Conectar
The multifaceted responsibilities borne by clinical facilitators can impose a significant strain on their mental and emotional health and well-being. Within nursing and other healthcare professions, the responsibilities of clinical facilitators extend beyond conventional clinical duties to encompass supervising, facilitating, assessing, and supporting students as they transition into professional nursing practice. There is a need for insights into the well-being of clinical facilitators in the face of demanding work conditions, limited resources, and the emotional toll of patient care. This article critically reviews the literature to determine the current state of mental well-being among clinical facilitators in undergraduate health professions education and how they should be supported.
A scoping review guided the study using the Population, Context, Concept framework with a search string incorporating associated Boolean operators. 233 records were retrieved from eight databases and reviewed according to the inclusion and exclusion criteria. A total of 13 full-text articles were found to be eligible for extraction and analysis.
Major findings resulted in thematising mental health issue characteristics according to high and low job demands and burnout. Literature outlined the causes of mental health issues, including lack of recognition and appreciation, work performance, teaching and learning practices, student characteristics, support structures, and the environment. Recommendations included training, appropriate support systems, workload, guidelines, monitoring, community of practice, and research-oriented support.
Educational institutions must move beyond ad hoc support and implement integrated, strategic initiatives grounded in the principles of the Job-Demand-Control model. Future research should focus on developing and rigorously evaluating multifaceted intervention programmes that address these systemic factors. By investing in the well-being of clinical facilitators, institutions ultimately invest in the quality of future healthcare providers and the safety of the patients they will serve.
This article sets the tone for factors to consider and provides recommendations for educational institutions to better support the mental well-being of clinical facilitators.
To map and synthesise the main recommendations for arterial blood gas (ABG) collection in intensive care units (ICUs).
A scoping review was conducted according to the PRISMA-ScR Checklist, supported with The PAGER framework and guided by the Joanna Briggs Institute methodology to ensure methodological rigour and analytical comprehensiveness.
Data collection was conducted from February to April 2024. The data sources included: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PubMed Central, Scientific Electronic Library Online (SciELO), Web of Science (WoS), SCOPUS, Science Direct, Virtual Health Library (VHL), Excerpta Medica database (Embase), CAPES Thesis and Dissertation Catalogue, Brazilian Digital Library of Theses and Dissertations (BDTD), Scientific Open Access Repository of Portugal (RCAAP), Theses Canada and the Oswaldo Cruz Foundation (Fiocruz) repository.
Key findings recommend the radial artery as the preferred puncture site, an insertion angle of 30° to 45°, the use of 1 or 3 mL syringes and 20G or 23G gauge needles. Transport and storage at room temperature are advised. Cryoanalgesia and subcutaneous analgesia methods were found to be effective for pain management.
The review highlights the best practices for arterial blood gas collection in critical care. The synthesized evidence strengthens clinical practice, informs guidelines for intensive care nursing and promotes safer, higher-quality care for critically ill patients.
The evidence-based recommendations identified can enhance nursing care related to arterial blood gas collection. Adherence to these practices promotes safer, more humanised and evidence-based care during the procedure.
The report of this study followed the PRISMA-ScR Checklist.
There was no patient or public involvement in this scoping review.
To evaluate the impact of a 5-min delay in needle removal after haemodialysis on complications and patient satisfaction in newly created arteriovenous fistulas.
Retrospective cohort study.
This study analysed 109 patients with new arteriovenous fistulas undergoing initial cannulation 8–12 weeks post-surgery. Participants were divided into two cohorts: a conventional group (n = 42) receiving immediate needle removal after pump cessation, and a delayed group (n = 67) retaining needles for 5 min post-pump cessation before removal. Outcomes included haemostasis time, hematoma incidence, 3-month reintervention rates, and patient satisfaction measured by a 5-point scale.
Delaying needle removal by 5 min reduced mean haemostasis time by 32% compared to immediate removal (16.4 min vs. 24.1 min). Hematoma incidence decreased substantially by 76% in the delayed group (3.3% vs. 13.1%). At 3-month follow-up, reintervention rates were 66% lower with delayed removal (9.0% vs. 26.2%). Patients also reported 50% less procedure-related pain and significantly higher satisfaction scores (median 4.5 vs. 2).
A brief 5-min delay in needle removal significantly reduces complications and enhances patient-centered outcomes during early arteriovenous fistula use.
This protocol establishes an evidence-based standard for post-dialysis needle management, directly reducing compression-induced pain and reintervention needs while requiring no additional nursing resources. Implementation can immediately improve vascular access safety in haemodialysis units.
The study addresses high complication rates (26.2%) from immediate needle removal in immature fistulas. Key findings demonstrate 76% fewer hematomas and 66% lower reinterventions with 5-min delayed removal. This evidence may transform global haemodialysis nursing protocols, benefiting a substantial population of patients receiving new fistulas annually.
This study follows the STROBE checklist.
Patients and the public were not involved in the design, conduct, or reporting of this retrospective medical record analysis.
To explore factors affecting research engagement among Nurses, Midwives and Allied Health Professionals (NMAHPs) in England by examining perceptions of research capacity at organisational, team and individual levels.
Research engagement strongly correlates with improved care quality. However, NMAHPs face persistent participation barriers compared to medical colleagues, limiting the development of a multi-professional research workforce.
National descriptive cross-sectional study using a validated survey tool.
Data from NMAHPs across England were collected using the validated Research Capacity and Culture tool. Quantitative data were analysed descriptively and inferentially; qualitative free-text responses were evaluated thematically.
Perceived capacity was moderate organisationally and in teams. Organisational strengths included promoting evidence-based practice (68.7%) and leadership support (61.6%). Teams offered moderate research opportunities (58.6%) but limited mentorship (47.9%). Individually, participants showed competence in literature review (69.5%) and data collection (63.4%) but required support for funding acquisition (43.8%) and publication (50.0%). Qualitatively, research was a highly valued aspect of professional identity, though participation is severely constrained by structural conditions, including extreme resource pressures, unclear career pathways, and professional inequality.
Despite strong motivation for evidence-based practice, significant structural barriers restrict NMAHP research engagement. Strengthening capacity demands coordinated action across clinical and policy systems, ensuring equitable access to protected time, mentorship, and vital research infrastructure.
Supporting NMAHPs in research enhances evidence-informed decisions and service innovation. Embedding research into everyday clinical work, rather than viewing it as optional, builds a sustainable multi-professional culture.
This survey pinpoints the specific factors most strongly influencing NMAHP research engagement. It provides healthcare leaders actionable insights to build sustainable research infrastructure and inclusive clinical academic pathways.
This study adhered to STROBE guidelines for cross-sectional research.
No patient or public contribution.
To investigate whether patient safety culture is associated with nurses' turnover intention and to examine correlational sequential pathways involving burnout and job satisfaction, drawing on Conservation of Resources theory.
A descriptive, correlational design.
This study used data collected during 2023 from a hospital-wide patient safety culture survey conducted in four hospitals in South Korea. The sample comprised 3082 nurses from diverse units. Relationships among patient safety culture, burnout, job satisfaction, and turnover intention were examined using a mediation model within a structural equation modelling framework (WLSMV estimator with probit link), controlling for age and hospital tenure.
Patient safety culture was associated with lower burnout and higher job satisfaction. Burnout was associated with lower job satisfaction and with a higher likelihood of turnover intention, whereas job satisfaction was associated with a lower likelihood of turnover intention. When burnout and job satisfaction were considered together, the association between patient safety culture and turnover intention was explained through these two factors rather than by a direct pathway.
Patient safety culture functions as an organizational resource that relates to reduced burnout and enhanced job satisfaction, which together relate to lower intention to leave.
Strengthening patient safety culture—alongside efforts to reduce strain and foster positive job attitudes—may support nurse well-being and improve retention, thereby supporting continuity and safety of patient care.
This study addresses persistent nurse turnover intention in hospitals and identifies patient safety culture as an organizational lever that operates through reduced burnout and improved job satisfaction. The findings can guide nurse leaders and policymakers in hospitals to implement culture-focused strategies that support staff well-being, enhance retention, and sustain safe patient care.
STROBE guidelines were followed.
No patient or public contribution.
This study defines adverse religious experiences (AREs), describes how these gendered harms affect women and develops a Classical Grounded Theory (CGT) model of women's recovery and inform trauma- and gender-responsive nursing practice.
Using the CGT design, the study explores women's lived experiences with AREs, focusing on their primary concern and the strategies they used to address it.
Fifteen North American women participated in open-ended, semi-structured interviews conducted between May and June 2023. Data collection and analysis occurred concurrently by using constant comparison. Theoretical saturation was reached by approximately 12 interviews and was confirmed through three additional interviews. Theoretical coding was guided by Glaser's Six Cs.
The central issue was Loss of Self, with limited agency, embodiment and autonomy due to internalised religious control. This study conceptualises AREs as a gendered determinant of health and introduces a nursing-generated explanatory model of women's recovery from religious harm. The Basic Social Process, Discovering Self, includes six cyclical phases: Living with Toxicity, Loss of Self, Recognizing Woundedness, Leaving Negativity, Seeking Restoration and Awakening to Wholeness. Analytic integration with the Six Cs showed that doctrinal rigidity, gendered hierarchies, conditional belonging, turning points and psychological, spiritual and relational consequences shaped individual recovery paths. Recovery proved a nonlinear, whole-person process spanning spiritual, physical, sexual and relational domains.
Discovering Self offers the first explanatory model of women's recovery from religious harm, identifying mechanisms of oppression and pathways for reclaiming agency, embodiment and voice.
This study provides a roadmap for trauma- and gender-responsive nursing care, education and policy. The findings align with global priorities in health and gender equality.
This study followed the SRQR guidelines and used CGT methodology.
Patients or the public were not involved in the study.
To compare attitudes and perceptions towards opioid use disorder among people with opioid use disorder and emergency providers, describe interactions between the two groups, and identify barriers to providing and receiving care.
Mixed methods observational study.
Participants were recruited from an academic, tertiary care hospital and a community-based harm reduction agency in New England. Emergency healthcare providers (nurses, physicians, and paramedics) and adult people with opioid use disorder were enrolled. Electronic surveys were administered to providers, and semi-structured interviews were conducted with people with opioid use disorder and a subset of providers. Descriptive statistics were calculated for surveys, and directed content analysis was used to analyse semi-structured interviews.
Sixty-eight providers completed the survey, 11 of whom also completed a semi-structured interview. Twenty-two people with opioid use disorder completed the semi-structured interview. Both providers and people with opioid use disorder agreed that addiction is a disease; however, opinions differed on the extent to which personal choice played a role in the onset of opioid use disorder. Participants described how factors such as experiencing homelessness, alongside other personal or familial challenges, contributed to ongoing substance use and presented barriers to accessing healthcare. There was discordance in priorities between providers and people with opioid use disorder, which often drove conflict and perceived stigma. Both groups described physical and emotional trauma from prior interactions, which shaped expectations of future interactions and biases towards each other.
Educational initiatives should arm providers not only with clinical knowledge about opioid use disorder but with skills to recognize implicit biases, navigate unique barriers related to social determinants of health, and effectively deploy shared decision-making techniques. Healthcare organizations should provide support for trauma that emergency care providers are exposed to in caring for people with opioid use disorder.
Consolidated criteria for reporting qualitative studies (COREQ)–32 item checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
To explain the relationship between occupational well-being dimensions and overall occupational well-being among nurse and social care educators, with particular focus on hybrid work status.
A cross-sectional survey study.
The quantitative data were collected from Finnish nurse and social care educators (n = 367) in autumn 2023 and analysed using multiple regression with interaction analysis.
Overall personal occupational well-being was rated higher than work community occupational well-being, especially among hybrid-working educators. In models including all occupational well-being dimensions (working conditions, work community, worker's resources and work, and professional competence), only work community and worker's resources and work remained statistically significant positive relationships with occupational well-being. Hybrid work status moderated these relationships: the relationship between work community and occupational well-being was stronger among on-site educators, and professional competence was associated with work community occupational well-being only among them.
Voluntary hybrid work may support personal occupational well-being among nurse and social care educators, yet the enduring importance of work community—particularly for on-site educators—highlights the need to sustain work community resources across all work modalities.
Occupational well-being strategies in educational institutions could benefit from reflecting diverse work arrangements. For hybrid models, emphasis might be placed on combining flexible work options with support for self-leadership and virtual community-building to ensure equitable well-being across modalities. Strengthening team-based collaboration can help maintain connection, competence, and resilience regardless of work setting.
This study provides evidence on the factors supporting occupational well-being among nurse and social care educators depending on the hybrid work status. Work community and individual resources are key predictors, with implications for tailoring support strategies in institutions adapting to hybrid work models.
The Strengthening the Reporting of Observational Studies in Epidemiology STROBE guidelines.
No Patient or Public Involvement.
This reflection examines the past 50 years of Indigenous nursing, highlighting both progress and persistent inequities. Fifty years ago, Indigenous nurses were largely invisible within the profession, their voices marginalised and their cultural backgrounds undervalued. Although numbers have grown, Indigenous nurses, particularly Māori in Aotearoa New Zealand, remain significantly underrepresented in the workforce relative to population need. Enduring structural and systemic barriers continue to impede recruitment, retention and the integration of Indigenous worldviews into nursing curricula and practice. This commentary refers to historical and contemporary contexts that shaped this landscape, including colonisation, racism and the suppression of Indigenous knowledge. It acknowledges significant milestones such as Dr. Irihapeti Ramsden's leadership in establishing Kawa Whakaruruhau and Cultural Safety, while also noting the political backlash that diluted its original focus on Māori health inequities. Indigenous nurses, past and present, bring culturally grounded, relational and holistic approaches to care, bridging the clinical and cultural worlds and building trust with Indigenous communities. Their growing scholarly contributions and international collaborations—such as the Indigenous Global Research Alliance in Nursing—are advancing Indigenous methodologies and evidence. While gains have been made, the future requires culturally responsive pipelines and collective commitment to addressing inequity, racism and structural injustice in nursing.
To critically analyse the federal Program of All-Inclusive Care for the Elderly (PACE) using the Integration Continuum Framework and the Conceptual Model for Nursing and Health Policy, identifying system-level strengths, equity gaps and nursing implications for long-term care reform.
The U.S. long-term care system remains fragmented and institutionally biased, disproportionately affecting dual-eligible older adults who account for outsized healthcare expenditures despite comprising just 17% of Medicare beneficiaries. Permanently authorised under the Balanced Budget Act of 1997, PACE delivers fully integrated, community-based care for individuals aged 55 and older who qualify for nursing home-level services but prefer to remain in their communities.
A policy analysis guided by dual conceptual frameworks assessing PACE structure, implementation and impact across four policy outcome levels: efficacy, effectiveness, equity and justice.
This policy analysis was conducted between May and July 2025. Two conceptual frameworks were applied to examine PACE structure, implementation and outcomes. Data sources included peer-reviewed studies, federal legislation, policy documents and grey literature published between 2020 and 2025, supplemented by international integrated care literature.
PACE demonstrates strong efficacy and effectiveness, with fully integrated interdisciplinary teams and reduced institutionalisation for enrolled older adults. However, the program falls short on equity and justice due to limited geographic reach, racial and ethnic disparities in enrollment, exclusion of Medicare-only populations and persistent nursing workforce challenges.
PACE exemplifies a high-functioning integrated model of community-based long-term care, but current policy constraints prevent it from achieving scale and equity. Without eligibility expansion, financing reform and workforce investment, its transformative potential will remain unrealised. Nurses are central to this vision and must be empowered as clinical leaders and policy advocates to sustain care coordination and advance health equity in aging populations.
To explore the views of healthcare practitioners in Britain regarding the role of midwives and nurses in the delivery of medical and surgical abortion.
An observational study of the Shaping Abortion for Change study healthcare practitioner survey (2021–2022).
Relationships between healthcare practitioner type, participant characteristics, knowledge of and attitudes towards abortion, and views about nurses' and midwives' role in abortion care were examined using Pearson's Chi-squared tests of association and multivariable logistic regression.
Amongst 763 participants including doctors, nurses, midwives and pharmacists, 71.6% supported specialist nurses in sexual and reproductive health and abortion clinics and hospitals, expanding their roles to include prescribing abortion medications and surgical abortion methods. Support was lower for midwives (35.8%) and primary care nurses (32.5%). There was considerable support for all nursing and midwifery groups to be involved in adjacent tasks of abortion care. Differences in support by healthcare practitioner type persisted after adjustment for exposure variables.
There is strong support for specialist nurses to expand their role in abortion care. This change could be implemented following clarification of the legal position. Some healthcare practitioner groups are more reluctant to support broader involvement of nurses and midwives in abortion provision.
Expanding specialist nurses' role in abortion care could increase service capacity and improve patient access and experience. Understanding and addressing the concerns of healthcare practitioners opposing this change is critical for successful implementation and patient safety.
This study addresses the potential for nurse and midwife role expansion in abortion care. The findings highlight broad support for specialist nurses whilst identifying barriers to wider role expansion. The research informs policy discussions on workforce optimisation and access to abortion services across Britain.
This study adheres to the STROBE guidelines for reporting observational studies.
In the SACHA study, patient and public involvement was included at all stages to inform study design, recruitment, data collection and analysis.
To explore public health nurses' experiences of child maltreatment preventive work in primary healthcare.
The metasynthesis approach was based on the guidelines by Sandelowski and Barroso for synthesising qualitative research.
The quality of the included studies was appraised using Joanna Briggs Institute Checklist for Qualitative Research. The analysis followed Braun and Clarke's reflexive thematic analysis.
Searches were conducted in five electronic databases: Cinahl, Medline, PsychINFO, Web of Science and SocINDEX in May and July 2024, and updated in April and December 2025.
Thirteen qualitative studies were included, and five themes were developed: Insufficient knowledge about when and how to act, building a therapeutic relationship with parents, keeping the child's best interest in focus, in need of better interdisciplinary support and ambivalence in addressing child maltreatment.
Public health nurses face challenges in child maltreatment preventive work, including insufficient knowledge and limited interdisciplinary support. Even so, public health nurses demonstrate a strong commitment to children's safety and well-being and to building relations with families.
The findings suggest an increased focus on strengthening public health nurses' knowledge of child maltreatment and improved interdisciplinary collaboration.
The findings are of interest to healthcare professionals and health authorities to improve child maltreatment preventive work in primary healthcare.
This review adhered to relevant EQUATOR guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
PROSPERO registration number: CRD42025637855.
FreshRSS 