Nursing Reports最新文献

Background: Nurses have unique insights into health systems yet remain underrepresented in policy processes. Strengthening political competence is widely regarded as important for evidence-informed nursing leadership. Objectives: To assess self-perceived political competence and policy participation among nurses and nursing students in Croatia. Methods: We conducted a cross-sectional online survey using open, non-probability recruitment. Of 447 individuals who opened the survey link, 440 provided responses and 390 completed all 19 competence items measuring political competence across three domains (attitudes, knowledge/evidence, and skills). Open recruitment precluded calculation of a conventional response rate. A 19-item self-report questionnaire measured political competence across three domains (attitudes, knowledge/evidence and skills); internal consistency was α = 0.91, although the Croatian version has not been fully validated. Data were analyzed using descriptive statistics, binomial tests and ordinal logistic regression on the complete-case sample. Results: Most respondents endorsed nurses' policy involvement, the importance of scientific evidence and nursing's holistic perspective. Conclusions: Nurses and nursing students reported strong conceptual support for a policy role but only moderate confidence in influencing policy. These cross-sectional findings highlight a gap between conceptual support and personal confidence that may be addressable through structured educational and institutional support; the impact of such initiatives on policy influence should be examined in future longitudinal or interventional studies.

Climate change poses a major global health threat, with healthcare systems contributing substantially to global greenhouse gas emissions. Health professionals and students play an essential role in advancing sustainable practice, yet many lack the knowledge, skills, and confidence needed to address the environmental impacts of healthcare. This study aims to co-design and evaluate a gamified e-resource that enhances pre-registration health profession students' knowledge, self-efficacy, and attitudes towards healthcare decarbonisation, while encouraging sustainable behaviour change. A sequential explanatory design will be employed in three phases: (1) a scoping review of the literature; (2) four co-design workshops with students (n = 20) followed by post-workshop focus groups using focused ethnography to explore co-design experiences; and (3) pre- and post-test questionnaires (n = 200) assessing knowledge, attitudes, self-efficacy, behaviours, willingness to act, and usability, followed by focus groups (n = 30) exploring behavioural changes after using the e-resource. The study will generate evidence on how a co-designed, gamified e-resources influence student learning and engagement with healthcare decarbonisation. Findings will inform the integration of sustainability and decarbonisation principles within education and support efforts to equip future health professionals with the competencies required for a low-carbon healthcare system.

Background/Objectives: The integration of Information Technologies has transformed interactions between healthcare professionals and the families of hospitalized patients, enabling more comprehensive, transparent, and patient-centered care. Artificial Intelligence is emerging as a transformative tool to further enhance these interactions; however, its implementation faces challenges associated with access to and availability of basic technological infrastructure. Methods: This cross-sectional pilot study, conducted at the Tamaulipas Children's Hospital, Mexico, included 51 healthcare professionals from diverse specialties. It examined the use of digital technologies and perceptions of information systems aimed at optimizing communication with families. Results: Findings indicated that 58.8% reported consistent use of digital devices, whereas only 41.2% had regular internet access. Between 60.0% and 67.0% consistently provided information regarding patients' health status, treatments, and medical procedures. With respect to a digital system, 37.3% considered its implementation necessary and 39.2% perceived potential benefits, although functions such as multimedia sharing and automated notifications were regarded with caution. The questionnaire demonstrated high reliability (α = 0.835) and acceptable construct validity (KMO = 0.705; Bartlett's test p < 0.001). Conclusions: Preliminary results suggest that the integration of AI-based digital systems in hospital settings remains conditional. They also highlight the need to ensure equitable access to technological infrastructure as a prerequisite for achieving sustainable adoption.

Background/Objectives: The institution of the nursing assistant (NA) profile in Italy, established by the Decree 28 February 2025 responds to the chronic shortage of healthcare personnel, especially in nursing. This figure, non-healthcare but trained to perform basic healthcare tasks, aims to support nurses and ensure continuity of care, especially in community and long-term care settings, through further nursing activities delegation. The model aligns with international practices, emphasizing delegation within multiprofessional teams, based on formalized protocols and continuous on-site training, within standardized, low-discretion contexts. The delegation of health activities, however, presents legal and medico-legal challenges regarding scope of practice and supervision. Methods: The aim of this paper is critically discussing delegation of health activities to non-healthcare providers and the related issues of liability in team-based delivery of care, considering the specific regulatory setting of health providers in Italy. Results: Critical activities such as nutrition and hydration, in particular artificially, and drug administration highlight the limits of delegation and the ongoing need for professional nurse oversight. In pre-hospital emergency care, standardized, protocol-based systems and simulation-based training successfully integrate non-healthcare personnel within the health team. Conversely, chronic and long-term care remain fragmented, lacking organizational maturity, regular supervision, and uniform regulation. Conclusions: The decree represents a step toward structured team-based care, but its success depends on robust governance, protocol clarity, organizational guidelines, and sustained practice-based education to prevent unsafe delegation and unauthorized practice.

In response to persistent gaps in pain management competencies among nurses in Saudi Arabian teaching hospitals and similar healthcare settings globally, this manuscript presents a developed and validated action plan designed to support the effective transfer of pain management competencies into clinical practice. The action plan was developed to address the critical need for structured, practical strategies that enhance nurses' ability to apply pain management knowledge in diverse interdisciplinary environments. The action plan was validated through a rigorous three-round e-Delphi technique involving 12 expert panel members, achieving a 75% consensus on its content and structure. The final validated plan includes clear action statements, implementation methods, designated responsibilities, and defined timeframes. The core action statements focus on the following: (i) motivating nurses to pursue further study; (ii) equipping nursing teams with appropriate pain management tools; (iii) developing content-specific, practice-oriented short training programs; (iv) tailoring training to accommodate different learning styles; (v) using diverse teaching methods; (vi) creating strategies to encourage participation in training; and (vii) promoting the application of acquired knowledge in clinical settings. Adoption and implementation of this action plan by nursing leadership are anticipated to significantly enhance the transfer of pain management competencies, ultimately improving patient outcomes. The plan is adaptable for use in similar healthcare settings worldwide, offering a replicable model for strengthening nursing practice through targeted competency development.

Background/Objectives: Structural empowerment involves access to opportunities, information, support, and resources within the work environment. These elements are crucial as they foster nurses' professional growth and autonomy. Given their significance, understanding hospital nurses' perceptions of structural empowerment is important. Therefore, the aim of this study is to explore hospital nurses' perceptions of their levels of structural empowerment. Methods: This cross-sectional study included 684 nurses from a Portuguese hospital, conducted between November 2024 and January 2025. The questionnaire collected demographic data and employed the Conditions of Work Effectiveness Questionnaire II. Results: The mean total score for structural empowerment was 18.74 (SD = 3.46), with significant differences found between nurses and specialist nurses, for those with the specialist title (p = 0.0477) and within the professional category (p = 0.0058), as well as between nurses working day shifts and those working day and night shifts (p < 0.0001). Additional significant differences were observed between nurses from the Medicine department (median [Q1-Q3]: 19.25 [17.00-21.50]) and those from the Surgery department (18.17 [16.00-20.25], p = 0.0104), as well as between Generation Z nurses (19.58 [17.33-21.83]) and Generation Y nurses (18.29 [16.25-20.33], p = 0.0018). Conclusions: These results underscore the importance of consistently promoting structural empowerment across the nursing staff, addressing disparities between groups, and improving both professional development and quality of patient care.

Background/Objectives: Clinical instruction and mentorship are essential components of nursing education and early professional development. In Greece, while nursing curricula align with EU directives mandating both theoretical and clinical training, significant gaps persist in the quality, coordination, and legislative support of mentorship. This work aims to (i) synthesise evidence on clinical instruction and mentorship in Greece and draw on selected European examples to provide contextual insight, and (ii) integrate national stakeholder perspectives to generate actionable recommendations for a Greek clinical mentorship framework. Methods: A narrative literature review was conducted, identifying 19 eligible articles examining mentorship, clinical instruction and preceptorship in European and Greek contexts. In addition, a national stakeholder focus group with 25 participants, including representatives from academia, healthcare institutions, regulatory bodies, and nursing associations, was held in Athens in 2024. Data from both sources were thematically analysed and integrated to identify gaps, best practices, and context-specific recommendations. Results: Findings revealed inconsistent collaboration between universities and clinical institutions, limited training and recognition for clinical instructors, and the absence of a unified national framework. Stakeholders highlighted structural barriers to clinical mentoring such as understaffing and lack of policy support and expressed strong interest in a mentorship reform. Comparative analysis with European models demonstrated feasible pathways for Greece, including structured training, certification, and non-financial incentives. During the national stakeholder focus group, a dual-pathway mentorship system tailored for nursing students and newly hired nurses was most recommended to ensure both continuity and quality in professional development of nurses. Conclusions: Despite alignment with EU directives, Greece lacks an integrated national mentorship framework that ensures consistent clinical learning and supports workforce development. Two priority policy actions emerge from this work: (1) establishing a legally supported national certification and training system for clinical mentorship, and (2) educational structures in the clinical setting to improve educational quality, workforce retention and patient care outcomes.

Background/Objectives: Community paramedicine programs have existed since the early 2000s, and while resource optimization remains a predominant driver, innovation in recent years demonstrates that when community paramedicine is integrated into healthcare, it is well-positioned to support the needs of structurally marginalized communities by focusing services for those facing barriers to accessing equitable care. A recent scoping review described the evolving ways community paramedicine models are addressing health and social needs within communities around the world. We aimed to identify and explore existing community needs assessment tools in Canada to guide the initial development of a needs assessment tool for community paramedicine. Methods: We conducted a document analysis of existing community needs assessment resources to identify current tools or processes used to identify community needs, as well as determine gaps to address and support. Documents were collected for review via a targeted literature search of both published and gray sources, and direct document requests of community paramedicine service providers to review guides informing current service planning in Canada. We presented a draft of the tool to participants at a community paramedicine conference for their review and feedback, and we incorporated this feedback into the final version. Results: We reviewed 38 documents to identify and synthesize key elements within community health and social needs assessment tools and frameworks. Findings informed an interim Community Paramedicine Needs Assessment Tool (CPNAT) that the team presented to 112 community paramedicine experts and partners. We received 33 group responses of detailed feedback that we used to further refine and finalize the tool. Conclusions: The CPNAT can support enhanced health equity by guiding community paramedicine programs to better align services, policies, and funding with the health and social care needs of communities.

Background: Nursing students face emotional and psychological challenges stemming from early clinical exposure, intense academic pressure, and persistent social stigmas. These stressors can contribute to mental health deterioration and increase the risk of suicidal thoughts and behavior. Objective: To evaluate the psychosocial context and identify risk and protective factors contributing to suicidal behavior in undergraduate nursing students. Methods: This cross-sectional study included 433 undergraduate nursing students and utilized validated psychological instruments to assess suicidal behavior, emotional distress, impulsivity, anhedonia, mental health, and perceived social support. Data were analyzed using descriptive statistics, bivariate tests, exploratory factor analysis, and multivariate modeling to identify key predictors of suicidal behavior. Network visualization was used to integrate significant point-biserial correlations with factor loadings. Results: Among 433 nursing students (77.8% women, 93.8% cisgender, mean age 19), 15.2% showed clinically significant suicidal risk. Suicidal behavior was more frequent among women and students living away from home (p < 0.05). Higher levels of impulsivity, ADHD symptoms, and especially moderate-to-severe hopelessness (p < 0.001) were strongly associated. Hazardous alcohol use was also a significant risk factor (p < 0.01), while strong material and emotional support showed a protective effect (p < 0.05). Two psychological dimensions, emotional distress/impulsivity and hopelessness/low support, explained most of the variance. Conclusions: 1 in 7 nursing students show clinically relevant suicidal risk, particularly those with heightened hopelessness, emotional dysregulation or hazardous alcohol use. Protective social support plays a key mitigating role. These results underline the urgent need for tailored mental health interventions that specifically address emotional regulation and hopelessness, while reinforcing social support systems within nursing education contexts.

Background/Objectives: Evidence-Based Practice (EBP) positively impacts health safety and quality while also empowering nursing as a discipline. A useful strategy for promoting EBP is to build learning paths adapted to the individuality of nurses. These elements establish the framework for effective learning, determining the availability of specific content at certain times and influencing the design of learning objects to ensure optimal efficacy in the teaching-learning process. It is essential to identify effective strategies in evidence-based nursing education to advance EBP and thereby enhance the quality and safety of nursing care. This review aims to summarize the evidence on the effectiveness of learning paths in the acquisition of EBP competencies by nurses. Methods: A systematic review of the literature will be carried out in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness. The results of the review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols (PRISMA-P). The protocol is registered in the PROSPERO database (CRD4202453155). The search will be performed using the EBSCOhost search engine in the following databases: CINAHL Plus, MedicLatina, MEDLINE, Psychology and Behavioral Sciences Collection, Academic Search Complete, eBook Collection, and Education Resources Information Center. The inclusion of studies, data extraction, and analysis will be carried out by two reviewers independently. Disagreements will be resolved by a third reviewer. All studies involving nurses, learning paths, EBP competencies, regardless of geographical area and context, with no time limit or language constraints, will be included. Results: Not applicable; this is a protocol. Findings will be synthesized as specified in the Methods. Conclusions: This review will provide a better understanding of the effectiveness of a learning path in the acquisition of EBP competencies by nurses. It will also assist in the identification of knowledge gaps in the literature and potential areas for future research and development.