for fast-track patients may be necessary
手术和麻醉技术的进步使一些门诊病人在手术室中就能达到麻醉后护理病房的出院标准。这些患者可以直接从手术室转移到专门的康复区，以加快出院回家的速度，这一概念被称为快速追踪。尽管这种创新的术后护理方法已经在临床实践中实施，但其对患者预后和患者安全的影响仍不确定。目的：本系统综述旨在评价门诊手术后快速康复途径与标准康复途径的有效性。信息来源MEDLINE， Embase, Web of Science， CINAHL， Cochrane和Scopus数据库被检索到2025年1月。方法本综述包括随机对照试验、病例对照研究、前瞻性和回顾性队列研究，这些研究报告了门诊外科手术成年患者的快速跟踪。两位审稿人独立评估了符合搜索策略的文章的合格性。使用随机对照试验的偏倚风险2工具和非随机对照试验的干预措施的非随机研究的偏倚风险来评估偏倚风险。由于纳入研究的异质性，我们进行了叙述性综合，以系统地总结和解释各研究的发现。结果文献检索发现5226条独特记录，包括7项低质量、高偏倚风险的研究。这7项研究中有5项发表于2005年之前。搭桥率从30%到87%不等。所有纳入的研究报告，与标准恢复途径相比，快速通道组的术后住院时间更短。研究表明，与标准恢复途径相比，快速通道患者在再入院率和术后不良反应发生率方面具有相似或在某些情况下甚至更好的结果。结论并非所有患者在门诊手术后都需要进入麻醉后护理病房。快速跟踪某些患者可能会带来好处，例如缩短术后住院时间，而不会对患者的预后产生负面影响。通过缩短住院时间，改善病人流量和优化资源利用，快速通道有可能在保持质量的同时提高效率和护理组织。然而，需要高质量的研究来评估快速跟踪的安全性和有效性。由于快速通道结合了麻醉后护理单元和二期康复单元的护理环境，因此可能需要为快速通道患者量身定制护理。注册编号crd4202452974，普洛斯彼罗，注册编号23/03/2024
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Pub Date : 2025-11-15DOI: 10.1016/j.ijnsa.2025.100456
Yi Liu , Chenxin Zhang , Liping Zhang , Xian Ma , Zhenghui Dong
Background
Osteopenia and osteoporosis are pressing public health issues associated with aging.
Objective
To systematically identify and synthesize the facilitators and barriers to exercise intervention adherence among individuals with osteopenia or osteoporosis.
Design
Systematic review
Data Sources
PubMed, Cochrane, EMBASE, Medline (Ovid), and Web of Science from inception to 31 March 2025.
Methods
Inclusion criteria: (1) Population: individuals with osteopenia/osteoporosis; (2) Intervention: exercise interventions targeting osteopenia/osteoporosis-related impairments; (3) Comparison: clear control group; (4) Outcomes: primary (adherence facilitators/barriers, e.g., pedometer/log data); secondary (dropout/adherence, adherence-promotion strategies, participant views); (5) Study type: randomized controlled trials. Exclusion criteria: (1) studies that were duplicates or had overlapping datasets; (2) incomplete publications/insufficient extractable data; (3) non-English literature. Two reviewers independently extracted data in duplicate and assessed bias risk.
Results
Thirty randomized controlled trials tested median 31-week programs (aerobic, balance, resistance, flexibility, impact, or functional training). Participants adhered to 83 % (59–100 %) of sessions; "lack of time" was the primary barrier (n=11/30) . Nine trials had low overall bias risk; allocation concealment or participant blinding was infrequently reported.
Conclusion
For individuals with osteopenia or osteoporosis, key barriers to activity were lack of time and existing health issues. Conversely, facilitators included expert coaching, engaging routines, group camaraderie, accessible facilities, and safety precautions. Future researchers should explore bone health-optimized exercises, identify activity facilitators/barriers, and develop tailored approaches to sustain patients’ fitness regimens.
Registration
The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration CRD420251013691).
Tweetable Abstract
Exercise boosts bone health but poor adherence limits efficacy. Our systematic review identifies top facilitators and barriers to optimize adherence.
背景：骨质疏松和骨质减少是与衰老相关的紧迫的公共卫生问题。目的系统识别和综合骨质疏松症患者运动干预依从性的促进因素和障碍因素。设计系统综述数据来源pubmed， Cochrane， EMBASE, Medline （Ovid）和Web of Science从成立到2025年3月31日。方法纳入标准：(1)人群：骨质减少/骨质疏松患者；(2)干预：针对骨质减少/骨质疏松相关损伤的运动干预；(3)对比：明确对照组；(4)结果：主要（依从性促进因素/障碍因素，例如计步器/日志数据）；次要（退学/坚持，坚持促进策略，参与者观点）；(5)研究类型：随机对照试验。排除标准：(1)重复或数据集重叠的研究；(2)出版物不完整/可提取数据不足；(3)非英语文学。两名审稿人独立提取重复数据并评估偏倚风险。结果30个随机对照试验测试了中位数为31周的项目（有氧、平衡、阻力、柔韧性、冲击或功能训练）。参与者坚持83%（59 - 100%）的疗程；“缺乏时间”是主要障碍（n=11/30）。9项试验的总体偏倚风险较低；分配隐瞒或参与者盲法很少被报道。结论对于骨质减少或骨质疏松症患者，缺乏运动时间和已有的健康问题是主要障碍。相反，促进者包括专家指导、有吸引力的日常活动、团体友情、无障碍设施和安全预防措施。未来的研究人员应该探索骨骼健康优化运动，确定活动促进因素/障碍，并开发量身定制的方法来维持患者的健身方案。该审查方案已在国际前瞻性系统评论注册（PROSPERO注册号CRD420251013691）中注册。运动可以促进骨骼健康，但坚持不良会限制效果。我们的系统评价确定了优化依从性的主要促进因素和障碍。
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Pub Date : 2025-11-15DOI: 10.1016/j.ijnsa.2025.100457
Marisa Onrust , Ingeborg van der Meulen , Marie Louise Luttik , Wolter Paans , Peter H.J. van der Voort , Fredrike Blokzijl
Background
The long-term consequences after an intensive care unit (ICU) hospitalization can be significant for both ICU survivors and their family members. Research in the past decades has shown that patients may develop new onset or worsened impairments in the physical, mental and cognitive domain and family members are known to experience psychological problems following ICU discharge. Furthermore, these impairments may affect daily functioning as well as family functioning.
Aim
To gain insight into the way ICU survivors and their family members experience their health, three months after ICU discharge and to what extend this affects their roles and relationships within the family system.
Design
An exploratory, qualitative study with in-depth interviewing.
Setting(s)
A large 38-bed ICU in a University Hospital in the Netherlands.
Participants
Ten ICU-survivors and ten family members.
Methods
ICU nurses performed in-depth interviews with ICU-survivors and family members, three months following discharge. Interviews were audio recorded and transcribed verbatim. Analysis was performed iteratively in accordance with the steps of inductive content analysis.
Findings
Ten ICU-survivors and ten family members participated. We found four main themes: personal autonomy, narrative reconstruction, relationship dynamics and empathetic concern, which manifest different for ICU-survivors and family members, highlighting the distinct nature of their experiences. Physical recovery was a primary concern for ICU-survivors as well as family members, in order to regain personal autonomy. The different ICU-narratives of survivors and family members was hindering emotional recovery. Relationship dynamics occurred due to feelings of connection and disconnection intertwining, and empathetic concern was shaped by feelings of guilt and ambivalence.
Conclusions
This study provides a deeper understanding of health perceptions of ICU-survivors and their family members, highlighting their contrasting experiences and the relational dynamics this can trigger. The findings of our study can be used to enhance the current approach of care after ICU discharge in any way, by actively involving the family system. Diagnostic, intervention, and outcome classification systems for nurses can be helpful in incorporating family-related aspects into the ICU context and aligning them with established family interventions, such as ‘the family health conversation’ and the ICU-diary.
{"title":"Health perspectives after intensive care unit-discharge: Insights from patient and family interviews","authors":"Marisa Onrust , Ingeborg van der Meulen , Marie Louise Luttik , Wolter Paans , Peter H.J. van der Voort , Fredrike Blokzijl","doi":"10.1016/j.ijnsa.2025.100457","DOIUrl":"10.1016/j.ijnsa.2025.100457","url":null,"abstract":"<div><h3>Background</h3><div>The long-term consequences after an intensive care unit (ICU) hospitalization can be significant for both ICU survivors and their family members. Research in the past decades has shown that patients may develop new onset or worsened impairments in the physical, mental and cognitive domain and family members are known to experience psychological problems following ICU discharge. Furthermore, these impairments may affect daily functioning as well as family functioning.</div></div><div><h3>Aim</h3><div>To gain insight into the way ICU survivors and their family members experience their health, three months after ICU discharge and to what extend this affects their roles and relationships within the family system.</div></div><div><h3>Design</h3><div>An exploratory, qualitative study with in-depth interviewing.</div></div><div><h3>Setting(s)</h3><div>A large 38-bed ICU in a University Hospital in the Netherlands.</div></div><div><h3>Participants</h3><div>Ten ICU-survivors and ten family members.</div></div><div><h3>Methods</h3><div>ICU nurses performed in-depth interviews with ICU-survivors and family members, three months following discharge. Interviews were audio recorded and transcribed verbatim. Analysis was performed iteratively in accordance with the steps of inductive content analysis.</div></div><div><h3>Findings</h3><div>Ten ICU-survivors and ten family members participated. We found four main themes: <strong>personal autonomy, narrative reconstruction, relationship dynamics and empathetic concern,</strong> which manifest different for ICU-survivors and family members, highlighting the distinct nature of their experiences. Physical recovery was a primary concern for ICU-survivors as well as family members, in order to regain personal autonomy. The different ICU-narratives of survivors and family members was hindering emotional recovery. Relationship dynamics occurred due to feelings of connection and disconnection intertwining, and empathetic concern was shaped by feelings of guilt and ambivalence.</div></div><div><h3>Conclusions</h3><div>This study provides a deeper understanding of health perceptions of ICU-survivors and their family members, highlighting their contrasting experiences and the relational dynamics this can trigger. The findings of our study can be used to enhance the current approach of care after ICU discharge in any way, by actively involving the family system. Diagnostic, intervention, and outcome classification systems for nurses can be helpful in incorporating family-related aspects into the ICU context and aligning them with established family interventions, such as ‘the family health conversation’ and the ICU-diary.</div></div><div><h3>Registration</h3><div>Not registered.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100457"},"PeriodicalIF":3.1,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145584588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-14DOI: 10.1016/j.ijnsa.2025.100455
Jesper M.A. Biesmans , Sascha R. Bolt , Sandra M.G. Zwakhalen , Daisy J.A. Janssen , Judith M.M. Meijers
Background
Palliative care aims to improve the quality of life of individuals with chronic, life-limiting diseases like dementia. Self-assessment by healthcare professionals of their learning needs helps to identify areas for improvement and enhance care provision. To support this, the Desired Dementia Care Towards End of Life (DEDICATED) questionnaire was developed; a self-assessment tool for measuring healthcare professionals’ skill development needs.
Objective
To describe the development of the questionnaire and examine its psychometric properties.
Data was collected in nursing homes, hospital wards, and home care organizations providing palliative care to people with dementia in the Netherlands.
Participants
The questionnaire was developed by healthcare professionals and researchers. Psychometric evaluation was then conducted with 332 Dutch healthcare professionals, divided over two samples.
Methods
Scientific literature and expert input were used to develop the questionnaire, which then underwent feasibility testing and psychometric evaluation. Construct validity was assessed via exploratory and confirmatory factor analysis. Inter-item correlations were used to evaluate convergent validity, and item-factor correlations to assess discriminant validity. Reliability was tested using item-total correlations, Cronbach’s alpha, and McDonald’s omega. Ceiling effects and the tool’s ability to differentiate outcomes across healthcare professions were assessed with ANOVA. Pearson’s correlation was used to assess concurrent validity between the questionnaire and the End-of-Life Professional Caregiver Survey.
Results
The 29-item questionnaire showed strong internal consistency, with a mean Cronbach’s alpha of .89 and McDonald’s omega of .90. Factor analysis identified five factors, explaining 71.68 % variance: (1) Familiarization with the person with dementia, (2) Timing for advance care planning, (3) Healthcare professional's role in advance care planning, (4) Interprofessional collaboration, and (5) Managing pain and responsive behavior. Statistically significant differences between nurses and nurse assistants suggest the questionnaire was able to differentiate outcomes across healthcare professions (mean difference = 6.15, 95 % CI: .15 to 12.2, p = .042). A moderate positive correlation was found between the questionnaire and End-of-Life Professional Caregiver Survey (r = .33, 95 % CI: .13 to .50, p = .002)
Conclusion
The DEDICATED questionnaire shows promising psychometric properties and could support the needs of healthcare professionals in providing palliative care for people with dementia.
{"title":"Development and psychometric evaluation of a learning needs assessment tool for healthcare professionals in palliative dementia care: A cross-sectional study","authors":"Jesper M.A. Biesmans , Sascha R. Bolt , Sandra M.G. Zwakhalen , Daisy J.A. Janssen , Judith M.M. Meijers","doi":"10.1016/j.ijnsa.2025.100455","DOIUrl":"10.1016/j.ijnsa.2025.100455","url":null,"abstract":"<div><h3>Background</h3><div>Palliative care aims to improve the quality of life of individuals with chronic, life-limiting diseases like dementia. Self-assessment by healthcare professionals of their learning needs helps to identify areas for improvement and enhance care provision. To support this, the Desired Dementia Care Towards End of Life (DEDICATED) questionnaire was developed; a self-assessment tool for measuring healthcare professionals’ skill development needs.</div></div><div><h3>Objective</h3><div>To describe the development of the questionnaire and examine its psychometric properties.</div></div><div><h3>Design</h3><div>Quantitative cross-sectional psychometric evaluation.</div></div><div><h3>Setting(s)</h3><div>Data was collected in nursing homes, hospital wards, and home care organizations providing palliative care to people with dementia in the Netherlands.</div></div><div><h3>Participants</h3><div>The questionnaire was developed by healthcare professionals and researchers. Psychometric evaluation was then conducted with 332 Dutch healthcare professionals, divided over two samples.</div></div><div><h3>Methods</h3><div>Scientific literature and expert input were used to develop the questionnaire, which then underwent feasibility testing and psychometric evaluation. Construct validity was assessed via exploratory and confirmatory factor analysis. Inter-item correlations were used to evaluate convergent validity, and item-factor correlations to assess discriminant validity. Reliability was tested using item-total correlations, Cronbach’s alpha, and McDonald’s omega. Ceiling effects and the tool’s ability to differentiate outcomes across healthcare professions were assessed with ANOVA. Pearson’s correlation was used to assess concurrent validity between the questionnaire and the End-of-Life Professional Caregiver Survey.</div></div><div><h3>Results</h3><div>The 29-item questionnaire showed strong internal consistency, with a mean Cronbach’s alpha of .89 and McDonald’s omega of .90. Factor analysis identified five factors, explaining 71.68 % variance: (1) Familiarization with the person with dementia, (2) Timing for advance care planning, (3) Healthcare professional's role in advance care planning, (4) Interprofessional collaboration, and (5) Managing pain and responsive behavior. Statistically significant differences between nurses and nurse assistants suggest the questionnaire was able to differentiate outcomes across healthcare professions (mean difference = 6.15, 95 % CI: .15 to 12.2, <em>p</em> = .042). A moderate positive correlation was found between the questionnaire and End-of-Life Professional Caregiver Survey (<em>r</em> = .33, 95 % CI: .13 to .50, <em>p</em> = .002)</div></div><div><h3>Conclusion</h3><div>The DEDICATED questionnaire shows promising psychometric properties and could support the needs of healthcare professionals in providing palliative care for people with dementia.</div></div><div><h3>Registration</h3><div>N","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100455"},"PeriodicalIF":3.1,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-11DOI: 10.1016/j.ijnsa.2025.100452
Anna Connolly, Anne Matthews, Marcia Kirwan
Background
The Fundamentals of Care Framework outlines the core dimensions involved in delivering essential nursing care. Resource shortages and increased care demands compromise fundamental care delivery and contribute to missed nursing care. This impacts quality and safety within healthcare settings but is disproportionately experienced by older patients, therefore both nurse and patient voices must be heard.
Objectives
To individually explore both nurse-reported and patient-reported perceptions of the frequency of missed nursing care. This research also aimed to estimate the factors that contribute to missed nursing care from nurses’ perspectives and to identify to what extent the MISSCARE instruments can represent the elements within the Fundamentals of Care framework.
Design
A cross-sectional study using the MISSCARE instruments to elicit nurse and patient perspectives of missed nursing care.
Setting
A single large university, tertiary hospital in Ireland with over 800 beds.
Participants
Approximately 929 fully qualified nurses working in direct patient care and all patients aged 65 or older in 31 adult inpatient wards were invited to participate.
Methods
The MISSCARE Survey and MISSCARE Survey-Patient were used to collect data between April and July 2024. Nurses indicated the frequency of and contributing factors to missed nursing care. Communication, timeliness and basic nursing care delivery were measured from the patients’ perspectives. The data were analysed using SPSS and mean scores were found for each care item. The items in the MISSCARE surveys were mapped to the elements in the Fundamentals of Care Framework.
Results
A total of 151 patients and 145 nurses participated. According to nurses, attending interdisciplinary care conferences, mobilisation and oral care were frequently missed. Patients reported that oral care, communication in relation to who their specific nurse was and mobilisation were frequently missed. The significant reasons for missed care included inadequate numbers of nursing staff and assistive personnel and urgent patient situations. The MISSCARE Survey-Patient demonstrated a higher percentage coverage (73.7 %) of the elements outlined within the Fundamentals of Care framework than the MISSCARE Survey (42.1 %).
Conclusions
This study reiterates the need to prioritise nurse recruitment and retention strategies and highlights areas which require attention to ensure the delivery of fundamental care. The MISSCARE surveys can measure the Fundamentals of Care Framework to a certain extent however, the development of a tool to directly measure all three framework dimensions is required. The development of a succinct tool to measure
{"title":"Nurses’ and older patients’ perspectives on missed nursing care contextualised within the Fundamentals of Care Framework: A cross-sectional survey","authors":"Anna Connolly, Anne Matthews, Marcia Kirwan","doi":"10.1016/j.ijnsa.2025.100452","DOIUrl":"10.1016/j.ijnsa.2025.100452","url":null,"abstract":"<div><h3>Background</h3><div>The Fundamentals of Care Framework outlines the core dimensions involved in delivering essential nursing care. Resource shortages and increased care demands compromise fundamental care delivery and contribute to missed nursing care. This impacts quality and safety within healthcare settings but is disproportionately experienced by older patients, therefore both nurse and patient voices must be heard.</div></div><div><h3>Objectives</h3><div>To individually explore both nurse-reported and patient-reported perceptions of the frequency of missed nursing care. This research also aimed to estimate the factors that contribute to missed nursing care from nurses’ perspectives and to identify to what extent the <em>MISSCARE</em> instruments can represent the elements within the Fundamentals of Care framework.</div></div><div><h3>Design</h3><div>A cross-sectional study using the <em>MISSCARE</em> instruments to elicit nurse and patient perspectives of missed nursing care.</div></div><div><h3>Setting</h3><div>A single large university, tertiary hospital in Ireland with over 800 beds.</div></div><div><h3>Participants</h3><div>Approximately 929 fully qualified nurses working in direct patient care and all patients aged 65 or older in 31 adult inpatient wards were invited to participate.</div></div><div><h3>Methods</h3><div>The <em>MISSCARE Survey</em> and <em>MISSCARE Survey-Patient</em> were used to collect data between April and July 2024. Nurses indicated the frequency of and contributing factors to missed nursing care. Communication, timeliness and basic nursing care delivery were measured from the patients’ perspectives. The data were analysed using SPSS and mean scores were found for each care item. The items in the <em>MISSCARE</em> surveys were mapped to the elements in the Fundamentals of Care Framework.</div></div><div><h3>Results</h3><div>A total of 151 patients and 145 nurses participated. According to nurses, attending interdisciplinary care conferences, mobilisation and oral care were frequently missed. Patients reported that oral care, communication in relation to who their specific nurse was and mobilisation were frequently missed. The significant reasons for missed care included inadequate numbers of nursing staff and assistive personnel and urgent patient situations. The <em>MISSCARE Survey-Patient</em> demonstrated a higher percentage coverage (73.7 %) of the elements outlined within the Fundamentals of Care framework than the <em>MISSCARE Survey</em> (42.1 %).</div></div><div><h3>Conclusions</h3><div>This study reiterates the need to prioritise nurse recruitment and retention strategies and highlights areas which require attention to ensure the delivery of fundamental care. <em>The MISSCARE</em> surveys can measure the Fundamentals of Care Framework to a certain extent however, the development of a tool to directly measure all three framework dimensions is required. The development of a succinct tool to measure ","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100452"},"PeriodicalIF":3.1,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-10DOI: 10.1016/j.ijnsa.2025.100451
Ezekwesiri Nwanosike , Chiara Dall’Ora , Peter Griffiths , Christina Saville , Thomas Monks , Natalie Pattison , Tolusha Dahanayake Yapa , SEISMIC-R study group
<div><h3>Background</h3><div>Staff wellbeing in intensive care units is essential for quality patient care, and nurse staffing configurations can impact nurse sickness absence. The COVID-19 pandemic imposed additional strain on nurses, potentially affecting sickness absence rates.</div></div><div><h3>Objective</h3><div>To examine the association between registered nurse staffing levels, skill mix, and staff sickness absence in intensive care units spanning prepandemic (01/19–02/20), early pandemic (03/20–02/21), later pandemic (03/21–02/22), and post-pandemic (03/22–12/22).</div></div><div><h3>Design</h3><div>Longitudinal retrospective study</div></div><div><h3>Setting(s)</h3><div>Three National Health Service hospital trusts in England</div></div><div><h3>Participants</h3><div>Five intensive care units with 6916 sickness episodes from staffing data.</div></div><div><h3>Methods</h3><div>We linked staffing data from electronic rostering systems. Variables included registered nurse hours per patient day, proportion of senior staff nurses with largely hands-on clinical experience, management presence, and sickness absence rates. Generalised linear mixed models analysed associations between staffing configurations in the previous 28 days and sickness absence.</div></div><div><h3>Results</h3><div>The mean sickness absences rate was 2.4 %. When analysing all time periods collectively, an increase in registered nurse staffing by 1 standard deviation (SD) (11.0 h per patient day) was associated with a 5 % reduction in sickness episodes (incidence rate ratio [IRR]=0.95; 95 % confidence interval [CI] 0.90–0.99, <em>p</em> = 0.018); a 1 SD (15.1 %) increase in the proportion of senior nurse hours per patient day was associated with a 22 % reduction in sickness episodes (IRR=0.78; 95 % CI 0.71–0.86; <em>p</em> < 0.001). For management, the relationship exhibited a non-linear pattern, with both higher and lower levels of managerial presence, compared to the norm, being associated with increased sickness absence. The observed relationships changed over time, especially during later and post-pandemic periods. A 1 SD (11.7 h per patient day) increase in registered nurse staffing was associated with a 19 % reduction in sickness absence in the post-pandemic period (IRR 0.81; 95 % CI 0.69–0.95, <em>p</em> = 0.010). A 1 SD increase in proportion of senior nurse hours per patient day was associated with both reduced (IRR 0.60; 95 % CI 0.48–0.74, <em>p</em> < 0.001 later pandemic) and increased sickness absence (IRR 2.00; 95 % CI 1.31–3.05, <em>p</em> = 0.001 post pandemic).</div></div><div><h3>Conclusions</h3><div>Sickness absence in intensive care units decreased with higher registered nurse staffing levels, although this relationship was most apparent post-pandemic. The presence of more senior registered nurses was generally associated with reduced sickness absence, although this relationship proved complex and varied across time periods. Pandemic conditions
重症监护室工作人员的健康状况对高质量的患者护理至关重要，护士人员配置会影响护士病假。COVID-19大流行给护士带来了额外的压力，可能会影响缺勤率。目的探讨大流行前（1月19日- 2月20日）、大流行早期（3月20日- 2月21日）、大流行后期（3月21日- 2月22日）和大流行后（3月22日- 12月22日）重症监护病房注册护士配备水平、技能组合和员工缺勤情况的关系。设计：纵向回顾性研究背景：英国三家国家卫生服务医院信托机构参与者：5个重症监护病房，6916例疾病发作，来自人员资料。方法将电子排班系统中的人员数据联系起来。变量包括每位患者每天的注册护士小时数、具有大量临床实践经验的高级护士比例、管理层出席率和病假缺勤率。广义线性混合模型分析了前28天的人员配置与病假之间的关系。结果平均病假缺勤率为2.4%。当对所有时间段进行整体分析时，注册护士人数每增加1个标准差（每病人每天11.0小时）与疾病发作减少5%相关（发病率比[IRR]=0.95； 95%可信区间[CI] 0.90-0.99, p = 0.018）；每名患者每天高级护士工作时间比例增加1个标准差（15.1%），疾病发作减少22% （IRR=0.78; 95% CI 0.71-0.86; p < 0.001）。对于管理人员来说，这种关系呈现出非线性模式，与正常情况相比，管理人员的出勤水平无论是高还是低，都与疾病缺勤增加有关。观察到的关系随着时间的推移而变化，特别是在大流行后期和后时期。注册护士人数增加1 SD（每病人每天11.7小时）与大流行后期间缺勤率减少19%相关（IRR 0.81; 95% CI 0.69-0.95, p = 0.010）。每名患者每天高级护士工作时数比例增加1个标准差，与大流行后病假缺勤减少（IRR 0.60; 95% CI 0.48-0.74, p < 0.001）和缺勤增加（IRR 2.00; 95% CI 1.31-3.05, p = 0.001）相关。结论重症监护病房的缺勤率随着注册护士人数的增加而下降，尽管这种关系在大流行后最为明显。更多的高级注册护士的存在通常与病假减少有关，尽管这种关系被证明是复杂的，并且在不同的时期有所不同。大流行情况似乎改变了典型的工作人员疾病模式，在大流行急性阶段，工作人员疾病受工作量的影响较小。对英国重症监护室的研究发现，更多的高级护士和更高的人员配备水平与减少缺勤有关——这是病人护理质量的关键！
{"title":"Nurse staffing configurations and sickness absence in English intensive care units: A longitudinal observational study","authors":"Ezekwesiri Nwanosike , Chiara Dall’Ora , Peter Griffiths , Christina Saville , Thomas Monks , Natalie Pattison , Tolusha Dahanayake Yapa , SEISMIC-R study group","doi":"10.1016/j.ijnsa.2025.100451","DOIUrl":"10.1016/j.ijnsa.2025.100451","url":null,"abstract":"<div><h3>Background</h3><div>Staff wellbeing in intensive care units is essential for quality patient care, and nurse staffing configurations can impact nurse sickness absence. The COVID-19 pandemic imposed additional strain on nurses, potentially affecting sickness absence rates.</div></div><div><h3>Objective</h3><div>To examine the association between registered nurse staffing levels, skill mix, and staff sickness absence in intensive care units spanning prepandemic (01/19–02/20), early pandemic (03/20–02/21), later pandemic (03/21–02/22), and post-pandemic (03/22–12/22).</div></div><div><h3>Design</h3><div>Longitudinal retrospective study</div></div><div><h3>Setting(s)</h3><div>Three National Health Service hospital trusts in England</div></div><div><h3>Participants</h3><div>Five intensive care units with 6916 sickness episodes from staffing data.</div></div><div><h3>Methods</h3><div>We linked staffing data from electronic rostering systems. Variables included registered nurse hours per patient day, proportion of senior staff nurses with largely hands-on clinical experience, management presence, and sickness absence rates. Generalised linear mixed models analysed associations between staffing configurations in the previous 28 days and sickness absence.</div></div><div><h3>Results</h3><div>The mean sickness absences rate was 2.4 %. When analysing all time periods collectively, an increase in registered nurse staffing by 1 standard deviation (SD) (11.0 h per patient day) was associated with a 5 % reduction in sickness episodes (incidence rate ratio [IRR]=0.95; 95 % confidence interval [CI] 0.90–0.99, <em>p</em> = 0.018); a 1 SD (15.1 %) increase in the proportion of senior nurse hours per patient day was associated with a 22 % reduction in sickness episodes (IRR=0.78; 95 % CI 0.71–0.86; <em>p</em> < 0.001). For management, the relationship exhibited a non-linear pattern, with both higher and lower levels of managerial presence, compared to the norm, being associated with increased sickness absence. The observed relationships changed over time, especially during later and post-pandemic periods. A 1 SD (11.7 h per patient day) increase in registered nurse staffing was associated with a 19 % reduction in sickness absence in the post-pandemic period (IRR 0.81; 95 % CI 0.69–0.95, <em>p</em> = 0.010). A 1 SD increase in proportion of senior nurse hours per patient day was associated with both reduced (IRR 0.60; 95 % CI 0.48–0.74, <em>p</em> < 0.001 later pandemic) and increased sickness absence (IRR 2.00; 95 % CI 1.31–3.05, <em>p</em> = 0.001 post pandemic).</div></div><div><h3>Conclusions</h3><div>Sickness absence in intensive care units decreased with higher registered nurse staffing levels, although this relationship was most apparent post-pandemic. The presence of more senior registered nurses was generally associated with reduced sickness absence, although this relationship proved complex and varied across time periods. Pandemic conditions ","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100451"},"PeriodicalIF":3.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Missed nursing care, defined as the failure to deliver essential patient care, has adverse effects on patients, nurses, and healthcare organizations. While efforts to reduce missed care exist, few interventions have been fully evaluated, and the mechanisms through which these interventions work remain poorly understood.
Objectives
This study aimed to develop, implement, and evaluate proactive huddles as a process to reduce missed nursing care in hospital inpatient wards. Additionally, the study examined the mediating role of personal situational awareness (cognitive mechanism) and relational coordination (motivational mechanism) in the relationship between proactive huddles and missed care.
Design
A cluster-randomized pre–post intervention design
Methods
Data were collected from March 2022 to May 2023 from six internal and four surgical wards in a medium-sized hospital. Wards were randomized into intervention (n = 85) and control (n = 95) groups. Nurses in the intervention group participated in daily huddles over three months, while those in the control group continued with standard care practices. The MISSCARE survey, Relational Coordination Survey, Situational Nursing Awareness Probe – Missed Nursing Care Edition (SANP-MNC), National Aeronautics and Space Administration (NASA) Task Load Index, and sociodemographic characteristics were assessed pre- and post-intervention. Mediation models were analyzed using mixed-linear model analyses.
Results
The proactive huddle intervention significantly reduced missed nursing care (β =0.123, p< 0.001), with partial mediation observed through improved relational coordination (β =-0.125, p< 0.001). However, while the intervention increased personal situational awareness (β =-0.142, p< 0.001), this cognitive mechanism did not mediate the relationship between the intervention and missed care.
Conclusions
Proactive huddles were effective in reducing missed nursing care by improving team communication and collaboration. Although situational awareness increased, the high workload and limited resources may have hindered nurses' ability to act on situational awareness. For proactive huddles to maximize their potential, additional support systems are needed to enable nurses to address care challenges effectively.
{"title":"Proactive huddles to reduce missed nursing care; the mediating roles of personal situational awareness and rational coordination: A cluster randomized pre post intervention study","authors":"Marina Vexler , Anat Drach-Zahavy , Einav Srulovici","doi":"10.1016/j.ijnsa.2025.100448","DOIUrl":"10.1016/j.ijnsa.2025.100448","url":null,"abstract":"<div><h3>Background</h3><div>Missed nursing care, defined as the failure to deliver essential patient care, has adverse effects on patients, nurses, and healthcare organizations. While efforts to reduce missed care exist, few interventions have been fully evaluated, and the mechanisms through which these interventions work remain poorly understood.</div></div><div><h3>Objectives</h3><div>This study aimed to develop, implement, and evaluate proactive huddles as a process to reduce missed nursing care in hospital inpatient wards. Additionally, the study examined the mediating role of personal situational awareness (cognitive mechanism) and relational coordination (motivational mechanism) in the relationship between proactive huddles and missed care.</div></div><div><h3>Design</h3><div>A cluster-randomized pre–post intervention design</div></div><div><h3>Methods</h3><div>Data were collected from March 2022 to May 2023 from six internal and four surgical wards in a medium-sized hospital. Wards were randomized into intervention (n = 85) and control (n = 95) groups. Nurses in the intervention group participated in daily huddles over three months, while those in the control group continued with standard care practices. The MISSCARE survey, Relational Coordination Survey, Situational Nursing Awareness Probe – Missed Nursing Care Edition (SANP-MNC), National Aeronautics and Space Administration (NASA) Task Load Index, and sociodemographic characteristics were assessed pre- and post-intervention. Mediation models were analyzed using mixed-linear model analyses.</div></div><div><h3>Results</h3><div>The proactive huddle intervention significantly reduced missed nursing care (β =0.123, p< 0.001), with partial mediation observed through improved relational coordination (β =-0.125, p< 0.001). However, while the intervention increased personal situational awareness (β =-0.142, p< 0.001), this cognitive mechanism did not mediate the relationship between the intervention and missed care.</div></div><div><h3>Conclusions</h3><div>Proactive huddles were effective in reducing missed nursing care by improving team communication and collaboration. Although situational awareness increased, the high workload and limited resources may have hindered nurses' ability to act on situational awareness. For proactive huddles to maximize their potential, additional support systems are needed to enable nurses to address care challenges effectively.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100448"},"PeriodicalIF":3.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background</h3><div>Conventional physical examinations sometimes fail to detect developmental hip dysplasia. Ultrasound hip screening, non-invasive and radiation-free, can identify these cases earlier, and nurse-led maternal, newborn, and infant home visits and childcare consultations at community health centers offer an ideal platform for community implementation. Knowing the relationship between Objective Structured Clinical Examination scores and nurses’ ability to capture diagnostic-quality hip images would inform training standards and credentialing, ensuring safe scale-up of nurse-led hip-screening services. However, this link remains unknown.</div></div><div><h3>Objective</h3><div>To examine the association between Objective Structured Clinical Examination performance and nurses’ success in capturing standard hip ultrasound images during <em>maternal and child health service</em> consultations.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Settings</h3><div>Three municipalities in Japan.</div></div><div><h3>Participants</h3><div>The study included 21 nurses (18 public health nurses, 1 registered nurse, and 2 midwives).</div></div><div><h3>Methods</h3><div>Participants completed an e-learning course, knowledge tests, hands-on training seminars, and the Objective Structured Clinical Examination before undergoing ultrasound examinations during home visits. Two trained researchers assessed exam performance using a global rating scale (range: 1–6), total score (range: 0–360 points), image acquisition time, and successful capture of standard images of the right and left hips using phantoms—infant-shaped models for training ultrasound hip screening. Pediatric orthopedic surgeons evaluated the ultrasound images obtained during home visits between February 2024 and May 2025. Linear regression analysis examined the associations among participant demographics, examination performance, and imaging success rates.</div></div><div><h3>Results</h3><div>The mean examination global rating score was 4.48 (standard deviation = 0.66), and the mean total score was 330.8 (standard deviation = 22.0). During home visits, 611 ultrasound examinations were conducted, of which 494 (80.9%) were successful. The success rate did not vary substantially based on the cumulative number of examinations performed by each nurse. Lower age (<em>B</em> = -5.2, <em>p</em> = 0.030) and successfully capturing a standard plane of the left hip during the examination were associated with significantly higher imaging success rates in maternal and child health service consultations (84.7% vs. 71.4%, <em>p</em> = 0.039). A shorter image acquisition time (<em>B</em> = -0.1, <em>p</em> = 0.009) was also significantly associated with higher success rates.</div></div><div><h3>Conclusions</h3><div>Successful capture of left-hip image and faster performance during the Objective Structured Clinical Examination independently predicted nurses’ field ima
传统的体格检查有时不能发现发育性髋关节发育不良。超声髋关节筛查，无创和无辐射，可以更早地发现这些病例，护士领导的产妇、新生儿和婴儿家访和社区卫生中心的托儿咨询为社区实施提供了理想的平台。了解客观结构化临床检查分数与护士获取诊断质量髋关节图像的能力之间的关系，将为培训标准和资格认证提供信息，确保护士主导的髋关节筛查服务的安全扩大。然而，这种联系仍然未知。目的探讨目的结构化临床检查表现与护士在妇幼保健服务会诊中获取标准髋关节超声图像的成功率之间的关系。前瞻性队列研究。日本的三个自治市。研究对象包括21名护士（18名公共卫生护士，1名注册护士，2名助产士）。方法参试者完成网上学习课程、知识测试、实践培训研讨会和客观结构化临床检查后，家访期间进行超声检查。两名训练有素的研究人员使用全球评分量表（范围：1-6）、总分（范围：0-360分）、图像采集时间和成功捕获左右臀部标准图像来评估考试成绩，这些图像使用的是用于训练超声髋关节筛查的幻影婴儿形状模型。儿科骨科医生对2024年2月至2025年5月家访期间获得的超声图像进行了评估。线性回归分析检查了参与者人口统计学、检查表现和成像成功率之间的关系。结果检查整体评分平均为4.48分（标准差= 0.66），总分平均为330.8分（标准差= 22.0）。在家访期间，进行了611次超声检查，其中494次（80.9%）成功。成功率并没有根据每个护士进行的累积检查次数而发生实质性的变化。较低的年龄（B = -5.2, p = 0.030）和在检查过程中成功捕获左髋关节标准平面与母婴健康服务咨询的成像成功率显著较高相关（84.7%对71.4%,p = 0.039）。较短的图像采集时间（B = -0.1, p = 0.009）也与较高的成功率显著相关。结论：在客观结构化临床检查中，成功捕获左臀部图像和更快的表现独立预测护士的现场成像成功，支持该检查作为准备检查点和有针对性的补救指导。注册；大学医院医学信息网临床试验注册；UMIN000051929 (https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_his_list.cgi?recptno=R000059248)。报名日期：2023年9月16日。招聘开始时间：2023年11月1日。目的结构化临床检查预测护士在实际实践中髋关节超声筛查的成功。
{"title":"Association of objective structured clinical examination performance on nurse-led hip ultrasound imaging success: A prospective cohort study","authors":"Kyoko Yoshioka-Maeda , Hiroshige Matsumoto , Chikako Honda , Takeshi Kinjo , Kiyoshi Aoki , Keita Okada , Mana Shirouchi , Misa Shiomi , Noriko Hosoya , Kenta Fujiwara , Tadashi Hattori","doi":"10.1016/j.ijnsa.2025.100449","DOIUrl":"10.1016/j.ijnsa.2025.100449","url":null,"abstract":"<div><h3>Background</h3><div>Conventional physical examinations sometimes fail to detect developmental hip dysplasia. Ultrasound hip screening, non-invasive and radiation-free, can identify these cases earlier, and nurse-led maternal, newborn, and infant home visits and childcare consultations at community health centers offer an ideal platform for community implementation. Knowing the relationship between Objective Structured Clinical Examination scores and nurses’ ability to capture diagnostic-quality hip images would inform training standards and credentialing, ensuring safe scale-up of nurse-led hip-screening services. However, this link remains unknown.</div></div><div><h3>Objective</h3><div>To examine the association between Objective Structured Clinical Examination performance and nurses’ success in capturing standard hip ultrasound images during <em>maternal and child health service</em> consultations.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Settings</h3><div>Three municipalities in Japan.</div></div><div><h3>Participants</h3><div>The study included 21 nurses (18 public health nurses, 1 registered nurse, and 2 midwives).</div></div><div><h3>Methods</h3><div>Participants completed an e-learning course, knowledge tests, hands-on training seminars, and the Objective Structured Clinical Examination before undergoing ultrasound examinations during home visits. Two trained researchers assessed exam performance using a global rating scale (range: 1–6), total score (range: 0–360 points), image acquisition time, and successful capture of standard images of the right and left hips using phantoms—infant-shaped models for training ultrasound hip screening. Pediatric orthopedic surgeons evaluated the ultrasound images obtained during home visits between February 2024 and May 2025. Linear regression analysis examined the associations among participant demographics, examination performance, and imaging success rates.</div></div><div><h3>Results</h3><div>The mean examination global rating score was 4.48 (standard deviation = 0.66), and the mean total score was 330.8 (standard deviation = 22.0). During home visits, 611 ultrasound examinations were conducted, of which 494 (80.9%) were successful. The success rate did not vary substantially based on the cumulative number of examinations performed by each nurse. Lower age (<em>B</em> = -5.2, <em>p</em> = 0.030) and successfully capturing a standard plane of the left hip during the examination were associated with significantly higher imaging success rates in maternal and child health service consultations (84.7% vs. 71.4%, <em>p</em> = 0.039). A shorter image acquisition time (<em>B</em> = -0.1, <em>p</em> = 0.009) was also significantly associated with higher success rates.</div></div><div><h3>Conclusions</h3><div>Successful capture of left-hip image and faster performance during the Objective Structured Clinical Examination independently predicted nurses’ field ima","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100449"},"PeriodicalIF":3.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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