Nursing Outlook最新文献

英文中文

Reimagining nursing education: Leveraging competency-based education, artificial intelligence, and simulation for a diverse and practice-ready workforce 重塑护理教育：利用以能力为基础的教育、人工智能和模拟来培养多样化和实践就绪的劳动力

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102582

Robert Atkins PhD, RN, FAAN , Kristen M. Brown DNP, CPNP-AC, FAAN , Shawna S. Mudd DNP, MBA, CPNP-AC, FAAN , Kimia Ghobadi PhD , Deborah J. Baker DNP, RN, FAAN , Sarah Szanton PhD, RN, FAAN

Background

Nurses represent the largest share of the U.S. health-care workforce and are central to improving population health. Transforming nursing education into a responsive, adaptive, competency-based system is essential to prepare a diverse, practice-ready workforce.

Purpose

This concept paper presents a vision for integrating artificial intelligence (AI), competency-based education (CBE), and simulation to personalize learning, enhance skill acquisition, and foster cultural respect in nursing education.

Methods

We propose shifting from rigid, time-bound curricula to flexible, competency-driven pathways that allow learners to progress at their own pace. Hypothetical student and faculty scenarios illustrate how these innovations can accommodate diverse life circumstances and learning styles.

Discussion

This approach expands access for underrepresented groups—including adult learners and those with caregiving responsibilities—while cultivating a workforce equipped to deliver community-oriented care and address social determinants of health such as housing, education, and nutrition.

Conclusions

By embracing AI, CBE, and simulation, nursing education can be reimagined to build a diverse, inclusive, and practice-ready workforce positioned to advance health equity and improve population health outcomes across the United States.

护士在美国医疗保健队伍中占最大份额，是改善人口健康的核心。将护理教育转变为一个反应迅速、适应性强、以能力为基础的体系，对于培养一支多样化、实践就绪的劳动力队伍至关重要。目的本概念论文提出了整合人工智能（AI）、能力本位教育（CBE）和模拟的愿景，以实现个性化学习，增强技能习得，并培养护理教育中的文化尊重。方法我们建议从僵化的、有时间限制的课程转向灵活的、能力驱动的途径，让学习者按照自己的节奏进步。假设的学生和教师场景说明了这些创新如何适应不同的生活环境和学习方式。这种方法扩大了代表性不足的群体（包括成人学习者和承担照顾责任的群体）获得服务的机会，同时培养了一支有能力提供面向社区的护理和解决住房、教育和营养等健康问题社会决定因素的劳动力队伍。通过采用人工智能、CBE和模拟，护理教育可以重新构想，以建立一支多样化、包容性和实践就绪的劳动力队伍，以促进健康公平，改善美国各地的人口健康状况。

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引用次数: 0

Variations in job turnover factors among internationally educated and U.S.-trained nurses: Insights from the 2018 and 2022 National Sample Survey of Registered Nurses 国际教育和美国培训护士的工作流动因素差异：来自2018年和2022年全国注册护士抽样调查的见解。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102574

Junhua Zhang PhD, RN , Brianna Lin BScN, RN , Yilei Yang BS, MS , Hyun Jin Jung PharmD, MS , Simon Paul P. Navarro MA, BSN, RN , Allison A. Norful PhD, RN, FAAN

Background

International migration of nurses is a common strategy to address workforce shortages in the United States.

Purpose

To compare workforce retention factors between U.S.-trained nurses and internationally educated nurses (IENs) working in the United States.

Methods

A secondary analysis of the 2018 and 2022 National Sample Survey of Registered Nurses (NSSRN) was conducted. Weighted descriptive statistics, linear regression, and stepwise analyses (unadjusted and adjusted) were applied.

Discussion

U.S.-trained and IENs differed significantly in demographics, professional characteristics, and predictors of turnover. Burnout consistently emerged as a significant driver of turnover for both groups. IENs more often cited factors related to professional autonomy, patient population, and personal caregiving responsibilities, whereas U.S.-trained nurses more frequently identified inadequate staffing, poor management, and stressful work environments.

Conclusion

Retention strategies should address distinct organizational and personal factors influencing turnover in different nurse subgroups to strengthen workforce stability.

背景：护士国际移民是解决美国劳动力短缺的一种常见策略。目的：比较在美国培训的护士和在美国工作的国际教育护士（IENs）的劳动力保留因素。方法：对2018年和2022年全国注册护士抽样调查（NSSRN）进行二次分析。采用加权描述性统计、线性回归和逐步分析（未调整和调整）。讨论：在人口统计学、专业特征和人员流动率预测指标上，美国培养的和外国培养的存在显著差异。在这两个群体中，职业倦怠一直是导致员工离职的重要因素。外国护士更多地提到与专业自主权、患者人数和个人护理责任有关的因素，而美国培训的护士更多地认为人员配备不足、管理不善和工作环境压力大。结论：保留策略应针对影响不同护理亚群人员流失的组织和个人因素，以增强员工队伍的稳定性。

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引用次数: 0

When active shooter drills become the threat: Organizational trauma and nursing implications 当主动射击演习成为威胁：组织创伤和护理的影响

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102579

Victor G. Petreca PhD, DNP , Joanne T. Barros PhD , Ann W. Burgess DNSc

Background

Healthcare organizations increasingly implement active shooter drills for emergency preparedness, yet research rarely examines how poorly coordinated drills may cause workplace trauma.

Purpose

This study examined healthcare staff experiences following an inappropriately conducted active shooter drill at a healthcare facility providing inpatient behavioral health care for children and adolescents.

Methods

A qualitative descriptive design analyzed deidentified statements from 88 healthcare workers collected 8 months post incident. Inductive thematic analysis identified patterns across experiences.

Discussion

Five themes emerged: organizational chaos and communication breakdown, immediate physical and emotional responses, pressure to resume normal duties, development of trauma symptoms, and long-term professional disruption. Many participants reported clinically significant symptoms, career instability, and loss of institutional trust.

Conclusion

Poorly coordinated preparedness drills without trauma-informed planning can cause lasting harm to staff well-being, patient care, and organizational trust. Healthcare systems must integrate trauma-informed principles into emergency preparedness to protect psychological safety.

医疗机构越来越多地实施主动射击演习作为应急准备，然而研究很少检查协调不良的演习如何导致工作场所创伤。目的：本研究调查了在一家为儿童和青少年提供住院行为卫生保健的医疗机构进行不适当的主动射击演习后，医疗人员的经历。方法采用定性描述设计对事件发生8个月后收集的88名医护人员的不确定陈述进行分析。归纳性专题分析确定了不同经历的模式。讨论出现了五个主题：组织混乱和沟通中断，即时的身体和情绪反应，恢复正常工作的压力，创伤症状的发展以及长期的专业中断。许多参与者报告了临床上明显的症状、职业不稳定和机构信任的丧失。结论缺乏创伤知情计划的应急演练协调性差，会对医护人员幸福感、患者护理和组织信任造成持久伤害。医疗保健系统必须将创伤知情原则纳入应急准备，以保护心理安全。

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引用次数: 0

Fostering equitable research partnerships with transgender, nonbinary, and gender-expansive communities: Lessons learned and challenges navigated 促进与跨性别、非二元性和性别扩张群体的公平研究伙伴关系：经验教训和应对挑战。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102576

Roque Anthony F. Velasco MS, APRN, AGPCNP-BC , Kimberly June Skeete , Anne Blakeley MS , Mita Beach LBBP , Ethan C. Cicero PhD, RN, FAAN , Christina J. Sun PhD, MS

Transgender, nonbinary, and gender expansive (TNGE) communities continue to call for research partnerships that center their voices and lived experiences. However, extant literature provides limited accounts of strategies researchers could employ when engaging TNGE people. Using a case study and informed by the Community-Based Collaborative Action Research (CBCAR) framework, we describe lessons learned and challenges we overcame when forming, operating, and maintaining of a community collaborative group (CCG). Lessons learned highlight the importance of building relationships grounded in trust, shared decision-making, and equalized power dynamics to foster inclusive and active engagement in all phases of research. Challenges include navigating logistical barriers. Findings demonstrate that the CBCARframework supports culturally informed and community-engaged research with TNGE communities. Establishing a CCG enhances mutual learning, promotes equitable relationships, and strengthens research relevance, trust, and impact through community-centered engagement.

跨性别、非二元性和性别膨胀（TNGE）群体继续呼吁建立以他们的声音和生活经历为中心的研究伙伴关系。然而，现有的文献提供了有限的策略，研究人员可以使用时聘请TNGE人。通过案例研究和基于社区的协作行动研究（CBCAR）框架，我们描述了我们在形成、运营和维护社区协作小组（CCG）时所获得的经验教训和克服的挑战。吸取的经验教训强调了建立基于信任、共同决策和平等权力动态的关系的重要性，以促进在研究的各个阶段的包容和积极参与。挑战包括克服后勤障碍。研究结果表明，cbcar框架支持TNGE社区的文化知情和社区参与研究。建立CCG可以加强相互学习，促进公平关系，并通过以社区为中心的参与加强研究的相关性、信任和影响。

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引用次数: 0

Attending to transgender health dilemmas: Practical and strategic nursing actions toward gender justice for health 关注跨性别健康困境：实现健康性别正义的实用和战略护理行动。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102593

Jerome Visperas Cleofas PhD, RN , Luis Emmanuel A. Abesamis MHSS

Transgender and gender-diverse (TGD) individuals face significant barriers to gender-affirming health care, leading to disproportionate poor health outcomes. These challenges are rooted in intersecting ideological structures of domination, manifesting as “transgender health dilemmas”: the forced choice between trans-specific health needs and other necessities, and subsequent disengagement from formal health care due to discriminatory and unaffordable systems. This discussion paper introduces and leverages these dilemmas through Moser's practical and strategic gender needs framework to articulate comprehensive nursing actions, advancing practical interventions for immediate support and strategic actions for systemic change in policy, education, and practice. This framework offers a practical framework for nurses to uphold dignity, alleviate suffering, and foster health justice, underscoring nursing's crucial role in achieving equitable health outcomes for TGD populations worldwide.

跨性别者和性别多样化者在性别确认保健方面面临重大障碍，导致不成比例的不良健康结果。这些挑战根植于相互交织的统治意识形态结构，表现为“跨性别卫生困境”：被迫在跨性别卫生需求和其他必需品之间做出选择，随后由于歧视性和负担不起的系统而脱离正规卫生保健。本讨论文件通过Moser的实践和战略性别需求框架介绍并利用这些困境，阐明综合护理行动，推进实际干预措施，为政策、教育和实践的系统性变革提供即时支持和战略行动。该框架为护士维护尊严、减轻痛苦和促进卫生正义提供了一个实用框架，强调了护理在为全世界TGD人群实现公平卫生结果方面的关键作用。

引用次数: 0

Nursing Science at the Frontier of Artificial Intelligence 人工智能前沿的护理科学

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102622

Marie Ann Marino EdD, RN, FAAN

引用次数: 0

In Memory of Marion E. Broome, PhD, RN, FAAN 纪念Marion E. Broome, PhD， RN， FAAN

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102595

Julia A. Snethen PhD, RN, FAAN, Annette Flanagin RN, MA, FAAN

引用次数: 0

A Global Gerontechnology Center for Nursing Science for improving aging-in-place technologies 全球老年护理科学技术中心，致力于改善就地老龄化技术

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102590

Roschelle L. Fritz PhD, RN, FAAN , Gordana Dermody PhD, RN, CNL , Harue Masaki PhD, RN, PHN , Chieko Greiner PhD, RN, PHN , Confidence Alorse Atakro PhD, RN , Masi Mohammadi PhD , Catherine Van Son PhD, RN, FAAN

Most older adults want to remain in their homes and independent for as long as possible. The field of gerontechnology emerged to advance aging-in-place possibilities in response to a globally increasing population of persons aged 65 and over. Yet, significant challenges to technology adoption remain. Gerontology nurse scientists and practitioners are well-positioned to address these challenges. However, they remain underrepresented in the field. No formal organization exists where international nurses leading technological innovations can collaborate and share knowledge – keeping up with the pace of innovation. We introduce the new Global Gerontechnology Center for Nursing Science, and share the mission, vision, values, and action plan. We invite nurse scientists and practitioners leading innovative gerontechnology research, and their interdisciplinary partners, to collaborate to advance possibilities for optimal aging in a digital world globally.

大多数老年人都希望尽可能长时间地呆在家里，独立生活。老年技术领域的出现是为了应对全球65岁及以上人口不断增加的情况，从而提高就地老龄化的可能性。然而，技术采用仍然面临重大挑战。老年学护士科学家和从业人员有能力应对这些挑战。然而，她们在实地的代表人数仍然不足。目前还没有一个正式的组织可以让引领技术创新的国际护士进行合作和分享知识，从而跟上创新的步伐。我们介绍了新的全球老年科技护理科学中心，并分享了使命、愿景、价值观和行动计划。我们邀请领导创新性老年技术研究的护理科学家和从业人员，以及他们的跨学科合作伙伴，共同努力，在全球数字世界中推进最佳老龄化的可能性。

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引用次数: 0

Improving engagement for enhancing social capital in the older adult: An American Academy of Nursing consensus paper 提高老年人社会资本的参与度：美国护理学会共识论文。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102555

Marian Newton PhD, RN, PMHNP-BC, ANEF, FAAN , Susan V. Brammer PhD, RN, CNE, FAAN , Yu-Ping Chang PhD, RN, FGSA, FAAN, FIAAN , Debra Hain PhD, APRN, AGPCNP-BC, PMHNP-BC, FAAN, FAANP , Warren Herbert DNP, RN, CAE, FAAN , Karan Kverno PhD, PMHNP-BC, PMHCNS-BC, FAANP, FAAN , Mercy Mumba PhD, RN, FAAN , JoEllen Schimmels PhD, DNP, PMHNP-BC, CNE, FAAN

Background

Loneliness in older adults is a growing public health concern linked to poorer physical and mental health. Social capital, defined as connections, relationships, and community resources, can shield these effects and improve community resilience.

Purpose

This paper presents the American Academy of Nursing’s position on addressing loneliness and highlights nurse-led strategies to strengthen social connections.

Methods

A review of current research, best practices, and policy initiatives informed expert consensus on effective interventions.

Discussion

Communities with stronger social capital experience, better health, safety, and civic engagement. Nurses can lead interventions such as community programs, peer support, and technology-assisted social engagement that are evidence-based, patient-centered, and culturally sensitive.

Conclusion

Enhancing social capital through nurse-led initiatives reduces loneliness, promotes health, and strengthens societal cohesion, demonstrating the critical role of nursing leadership in addressing this urgent public health issue.

背景：老年人的孤独感是一个日益严重的公共卫生问题，与较差的身心健康有关。社会资本，定义为联系、关系和社区资源，可以屏蔽这些影响并提高社区弹性。目的：本文介绍了美国护理学会在解决孤独问题上的立场，并强调了护士主导的加强社会联系的策略。方法：回顾当前的研究、最佳实践和政策举措，使专家对有效干预达成共识。讨论：拥有更强的社会资本经验、更好的健康、安全和公民参与的社区。护士可以领导干预措施，如社区项目、同伴支持和技术辅助的社会参与，这些干预措施以证据为基础，以患者为中心，并具有文化敏感性。结论：通过护士主导的举措增强社会资本，减少孤独感，促进健康，加强社会凝聚力，表明护理领导在解决这一紧迫的公共卫生问题方面的关键作用。

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引用次数: 0

Engaging transgender and gender-expansive adults in qualitative research studies 参与跨性别和性别膨胀成人定性研究。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-11-01 DOI: 10.1016/j.outlook.2025.102594

Lauren Catlett PhD, RN, CNL , Crystal Chu PhD, RN , Jennifer Goldman BA , Ames Simmons JD , John T. Stranix MD , Randy Jones PhD, RN, FAAN , Kimberly D. Acquaviva PhD, MSW, FNAP

With increasing barriers to conducting transgender health research in the US, recruiting transgender, nonbinary, and gender-expansive (TNGE) people for research studies has grown in complexity and criticality. The purpose of this study was to explore methods used to recruit TNGE adults in qualitative research studies and to identify participant motivations for joining these studies. Researchers used a qualitative descriptive approach to conduct a secondary analysis of qualitative data from two distinct nurse-led studies related to transgender health. Using data from interviews with 59 TNGE participants, a framework for effective recruitment activities was generated, and three themes describing participant motivations for enrolling were developed: (1) benefit to self and others, (2) advocacy for self and others, and (3) support for research and education. Analysis of recruitment methods and outcomes in these qualitative studies may aid researchers in conducting transgender health research in a challenging sociopolitical climate.

随着在美国开展跨性别健康研究的障碍越来越多，招募跨性别、非二元性和性别膨胀（TNGE）人群进行研究变得越来越复杂和重要。本研究的目的是探索在定性研究中招募TNGE成人的方法，并确定参与者加入这些研究的动机。研究人员使用定性描述方法对来自两项不同的护士主导的与跨性别健康相关的研究的定性数据进行二次分析。利用对59名TNGE参与者的访谈数据，生成了有效招募活动的框架，并制定了描述参与者入学动机的三个主题：(1)对自己和他人的利益；(2)对自己和他人的倡导；(3)对研究和教育的支持。对这些定性研究的招募方法和结果的分析可能有助于研究人员在具有挑战性的社会政治气候中开展跨性别健康研究。

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