International Journal of Nursing Studies Advances最新文献

{"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}

{"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 ,&nbsp;Anat Drach-Zahavy ,&nbsp;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&lt; 0.001), with partial mediation observed through improved relational coordination (β =-0.125, p&lt; 0.001). However, while the intervention increased personal situational awareness (β =-0.142, p&lt; 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}

{"title":"Association of objective structured clinical examination performance on nurse-led hip ultrasound imaging success: A prospective cohort study","authors":"Kyoko Yoshioka-Maeda ,&nbsp;Hiroshige Matsumoto ,&nbsp;Chikako Honda ,&nbsp;Takeshi Kinjo ,&nbsp;Kiyoshi Aoki ,&nbsp;Keita Okada ,&nbsp;Mana Shirouchi ,&nbsp;Misa Shiomi ,&nbsp;Noriko Hosoya ,&nbsp;Kenta Fujiwara ,&nbsp;Tadashi Hattori","doi":"10.1016/j.ijnsa.2025.100449","DOIUrl":"10.1016/j.ijnsa.2025.100449","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To examine the association between Objective Structured Clinical Examination performance and nurses’ success in capturing standard hip ultrasound images during &lt;em&gt;maternal and child health service&lt;/em&gt; consultations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Prospective cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Settings&lt;/h3&gt;&lt;div&gt;Three municipalities in Japan.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;The study included 21 nurses (18 public health nurses, 1 registered nurse, and 2 midwives).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;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 (&lt;em&gt;B&lt;/em&gt; = -5.2, &lt;em&gt;p&lt;/em&gt; = 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%, &lt;em&gt;p&lt;/em&gt; = 0.039). A shorter image acquisition time (&lt;em&gt;B&lt;/em&gt; = -0.1, &lt;em&gt;p&lt;/em&gt; = 0.009) was also significantly associated with higher success rates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;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}

{"title":"Umbilical venous catheter and peripherally inserted central catheter malposition and tip migration in neonates: A mixed methods cost analysis","authors":"Arun M Jones ,&nbsp;Suzanna Mongan ,&nbsp;Amanda Ullman ,&nbsp;Deanne August ,&nbsp;Elizabeth Sharpe ,&nbsp;Angela A Alderman ,&nbsp;Darcy Doellman ,&nbsp;Caitlin Anders ,&nbsp;Kacey Wiseman ,&nbsp;Cheryl Gillette ,&nbsp;Hansoo Kim ,&nbsp;Joshua Byrnes","doi":"10.1016/j.ijnsa.2025.100450","DOIUrl":"10.1016/j.ijnsa.2025.100450","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Hospitalized neonates require reliable vascular access for life-saving care. The costs associated with their clinical management, and which aspects of care these costs are attributable to, is not well-known.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To estimate the economic burden of vascular access care in neonates in the United States and to break down the attribution of costs therein by establishing an economic model of standard care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design and methods&lt;/h3&gt;&lt;div&gt;A four step, mixed-methods study was used to determine and analyse an appropriate economic model for neonatal umbilical venous catheter and peripherally inserted central catheter insertion from the payer’s perspective in the US. An initial model was developed based on a purposive literature search. Secondly, initial face validity of the model was assessed with input from North American clinical experts identified to have appropriate expertise (&lt;em&gt;n&lt;/em&gt; = 13 for the care of peripherally inserted central catheters and &lt;em&gt;n&lt;/em&gt; = 12 for the care of umbilical venous catheters).Thirdly, a face-to-face meeting with the same clinical experts was undertaken to ensure the model structure and inputs accurately reflected clinical practice. Lastly, the finalised model was analysed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Feedback from the survey and focus group on model structure, resource usage and costings were incorporated to create decision-tree models for both umbilical venous catheter and peripherally inserted central catheter care. High variability between the opinions of clinicians was noted, which was incorporated into the sensitivity analyses. The umbilical venous catheter base-case expected cost was $390.24 per patient, with an average of 0.04 complications expected per-patient. The peripherally inserted central catheter model base-case expected cost was $1517.83 per patient, with an average of 0.1 complications per-patient. In the umbilical venous catheter model $82.73 of cost was attributable to malposition and $46.36 to migration. In the peripherally inserted central catheter model, $75.58 was attributable to malposition and $755.14 to migration. Deterministic sensitivity analysis indicated that the strongest driver of costs was catheter dwell time (umbilical venous catheter lower: $245.55, umbilical venous catheter upper: $578.77, peripherally inserted central catheter lower: $1263.40, peripherally inserted central catheter upper: $1771.74), followed by probability of migration (umbilical venous catheter lower: $343.91, umbilical venous catheter upper: $439.14, peripherally inserted central catheter lower: $1329.04, peripherally inserted central catheter upper: $1733.58) in both models.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The migration and malposition of peripherally inserted central catheters and umbilical venous catheters has significant costs and consequences. These should be targeted for evidence-based and innovative solutions ","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100450"},"PeriodicalIF":3.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525565","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}

{"title":"Occupational self-efficacy, job satisfaction and learning potential of the workplace in a sample of diabetes specialist nurses: A structural equation modeling analysis","authors":"Alma Dautovic ,&nbsp;Ulla Fredriksson-Larsson ,&nbsp;Kajsa Yang Hansen ,&nbsp;Eva Brink","doi":"10.1016/j.ijnsa.2025.100446","DOIUrl":"10.1016/j.ijnsa.2025.100446","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Diabetes mellitus is a chronic condition, cases of which are expected to continue rising worldwide. Diabetes specialist nurses play an essential role by assisting patients with preventing or delaying disease complications. Research has suggested an association between occupational self-efficacy and job satisfaction among professionals. However, the relationship between these factors among diabetes specialist nurses, as well as the learning potential of the workplace in this context, remains unexplored.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aimed to explore the relationships between occupational self-efficacy, the learning potential of the workplace and job satisfaction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A cross-sectional study design was used.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;The study data were collected through a national online survey conducted in Sweden.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;A total of 157 registered nurses who provide diabetes care to patients were included.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Data were obtained through an online survey with a response rate of 28%. All variables were measured using Swedish-translated standardised instruments. The model was constructed and tested using structural equation modeling analysis with the hypothesis that perceived occupational self-efficacy has both direct and indirect effects on diabetes specialist nurses' job satisfaction and is mediated by the learning potential of the workplace.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The findings supported the hypothesised model. The total effect of the relationship between occupational self-efficacy and job satisfaction was 0.547 (&lt;em&gt;p&lt;/em&gt; &lt; .001), comprising both the direct effect (β = 0.359, &lt;em&gt;p&lt;/em&gt; &lt; .0001) between these constructs and the indirect effect (0.188, &lt;em&gt;p&lt;/em&gt; &lt; .001). The indirect pathways included occupational self-efficacy, which was statistically significantly associated with all three dimensions of the &lt;em&gt;Learning Potential of the Workplace&lt;/em&gt; scale: &lt;em&gt;Opportunity to reflect&lt;/em&gt; (β = 0.480, &lt;em&gt;p&lt;/em&gt; &lt; .0001), &lt;em&gt;Support in learning&lt;/em&gt; (β = 0.226, &lt;em&gt;p&lt;/em&gt; &lt; .01), and &lt;em&gt;Time for exploration&lt;/em&gt; (β = 0.330, &lt;em&gt;p&lt;/em&gt; &lt; .0001). Both &lt;em&gt;Support in learning&lt;/em&gt; and &lt;em&gt;Time for exploration&lt;/em&gt; were also statistically significantly associated with job satisfaction (β = 0.236 and β = 0.266, respectively, &lt;em&gt;p&lt;/em&gt; &lt; .01), thereby contributing to the sum of the indirect effect (0.188, &lt;em&gt;p&lt;/em&gt; &lt; .001). One dimension, &lt;em&gt;Time for exploration&lt;/em&gt;, was identified as a mediator between occupational self-efficacy and job satisfaction, which explained 9% (&lt;em&gt;p&lt;/em&gt; &lt; .01) of the variance in job satisfaction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;These results demonstrated the association between occupational self-efficacy and job satisfaction among diabetes specialist nurses. The mediation effect of the &lt;em&gt;Time for exploration","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100446"},"PeriodicalIF":3.1,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473482","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}

{"title":"Investigating whether routinely collected biomarkers improve the prediction of hospital-acquired pressure injury occurrence: A retrospective cohort study","authors":"Clair Merriman ,&nbsp;Kathryn Suzann Taylor ,&nbsp;Ria Betteridge ,&nbsp;Neesha Oozageer Gunowa ,&nbsp;Helen Walthall ,&nbsp;Zoe Maunsell ,&nbsp;Debra Jackson","doi":"10.1016/j.ijnsa.2025.100445","DOIUrl":"10.1016/j.ijnsa.2025.100445","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Despite being largely preventable, hospital-acquired pressure injuries remain a significant challenge in healthcare, contributing to prolonged hospital stays, increased patient morbidity, and substantial healthcare costs. Commonly used risk assessment tools have limited predictive accuracy, and early detection of hospital acquired pressure injuries often depends on subjective visual skin assessments. Emerging evidence suggests routinely collected biomarkers may offer an objective and reliable approach to predicting hospital acquired pressure injuries risk.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To explore how biomarkers improve hospital acquired pressure injuries prediction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Retrospective cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Acute NHS Trust in England, UK.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;10,504 adult patients admitted to acute medical wards for at least 24 h in 2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We considered the first hospital acquired pressure injuries and first record of other variables per hospital episode, measured at or soon after admission. Population characteristics of those who developed a hospital acquired pressure injuries or not were compared, overall and stratified by categories of length of stay (&lt;6 days, ≥6 days), Braden, Malnutrition Universal Screening Tool and Mobility scores. Using multivariable logistic regression, we assessed the predictive value of the risk scores, adjusted for age and gender, and adding single biomarkers. Predictive performance was evaluated by discrimination and calibration. Analyses were exploratory. We used Stata v16 and R v4.4.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Median hospital stay for patients with hospital acquired pressure injuries (&lt;em&gt;n&lt;/em&gt; = 293) was 18 days (interquartile range 12–31) compared with 5 days (2–11) for those without. Patients with hospital acquired pressure injuries were older than those without (84 (77–89) vs 78 (66–86) years. Levels of urea, C-reactive protein, and prothrombin time were significantly higher and albumin, haemoglobin and red blood cell count were significantly lower in those who developed hospital acquired pressure injuries. The incidence of hospital acquired pressure injuries was higher in those with longer hospital stays and increased across the risk score categories. Adjusting for age and gender, a unit increase in the Braden score reduced the odds of developing a hospital acquired pressure injuries by 15 %. The discrimination was adequate (AUC 0.72), but calibration was poor. Several individual biomarkers enhanced discrimination, but with miscalibration. Albumin was an independent predictor of hospital acquired pressure injuries in all models. The model with mobility adjusted for age and gender had adequate discrimination (AUC 0.71) and was well calibrated. Compared to those fully mobile, there was a sevenfold increase in the odds of hospital acquired pressure","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100445"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525564","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}

{"title":"Adapting program theory to guide the implementation and evaluation of interventions delivered by advanced practice nurses in Hospital at Home: A programmatic framework for implementation and assessment","authors":"Rachid Akrour ,&nbsp;Philip Larkin ,&nbsp;Henk Verloo","doi":"10.1016/j.ijnsa.2025.100444","DOIUrl":"10.1016/j.ijnsa.2025.100444","url":null,"abstract":"<div><div>This article presents an adaptation of Program Theory framework designed to support the implementation and evaluation of interventions delivered by advanced practice nurses within Hospital at Home models. In response to increasing healthcare demands associated with aging populations and multimorbidity, this framework integrates three interrelated theories; Program Organizational, Service Utilization, and Impact theories to conceptualize and assess advanced practice nurse led care delivery in Hospital at Home settings.</div><div>Organizational Theory outlines the structural and functional requirements for integrating advanced practice nurses into Hospital at Home, including role definition, interprofessional collaboration, governance structures, and resource allocation. It emphasizes ways to foster the autonomy of advanced practice nurses, supporting clinical decision-making, and ensuring infrastructure for coordinated care. Service Utilization Theory focuses on the determinants of access, acceptance, and appropriateness of care. It addresses mechanisms for patient referral, eligibility assessment, and care escalation, and highlights the importance of aligning patient needs with the expertise of advanced practice nurses.</div><div>The adapted Impact Theory identifies causal pathways linking interventions delivered by advanced practice nurses, such as early assessment, individualized care planning, home visits, therapeutic education, and care coordination to patient and caregiver, for system-level outcomes. These outcomes include reduced hospital admissions and readmissions, fewer emergency department visits, lower nursing home placement rates, and improved functional status, quality of life, and patient satisfaction. The Program Theory framework also supports the evaluation of caregiver burden and the effectiveness of self-management support including health literacy.</div><div>Applied in the context of a French-speaking canton in Switzerland, where Hospital at Home services remain underdeveloped and advanced practice nurses are not integrated into these services, this framework provides a structured and theory-driven approach to guide the operationalization and evaluation of their interventions. It establishes a basis for the measurement of outcomes across care processes, individual experiences, and health system impacts. By aligning intervention components with expected outcomes, this approach addresses the complexity of Hospital at Home and the multidimensional contribution of advanced practice nurses, offering a foundation for future implementation and research.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100444"},"PeriodicalIF":3.1,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424330","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}

{"title":"From data to practice: an improvement pathway for trauma teams based on the T-NOTECHS scale and the PEARLS feedback framework: A pre–post interventional study","authors":"Jing Cheng ,&nbsp;Yuwei Wang ,&nbsp;Zuojia Wu ,&nbsp;Shuaishuai Zhou ,&nbsp;Yu Jia ,&nbsp;Danping Yan ,&nbsp;Sa Wang ,&nbsp;Fan Luo","doi":"10.1016/j.ijnsa.2025.100443","DOIUrl":"10.1016/j.ijnsa.2025.100443","url":null,"abstract":"<div><h3>Background</h3><div>The efficiency of trauma resuscitation teams depends not only on the precise execution of technical skills but also on the proficiency in non-technical skills, such as communication, decision-making, leadership, and situational awareness. The integrated development of both skill sets is essential for optimizing trauma care delivery and ensuring patient safety. This study investigates a training model that integrates the Trauma Non-Technical Skills (T-NOTECHS) scale with the Promoting Excellence and Reflective Learning in Simulation (PEARLS) feedback framework, aimed at enhancing both technical and non-technical competencies among trauma team members.</div></div><div><h3>Objective</h3><div>To evaluate the dual impact of a combined T-NOTECHS and PEARLS-based training model on enhancing the technical and non-technical competencies of trauma care teams and to examine its influence on patient-centered, time-sensitive treatment metrics.</div></div><div><h3>Methods</h3><div>A pre–post interventional study design was adopted. Trauma team members underwent training utilizing the T-NOTECHS assessment tool and the PEARLS debriefing framework. Effectiveness was assessed by comparing technical and non-technical performance metrics before and after the intervention, and by evaluating time-sensitive clinical metrics.</div></div><div><h3>Results</h3><div>Post-training assessments revealed statistically significant improvements across both technical and non-technical domains (<em>p</em>&lt; 0.05). Notable gains were observed in communication, decision-making, situational awareness, and leadership, complementing enhanced procedural execution. These improvements were associated with substantial reductions in time-sensitive clinical indicators related to trauma care delivery.</div></div><div><h3>Conclusion</h3><div>The integration of the T-NOTECHS scale and PEARLS feedback framework represents an effective training model for concurrently advancing both technical and non-technical competencies in trauma teams. This model not only fosters interprofessional collaboration and procedural precision but also enhances both the efficiency and safety of trauma patient care. Given its demonstrable benefits, this model demonstrates considerable potential for broader implementation in high-acuity emergency and critical care settings.</div><div>Not registered.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100443"},"PeriodicalIF":3.1,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624853","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}

{"title":"Nurse-led fall prevention programs in acute care settings: An integrative review","authors":"Sahar Abdulkarim AlGhareeb ,&nbsp;Nora Ghalib AlOtaibi ,&nbsp;Lujain Adel Sallam ,&nbsp;Adnan Innab","doi":"10.1016/j.ijnsa.2025.100440","DOIUrl":"10.1016/j.ijnsa.2025.100440","url":null,"abstract":"<div><h3>Background</h3><div>Falls in acute care settings are associated with negative consequences to patients and the healthcare system. Despite growing awareness of the importance of fall prevention in healthcare, there remains a notable lack of comprehensive reviews specifically evaluating nurse-led fall prevention programs in acute care settings.</div></div><div><h3>Objectives</h3><div>This integrative review aimed to synthesize the current evidence on the nurse-led programs designed to prevent falls among adult inpatients in acute care settings.</div></div><div><h3>Methods</h3><div>This integrative review has been registered on the International Prospective Register of Systematic Reviews (PROSPERO). The review was guided by Whittemore and Knafl's five-stage integrative review framework. A systematic literature search was conducted across the CINAHL, Scopus, Medline, Web of Science, and ProQuest databases. Only studies published in English between 2016 and 2024, involving adult populations in acute care settings, were included, regardless of geographic location. Three reviewers independently reviewed and assessed the data extraction and methodological quality of each study using the Mixed Methods Appraisal Tool. The results were then analyzed and synthesized through narrative synthesis.</div></div><div><h3>Results</h3><div>Of 873 articles screened, 23 were included in the review. Four primary themes related to fall prevention strategies have been identified: the fall prevention strategies, nursing training and education, fall rate outcomes, and organizational and environmental factors.</div></div><div><h3>Conclusion</h3><div>This integrative review highlights the critical role of nurse-led interventions in reducing inpatient falls within acute care settings. Analyzing the key features of these prevention strategies may enable future researchers to enhance and recommend employing multiple intervention strategies for more effective methods for minimizing fall incidents in such environments. Using a single fall prevention strategy demonstrated lower effectiveness than the multiple strategies.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100440"},"PeriodicalIF":3.1,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424421","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}