Contemporary nurse最新文献

Background: Transitioning into intensive care nursing is complex and emotionally demanding for early career nurses. High attrition and psychological stress underscore the need for education that supports resilience and wellbeing alongside clinical competency.

Aim: This paper describes the integration of self-care and wellbeing strategies into a redesigned statewide postgraduate Intensive Care Nursing Transition to Specialty Practice (ICN-TTSP) program in New South Wales, Australia.

Methods: Curriculum mapping aligned the existing ICN-TTSP program with national nursing standards, identify gaps in self-care, resilience, and professional identity. A narrative literature review informed pedagogical strategies, including reflective journaling, role modelling, virtual simulation, and work-integrated learning.

Results: The reimagined ICN-TTSP program embeds self-care and resilience through multimodal educational strategies, including ePortfolio's, video vignettes, and patient/family experience stories. These strategies normalise self-care as professional wellbeing behaviour. Preliminary evaluation shows strong engagement and improved emotional awareness amongst learners.

Conclusion: Embedding wellbeing into postgraduate nursing education is essential for workforce sustainablilty. Further evaluation will assess long-term impact..

Background: Artificial Intelligence (AI) has the potential to revolutionize healthcare by enhancing diagnostic accuracy, streamlining administrative tasks, and improving patient care. However, the integration of AI into clinical practice faces significant barriers, particularly in nursing. Nurses, like frontline healthcare providers, are uniquely positioned to observe and experience these challenges. Understanding their perspectives can offer valuable insights into the obstacles hindering AI adoption in nursing practice, especially within acute care settings.

Aims: This study aimed to explore the perceptions of nurses regarding the barriers to integrating AI technologies into clinical practice.

Design: A qualitative design.

Methods: A qualitative phenomenological approach was employed to capture nurses lived experiences. Twenty nurses were recruited through purposive sampling from 20 healthcare institutions (eight tertiary care hospitals, eleven general hospitals, and one district hospital) in Dhaka, Bangladesh. Data were collected over a three-month period (April to June 2025) using semi-structured interviews and focus group discussions. Transcripts were analyzed using van Manen's reflective methodology. The conceptual framework incorporated the Technology Acceptance Model, emphasizing perceived usefulness and ease of use, while also considering the cultural and infrastructural context.

Results: The study identified three major themes: (i) knowledge and awareness gaps, (ii) organizational barriers, and (iii) ethical and interpersonal concerns. Nurses highlighted a lack of AI-focused education, inadequate institutional support, and concerns about privacy and dehumanization of care. Misconceptions about AI's capabilities and exclusion from AI-related decision-making processes further contributed to resistance and skepticism.

Conclusions: The study underscores the need for targeted reforms in nursing education to include comprehensive AI training. Addressing organizational and ethical barriers, such as providing adequate resources, robust privacy measures, and inclusive policies, is crucial. By empowering nurses and fostering interdisciplinary collaboration, healthcare systems can leverage AI effectively while preserving human-centered care.

Background: As populations age, rising dementia prevalence increases workload in medical long-term care (MLTC) facilities and nursing homes (NHs).

Objectives: This study compared perceived person-centred care (PCC) and dementia-related burden (DRB) among care teams in both settings, considering occupation, age, sex, and professional experience.

Methods: A cross-sectional design included 689 participants (81.3% women; 33.5% registered nurses, 43.4% caregivers) from MLTC (n = 531) and NHs (n = 158). Data were collected using the Person-centred Care Assessment Tool and the Professional Care Team Burden scale. Propensity score matching and generalised linear models were used to reduce bias and analyse group differences.

Results: MLTC staff reported more environmental challenges, while NH staff perceived more favourable outcomes but greater stress in managing dementia behaviours. Registered nurses tended to be more critical of PCC than caregivers.

Conclusion: Findings highlight how institutional context, professional role, and demographics shape PCC and DRB perceptions. Tailored support and targeted interventions are essential to enhance dementia care quality and staff well-being.

Background: Patient education is crucial for understanding medical conditions, treatment options, and self-management techniques. Digital technology has revolutionised patient education, providing efficient and cost-effective alternatives to traditional methods. However, challenges persist in customising educational materials to specific clinical settings.

Objectives: We investigated the relationship between healthcare terminology standards and the Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) dictionary. Our aim was to provide practical mapping guidance and case examples to help users better understand how to map patient education materials (PEM) to SNOMED CT to generate consistent results across different institutions.

Methods: We mapped the titles of PEM in a single hospital setting using SNOMED CT terms. We focused on materials made between October 1, 2018, and November 30, 2022, and found 1,271 matchable PEM titles. Keywords were identified and sorted into categories like Target, Time, Condition, and Procedure. Two researchers worked independently to match these keywords with SNOMED CT, and any differences were resolved through discussion or third-party review.

Results: Out of 1,271 PEM titles that were assigned to categories, only 3.9% remained unmapped. Most of the mapped titles were related to Procedure (93.3%), Condition (56.8%), Time (17.5%), and Target (12%); 2,688 keywords were mapped, with 62.4% single-mapped and 36.9% were multi-mapped. Among the keywords mapped to various categories, Procedures accounted for the highest proportion (49.4%).

Conclusions: Examining the keywords mapped to each SNOMED CT concept in different categories provided valuable insights into how terms are distributed and improved our understanding of the specific terms used in PEM. When educational materials are mapped to standard clinical terminologies and integrated into the Electronic Health Record (EHR), patients receive personalised and relevant health information, potentially improving engagement and health outcomes. This approach may reduce the workload of healthcare personnel, reduce miscommunication, and improve overall healthcare efficiency.

Background: Delirium is a complex cognitive syndrome commonly observed in hospital settings. While non-pharmacological approaches are recommended for its management, delirium-related behaviours can present significant challenges to nursing care. Digital technologies are being increasingly used to predict risk of delirium, however there is limited evidence regarding the use of digital technologies to support delirium management. Understanding the impact of digital technologies on nursing workflow and patient outcomes can help to inform and support the effective implementation of these tools in delirium management.

Aim: To examine the use of digital technologies in supporting nurses to care for adult patients with delirium in acute hospital settings.

Methods: A scoping review following the Joanna Briggs Institute (JBI) methodology for scoping reviews undertaken. Tailored search strategies were applied across MEDLINE, CINAHL, APA PsycINFO, and Embase.

Results: Fifteen studies were included, examining technologies such as clinical decision systems, mobile apps, family simulations, music interventions, web-based platforms, and EMR-integrated tools. Reported benefits included reductions in delirium incidence and duration, decreased anxiety and agitation, and shorter hospital stays. Technologies improved nurses' adherence to guidelines, offered real-time decision support, and reduced cognitive burden. Interventions featuring personalisation through tailored care plans or familiar sensory stimuli were effective in enhancing patient engagement and outcomes.

Conclusions: This review highlights the potential role of digital technologies in optimising delirium management within hospital settings. Findings emphasise the potential for improving patient care and guiding future research and integration strategies in clinical practice.

Discussion: While the link between Cultural Safety and patient outcomes is clear, consistent application in practice is lacking. Cultural Safety is equally vital as clinical safety in ensuring quality care, particularly for Indigenous Australians affected by culturally unsafe practices.

Recommendations: In healthcare delivery Indigenous Australians health and the 'Closing the Gap' agenda is everybody's business, it is not the responsibility of the patient, their family or their Community. The authors propose a reconceptualisation of the way health and wellbeing is perceived by health professionals, in which providing culturally safe care is symbiotic with providing clinically safe care. As an integrated foundation for quality and safety in health care, this strategy brings together the social determinants of culturally safe care with competent, evidence-based, equitable and non-bias care for all, and could help advance the Closing the Gap agenda.

Background: Chronic conditions negatively impact health and well-being; however, lifestyle risk reduction can slow their progression. Monitoring behaviours, tracking health statistics and receiving health education via mobile Health (mHealth) apps can empower patients with chronic conditions to adopt and maintain healthy lifestyles. Given nurses' roles in managing chronic conditions, they are ideally positioned to integrate mHealth apps into patient care. However, there is currently a gap in our understanding of nurses' experiences using this technology in their practice.

Aim: This paper explores nurses' experiences using mHealth apps to support patients with, or at risk of, chronic conditions.

Design: This qualitative descriptive study was undertaken within a concurrent mixed methods project.

Method: Data were collected through semi-structured video interviews with 13 nurses. Interviews were analysed using reflexive thematic analysis. The COREQ checklist was used to guide reporting.

Results: Three themes were identified regarding nurses' experiences of using mHealth apps. The first theme focused on perceptions of mHealth app personal use. In the second theme of perceived benefits of mHealth app use in practice, the two subthemes were: a) health tracking and health literacy, and b) mHealth apps are the future. The final theme, perceived confidence in mHealth app recommendation, also included two subthemes, namely: a) perceived role in app recommendation and b) nurses' education needs.

Conclusion: Exploring nurses' experience with mHealth apps is crucial for improving the uptake of this technology in usual care. Nurses recognise the potential of mHealth apps to increase health literacy and patient independence, but often lack confidence in using them in practice. Therefore, it is essential to prepare nurses to integrate mHealth apps into their routine practice. This can be achieved by developing a clear framework for mHealth app appraisal and providing the necessary education and training to utilise this framework effectively.

Aim: To identify and synthesise the non-technical skills used by circulating nurses to maintain the safety of the surgical patient in the intra-operative setting.

Design: Scoping review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses Scoping Review Extension (PRISMA-ScR) guideline.

Methods: Data were extracted and tabulated based on aim, methods, main findings, and limitations, and non-technical skills were identified. Four electronic databases, including CINAHL, PubMed, Scopus and Medline, were searched in May 2024. Twelve studies met the eligibility criteria.

Results: A total of eight non-technical skills were identified from the twelve included studies from six countries. The circulating nurse role was well defined, as well as each NTS, but the link between the use of non-technical skills by circulating nurses and how they maintain patient safety was not clear. There was some ambiguity around which non-technical skills were most applicable to the circulating nurses' role in maintaining patient safety, with various practical examples.

Conclusion: The use of non-technical skills is essential to safeguarding intra-operative patient safety among all theatre staff, though it remains unclear which skills are most relevant to circulating nurses.

Background: Aspiration during intramuscular (IM) injection is a traditional technique intended to prevent intravascular administration. However, its routine use has been increasingly debated due to potential discomfort and lack of evidence supporting clinical benefit.

Aim: To systematically evaluate the effect of aspiration on pain intensity, procedure duration, and complications in IM injections through a meta-analysis of randomized controlled trials.

Methods: A comprehensive literature search was conducted in PubMed, Cochrane Library, Embase, Web of Science, Scopus, EBSCOhost, TR Dizin, and PsycINFO up to May 2, 2025. Eligible studies compared aspiration versus no-aspiration techniques in IM injections. Data were analyzed using RevMan 5.4.1, with standardized mean differences (SMD) and mean differences (MD) calculated using random-effects models. Subgroup analyses were performed by age group and injection site. Risk of bias was assessed using the Cochrane ROB-2 tool.

Results: Six studies involving 693 participants were included. Aspiration significantly increased pain scores (SMD = 0.83; 95% CI: 0.31-1.35; p = 0.002), particularly in pediatric populations (SMD = 1.29; 95% CI: 1.12-1.46) and in deltoid injections. It also prolonged injection time by an average of 4.53 s (MD = 4.53; 95% CI: 3.87-5.20). No serious complications were reported in association with omitting aspiration.

Conclusion: Aspiration during IM injections increases pain and procedure time without reducing complication risk. These findings support current international guidelines discouraging routine aspiration, particularly in pediatric and vaccine-related applications. Injection technique should be individualized based on patient characteristics and medication type.

Background: The rapid evolution and adoption of wearable technologies shows both promise and complexity for contemporary nursing practice.

Aim: To critically examine the integration of digital health innovation, particularly wearable and implantable cardiac monitoring devices, within acute care.

Design: Discursive paper.

Summary: While these technologies offer opportunities for continuous, real-time monitoring and early detection of arrhythmias such as atrial fibrillation (AF), translation and adoption are hindered by evidence, regulatory challenges, and limited co-design with clinicians and consumers. Nurses are well-positioned to lead the translation and adoption of these technologies into practice, yet must navigate issues of data accuracy, cybersecurity, and workflow disruption. Drawing on recent evidence and clinical guidelines, the potential of wearables to reduce stroke burden through improved AF detection is explored and emerging smart-technologies capable of generating holistic 'digital phenotypes' featured. The ethical and clinical implications of shifting routine nursing activities, such as routine vital sign monitoring, towards automated systems are reviewed in relation to the merits of recalibrating nursing care to focus on high-value care activities. This discussion highlights the need for new and agile research methodologies, cross-disciplinary partnerships, and nurse-led innovation to ensure that wearable technologies are safe, effective, and tailored to patient needs. The paper provides a call to action for a proactive nursing agenda that leads in digital transformation, whilst upholding the principles of person-centred care.