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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.
The aim of this study is to assess nurse practitioner students' perceptions and engagement with Isabel's artificial intelligence (AI) based differential diagnosis tool to support their decision-making skills during their theoretical and clinical placement training.
This pilot study used a cross-sectional design.
Twenty-six nurse practitioner students provided feedback on their use of an AI differential diagnosis tool in both academic and clinical contexts. This survey used the Post-Study System Usability Questionnaire to assess the engagement levels and usability of the AI tool. Additional questions were included to evaluate the usage patterns, adequacy in training and confidence in diagnosis.
There were mixed engagement levels: 44.4% (n = 8/18) used Isabel in two subjects—typically one or both clinical placement units—and 27.8% (n = 5/18) in one subject; students most often used the tool to confirm differential diagnoses. Usability was rated positively with the disease ranking, red flag diagnosis and link to national guideline features demonstrating the highest student usage. While most students found the tool beneficial to use during clinical placement and completing university assignments, some reported challenges due to insufficient training, impacting confidence in clinical application.
Isabel has potential as a valuable educational tool in Nurse Practitioner programs, but successful implementation depends on adequate training and support. The findings highlight the importance of comprehensive training and support to maximise AI tool utilisation, with direct implications for programme curricula, clinical education strategies and potential improvements in diagnostic reasoning skills for future nurse practitioners.
This study provides an example of integrating artificial intelligence (AI) guided clinical decision-making training in nurse practitioner (NP) education. The findings can be used by educational institutions to trial similar AI-integrated learning approaches, enhancing diagnostic competence and potentially improving patient care outcomes.
The Study adhered to the STROBE checklist for reporting.
No patient or public contribution was made to this study.
Psychological burden is a central aspect of living with chronic cardiovascular disorders and profoundly affects how individuals experience and cope with fear, dependency and loss of control. Understanding these experiences is essential for delivering high-quality, holistic and person-centred care.
This study explored the experiences of psychological burden among individuals living with chronic cardiovascular disorders in a low- and middle-income context.
We conducted a qualitative descriptive study. Nineteen individuals were purposively recruited using maximum variation sampling and interviewed using a semi-structured interview guide between May and September 2024. Data were analysed using reflexive thematic analysis software (MAXQDA).
The analysis of 19 interviews generated three overarching themes: (a) multifaceted disruption of life from acute onset to enduring dependency; (b) burden of existential fear and struggle for control; and (c) faith-based burden management: prayer, practice and spiritual resilience.
Individuals with chronic cardiovascular disorders experience a significant psychological burden, including sudden illness onset, dependency and existential fear, despite available treatment. Faith, family and community support serve as key sources of coping. The integration of psychological care, spiritual support and culturally sensitive interventions alongside biomedical management is essential for improving outcomes in low and middle-income countries.
Health care professionals should integrate psychological screening and counselling to address existential fears, social withdrawal and suppressed emotional expression among individuals with chronic cardiovascular disorders.
Patients with chronic cardiovascular disorders informed the design of the interview guide, participated in interviews and helped validate the interpretation of findings, ensuring that the study reflected their lived experiences.
This study adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ).
Nanocrystalline silver dressings are increasingly used as alternatives to silver sulfadiazine dressings in burn management, but comparative evidence remains inconclusive. This meta-analysis aimed to compare the efficacy and safety of nanocrystalline silver dressings versus silver sulfadiazine dressings in burn patients.
Systematic review and meta-analysis following PRISMA guidelines. The review was registered with PROSPERO (CRD420251060978).
PubMed, Embase, Cochrane Library and Web of Science were searched from inception through April 2025.
Randomized controlled trials comparing nanocrystalline silver dressings with silver sulfadiazine dressings in burn patients were included. Primary outcomes were wound healing time and adverse events. Secondary outcomes included complete re-epithelialization rates and dressing change frequency. Risk of bias was assessed using the Cochrane risk of bias tool. Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations framework. Meta-analysis was performed using Review Manager 5.4.
Eight randomized controlled trials (724 patients) were included. Nanocrystalline silver dressings significantly reduced wound healing time (mean difference [MD] = −3.29 days, 95% confidence interval [CI]: −3.82 to −2.76; p < 0.00001; I 2 = 0%) and dressing change frequency (MD = −8.76, 95% CI: −12.68 to −4.85; p < 0.00001; I 2 = 94%). No significant differences were found in re-epithelialization rates (odds ratio = 1.08, p = 0.80) or adverse events (risk difference = −0.00, p = 0.99). Evidence certainty was low to very low across all outcomes.
Nanocrystalline silver dressings may offer advantages over silver sulfadiazine dressings in reducing wound healing time and dressing change frequency in burn patients, but the overall certainty of evidence is low to very low. Future well-powered, multicenter trials with standardized outcomes and extended follow-up are needed.
These findings support the consideration of nanocrystalline silver dressings for burn wound management, particularly for reducing wound healing time and nursing workload associated with dressing changes. However, dressing selection should be guided by burn depth, infection risk, patient-specific factors, and resource availability.
We have adhered to relevant EQUATOR guidelines, particularly the PRISMA checklist.
No patient or public contribution.
PROSPERO CRD420251060978.
To explore how nurse practitioners and physicians providing primary care for LGBTQ+ people experience and make sense of their practice.
Qualitative study using Interpretative Phenomenological Analysis.
In-depth, semi-structured interviews were conducted with 12 clinicians (four nurse practitioners, eight physicians) working in LGBTQ+-focused primary care across diverse U.S. regions. Interviews were online, audio-recorded via Zoom, and lasted 50–90 min. Reflexive notes were maintained. Analysis followed Smith and Nizza's six-stage Interpretive Phenomenological Analysis (IPA) process from close reading to experiential statements, clustering to personal experiential themes, development of group experiential themes, and synthesis, supported by memoing and peer debriefing.
Four Group Experiential Themes: (1) Belonging, Affirmation, and the Power of LGBTQ+-Centred Spaces: clinicians practised as their full selves and modelled culturally safe care; (2) Personal Pain as Professional Purpose: personal histories of marginalisation informed a reparative ethic that fostered empathy, trust, and safety; (3) Expanding the Boundaries of Health Work: care routinely extended beyond clinic walls to advocacy, harm reduction, administrative support, and navigation of social determinants amid political precarity; (4) Resistance Within Broken Systems: persistent, invisible labour was required to navigate heteronormative and cisnormative infrastructures.
LGBTQ+-focused primary care operates as clinical practice and social justice work. Clinicians translate lived experience into reparative, relational care while constantly negotiating systemic constraints and policy volatility.
Embed LGBTQ+-affirming competencies and reflexivity in education; redesign digital/administrative systems for affirmed names/pronouns and streamlined access; resource and protect services and staff wellbeing in hostile policy climates.
Problem: Persistent inequities and under-recognised experiential labour in LGBTQ+ primary care. Main Findings: Belonging and affirmation; reparative ethic; expanded health work; daily systemic workarounds. Impact Audience: Nurses, physicians, educators, leaders, and policymakers. Reporting Method: COREQ.
No Patient or Public Contribution.
Chronic diseases are a major global health burden, contributing to morbidity, mortality and healthcare costs. Self-care is essential for effective disease management, with health literacy (HL) and digital health literacy (eHL) playing a role in enabling individuals to engage in health-promoting behaviours. However, the relationship between HL and self-care remains inconclusive, necessitating further investigation to clarify its impact.
To synthesise evidence on the association between HL and self-care in chronic diseases and identify mediating and moderating factors influencing this relationship.
A systematic search was conducted across PubMed, CINAHL, PsycINFO, Embase, Web of Science and Cochrane CENTRAL, supplemented by manual reference checks and author correspondence.
This systematic review and meta-analysis followed PRISMA guidelines, including observational studies and RCTs assessing HL and self-care. Meta-analyses were performed using Fisher's Z transformation. Risk of bias was assessed using ROBINS-E and certainty of evidence was evaluated through GRADE.
A total of 138 studies were included, with 52 meta-analysed. Higher HL was associated with improved self-care behaviours, including medication adherence, disease monitoring and lifestyle modifications across chronic diseases, including type 2 diabetes, heart failure, hypertension, chronic kidney disease, asthma, coronary artery disease, arthritis and COPD. Psychological (self-efficacy, empowerment), cognitive (disease knowledge, decision-making) and social (healthcare communication, social support) factors mediated this relationship, while distress and depression moderated it. Meta-analysis revealed a moderate positive association between HL and self-care (r = 0.29, 95% CI: 0.26–0.31, p < 0.001). Subgroup analyses showed consistent positive effects across conditions. No significant publication bias was detected (Egger's test, p = 0.294). Risk of bias was high in 62 studies, while certainty of evidence ranged from very low to moderate.
HL positively influences self-care in chronic diseases, with its impact shaped by multiple mediators and moderators. Future interventions should integrate tailored education, digital tools and mental health support to enhance HL effectiveness.
PROSPERO (CRD42024488061, registered 20.01.2024).
To explore the meaning of lived experiences of women with a hereditary risk of breast cancer who participate in surveillance of their breasts with magnetic resonance imaging.
Hermeneutic phenomenology.
Interviews on two occasions were made with 14 women in the surveillance programme. The verbatim transcripts were analysed according to van Manen. The analysis was an insightful iterative process and provided a sensitive understanding of the meaning of lived experiences.
Women's lived experiences were that surveillance was constantly present in their lives. Their experiences implied ‘needing to put on a mantle’, ‘not wanting to go through this alone’ and ‘wanting to keep their breasts’. The women created an invisible mantle that they put on when necessary to protect themselves. They wished to be open about their experiences and longed to be truly listened to. The women needed confirmation that they had the ethical right to their values and the choice they had made to participate in the programme. They were aware of the consequences of their decision, but they valued their breasts as a part of their identity and wanted to keep their breasts to remain who they were.
The understanding of the meaning of lived experiences of women in surveillance is vital for the development of person-centred care practice. Person-centredness should be integrated in the surveillance programme guidelines.
The study provides an understanding of the meaning of surveillance from the perspective of women. The evidence that women want to keep their breasts to preserve themselves as a person questions the norm of prioritising the bio-medical perspective in women's care.
COREQ.
No patient or public contribution.
FreshRSS 