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The aim of this integrative review is to critically appraise and synthesise empirical evidence on the clinical applications, outcomes, and implications of generative artificial intelligence in nursing practice.
Integrative review following Whittemore and Knafl's five-stage framework.
Systematic searches were performed for peer-reviewed articles and book chapters published between 1 January 2018 and 30 June 2025. Two reviewers independently screened titles/abstracts and full texts against predefined inclusion/exclusion criteria focused on generative artificial intelligence tools embedded in nursing clinical workflow (excluding nursing education-only applications). Data were extracted into a standardised matrix and appraised for quality using design-appropriate checklists. Guided by Whittemore and Knafl's integrative review framework, a constant comparative analysis was applied to derive the main themes and subthemes.
CINAHL, MEDLINE, and Embase.
Included literature was a representative mix of single-group quality improvement pilots, mixed-method usability and feasibility studies, randomised controlled trials, qualitative descriptive and phenomenological studies, as well as preliminary and proof-of-concept observational research. Four overarching themes emerged: (1) Workflow Integration and Efficiency, (2) AI-Augmented Clinical Reasoning, (3) Patient-Facing Communication and Education, and (4) Role Boundaries, Ethics and Trust.
Generative artificial intelligence holds promise for enhancing nursing efficiency, supporting clinical decision making, and extending patient communication. However, consistent human validation, ethical boundary setting, and more rigorous, longitudinal outcome and equity evaluations are essential before widespread clinical adoption.
Although generative artificial intelligence could reduce nurses' documentation workload and routine decision-making burden, these gains cannot be assumed. Safe and effective integration will require rigorous nurse training, robust governance, transparent labelling of AI-generated content, and ongoing evaluation of both clinical outcomes and equity impacts. Without these safeguards, generative artificial intelligence risks introducing new errors and undermining patient safety and trust.
PRISMA 2020.
The best evidence on programmed weaning from mechanical ventilation in neurocritical care patients should be gathered, evaluated, and integrated to provide an evidence basis for determining the optimal weaning program for these patients.
According to the ‘6S’ pyramid model of evidence-based practice resources, Chinese and international guideline websites, websites of relevant professional societies, and Chinese and English databases were systematically searched. The databases were searched from the time of establishment to October 2024. Literature screening was subsequently performed according to the inclusion and exclusion criteria. Two researchers independently evaluated the literature quality and extracted and summarised the evidence.
A total of 21 publications were included, including 3 guidelines, 5 expert consensus papers, 1 evidence summary, and 12 systematic reviews. A total of 29 pieces of best evidence in the following 5 aspects were summarised: preweaning preparation and screening, a weaning protocol, extubation assessment, extubation preparation and procedure, and postextubation management.
This study summarises the best evidence for the programmed weaning of neurocritical care patients from mechanical ventilation and provides a basis for clinical medical personnel to standardise this weaning process. Evidence-based application of these strategies should be implemented to verify their clinical efficacy and safety in practice.
Successful weaning is key in the management of neurocritical care patients receiving mechanical ventilation. The establishment of a localised extubation protocol guided by a multidisciplinary team can significantly reduce the extubation failure rate, the duration of mechanical ventilation and the incidence of related complications. However, evidence-based application is needed to verify the efficacy and safety of these strategies in clinical practice.
This evidence review adhered to the evidence review report guidelines formulated by the Evidence-Based Nursing Center of Fudan University. These guidelines cover aspects such as problem establishment, literature search, literature screening, literature evaluation, evidence summary and classification, as well as the formulation of practical suggestions. This evidence summary followed the evidence summary reporting specifications of the Fudan University Center for Evidence-Based Nursing (http://ebn.nursing.fudan.edu.cn) with registration number ES20244849.
This study was based on the evidence summary reporting specifications of the Fudan University Center for Evidence-based Nursing; the registered name is ‘Summary of the best evidence for weaning from mechanical ventilation in neurocritical care patients’; the registration number is ES20231823
To report organisational factors known to positively contribute to nurses' well-being in the workplace.
Integrative literature review.
Peer-reviewed journal articles using various methodological approaches, and theoretical works, published in English with a focus on organisational factors and nurses' well-being were included. Papers reporting on other healthcare professional groups and/or nursing students were excluded. Data were synthesised into an integrative review, with findings organised theoretically, according to the PERMA model (Positive emotions, Engagement, Relationships, Meaning, Accomplishment), otherwise known as The Well-being Model.
Relevant papers published between May 2020 and April 2025 were identified using CINAHL and PsycINFO electronic databases. Search date, April 24, 2025.
The review included 18 articles, mostly from Europe and the United States, examining workplace factors that contribute to the health and well-being of nurses. Mapping findings to the PERMA domains showed that organisational support and individual strategies together foster flourishing among nurses.
This review highlights both individual factors (such as self-care, strength use and adaptive coping) and organisational structures (including supportive environments, professional development and recognition) that are essential for nurses' well-being and flourishing. However, effective interventions require systemic change, with leadership and education playing key roles in supporting nurses to flourish in the workplace.
This review addressed the need to go beyond deficit models of nurses' well-being to pinpoint specific organisational factors that can help nurses to flourish. Prioritising nurse well-being is vital for high-quality, safe and sustainable healthcare systems. Investing in environments where nurses can flourish benefits both individuals and the broader healthcare system.
This integrative review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
To report the current state of nurses' engagement in professional and organisational citizenship behaviours worldwide and identify the factors that enable or hinder these discretionary, value-adding actions.
Integrative literature review.
Peer-reviewed empirical studies, theoretical works and editorials published in English between January 2015 and April 2025 were eligible. Reports had to examine nurses' engagement in professional citizenship behaviours or organisational citizenship behaviours. Conference abstracts, dissertations and studies centred on non-nursing workforces were excluded. Quality was appraised with the mixed methods appraisal tool; data were synthesised narratively using constant-comparison techniques.
CINAHL Complete and MEDLINE were searched on 30 April 2025.
Nineteen articles met the inclusion criteria: seventeen empirical studies (sixteen cross-sectional surveys; one randomised controlled trial) and two editorials. Research emerged across eight countries, including Asia, the Middle East, Europe and North America. For organisational citizenship, six inter-locking themes emerged: (1) psychological resources and personality, (2) attitudinal and affective mediators, (3) leadership effects, (4) ethical, fair and supportive climate, (5) outcomes (patient safety, job satisfaction, retention) of organisational citizenship and (6) sparse intervention evidence (one neurolinguistic programming RCT). No empirical studies directly measured professional citizenship; evidence is limited to two conceptual papers calling for civic, policy and professional association engagement. Thus, the main theme was (7) professional citizenship as a nascent (i.e., emerging) field. Overall, citizenship flourished when nurses felt psychologically resourced, fairly treated and supported by transformational or ethical leaders. Burnout, incivility and destructive leadership suppressed organisational citizenship behaviours.
Nurses' organisational citizenship behaviours yield important benefits for patients, staff and healthcare organisations, including improved safety, satisfaction and retention. In contrast, professional citizenship behaviours remain largely conceptual, highlighting the need for foundational research to define and operationalise this construct. Advancing both organisational and professional citizenship should be a strategic priority for health systems worldwide to sustain the nursing workforce and strengthen care quality.
Embedding citizenship behaviours in education, leadership development and policy can strengthen workforce retention, enhance patient-safety culture and drive professional advocacy. Priority actions include routine assessment of organisational citizenship behaviours, leadership coaching and instrument development, plus intervention trials targeting professional citizenship behaviours.
Poor oral health is a common but often overlooked concern in palliative care, negatively impacting patients' quality of life. There is limited understanding of how palliative care providers (PCPs) approach oral health promotion in this context. This review synthesises evidence on the knowledge, attitudes and practices of PCPs regarding oral health care and strategies to support them in this area.
Integrative review.
A systematic literature search was undertaken until January 2025 across multiple databases (MEDLINE, CINAHL, Cochrane, ProQuest, EMBASE and Scopus) and grey literature. Inclusion criteria focused on nurses, medical specialists and allied health professionals involved in palliative or end-of-life care, with no publication year restriction.
This review followed Whittemore and Knafl's (2005) framework for integrative reviews. Study quality was assessed using appropriate tools for qualitative and quantitative studies, clinical guidelines and screening tools. A hybrid thematic synthesis approach was used for analysis.
Twenty-five studies were included, mostly of moderate to high quality. Sample sizes ranged from 8 to 1339, with most participants being nurses and nursing assistants, followed by medical professionals. Findings revealed inconsistent knowledge, varied practices and limited prioritisation of oral health care. Barriers included system constraints, limited training and patient-related challenges. Supportive strategies such as guidelines, screening tools and educational interventions were identified.
A significant gap exists in PCP knowledge and practices regarding oral healthcare due to various barriers, with few supportive strategies documented in this field.
There is an urgent need for enhanced education, robust evidence-based guidelines and tailored training for providers to advance and integrate oral health care in palliative care settings.
PRISMA Checklist.
No patient or public contribution.
To critically synthesise current literature on the nurses' experiences in providing care for people presenting with mental health issues to the emergency department (ED).
Mental health-related presentations to EDs are increasing. Understanding nurses' experiences of providing care for this patient group will inform future strategies to enhance the care delivered in the ED.
CINAHL, MEDLINE, APA PsycInfo and Psychology and Behavioural Sciences Collection were searched from 2009 to 2024 for peer-reviewed qualitative papers exploring emergency nurses' perspectives of providing care for people with mental health issues, published in the English language. Quality was appraised using the JBI Critical Appraisal tool. This review follows the PRISMA checklist for reporting.
Nine papers, reporting eight studies, were included in the review. Three themes emerged: attitudes towards mental illness, education limitations impacting confidence and structural barriers impacting care quality. The review reveals a disconnect between nurses' compassionate intentions and barriers such as unconscious stigma and prioritising physical illness over mental health concerns. The findings highlight the need for targeted mental health education to enhance ED nurses' confidence and competence. Inadequate local mental health policies also impact care delivery, contributing to suboptimal patient outcomes.
This review provides a deeper understanding of ED nurses' experiences of caring for people with mental health issues. A need to implement a multifaceted approach to mental health education, clear policies to guide care delivery and systems that promote prioritisation of patients presenting with mental health concerns was identified.
Insights into nurses' experiences can shape future ED practices and enhance outcomes for patients. Building ED nurses' capacity to deliver high-quality mental health care is critical.
As a review paper, no patient or public consultation took place.
This review explores the roles, competencies, and scope of practice of APNs in critical care based on international literature. It also derives implications for the development of advanced nursing roles in Austria.
Integrative review.
The research team conducted a systematic search of PubMed, CINAHL, and Web of Science to identify relevant peer-reviewed publications from 2007 to 2023.
A systematic search of electronic databases was undertaken, following Whittemore and Knafl's five-step methodology. The included publications met the defined inclusion criteria and were appraised for quality using the Joanna Briggs Institute critical appraisal checklists. Relevant data were extracted and thematically analysed.
The analysis of 14 international studies revealed recurring themes related to APN core competencies and scope of practice in critical care. These were structured according to Hamric's model. However, Austria faces several challenges, including limited legal frameworks, missing educational structures, and a lack of role clarity. These factors hinder the implementation of APN roles.
Internationally, APNs demonstrate advanced clinical skills, provide leadership in team-based care, and integrate evidence-based practice. These attributes enhance patient outcomes and system efficiency. In Austria, restrictive regulations, limited education, and unclear roles hinder these competencies. Reform is needed to align with international standards, and further research should explore their implementation in Austria.
A gap exists between internationally demonstrated APN competencies and the current state of advanced nursing practice in Austria. This highlights the need for clearer role definitions, regulatory frameworks, and educational strategies. Addressing this gap would strengthen APN roles and improve healthcare quality. This study highlights the need to bridge this disparity.
This review follows the PRISMA 2020 guidelines for systematic reviews Page et al. (2021).
No patient or public contribution.
To systematically analyse international empirical literature and establish a comprehensive understanding of the push and pull factors influencing retention and turnover among mid-career nurses.
An integrative review.
PubMed, Web of Science, Scopus, EMBASE (Ovid), and CINAHL (EBSCO) were searched for studies published between January 2001 and November 2024.
An integrative literature review was conducted following the five-step process outlined by Whittemore and Knafl. Articles were screened by title, abstract, and full text based on predefined inclusion and exclusion criteria. The quality of eligible studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Data were extracted and synthesised narratively, and the findings were presented according to the socio-ecological framework.
A total of 1930 studies were identified, with 14 included for analysis: 10 qualitative, 3 quantitative, and 1 mixed-methods study. Guided by the socio-ecological framework, four themes and 10 subthemes emerged: (1) Intrapersonal (professional knowledge/skills, health issues, work-family balance); (2) Interpersonal (professional collaborative relationships, supervisor support); (3) Organisational (organisational characteristics, work characteristics, career development); and (4) Societal (salary/benefits, Social/governmental recognition).
This review reveals the heterogeneity of research on this topic and confirms previous findings. It identifies certain push-and-pull factors common to nurses across all stages of their careers. However, mid-career nurses face unique challenges, including more complex healthcare demands, declining health status, growing family caregiving responsibilities, unclear organisational roles, underutilisation of professional skills, career stagnation, and limitations on salary growth. These findings highlight the need for tailored retention strategies for mid-career nurses.
A “one-size-fits-all” retention strategy does not meet the needs of all nurses. To improve nurse retention rates, it is essential to address the shifting demands and priorities that arise as nurses reassess and transition through different career stages. For mid-career nurses, acknowledging and valuing their expertise and capabilities, providing sufficient resources, and fostering a supportive work environment that promotes career development may be effective strategies for retaining these experienced professionals.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
No Patient or Public Contribution.
To synthesise the existing literature on effective interventions aligned with the 2015 U.S. Occupational Safety and Health Administration guidelines to address workplace violence against nurses.
An integrative review.
PubMed, Embase, CINAH, and PsycINFO databases were searched for articles published between 2010 and 2023. Articles addressing WPV interventions and published in English were included.
Thirty-seven of 834 articles met the inclusion criteria. The review revealed several strategies to address workplace violence in healthcare settings, with staff training being the most common strategy. However, most interventions were researcher-designed, often excluding input from nurses or other stakeholders. Limited managerial support for nurses following the incidents was another prominent finding.
Although safety training programmes are common, there are critical gaps in managerial support and nurse involvement in intervention development. Further research should focus on incorporating nurse contributions and strengthening managerial support to enhance prevention efforts.
Addressing workplace violence in healthcare settings requires a comprehensive approach beyond safety training. Active nurses' participation in intervention design and enhanced managerial support are essential for creating effective solutions. Healthcare administrators should create environments that empower nurses to contribute to solutions.
This review highlights existing gaps in interventions and emphasises the need for collaborative and nurse-centered approaches to address workplace violence.
The reporting of this review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
No patient or public contribution.
The aim of this integrative review was to explore registered nurses' understandings of organisational culture and cultures of care in aged care.
Integrative literature review.
A literature search was conducted of Medline (OVID), CINAHL Plus with Full Text, Scopus, Proquest Nursing and Allied Health, and Informit databases in June 2024. In October 2024, a search for grey literature was conducted focusing on Google Scholar, the Analysis and Policy Observatory (Australia), Australian Government websites, European Union Institutions and Bodies, and usa.gov. The inclusion criteria were Australian and international literature published in English between 2004 and 2024. The inclusion criteria were amended to focus on literature published from 2014 to 2024.
Seventeen research studies met the inclusion criteria for the review. Four primary themes were identified: competing hierarchies of power; the multifaceted role of nurses in long-term care settings; standing still is not an option; and implications for culture change strategies in practice.
Registered nurses in aged care are pivotal to evolving clinical and administrative practice and creating organisational cultures that affirm the rights of older people, including providing a supportive workplace for those who care for them, in an environment focussed on developing and sustaining quality care. Viewing the complex relationships at different organisational levels through the prism of Foucault's ideas on disciplinary power generates new insights into the role of registered nurses in aged care settings. This review also underscores that research on organisational culture in aged care is at a formative stage. There is potential for future research that fosters a robust evidence base to support the development of organisational cultures that nurture a person-centred environment ultimately leading to improved care and staff experience.
Registered nurses in aged care settings are advocating for a transformative shift in organisational cultures that prioritises inclusivity, compassion and person-centred care. Empowering nurses through clinical and administrative leadership roles is crucial for cultivating person-centred organisational cultures in aged care settings. It is essential that policymakers invest in the development of registered nurses who can excel in clinical and operational roles at management and executive levels. Policy changes that promote frameworks that facilitate nursing leadership are essential for establishing and maintaining person-centred workplace cultures.
Prisma extension for scoping reviews (PRISMA—ScR).
This study did not include patient or public involvement in its design, conduct, or reporting.
To review primary research reporting the inclusion of informal carers in caring for older people in the emergency department.
An integrative review employing Whittemore and Knafl's updated integrative review methodology.
A systematic search was undertaken between November 2023 and September 2024. Ten articles met the inclusion criteria of primary research reporting the inclusion of carers in the care of older adults in the emergency department. Exclusion criteria included studies conducted outside of the emergency department, not carer-related, and those not restricted to carers of older adults. The Mixed Method Appraisal Tool (MMAT) was used to assess the quality of the articles.
Medline @ Ovid, EBSCO, Wiley Online Library, Cochrane, EMBASE and SCOPUS.
Thematic analysis produced two reoccurring themes: Carers as advocates and Carers as outsiders. Through sharing of information and support of the older adult, carers can act as advocates. Restrictive admission policies, exclusion from decision-making processes, and failure to be heard by the healthcare professional resulted in carers feeling like outsiders.
Including carers is essential to support the care of vulnerable older adults in the emergency department. Care partnerships between healthcare professionals and carers can be enhanced with education on effective and respectful communication processes and support of carer well-being.
This review highlights the essential nature of care partnerships involving informal carers in the emergency department for providing high-quality care to older adults with complex care needs. An appropriate carer inclusion programme could support emergency department clinicians, carers and older adults.
The PRISMA 2020 checklist was used to ensure adherence to review processes.
No patient or public contribution.
Nurse-to-nurse horizontal violence is a highly prevalent issue in healthcare, significantly affecting nurses' well-being, job satisfaction and professional performance. Despite its widespread occurrence, it remains largely invisible due to organisational culture, normalisation and underreporting. Recognising and addressing this phenomenon is a priority to improve workplace environments and safeguard both nurses and patient care.
The aim was to synthesise the existing evidence on the main predisposing factors of nurse-to-nurse horizontal violence in a hospital setting.
An integrative review.
Four databases: PubMed, CINAHL, Scopus and Web of Science.
This integrative review followed Whittemore and Knafl's approach and was reported according to SWiM checklist. Database searches occurred from September 2022 to February 2023, including studies published between 2013 and 2023. Articles were screened by title, abstract and full text based on set criteria. Additional articles were identified through backward citation searching. Quality was appraised using Joanna Briggs instruments, and a narrative synthesis summarised the findings.
Fifteen articles were reviewed, focusing on nurse-to-nurse horizontal violence. Most studies used the Revised Negative Acts Questionnaire and were rated as ‘good quality’. The predisposing factors identified were grouped into three categories: organisational, professional and work related.
The findings highlight that the predisposing factors of nurse-to-nurse horizontal violence are multidimensional and interrelated. Addressing this issue requires a comprehensive and coordinated approach that strengthens leadership and implements standardised early detection and measurement tools to develop effective preventive strategies.
Horizontal violence promotes disruptive work environments. Management-related issues, professional hierarchies and unhealthy working conditions contribute to its occurrence. Therefore, strengthening leadership, promoting peer support and improving work environments are key to mitigating its impact and enhancing nurse well-being and care quality.
PROSPERO: CRD42023396684
To summarise and critically appraise the evidence of mindfulness-based interventions for psychological distress in patients with cancer and their partners.
A critical review.
The critical appraisal checklists of the Centre for Evidence-Based Management were utilised for the quality appraisal while reporting the results using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.
Six electronic databases were searched, including MEDLINE, CINHAL, Embase, PsycINFO, the Cochrane Library, and Web of Science, from inception to August 2023.
A total of six studies were included. Mindfulness-based interventions in general improved psychological distress among patients with cancer and their partners. However, the components of the interventions varied.
Treating patients with cancer and their partners as a unit may improve psychological distress for both parties. It is recommended that cancer couples be involved in mindfulness-based interventions simultaneously to achieve positive effects. Future research into the effectiveness and best practices of mindfulness-based interventions remains necessary.
The findings provide information and evidence for improving psychological distress among patients with cancer and their partners to guide the development of a mindfulness-based intervention.
Mindfulness-based interventions were effective in improving psychological distress in patients with cancer and their partners. The effectiveness of mindfulness-based interventions varied based on intervention formats. Engaging cancer couples in mindfulness-based intervention together may have a positive impact on both partners.
Preferred Reporting Item for Systematic Reviews and Meta-Analyses Statement 2020.
No Patient or Public Contribution.
To synthesise evidence on the types of Medication Management Services (MMS) and establish the effect of the different MMS interventions on Economic, Clinical and Humanistic Outcomes (ECHO) in dialysis patients.
Integrative review.
A systematic search was conducted from May to June 2024 using four databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library and Web of Science.
This review followed Whittemore and Knafl's framework and adhered to the PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Data extraction and quality assessment were independently conducted by three reviewers using the Joanna Briggs Institute Critical Appraisal Tool and the Quality Improvement Minimum Quality Criteria Set. Only English-language articles, primary and quality improvement studies were included, with no restrictions on publication date. Findings were narratively synthesised and thematically grouped by review aims.
A total of 14 articles were included. This review identified (1) the types of MMS provided to renal dialysis patients, and (2) the effects of these services on ECHO. Services varied in practices, including obtaining accurate medication histories, identifying discrepancies, reviewing laboratory results, making recommendations to prescribers, resolving issues based on collaborative agreements and providing patient education. These services were compared in terms of economic outcomes (e.g., 30-day readmission rates), clinical outcomes (e.g., medication discrepancies, MRPs, laboratory and clinical parameters) and humanistic outcomes (e.g., medication burden-related quality of life).
This review highlighted various types of MMS available for dialysis patients and their impact on ECHO. Key benefits include recognising medication discrepancies, reducing MRPs, improving laboratory and clinical parameters, lowering 30-day readmission rates and enhancing medication burden-related quality of life. However, limitations such as retrospective studies, English-only publications and limited comparison across MMS models highlight the need for additional robust and diverse research.
This integrative review was conducted in accordance with the PRISMA statement.
No Patient or Public Contribution.
The aim of this review was to explore the influencing factors that contribute to medication administration errors (MAEs) made by novice registered nurses (NRNs).
MAEs are a significant yet preventable risk to patient safety in healthcare settings, compromising both patient health and care quality. Evidence suggests that NRNs are more prone to MAEs, highlighting the importance of exploring the contributing factors to develop effective prevention strategies.
An integrative review.
An electronic literature search was conducted in which articles were restricted to peer-reviewed, full-text articles published in the English language between January 2013 and December 2023. Quality assessments and data syntheses were conducted by two independent authors.
CINAHL Complete, MEDLINE, APA PsycArticles, APA PsycInfo, PubMed, Cochrane Library and Web of Science.
Eleven studies met the inclusion criteria. The main influencing factors identified in this review were intrinsic factors (lack of confidence, reduced coping skills and reluctance to seek assistance) and extrinsic factors (time pressures, hectic workloads, low staffing and high-stress environments). Clinical, educational and research implications were also identified.
This integrative review explored the various influencing factors contributing to MAEs by NRNs in healthcare settings. These included gaps in pharmacological knowledge, limited simulation-based learning and challenges in using electronic medical records. Addressing these issues through targeted education and increased simulation experiences in undergraduate curricula could enhance NRNs' competence and confidence.
Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
No patient or public contribution was made due to the study design.
Understanding the factors behind medication administration errors among new nurses helps organisations develop strategies to address these issues, reducing patient harm and enhancing nursing practice. Our findings offer recommendations to improve nursing education worldwide.
To explore the experience of nursing staff who provide one-to-one observations for patients aged ≥ 18 years admitted to acute hospitals.
Integrative review reported in accordance with the method described by Wittemore and Knafl (2005) which focused on the period 2000–2024.
Papers were included if they reported on novel studies, service or educational improvement interventions. All studies were critically appraised for quality; no study was excluded because of methodological quality. Included data were synthesised narratively.
Eight databases were searched in August 2024. Search terms related to nurses' experience and one-to-one observations, with no restrictions placed on language.
Nine papers were included. Nurses' experience of delivering one-to-one observations ranged from ‘frightening’ to ‘satisfying’. Nursing staff were more likely to have a positive experience if they had access to training on delivering one-to-one observations, felt themselves part of a cohesive team and worked in an organisation with a supportive culture.
Nurses' experience of delivering one-to-one observations is influenced by organisational factors, sense of teamwork and access (or lack thereof) to relevant training.
The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were used to report the review findings.
No Patient or Public Contribution.
Explore how previous patient safety research has described issues related to patient participation in psychiatric hospital care.
Integrated literature review.
The literature review was conducted according to Cooper's framework with the following five-step protocol: problem identification, a literature search, data evaluation, data analysis, and the presentation of results.
CINAHL, PubMed, PsycINFO, Scopus databases, years 2005–2023. After quality appraisal, a total of 62 articles were reviewed.
Three main categories related to patient participation in psychiatric hospital care were identified: communication (having information, being heard, therapeutic relationships and interaction quality), decision-making (treatment planning, treatment decisions, activities and working on behalf of patients) and restrictive measures (setting limits, exercising power, balancing patient autonomy and safety).
Psychiatric hospital care nursing staff continuously balance patients' autonomy, self-determination, and safety, taking into account their well-being and issues of responsibility. Wider use of positive risk-taking is needed to increase patient participation and safety in psychiatric hospital care.
Nursing staff should create favourable facilities for patient participation, foster an atmosphere of trust, respect, and encouragement, provide patients individual time to improve patient safety and recognise that they can exert power over patients due to constantly balancing patient autonomy and safety.
PRISMA guidelines.
No patient or public contribution.
To retrieve, evaluate and summarise the best evidence for non-pharmacological management of sleep disturbances in ICU patients, and to provide basis for clinical nursing practice.
This study was an evidence summary followed by the evidence summary reporting standard of Fudan University Center for Evidence-based Nursing.
All evidence on non-pharmacological management of sleep disturbances in ICU patients from both domestic and international databases and relevant websites was systematically searched, including guidelines, expert consensuses, best practice, clinical decision-making, evidence summaries and systematic review.
UpToDate, BMJ Best Practice, Joanna Briggs Institute, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, Yi Maitong Guidelines Network, Registered Nurses Association of Ontario, Canadian Medical Association: Clinical Practice Guideline, Guidelines International Network, WHO, the Cochrane Library, CINAHL, Embase, PubMed, Web of Science, CNKI, WanFang database, VIP database, SinoMed, The American Psychological Association, European Sleep Research Society, American Academy of Sleep Medicine and National Sleep Foundation were searched from the establishment of the databases to June 1, 2024.
A total of 18 pieces of literature were included, involving 4 guidelines, 2 expert consensuses, 1 best practice and 11 systematic reviews. 25 pieces of evidence covering 4 categories of risk factors, sleep monitoring, non-pharmaceutical intervention, education and training were summarised.
This study summarises the best evidence for non-pharmacological management of sleep disturbances in ICU patients. In clinical application, medical staff should make professional judgements and fully combine clinical situations and patient preferences to select evidence, laying a theoretical foundation for later empirical research to reduce the incidence of sleep disturbances in ICU patients and improve the sleep quality of critically ill patients.
Medical staff can refer to the best evidence to provide reasonable non-pharmacological management plans for sleep disturbances in ICU patients, improving their sleep quality and life satisfaction.
The management of sleep disturbances in critically ill patients has not received sufficient attention and standardisation. This study summarises 25 pieces of the best evidence for non-pharmacological management of sleep disturbances in critically ill patients. Accurate and standardised evaluation and monitoring are the foundation of sleep management for ICU patients. This summary of evidence can help ICU nurses enhance their clinical practice.
This evidence summary followed the evidence summary reporting specifications of Fudan University Center for Evidence-based Nursing, which were based on the methodological process for the summary of the evidence produced by the Joanna Briggs Institute. This study was based on the evidence summary reporting specifications of the Fudan University Center for the Evidence-based Nursing; the registration number is ‘ES20231708’.
No Patient or Public Contribution.
To systematically search, evaluate and synthesise the most robust evidence regarding pressure injury prevention in orthopaedic patients admitted to general wards.
The present study provides an evidence-based summary of the most robust findings, adhering to the evidence guidelines established by the Center for Evidence-Based Nursing of Fudan University.
According to the “6S” model, a systematic search was conducted for literature on pressure injury prevention among orthopaedic patients in general wards. The types of literature included guidelines, clinical decisions, expert Consensus, evidence summaries, etc. The search period covered the time from the beginning of the database up to December 2023.
The following databases and resources were systematically searched: Up To Date, JBI, NICE, WOCN, NZWCS, etc.
Fifteen literature sources were included, comprising one clinical decision, eight guidelines, one systematic review, and one expert Consensus. In these sources, a comprehensive collection of 34 pieces of best evidence was formed across six key topics: risk assessment, position management, skin care, device used for device-related pressure injury, nutritional assessment, and support, as well as health education and training. Among the evidence gathered, a strong recommendation was made for 18 pieces, while the remaining 16 received a weak recommendation.
This study provides a comprehensive synthesis of the most robust evidence on pressure injury prevention in orthopaedic patients, encompassing 34 pieces of evidence that can serve as valuable references for clinical practice. Before implementing this evidence, it is crucial to evaluate the specific contextual factors within different countries and medical institutions, as well as the facilitators and barriers influencing its application by healthcare professionals and patient's preferences. Furthermore, targeted evidence selection should be conducted through careful screening and subsequent adjustments in implementation, thereby offering a more scientifically grounded basis for clinical nursing practice. Future research endeavours should prioritise investigating strategies for effective evidence utilisation.
The prevention of pressure injuries poses a significant challenge for orthopaedic patients. This study presents a synthesis of 34 pieces of best evidence to provide guidance on preventive measures for pressure injuries in orthopaedic patients. Adhering to and implementing these 34 pieces of evidence can effectively aid in preventing pressure injuries in clinical practice. This evidence encompasses risk assessment, position management, skin care, device usage for device-related pressure injuries, nutritional support and evaluation, and health education and training, establishing a comprehensive and systematic implementation process. Assessing the risk of pressure injuries during interventions serves as an essential prerequisite for developing effective strategies to prevent such injuries among orthopaedic patients. Ultimately, this study will offer valuable guidance to healthcare professionals worldwide regarding preventing pressure injuries in orthopaedic patients.
Upon admission to the hospital, it is essential to conduct a risk assessment and implement evidence-based, individualised prevention measures for pressure ulcers in patients to prevent their occurrence. This study will provide valuable insights into preventing pressure injuries in orthopaedic patients admitted to orthopaedic wards for healthcare workers worldwide.
The PRIMA manifest is utilised during the text preparation process.
Trail Registration: ES20245365
To summarise the evidence and present the state of the science on pressure injury care bundles in the community. Specifically, this review examined (i) the extent of pressure injury by studying its prevalence and incidence in the last 10 years, (ii) the risk factors associated with community-acquired pressure injury and (iii) the components and outcomes associated with effective pressure injury care bundles in the community.
PI care bundles have effectively reduced PI rates; however, there is limited evidence of care bundles used in community settings.
Integrative review.
This integrative review is guided by the Whittemore and Knafl framework and follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Quality appraisal was applied to assess the quality of selected articles. Data relevant to the review aims were extracted, and findings were synthesised and presented. PubMed, Medline, CINAHL and Web of Science were searched. Studies published in the English language between 2012 and 2022 were retrieved.
A total of 89 articles were retrieved; 25 met the inclusion criteria. Most studies reported the point prevalence and period prevalence of community-acquired pressure injuries, and only one study reported the incidence of community-acquired pressure injuries. The point prevalence and period prevalence of community-acquired pressure injury were 0.02% to 10.8% and 2.7% to 86.4%, respectively, and the cumulative incidence was 1.3%. The risk factors for community-acquired pressure injury assessed vary between studies; older age, poor nutrition, immobility and multiple comorbidities are commonly reported. Socioeconomic and caregiving factors were not studied. Very few studies evaluated pressure injury care bundles in the community. Even so, the components of the pressure injury care bundle vary between studies.
Pressure injury development is associated with a complex interplay of factors. Socioeconomic and caregiving factors were not examined in any of the papers. There is a lack of understanding of the components and outcomes associated with effective pressure injury care bundles in the community.
Despite their prevalence, community-acquired pressure injuries (CAPIs) are often underreported due to inadequate follow-up and reporting mechanisms. Although the risk factors for CAPIs vary across studies, older age, impaired mobility, multiple comorbidities and malnutrition consistently emerge as key contributors. Pressure injury preventive care bundles are more commonly used in the acute care setting rather than the community setting.
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