Journal of Clinical Nursing最新文献

Background: The use of technology to support nurses' decision-making is increasing in response to growing healthcare demands. AI, a global trend, holds great potential to enhance nurses' daily work if implemented systematically, paving the way for a promising future in healthcare.

Objectives: To identify and describe AI technologies for nurses' clinical decision-making in healthcare settings.

Design: A systematic literature review.

Data sources: CINAHL, PubMed, Scopus, ProQuest, and Medic were searched for studies with experimental design published between 2005 and 2024.

Review methods: JBI guidelines guided the review. At least two researchers independently assessed the eligibility of the studies based on title, abstract, and full text, as well as the methodological quality of the studies. Narrative analysis of the study findings was performed.

Results: Eight studies showed AI tools improved decision-making, patient care, and staff performance. A discharge support system reduced 30-day readmissions from 22.2% to 9.4% (p = 0.015); a deterioration algorithm cut time to contact senior staff (p = 0.040) and order tests (p = 0.049). Neonatal resuscitation accuracy rose to 94%-95% versus 55%-80% (p < 0.001); seizure assessment confidence improved (p = 0.01); pressure ulcer prevention (p = 0.002) and visual differentiation (p < 0.001) improved. Documentation quality increased (p < 0.001).

Conclusions: AI integration in nursing has the potential to optimise decision-making, improve patient care quality, and enhance workflow efficiency. Ethical considerations must address transparency, bias mitigation, data privacy, and accountability in AI-driven decisions, ensuring patient safety and trust while supporting equitable, evidence-based care delivery.

Impact: The findings underline the transformative role of AI in addressing pressing nursing challenges such as staffing shortages, workload management, and error reduction. By supporting clinical decision-making and workflow efficiency, AI can enhance patient safety, care quality, and nurses' capacity to focus on direct patient care. A stronger emphasis on research and implementation will help bridge usability and scalability gaps, ensuring sustainable integration of AI across diverse healthcare settings.

Background: Post-intensive care syndrome (PICS) is defined as mental, physical, cognitive, and social sequelae in survivors of critical illness. Survivors of liver transplantation exhibit a complex clinical condition following discharge from the intensive care unit (ICU). There is a lack of knowledge about the lived experience of PICS in survivors after liver transplantation.

Objectives: Describe the lived experiences of PICS in ICU survivors following liver transplantation.

Methods: A phenomenological study was carried out using interpretative phenomenological analysis (IPA). Semi-structured interviews were conducted with ICU survivors one month after discharge.

Results: Twenty ICU survivors were enrolled and interviewed after critical illness. The main themes that emerged from the data analysis were: (1) Profound life reorientation, (2) Physical impairment, (3) Psychological distress experiences, (4) Human-Centred Nursing Care, and (5) Return to daily life. Our results showed a particular impact of the dimensions of PICS, such as mental, physical, and social dimensions, on ICU survivors after liver transplantation.

Conclusion: The study concludes that ICU survivors experience profound life reorientation, physical impairment, and psychological distress experiences, yet benefit from human-centred nursing care, which facilitates their eventual return to daily life.

Patient or public contribution: The findings highlight the importance of human-centred nursing care in the post-ICU recovery process, where the multidisciplinary team plays a critical role in addressing both psychological distress and physical rehabilitation, supporting survivors' reintegration into daily life.

Impact: Post-liver transplant ICU survivors experience profound physical, psychological, and social impacts. Life reorientation, altered body image, and emotional distress emerge. Human-centred nursing facilitates rehabilitation, reintegration, and overall recovery.

Reporting method: Reporting was structured based on the COREQ checklist.

Protocol registration: Prot. N. 00014635-31/05/2023.

Aim(s): To explore the caregiving experiences and support needs of fathers of children with medical complexity in Canada.

Design: A qualitative study guided by interpretive description methodology and informed by a Gender-Based Analysis Plus (GBA+) lens.

Methods: Data were collected through 60-min semi-structured interviews with seven fathers of children with medical complexity and analyzed using thematic analysis. The study followed the COREQ guidelines and checklist.

Results: Thematic analysis identified fathers' key roles as financial providers, hands-on caregivers, and as playing a key role in supporting their partners emotionally with the challenges of caregiving. Fathers prioritised the need for peer support, flexible workplace policies and improved access to mental health services.

Conclusion: The findings indicate that there is a critical need for more inclusive and flexible support systems and workplace policies that acknowledge and accommodate the important caregiving roles of fathers of children with medical complexity.

Relevance to clinical practice: The implications for healthcare professionals include actively involving fathers in care planning and providing targeted support services that recognise their roles to enhance child and family outcomes.

Patient or public contribution: We worked closely with our community advisory team, comprised of a physician, social worker and community organisation leader, who contributed to the study design, supported participant recruitment, and assisted in disseminating the findings back to the community, helping to ensure the research was grounded in and responsive to the needs of families of children with medical complexity.

Aims: To summarise current research that defines cardiopulmonary resuscitation and to provide a succinct conceptual definition of cardiopulmonary resuscitation.

Design: Scoping review using JBI guidelines to develop the study protocol.

Methods: The most recent (2024) research papers on cardiopulmonary resuscitation were evaluated for inclusion. Individual definitions of cardiopulmonary resuscitation extracted from 25 papers were summarised and then analysed to conceptualise a single definition for cardiopulmonary resuscitation.

Data sources: CINAHL, Medline and Scopus databases were evaluated for inclusion.

Results: Definitions of cardiopulmonary resuscitation focused on interventions, mainly chest compressions and ventilation. Defibrillation was inconsistently included. There was less emphasis on criteria for initiating cardiopulmonary resuscitation and desired outcomes.

Conclusion: This scoping review found limited consensus between definitions of cardiopulmonary resuscitation. Analysis of the range of perspectives found in the review enabled the researchers to propose definitions in three areas: cardiopulmonary resuscitation, basic life support and advanced life support.

Implications for the profession and patient care: Nurses working in hospitals and responding to cardiac arrests are guided by Advanced Resuscitation Plans and Do Not Resuscitate orders. In turn, these documents should communicate a clear definition of cardiopulmonary resuscitation in policies, procedures and standards. This is important for clinical nurses to ensure patients' consent for cardiopulmonary resuscitation and defibrillation is informed.

Impact: Currently cardiopulmonary resuscitation is inconsistently defined. Cardiopulmonary resuscitation includes compressions and ventilation. A standardised definition of cardiopulmonary resuscitation supports professional nursing practice and has wider implications for patient consent and research practice.

Reporting method: This scoping review adheres to and is reported according to PRISMA-ScR.

Patient or public contribution: No patient or public contribution.

Aim: To examine the characteristics of the health care needs corresponding to the medical care process and HR-QOL of women with cancer.

Design: A descriptive design was adopted.

Methods: The study's participants were 122 women with cancer who completed a survey before and 6 months after treatment initiation. A principal component analysis (PCA) was conducted on a set of 12 health care satisfaction scores at each point. Correlations were examined between the resulting components and HR-QOL indicators, including subjective well-being, symptoms, symptom-related interference, anxiety and depression.

Results: Most participants reported high health care satisfaction in both phases. PCA indicated the presence of 3 distinct domains: satisfaction with health care, health care management and supportive care. In both phases, these domains accounted for about 60% of the variance, while the remaining 40% was unexplained. Only satisfaction with health care was correlated with HR-QOL at both phases, with particularly strong associations observed for subjective well-being and depression at 6 months. Before treatment initiation, the item of 'nursing care and practice' received the highest average score, but demonstrated a negative loading on the component of 'satisfaction with health care management'. The component of 'satisfaction with supportive care needs' was retained at both phases.

Conclusion: Health care plays a pivotal role in maintaining patients' quality of life, while supportive care and the integration of nursing practice within health care management remain essential.

Implications for patient care: High satisfaction scores do not necessarily mean that all health care needs are met. Addressing unmet needs from the perspective of HR-QOL and ensuring continuous supportive care throughout the treatment process is imperative.

Patient contribution: Data provided by women with cancer was used.