Contemporary nurse最新文献

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.

Background: Clinical nurses' motivation to participate in continuing education is critical to improving professional competence and the quality of care delivery, but this motivation remains variable, especially in resource-limited settings. Understanding the underlying characteristics of motivation and the factors that influence it is essential for nurse managers to develop targeted interventions.

Objectives: This study aimed to identify distinct motivational profiles among clinical nurses in a third-tier city in western China and explore factors associated with these profiles, with a focus on self-efficacy and demographic variables.

Design: A cross-sectional survey was conducted from January to April 2025.

Methods: Participants included 400 clinical nurses from a tertiary hospital in a third-tier city in western China, a resource-limited setting with fewer continuing education opportunities compared to developed regions. Inclusion criteria required registered nurses with ≥1 year of clinical experience, recent continuing education participation, and voluntary consent. Exclusion criteria included nursing educators, trainees, and those on leave. Data were collected using the Education Participation Scale (EPS), General Self-Efficacy Scale (GSES), and demographic questionnaires. Latent profile analysis (LPA) was employed to categorize motivational profiles, and multivariate logistic regression analyzed associated factors.

Results: LPA identified three motivational profiles: high motivation-self-efficacy driven (25%), moderate motivation-career development oriented (49.25%), and low motivation-externally pressured (25.75%). Univariate analysis showed that self-efficacy and parental responsibilities were significantly associated with motivation category (p < 0.05). Multivariate logistic regression demonstrated that self-efficacy was a strong predictor of high motivation (OR = 0.392, 95% CI: 0.331-0.464), while other factors like age and marital status showed no significant effects.

Conclusion: Clinical nurses' motivation for continuing education exhibits significant heterogeneity, with self-efficacy being a key determinant. Stratified interventions, such as enhancing self-efficacy, optimizing career support, and addressing external barriers, are recommended to improve participation and service quality. Future research should explore longitudinal effects and additional influencing factors.

Background: While teamwork is widely recognized as essential to safe and high-quality nursing care, its evaluation has been underexplored in Central and Eastern Europe. This study offers original insights by systematically assessing nursing teamwork in Slovak public hospitals. By identifying strengths and weaknesses in team dynamics through structured evaluation, it becomes possible to implement targeted, context-specific improvements that reflect the realities of the local healthcare system.

Objectives: This study aimed to explore how registered nurses (RNs) perceive the level of teamwork in selected public hospitals in Slovakia and to identify key factors that influence these perceptions, addressing a significant gap in research within the Central and Eastern European healthcare context.

Design: The cross-sectional study.

Methods: The study included 346 RNs from four selected hospitals in the Slovak Republic. Data were collected using the Nursing Teamwork Survey (NTS) instrument between April 2022 and February 2023 and analyzed using descriptive and inferential statistics.

Results: Registered nurses perceived moderate teamwork during their last working shift. Perceived level of teamwork was significantly influenced by the unit type, the number of overtime hours in the past month, and the intention to leave the position. The results show significant associations between the perceived level of teamwork and overall job satisfaction, job satisfaction in the current position, satisfaction with teamwork, and overall patient safety level. Several variables were found to be significant predictors of teamwork among RNs (p ≤ 0.05).

Conclusions: Effective teamwork among nurses is crucial for optimal patient outcomes. The study highlights the importance of enhancing teamwork in the Slovak healthcare setting and identifies factors influencing nurses' perceptions of teamwork. Addressing these factors can lead to a more positive teamwork environment and improved work satisfaction among nursing professionals. Targeted interventions based on identified predictors could be beneficial in achieving this goal.

Background: In the emergency department (ED) a positive patient safety culture exhibits characteristics that include a shared understanding of the importance of safety, constructive communication, mutual trust and the ability to recognise and learn from adverse events.

Methods: A cross-sectional survey of multidisciplinary staff from a major metropolitan emergency medicine and access (EMA) division was undertaken. The Australian Hospital Survey on Patient Safety Culture (Version 2.0) was distributed to all staff employed in the EMA Division; three emergency departments (ED), and six general medicine and specialty medicine inpatient wards.

Results: There were 333 (29.3%) responses, and 61 surveys were excluded due to missing data for a final response rate of 24% (n = 272). The number of responses from staff in ED (n = 148, 54%) and in-patient wards (n = 124, 46%) was similar. The 'teamwork', 'communication openness' and 'supervisor/manager support for patient safety' subscales were highly scored. The lowest percentage positive scores were reported for items within the 'hospital management support for patient safety', 'handovers' and 'response to error' subscales.

Conclusion: Teamwork and supervisor/manager support for patient safety were highly valued in this cohort. There is scope for improvement in how hospital level management supports patient safety culture.

Background: Maternity service closure across Australia over the last 20 years has significantly impacted maternity care accessibility, particularly rural areas. How rural health service board members and executives consider maintaining maternity service is unknown.

Aim: To examine how rural Victorian (Australian) boards and health executives consider ongoing maternity service provision and factors that influence continued maternity operation or closure.

Methods: A cross-sectional online survey gathered perspectives from rural Victorian board members and health executives, with data analysed using descriptive statistics, correlation analysis, and thematic analysis.

Findings: Responses from 44 participants revealed that rural maternity workforce availability, funding, midwifery leadership, community factors, and regional health service support critically impact service continuation decisions.

Discussion: Findings highlight disconnects between prioritising continuity of care and implementing flexible workforce models like midwifery group practice. Critical deficits in workforce, leadership, and 24/7 theatre staffing challenge rural maternity service sustainability.

Conclusion: Targeted funding through regional partnerships and strong midwifery leadership are essential for maintaining accessible, safe rural maternity services.

Background: The motivation of healthcare workers is a multifaceted challenge that demands a sustained and structured approach.Aim: The aim of the review was to gather and summarize findings from qualitative research exploring the factors that motivate nurses.Methods: A literature review search was conducted across five databases: Scopus, ProQuest, PubMed, Web of Science, and ScienceDirect. Fourteen papers were identified as appropriate for quality evaluation using a standardized tool. Eleven studies, all demonstrating high quality, met the inclusion criteria.Results: Through the analysis of 11 qualitative studies, 4 primary themes emerged, each with multiple sub-themes. These themes collectively provided a comprehensive understanding of the key motivational factors for nurses, including Appreciation, Support and Professional Development.Conclusion: The findings highlight the key factors motivating nurses. Investing in employee motivation leads to improved care quality, reduced turnover, and increased overall well-being.

Background: A continuity-aligned dedicated education unit is a novel professional experience model focused on teaching and learning in clinical environments. Students complete repeat placements within a clinical ward designed to support student learning. Evidence reports high student and preceptor satisfaction within dedicated education units. However, information concerning nurse preceptor experiences within a continuity-aligned dedicated education unit have not been explored.

Aims: To explore the experiences of nurse preceptors who mentor students in a continuity-aligned dedicated education unit at the commencement of the initial four weeks of professional experience placement.

Design: Qualitative descriptive study.

Methods: Registered nurses (n = 8) employed for >6 months with a minimum of 12 months' experience working within the clinical ward participated in group or individual 30-minute recorded interviews. The interviews were conducted face-to-face or via Zoom. All recordings were transcribed verbatim. Data analysis was undertaken using inductive thematic analysis.

Results/findings: Participants had a median (Q1, Q3) age of 44 (25, 36) years. Four themes emerged: (i) preceptorship is a multifaceted role, (ii) precepting is important and positive, (iii) continuity-aligned dedicated education unit model brings hope, and (iv) endorsed model.

Conclusion: Preceptors perceive the continuity-aligned dedicated education unit as beneficial for students' learning and their professional development. However, the model can be impacted by occasional staffing challenges. Further studies are required to explore the long-term impact of continuity-aligned dedicated education units on both student nurses and nurse preceptors.