Pub Date : 2025-11-26DOI: 10.1016/j.outlook.2025.102611
Jason R Thrift, Kimberly Hill, Jennifer Bagwell, Lucia Gonzales, Kimberly Stewart, Raven Anderson, Andrea O'dell, Olivia Boice, Ben Card
{"title":"Response to the letter to the editor, virtual reality in nursing curricula: Moving toward evidence-informed and sustainable integration.","authors":"Jason R Thrift, Kimberly Hill, Jennifer Bagwell, Lucia Gonzales, Kimberly Stewart, Raven Anderson, Andrea O'dell, Olivia Boice, Ben Card","doi":"10.1016/j.outlook.2025.102611","DOIUrl":"https://doi.org/10.1016/j.outlook.2025.102611","url":null,"abstract":"","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":" ","pages":"102611"},"PeriodicalIF":3.7,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-24DOI: 10.1016/j.outlook.2025.102602
Jun-Tong Jing , Hang-Na Qiu , Yong-Kang Fu , Zheng-Yi Ma , Dong-Ru Liu , Jie Liu , Chao-Ran Chen
Background
Nurse presenteeism threatens healthcare quality and team stability, yet its antecedents remain insufficiently explored.
Purpose
To examine the longitudinal impact of ethical leadership on nurse presenteeism and the mediating roles of organizational climate and professional identity.
Methods
A three-wave study (February–August 2024) surveyed 1,218 nurses using validated scales. Data were analyzed using SPSS 25.0 and AMOS 26.0.
Discussion
Ethical leadership consistently predicted lower presenteeism across waves. Organizational climate and professional identity partially mediated this association, forming a significant sequential pathway.
Conclusion
Ethical leadership reduces nurse presenteeism directly and through improvements in organizational climate and professional identity, highlighting the importance of leadership-driven, multilevel interventions in nursing management.
{"title":"The impact and mechanisms of ethical leadership on nurse presenteeism: A multicenter longitudinal study","authors":"Jun-Tong Jing , Hang-Na Qiu , Yong-Kang Fu , Zheng-Yi Ma , Dong-Ru Liu , Jie Liu , Chao-Ran Chen","doi":"10.1016/j.outlook.2025.102602","DOIUrl":"10.1016/j.outlook.2025.102602","url":null,"abstract":"<div><h3>Background</h3><div>Nurse presenteeism threatens healthcare quality and team stability, yet its antecedents remain insufficiently explored.</div></div><div><h3>Purpose</h3><div>To examine the longitudinal impact of ethical leadership on nurse presenteeism and the mediating roles of organizational climate and professional identity.</div></div><div><h3>Methods</h3><div>A three-wave study (February–August 2024) surveyed 1,218 nurses using validated scales. Data were analyzed using SPSS 25.0 and AMOS 26.0.</div></div><div><h3>Discussion</h3><div>Ethical leadership consistently predicted lower presenteeism across waves. Organizational climate and professional identity partially mediated this association, forming a significant sequential pathway.</div></div><div><h3>Conclusion</h3><div>Ethical leadership reduces nurse presenteeism directly and through improvements in organizational climate and professional identity, highlighting the importance of leadership-driven, multilevel interventions in nursing management.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 1","pages":"Article 102602"},"PeriodicalIF":3.7,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart failure (HF) is a leading cause of hospitalization and death. Advanced nursing roles may improve patient outcomes, but evidence from acute-care settings is limited.
Purpose
To examine whether certified nurses (CNs) specialized in HF—who are not formally advanced practice nurses (APNs) in Japan but possess advanced competencies comparable to international APN definitions—are associated with improved outcomes in hospitalized HF patients.
Methods
We conducted a nationwide retrospective cohort study involving 991,423 HF patients from 1,558 hospitals. Multivariable logistic regression and instrumental variable analyses were performed to evaluate the associations between CN presence and in-hospital mortality or 30-day readmission.
Discussion
CN presence was significantly associated with lower in-hospital mortality (adjusted odds ratio: 0.96, 95% confidence interval: 0.93–0.99). No significant association was observed for 30-day readmission.
Conclusion
CNs may help improve HF outcomes in acute-care settings, informing policies to better utilize specialized nursing roles.
{"title":"Impact of certified nurses specialized in heart failure on in-hospital mortality: A nationwide retrospective cohort study in Japan","authors":"Kojiro Morita PhD, MPH, RN , Gojiro Nakagami PhD, RN , Taisuke Yasaka PhD, RN , Ryohei Kida PhD, RN , Aya Kitamura PhD, RN , Tamaki Isobe PhD, RN, PHN , Yoshie Takahashi PhD, RN, PHN , Hideaki Watanabe MPH, MD , Mari Ikeda PhD, RN, PHN , Hiroki Matsui PhD, MPH , Kiyohide Fushimi PhD, MD , Hideo Yasunaga PhD, MD","doi":"10.1016/j.outlook.2025.102605","DOIUrl":"10.1016/j.outlook.2025.102605","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) is a leading cause of hospitalization and death. Advanced nursing roles may improve patient outcomes, but evidence from acute-care settings is limited.</div></div><div><h3>Purpose</h3><div>To examine whether certified nurses (CNs) specialized in HF—who are not formally advanced practice nurses (APNs) in Japan but possess advanced competencies comparable to international APN definitions—are associated with improved outcomes in hospitalized HF patients.</div></div><div><h3>Methods</h3><div>We conducted a nationwide retrospective cohort study involving 991,423 HF patients from 1,558 hospitals. Multivariable logistic regression and instrumental variable analyses were performed to evaluate the associations between CN presence and in-hospital mortality or 30-day readmission.</div></div><div><h3>Discussion</h3><div>CN presence was significantly associated with lower in-hospital mortality (adjusted odds ratio: 0.96, 95% confidence interval: 0.93–0.99). No significant association was observed for 30-day readmission.</div></div><div><h3>Conclusion</h3><div>CNs may help improve HF outcomes in acute-care settings, informing policies to better utilize specialized nursing roles.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 1","pages":"Article 102605"},"PeriodicalIF":3.7,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-22DOI: 10.1016/j.outlook.2025.102609
Abdulsamed Kaya , Güzel Nur Yildiz
Background
The use of artificial intelligence in nursing care is advancing rapidly and could improve areas such as nursing management, care quality, safety management and team communication.
Purpose
This study conducted a bibliometric analysis to explore the characteristics, priorities, and trends in the use of artificial intelligence in nursing.
Methods
A total of 434 publications from 2001 to 2025 were analyzed, with a notable peak in interest observed in 2024.
Discussion
The findings demonstrate the growing adoption of artificial intelligence in nursing, with expectations for continued expansion in the literature. Most studies have concentrated on education and workforce transformation, while research on patient outcomes and care quality remains limited.
Conclusion
Future research should focus on clinical and outcome-based studies. To ensure the safe and effective integration of artificial intelligence, leaders in education, practice, and policy must support curriculum development, establish ethical guidelines, invest in infrastructure, and promote international collaboration.
{"title":"The evolution of publications on applications of artificial intelligence to nursing care: A bibliometric and visual mapping approach","authors":"Abdulsamed Kaya , Güzel Nur Yildiz","doi":"10.1016/j.outlook.2025.102609","DOIUrl":"10.1016/j.outlook.2025.102609","url":null,"abstract":"<div><h3>Background</h3><div>The use of artificial intelligence in nursing care is advancing rapidly and could improve areas such as nursing management, care quality, safety management and team communication.</div></div><div><h3>Purpose</h3><div>This study conducted a bibliometric analysis to explore the characteristics, priorities, and trends in the use of artificial intelligence in nursing.</div></div><div><h3>Methods</h3><div>A total of 434 publications from 2001 to 2025 were analyzed, with a notable peak in interest observed in 2024.</div></div><div><h3>Discussion</h3><div>The findings demonstrate the growing adoption of artificial intelligence in nursing, with expectations for continued expansion in the literature. Most studies have concentrated on education and workforce transformation, while research on patient outcomes and care quality remains limited.</div></div><div><h3>Conclusion</h3><div>Future research should focus on clinical and outcome-based studies. To ensure the safe and effective integration of artificial intelligence, leaders in education, practice, and policy must support curriculum development, establish ethical guidelines, invest in infrastructure, and promote international collaboration.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 1","pages":"Article 102609"},"PeriodicalIF":3.7,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-22DOI: 10.1016/j.outlook.2025.102606
Rose Milano DNP, APRN, ACNP-BC, Bridget O'Brien DNP,APRN, FNP, AOCNP, Jennifer B. Rousseau DNP, WHNP-BC, CNE,FAWHONN, Lynn Mohr PhD, APRN-BC, CPN, FCNS, FAAN, Urmeka T Jefferson PhD, RN, FAWHONN, Sarah H. Ailey PhD, RN, FAAN, CDDN, PHNA-BC, CNE, Frank D. Hicks PhD, RN, CNE, ANEF
Background
The faculty demographic in schools of nursing is changing with the inclusion of more Doctor of Nursing Practice [DNP] -prepared faculty than ever before. This may create a dissonance between the preparation of the DNP faculty and the school’s requirement for rank and promotion. Such was the case at our College of Nursing after creating a new strategic plan, where one pillar of this plan was to become a national leader in practice-based scholarship.
Purpose
In examining our rank and promotion criteria, it was evident that there was poor alignment between this strategic goal and the process by which we recognize excellence in our faculty.
Methods
This article describes the process we used to undertake a complete revision of our rank and promotion criteria, including descriptions of the outcomes and an evaluation of the process.
Discussion
This activity resulted in a more transparent and equitable process for our faculty.
Conclusion
These criteria could be used by other schools who are interested in promoting practice-based scholarship.
{"title":"Transforming rank criteria for contemporary nursing academia: The journey to recognizing practice-based scholarship","authors":"Rose Milano DNP, APRN, ACNP-BC, Bridget O'Brien DNP,APRN, FNP, AOCNP, Jennifer B. Rousseau DNP, WHNP-BC, CNE,FAWHONN, Lynn Mohr PhD, APRN-BC, CPN, FCNS, FAAN, Urmeka T Jefferson PhD, RN, FAWHONN, Sarah H. Ailey PhD, RN, FAAN, CDDN, PHNA-BC, CNE, Frank D. Hicks PhD, RN, CNE, ANEF","doi":"10.1016/j.outlook.2025.102606","DOIUrl":"10.1016/j.outlook.2025.102606","url":null,"abstract":"<div><h3>Background</h3><div>The faculty demographic in schools of nursing is changing with the inclusion of more Doctor of Nursing Practice [DNP] -prepared faculty than ever before. This may create a dissonance between the preparation of the DNP faculty and the school’s requirement for rank and promotion. Such was the case at our College of Nursing after creating a new strategic plan, where one pillar of this plan was to become a national leader in practice-based scholarship.</div></div><div><h3>Purpose</h3><div>In examining our rank and promotion criteria, it was evident that there was poor alignment between this strategic goal and the process by which we recognize excellence in our faculty.</div></div><div><h3>Methods</h3><div>This article describes the process we used to undertake a complete revision of our rank and promotion criteria, including descriptions of the outcomes and an evaluation of the process.</div></div><div><h3>Discussion</h3><div>This activity resulted in a more transparent and equitable process for our faculty.</div></div><div><h3>Conclusion</h3><div>These criteria could be used by other schools who are interested in promoting practice-based scholarship.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 1","pages":"Article 102606"},"PeriodicalIF":3.7,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","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.outlook.2025.102610
Evans F. Kyei PhD, MSN, RN , Grace K. Kyei BSN, RN , Charles Boakye Kwanin MSc, MIA, BSN, RN , Rockson Ansong PhD, MSc, RN
Background
The Older Americans Act (OAA) is the principal federal framework for community-based aging services, yet its alignment with nursing practice and health equity goals remains underexamined.
Purpose
To evaluate the OAA using the Conceptual Model for Nursing and Health Policy (CMNHP) across policy sources, components, and four outcome levels.
Methods
A conceptually guided policy evaluation synthesized peer-reviewed literature (2018–2025), federal reports, and practice evidence, applying thematic analysis across efficacy, effectiveness, equity, and justice domains.
Discussion
The OAA supports nursing functions such as care coordination and aging in place but lacks formalized nursing roles, workforce development investment, and equitable access for rural and minority populations. It demonstrates system-level effectiveness in reducing institutionalization but limited justice-level impact on structural determinants of health.
Conclusion
Policy refinement is needed through nursing integration, workforce investment, and equity-focused funding. The CMNHP provides a valuable framework for nursing-informed policy evaluation and reform.
{"title":"Advancing aging: A policy evaluation of the Older Americans Act using the Conceptual Model for Nursing and Health Policy","authors":"Evans F. Kyei PhD, MSN, RN , Grace K. Kyei BSN, RN , Charles Boakye Kwanin MSc, MIA, BSN, RN , Rockson Ansong PhD, MSc, RN","doi":"10.1016/j.outlook.2025.102610","DOIUrl":"10.1016/j.outlook.2025.102610","url":null,"abstract":"<div><h3>Background</h3><div>The Older Americans Act (OAA) is the principal federal framework for community-based aging services, yet its alignment with nursing practice and health equity goals remains underexamined.</div></div><div><h3>Purpose</h3><div>To evaluate the OAA using the Conceptual Model for Nursing and Health Policy (CMNHP) across policy sources, components, and four outcome levels.</div></div><div><h3>Methods</h3><div>A conceptually guided policy evaluation synthesized peer-reviewed literature (2018–2025), federal reports, and practice evidence, applying thematic analysis across efficacy, effectiveness, equity, and justice domains.</div></div><div><h3>Discussion</h3><div>The OAA supports nursing functions such as care coordination and aging in place but lacks formalized nursing roles, workforce development investment, and equitable access for rural and minority populations. It demonstrates system-level effectiveness in reducing institutionalization but limited justice-level impact on structural determinants of health.</div></div><div><h3>Conclusion</h3><div>Policy refinement is needed through nursing integration, workforce investment, and equity-focused funding. The CMNHP provides a valuable framework for nursing-informed policy evaluation and reform.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 1","pages":"Article 102610"},"PeriodicalIF":3.7,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Research on adverse social behavior among healthcare employees has rarely contrasted the predictive power of conflict with colleagues and workplace violence from patients and their family on individual and organizational outcomes.
Purpose
To explore the potential unique impact of conflict and workplace violence and their interactive effect on emotional exhaustion and turnover intentions, controlling for job demand and control, sociodemographic, and occupational variables.
Methods
Hierarchical multiple regression analyses were used on a sample of N = 802 employees from Italy, mostly nurses.
Discussion
Both conflict and workplace violence were significant predictors of emotional exhaustion and turnover intentions. Conflict had a stronger association with emotional exhaustion; for turnover intention, workplace violence was more strongly related to turnover intentions when conflict and tension were high.
Conclusion
These findings underscore the importance of addressing not only external aggression but also internal relational dynamics in healthcare environments to protect employee well-being and reduce the risk of turnover.
{"title":"Conflicts and relationship tension with colleagues vs. violence from patients and their family members: Unique predictive impact and interactive relationship on emotional exhaustion and turnover intention","authors":"Francesca Barbon MSc , Cristian Balducci PhD , Sara Zaniboni PhD","doi":"10.1016/j.outlook.2025.102600","DOIUrl":"10.1016/j.outlook.2025.102600","url":null,"abstract":"<div><h3>Background</h3><div>Research on adverse social behavior among healthcare employees has rarely contrasted the predictive power of conflict with colleagues and workplace violence from patients and their family on individual and organizational outcomes.</div></div><div><h3>Purpose</h3><div>To explore the potential unique impact of conflict and workplace violence and their interactive effect on emotional exhaustion and turnover intentions, controlling for job demand and control, sociodemographic, and occupational variables.</div></div><div><h3>Methods</h3><div>Hierarchical multiple regression analyses were used on a sample of <em>N</em> = 802 employees from Italy, mostly nurses.</div></div><div><h3>Discussion</h3><div>Both conflict and workplace violence were significant predictors of emotional exhaustion and turnover intentions. Conflict had a stronger association with emotional exhaustion; for turnover intention, workplace violence was more strongly related to turnover intentions when conflict and tension were high.</div></div><div><h3>Conclusion</h3><div>These findings underscore the importance of addressing not only external aggression but also internal relational dynamics in healthcare environments to protect employee well-being and reduce the risk of turnover.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 1","pages":"Article 102600"},"PeriodicalIF":3.7,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1016/j.outlook.2025.102599
Michael Paul Cary Jr PhD, RN, Kay S. Lytle DNP, RN, Ian D. Wolfe PhD, RN
{"title":"Driving the future of nurse-led artificial intelligence: A roadmap for leadership, governance, partnerships, equity, and workforce transformation","authors":"Michael Paul Cary Jr PhD, RN, Kay S. Lytle DNP, RN, Ian D. Wolfe PhD, RN","doi":"10.1016/j.outlook.2025.102599","DOIUrl":"10.1016/j.outlook.2025.102599","url":null,"abstract":"","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 1","pages":"Article 102599"},"PeriodicalIF":3.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1016/j.outlook.2025.102604
Pablo Martínez-Angulo PhD , Isabel Gil PhD
Background
Unsheltered homelessness in Portugal has grown, yet nurse-led street outreach remains under-studied.
Purpose
To analyze how homeless men construct health and dependency, interrogate their institutional encounters, and generate nurse-led street outreach recommendations aligned with The Future of Nursing 2020–2030 and the National Plan for Health Equity.
Methods
A critical discourse study, comprising five semi-structured interviews with men who experienced homelessness in Coimbra, was conducted in July 2024 and analyzed incorporating Tronto’s ethic of care and Rogers’ bioethics of vulnerability.
Discussion
Four interlocking discourse terrains emerged: (a) corporeal safety—health begins with protected space; (b) procedural violence—bureaucratic hurdles re-inscribe exclusion; (c) relational discipline—earned trust and disclosure; and (d) micropolitics of respect—eye contact, conversational stance, and permissions signaled equality, unlocking unmet needs.
Conclusion
Tailoring street-outreach policy, expanding nurse prescribing, and crediting trust labor can transform outreach from charity to a strategic lever for advancing coverage and equity.
{"title":"“We live in a stone cage where everyone wants to be a lion”: A critical discourse-ethical study for homelessness nurse-led street outreach in Portugal","authors":"Pablo Martínez-Angulo PhD , Isabel Gil PhD","doi":"10.1016/j.outlook.2025.102604","DOIUrl":"10.1016/j.outlook.2025.102604","url":null,"abstract":"<div><h3>Background</h3><div>Unsheltered homelessness in Portugal has grown, yet nurse-led street outreach remains under-studied.</div></div><div><h3>Purpose</h3><div>To analyze how homeless men construct health and dependency, interrogate their institutional encounters, and generate nurse-led street outreach recommendations aligned with <em>The Future of Nursing 2020–2030</em> and the National Plan for Health Equity.</div></div><div><h3>Methods</h3><div>A critical discourse study, comprising five semi-structured interviews with men who experienced homelessness in Coimbra, was conducted in July 2024 and analyzed incorporating Tronto’s ethic of care and Rogers’ bioethics of vulnerability.</div></div><div><h3>Discussion</h3><div>Four interlocking discourse terrains emerged: (a) <em>corporeal safety</em>—health begins with protected space; (b) <em>procedural violence</em>—bureaucratic hurdles re-inscribe exclusion; (c) <em>relational discipline</em>—earned trust and disclosure; and (d) <em>micropolitics of respect</em>—eye contact, conversational stance, and permissions signaled equality, unlocking unmet needs.</div></div><div><h3>Conclusion</h3><div>Tailoring street-outreach policy, expanding nurse prescribing, and crediting trust labor can transform outreach from charity to a strategic lever for advancing coverage and equity.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 1","pages":"Article 102604"},"PeriodicalIF":3.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1016/j.outlook.2025.102607
Kathleen Hall PhD, APRN, GNP-BC, AGPCNP-BC, Mary Jo Stanley PhD, RN, CNE
Background
Theoretical and pragmatic approaches are needed to support practice and teaching in nursing education. While prior research elucidates complex adaptive system models and theories directing nursing practice, less is understood about nursing education with respect to complex adaptive systems. Addressing this gap might help nurse educators prepare students for the complexities of modern nursing practice
Purpose
The purpose of this manuscript is to describe the Nursing Education for Complex Adaptive Systems (NEXAS) model.
Methods
NEXAS was born out of inductive research through a scoping review of the Nursing Education Model. Results were organized according to original model concepts of learner, instructor, and shared outcomes.
Discussion
Findings from the scoping review revealed the need to include an additional concept: complex adaptive systems. Complex adaptive systems include entropy and butterfly effects, both of which contribute to, or detract from, learners, instructors, and their shared outcomes within healthcare or academic environments.
Conclusion
By incorporating complex adaptive systems thinking, the NEXAS framework equips nurse educators to prepare students for any modern practice setting.
{"title":"Nursing education for complex adaptive systems: Redesigning education and practice","authors":"Kathleen Hall PhD, APRN, GNP-BC, AGPCNP-BC, Mary Jo Stanley PhD, RN, CNE","doi":"10.1016/j.outlook.2025.102607","DOIUrl":"10.1016/j.outlook.2025.102607","url":null,"abstract":"<div><h3>Background</h3><div>Theoretical and pragmatic approaches are needed to support practice and teaching in nursing education. While prior research elucidates complex adaptive system models and theories directing nursing practice, less is understood about nursing education with respect to complex adaptive systems. Addressing this gap might help nurse educators prepare students for the complexities of modern nursing practice</div></div><div><h3>Purpose</h3><div>The purpose of this manuscript is to describe the Nursing Education for Complex Adaptive Systems (NEXAS) model.</div></div><div><h3>Methods</h3><div>NEXAS was born out of inductive research through a scoping review of the Nursing Education Model. Results were organized according to original model concepts of learner, instructor, and shared outcomes.</div></div><div><h3>Discussion</h3><div>Findings from the scoping review revealed the need to include an additional concept: complex adaptive systems. Complex adaptive systems include entropy and butterfly effects, both of which contribute to, or detract from, learners, instructors, and their shared outcomes within healthcare or academic environments.</div></div><div><h3>Conclusion</h3><div>By incorporating complex adaptive systems thinking, the NEXAS framework equips nurse educators to prepare students for any modern practice setting.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 1","pages":"Article 102607"},"PeriodicalIF":3.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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