Conectar
To examine the use of triage systems in primary care in the UK.
Integrative literature review and narrative synthesis.
PubMed, EMBASE, CINAHL and Cochrane Library were searched in October 2024.
An integrative literature review was conducted following Whittemore and Knafl's (2005) five-step process. Of 1440 articles retrieved, 305 duplicates were removed, and 1086 excluded after title and abstract screening. Two additional articles were identified through citation and hand searches. Twenty studies were quality-assessed using the Mixed Methods Appraisal Tool, and data were extracted for narrative synthesis.
Twenty studies were selected, including four randomised controlled trials, three quasi-experimental studies, eleven descriptive studies and two qualitative studies. The most common type of triage was telephone triage, most frequently performed by nurses. The most common health outcomes included subsequent patient re-contacts after triage, patient symptoms or complaints, current health status and patient safety. The benefits of triage included high patient satisfaction, workload redistribution, reduced GP workload and emergency department crowding, improved resource utilisation, access to care and communication. The challenges of triage included increased overall contact time, mis-triage issues, recruitment and retention challenges, the unsuitability of the decision support tool for the primary care setting and lower usage among older and less affluent groups.
This review examined the current use of triage in primary care in the UK, identifying common patterns in triage processes and classifications. Several benefits were identified, though some ongoing concerns about triage remain.
This paper provides essential evidence about the current use, effectiveness and challenges of triage in UK primary care. The findings can support healthcare policymakers, practitioners and researchers in planning and improving triage systems.
Integrative review.
To explore the direct relationship between financial stress and mental health and wellbeing of nursing students and characterise the effectiveness of available support mechanisms.
Systematic integrative review.
Academic Search Complete, CINAHL, Education Research Complete, MEDLINE, ProQuest Central, PsycNET, Scopus and Web of Science were searched in January and October 2024.
Studies reporting a direct relationship between financial stress and mental health and wellbeing in nursing students were included. Data related to sources of financial stress, mental health impacts, and support mechanisms were extracted, synthesised narratively, and reported thematically.
Findings from nine studies reveal that financial stress significantly affects nursing students' mental health and wellbeing, contributing to emotional distress and reduced quality of life. Financial stress arises from personal, academic and clinical sources, with the intensity varying based on individual demographic profiles and fluctuating throughout their educational journeys. Marginalised and underserved groups experience greater impacts due to pre-existing disadvantages. Current support mechanisms are largely reactive, providing only short-term relief and failing to address root causes. Additionally, students' efforts to alleviate financial stress in one domain often exacerbated it in another.
This review highlights the multifaceted and compounding effects of financial stress on nursing students' mental health and wellbeing. Proactive strategies, including structured employment programs, embedded financial literacy education, and transparent pre-enrolment information offer promising solutions.
While financial stress cannot be fully eradicated, targeted support for at-risk students can mitigate its impacts, improving their mental health and educational outcomes.
This review addresses the critical issue of financial stress among nursing students, highlighting its disproportionate impact on marginalised and underserved groups. It underscores the need for proactive interventions and systemic reform to improve educational experiences globally.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement.
No patient or public contribution.
Trial Registration: PROSPERO: CRD42024514262
To identify the available records surrounding the deployment of perioperative nurses into differing clinical settings during the COVID-19 pandemic.
Integrative review methodology.
Quality appraisal of each record was conducted using a modified Critical Appraisal Skills Programme checklist. Data were extracted and presented based on outlined research objectives.
Six electronic databases (CINAHL Plus, Google Scholar, MEDLINE, Pubmed, Scopus, and Web of Science) were searched, with relevant peer-reviewed records published after 2019 until February 2025 included to differentiate from other respiratory pandemics.
Ten records were included in the review. Opposing discourse exists between perioperative decision makers and those perioperative nurses who underwent deployment to differing clinical areas surrounding perceptions and experiences of deployment during the COVID-19 pandemic.
Few studies exist exploring experiences of perioperative nurse deployment to a different clinical area during the COVID-19 pandemic. Further research is vital to develop strategies that enhance the deployment process and ensure effective patient care across various clinical settings when cared for by deployed perioperative nurses.
Further research exploring transferable perioperative nursing skills and its subsequent influence on safe patient care may enhance and inform nurse deployment practices, enriching future staffing protocols in the event of a future pandemic.
PRISMA guidelines for reporting systematic reviews guided this review.
This study did not include patient or public involvement in its design, conduct, or reporting.
To review current evidence on the implementation and impact of virtual nursing care in long-term aged care.
An integrative rapid literature review.
Medline, CINAHL, Web of Science, Embase, Ageline and Scopus.
The review included studies involving virtual care interventions provided by nurses (or by a multidisciplinary team including nurses) to older people in residential aged care that reported health outcomes or stakeholder experiences. Consistent with PRISMA guidelines, databases were systematically searched in July and August 2024, focusing on literature published since 2014. Studies were screened in Covidence by three team members, with conflicts resolved by additional reviewers. Studies not involving nurses or not set in aged care were excluded.
The search identified 13 studies, which included quantitative, qualitative and mixed-method approaches, conducted in both Australian and international settings, as well as in rural and metropolitan locations. Nurses were often involved as part of an existing virtual care programme, typically located in a hospital setting. The training and credentials of nurses delivering VN varied in terms of specialisation and advanced practice. The model of care in general was ad hoc, though in some cases there were regular, scheduled VN consultations. The time requirements for onsite staff and nurses were not well articulated in any of the studies, and information on the funding models used was also lacking.
There is some evidence that VN interventions in aged care may improve communication, enhance person-centred care and reduce emergency department presentations and hospitalisations.
Rigorous, ongoing evaluation of VN interventions is required to ensure their appropriate application in residential aged care.
To explore the perspectives and experiences of maternity care providers regarding obstetric violence across low-, middle-, and high-income countries.
An integrative review of the literature.
A systematic literature search in CINAHL, Medline (via Ovid), SCOPUS, and the Cochrane Library was conducted from 2014 to 2024. Further papers were identified through a review of the reference lists of identified studies and through email alerts from searched databases. Articles were appraised using the applicable Joanna Briggs Institute qualitative or cross-sectional critical appraisal tool.
Title and abstract screen were undertaken on 2748 records. Fifty-four studies using qualitative, quantitative, and mixed-methods designs were included. Maternity providers across all socio-economic levels described witnessing, and/or involvement in both respectful care and incidents of obstetric violence. The most common forms of obstetric violence were verbal and physical abuse, coercion, unconsented and unnecessary interventions, and violations of privacy and autonomy. Women who were socially marginalised, impoverished, and illiterate were vulnerable to obstetric violence. Differences were noted between low- and high-income countries, with detention of women for non-payment, privacy violations due to building design and lack of space, mistreatment due to HIV status, and women who were considered non-compliant being more vulnerable to obstetric violence in low-and low-middle-income countries. Obstetric violence was justified and normalised in the name of saving the baby, with less focus on the psychological health of the mother.
Our findings demonstrate that obstetric violence is a gender-based violence enabled through patriarchal structures and power imbalances. Maternity providers are witnessing or enacting obstetric violence across low-, middle- and high-income countries, with significant impacts on women and maternity care providers alike. This review highlights opportunities for further research and action to develop health and legal frameworks to prevent instances of obstetric violence and improve outcomes for women and maternity care providers.
A woman-centred approach underpinned by respectful maternity care has benefits for pregnant and birthing women. Obstetric violence, including verbal and physical abuse, coercion, and overmedicalisation, is prevalent in maternity services globally. This integrative review explored the perspectives and experiences of maternity care providers regarding obstetric violence across low-, middle-, and high-income countries. This review highlights the similarities and differences of witnessed, enacted, and perceived obstetric violence from the experience of maternity care providers. This review identifies the covert and overt nature of obstetric violence across low-, middle- and high-income countries. Gaining insight into provider perspectives across low-, middle-, and high-income countries may inform policy and practice reforms to eliminate obstetric violence and advance the provision of respectful maternity care.
This integrative review adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.
No patient or public contribution.
To consolidate the best evidence on digital therapeutic interventions for self-management in patients with hip fragility fractures, providing a foundational guide for clinicians in developing digital therapy-based self-management plans.
Integrative review.
A comprehensive electronic search was conducted across multiple databases, including UpToDate, BMJ Best Practice, Joanna Briggs Institute, Health and Clinical Excellence, Cochrane Library, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Chinese databases like China National Knowledge Infrastructure and SinoMed. This study retrieved papers published from the establishment of the database to September 2023.
Studies were selected based on inclusion criteria, such as relevance to hip fragility fractures and self-management through digital therapies. Quality assessments were conducted independently by two reviewers using established tools for each type of study, ensuring the inclusion of high-quality evidence.
Fifteen studies were included: 4 guidelines, 5 expert consensus documents, 5 systematic reviews and 1 evidence summary. From these, 26 best practices were identified across 4 domains: digital design, self-management influencing factors, intervention plans and intervention content.
This integrative review provides a comprehensive, evidence-based summary of digital therapeutic interventions for self-management in patients with hip fragility fractures. The findings offer healthcare professionals a scientific basis for integrating digital therapy into clinical practice, highlighting its potential to enhance patient self-management.
This review underscores the value of digital therapies in empowering patients to take an active role in their rehabilitation, potentially improving adherence to self-management strategies and long-term outcomes.
No patient or public contribution was used for this study.
To describe interventions to mitigate weight bias among practicing healthcare providers and examine their effectiveness.
An integrative review.
The framework of Whittemore and Knafl (2005) was utilised to identify and synthesise studies of weight bias interventions. Covidence reference management software facilitated screening using predetermined eligibility criteria that is, published in peer-reviewed journals, reported in English, and described outcomes for weight bias mitigation interventions among healthcare providers with a professional practice licence. We evaluated study quality using Joanna Briggs Institute's Critical Appraisal Tools for qualitative and quantitative studies.
Five databases were searched (CINAHL, Embase, EBSCOhost, APA PsycINFO, and Scopus) in July 2024.
Sixteen articles met the inclusion criteria. Four themes emerged: (1) active learning lessens weight bias more than passive learning, (2) multicomponent approaches yield better outcomes, (3) healthcare providers are willing to change their practices, and (4) explicit attitudes and beliefs are more amenable to change than implicit ones. Four sub-themes within theme one included the use of in-person workgroups; films, computer-based, and podcast delivery; written modules; and physical characteristic modifications, such as the use of an adiposity empathy suit. Intervention designs using a theory-based, active learning approach with repeated sessions were most successful at decreasing negative weight-biased attitudes and beliefs.
Interventions that effectively reduce weight bias among practicing healthcare providers vary, yet evidence suggests that weight bias mitigation is achievable. These interventions offer strategies to improve patient-centred care among patients living with obesity.
Healthcare providers often display weight bias. This review synthesises information on effective interventions for reducing bias, which may limit the subsequent negative patient outcomes associated with it.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was the structure used for this paper.
There were no patient or public contributions.
To analyse, critique, and synthesise available research to create a unique framework of the impacts of COVID-19 on acute care nurses.
Whittemore and Knafl's framework was used to organise this review. The Mixed Methods Appraisal Tool was used for quality analysis.
CINAHL, MEDLINE, Web of Science, Scopus and the National Institute of Health COVID-19 database were searched.
Twenty-five articles were included. Impacts on acute care nurses came from changes, access to resources, interrupted relationships, and the virus itself. The outcomes from nurses were categorised as positive, physical, emotional responses, leaving and mental disorders. These outcomes were mediated by making connections, coping, learning and experience, and finding meaning.
Nurses working in acute care during COVID-19 were faced with immense stressors in a tumultuous and dangerous time. The vastly negative outcomes were less surprising than the fact nurses were left to find mitigating factors on their own. Given the large attrition from nursing that occurred and is still occurring, health systems that can both lessen the impacts and strengthen the buffering effects of mediating factors may fare better when the next pandemic comes.
Lessons learned can be used to prepare for future pandemics. Nurses should be at the forefront of all planning whether through education, policy, or research. Having a framework allows for a more comprehensive understanding and provides an underpinning for future action.
The possibility for impact spans nurses across the globe who have worked, and who may work, during a pandemic. This framework provides a basis for changes related to pandemic planning throughout nursing domains.
The researcher has adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement.
No Patient or Public Contribution.
To explore how, under what circumstances and why telerehabilitation can improve adherence to pulmonary rehabilitation in patients with chronic respiratory diseases.
A realist review.
Embase, MEDLINE, CINAHL, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to 2 July 2024 to identify relevant literature.
Initial programme theory was developed through research team meeting, informal literature reading and the use of Capability, Opportunity, Motivation, Behaviour model. After completing the literature search, key evidence was appraised, extracted and synthesised into context-mechanism-outcome configurations.
The review included 23 studies. Seven context-mechanism-outcome configurations were identified. Accessibility and convenience of pulmonary rehabilitation; social interaction and support; technical support; individuality and flexibility of program; getting feedback and seeing results; real-time monitoring of diseases; and diverse motivational incentives were found to be critical for telerehabilitation to improve adherence to pulmonary rehabilitation in patients with chronic respiratory diseases.
This review explains the key mechanisms by which telerehabilitation improves adherence to pulmonary rehabilitation in patients with chronic respiratory diseases, which may contribute to the development and improvement of future pulmonary telerehabilitation interventions.
The program theory developed in this study may guide researchers and clinical staff in the development or improvement of pulmonary telerehabilitation interventions to improve patients' adherence to pulmonary rehabilitation and further support better pulmonary rehabilitation outcomes.
This study adheres to The RAMESES reporting standards.
No patient or public contribution.
Open Science Framework (https://osf.io/). DOI: https://doi.org/10.17605/OSF.IO/YWMQ8
To explore how the legalisation of medical assistance in dying (MAiD) has shaped the discourse of MAiD and its relationship with hospice palliative care (HPC) in Canada.
There is perceived tension in the discourse between the goals of MAiD and HPC, but little literature examines this relationship and the effect it has on healthcare providers such as nurses.
Integrative review following Whittemore and Knafl's and Toronto and Remington's methodology.
A search was conducted to identify literature discussing MAiD and HPC in Canada. Articles were critically appraised for methodological quality. Data from each article were abstracted, thematically analysed, and synthesised.
Initial searches were conducted in CINAHL, PubMed, and professional association and government websites in September 2018 and updated in May 2023.
A total of 457 records were screened for inclusion, and 83 articles were included. Articles included healthcare provider, patient, public, and institutional perspectives. Three themes identified from the data were the relationship between MAiD and HPC, suffering in the context of MAiD, and moral distress and moral uncertainty in providing or not providing MAiD.
The discourse around the relationship between MAiD and HPC is complex and contextual. Personal and professional understandings of end-of-life care differ and influence perspectives on how and whether MAiD and hospice palliative care can be reconciled. More exploration of this topic is recommended, given the changing legislation and beliefs around MAiD.
Findings consider how the concepts of end of life, MAiD, HPC, suffering, and moral distress influence and are influenced by the discourse of dying. This review provides direction for healthcare professionals working in end-of-life care and future ethical and moral areas for consideration.
No patient or public contribution was necessary for this literature review.
To comprehensively understand the meaning of person inclusive care and the care expectations of transgender individuals from health care professionals.
An integrative review was conducted.
Literature was searched in four databases (CINAHL, PubMed, Web of Science and Scopus) and 25 qualitative, quantitative and mixed methods studies published during January 2019–October 2024 were included.
All articles were critically appraised using validated critical appraisal tools. Deductive and constant comparative analyses were used to develop themes and sub-themes.
Person inclusive care was described as: (a) recognition and respect of identity, (b) holistic and individualised care and (c) creating safe and affirming healthcare environments. Care expectations included: (a) empowerment through shared decision-making, (b) person-centred communication, (c) advocacy as a supportive gesture and (d) intersectionality-informed care.
This review highlights the critical importance of person-inclusive care for transgender individuals, emphasising the need for healthcare practices that respect and affirm their identities, provide holistic care, and foster safe and supportive environments.
Transgender individuals experience persistent stigma and discrimination in healthcare settings and beyond. Understanding how to provide person-inclusive care and their care expectations from healthcare professionals is crucial to improving the delivery of quality care. The current body of evidence underscores significant disparities in healthcare for transgender individuals. While advancements in inclusive practices and affirming care models are evident in specific settings, these practices are not universally adopted. Inclusive care equips healthcare professionals with the necessary competencies to deliver high-quality, sensitive care that meets the unique needs of transgender individuals, ultimately fostering trust and equitable health outcomes. Nurses must ensure the delivery of person-inclusive care by demonstrating respect, advocacy, holistic assessment and care and genuine involvement of transgender individuals in decision-making for their care.
No direct patient or public contribution.
To explore the experiences of healthcare staff in organisations undergoing regulatory scrutiny and to identify the professional and organisational impact.
Integrative review.
Medline, CINAHL, Scopus, and Google Scholar.
This review followed Whittemore and Knafl's framework, adhering to PRISMA guidelines. Searches identified peer-reviewed studies from 2010 to 2025 examining healthcare staff under regulatory scrutiny. Studies employing diverse methodologies were included and synthesised using the constant comparison method to identify and refine key themes.
Eight studies were included. Four interrelated themes were identified: (1) workforce wellbeing, autonomy, and professional identity; (2) regulatory culture, organisational adaptation, and quality improvement; (3) communication and relationships; and (4) impact on patient care and contextual variation.
Regulatory scrutiny profoundly shapes healthcare quality and professional culture but can unintentionally undermine workforce adaptability and innovation essential for effective care. These findings highlight the need for nursing-sensitive regulatory approaches that support professional autonomy, reduce burden, and enhance patient-centred care.
This evidence will inform nursing and midwifery policy and practice globally by providing support to inform nuanced, context-sensitive regulatory approaches that safeguard professional autonomy, reduce administrative burden, and promote safe, person-centred care across diverse healthcare settings. It will assist policymakers, healthcare leaders, and educators worldwide in enhancing workforce sustainability, patient safety, and care quality, facilitating the transfer of learning to varied healthcare environments and systems.
Not applicable.
To synthesise the literature around the roles of general practice nurses (GPNs) and the barriers and facilitators of their role.
Integrative literature review using Whittemore and Knafls framework.
Papers were exported into Covidence for screening. Quality was appraised using the Mixed Method Appraisal Tool. Data were extracted into a summary table and analysed using thematic analysis.
CINAHL, Medline, and Google Scholar were used to identify papers published between January 2000 and February 2025 in English that reported primary research about GPN roles.
Twelve papers were included in the review. The four overarching themes were role characteristics, the clinical role, the non-clinical role, and barriers and enablers. Findings suggest ambiguity surrounding the GPN role, with inconsistent perspectives and overlapping responsibilities contributing to underutilisation. GPNs played an important role in continuity of care and reported a desire to spend more time on health promotion, health education and assessment. GPNs were leaders in collaboration as they functioned as agents of connectivity for patients and staff. The GPN role faces both barriers and enablers, with the organisational structure, interprofessional relationships, and professional development.
The GPN role offers an opportunity to enhance access to general practice care. However, there is limited and mixed literature describing the roles of GPNs. Future research should more closely explore the current practice of GPNs to inform policy and optimal utilisation of the workforce to the full extent of their practice scope.
Understanding the complex roles of GPNs requires more robust data on clinical activity. These data would have the potential to inform ways to optimise the GPN role within the multidisciplinary team.
This study adhered to the PRISMA reporting guideline.
This review did not include patient or public involvement.
Using advanced forms of medical technology such as extracorporeal organ support to take over organ function in the face of critical illness is a manifestation of the technological expertise to support and prolong life. However, clinician focus on the technical aspects of extracorporeal organ support both in research and clinical practice has the tendency to relegate to the background and disregard multiple, non-technical components such as the meanings, interactions, and experiences of nurses, families and other healthcare professionals.
To understand how experiences and social interactions of critically ill children, families, and healthcare professionals are influenced by the use of extracorporeal organ support.
Hermeneutic review of the literature.
CINAHL, PubMed and Web of Science followed by cross-citations and snowballing.
A total of 24 studies were included in the review, representing four conceptual streams, namely (1) extracorporeal organ support as a biomedical intervention, (2) relationality concerning extracorporeal organ support, (3) performativity in using extracorporeal organ support and (4) the agential role of extracorporeal organ support.
The hermeneutic framework helped foreground perspectives demonstrating that extracorporeal organ support is not merely a piece of medical technology, but is an active fulcrum upon which human and material elements revolve, interact, and integrate to form multiple assemblages that can influence how the huge volume of nurse work can be reframed beyond the perpetuation of the patient-machine connection and affect the ways by which patients and families are cared for.
Understanding extracorporeal organ support as more than a medical device can enable nurses to develop informed plans of care and advocate for the interests of the family and that of the critically ill child who remains a passive recipient of care in an intensive care bed.
No patient or public contribution.
To advance the understanding of chronic illness self-management among Chinese immigrants in Western countries by synthesising evidence and through the lens of the Middle Range Theory of Self- and Family Management of Chronic Illness.
Integrative review following Whittemore and Knafl.
Two reviewers used Covidence software to screen potential articles. After identifying the sample, reviewers extracted data into a matrix and appraised study quality using Critical Appraisal Skills Programme checklists. Reviewers used the constant comparative method to categorise data into categories: (1) facilitators/barriers, (2) processes and (3) outcomes. Findings were then synthesised and mapped to the theory domains.
MEDLINE, CINAHL, Web of Science, Embase, PsycINFO and ProQuest Central (database inception—August 2025).
Of 3205 records screened, 20 studies met the inclusion criteria with acceptable quality. Personal characteristics/health status, resources/environment, Chinese-Western cross-cultural experiences, family and healthcare systems, and linguistic barriers shaped the processes of Focusing on Illness Needs (developing illness insights, taking ownership of health needs, and health promotion); Activating Resources (Western health care, traditional Chinese practices, community and family support, and blended spiritual resources); and Living with a Chronic Illness (processing emotions, adjusting, integrating, and meaning-making). These processes lead to outcomes including improved disease control, psychological/cognitive well-being, and healthcare utilisation and unintended negative consequences such as emotional burden and delayed care-seeking.
While Chinese immigrants share certain aspects of self-management with Western populations, their approaches are shaped by culturally grounded, family-centred values, traditional health practices, and immigrant experiences, which underscore the need for culturally and contextually sensitive self-management support. The findings also expand the applicability of the guiding theory by identifying new cultural elements.
Nurses can support self-management among Chinese immigrants by developing culturally and linguistically tailored interventions, engaging family members in health education and treatment planning, enhancing accessible digital, community and navigational resources, providing language assistance and strengthening staff training.
We used the PRISMA 2020 checklist for adherence to review protocols.
This study did not include patient or public involvement in its design, conduct or reporting.
This review aims to explore instructional approaches employed in teaching complex procedural skills among caregivers.
Integrative Review.
Electronic searches were conducted across seven databases: CINAHL, PubMed, OVID, ScienceDirect, Web of Science, ProQuest Central and Google Scholar. Manual searches of references within relevant studies were also performed. Original, peer-reviewed studies published in English between 2014 and 2025 were reviewed.
The Whittemore and Knafl method of integrative review was utilised to comprehensively examine literature encompassing various methodological designs. 17 articles that examined the learning of procedural skills among caregivers were included.
The optimal approach to enhancing caregivers' knowledge, competence and confidence involves a learner-centric training model involving multiple phases. Effective caregiving begins with a thorough preparation of the caregiver, which is key to ensuring the success of the training programme. Next, knowledge can be imparted through diverse learning approaches and paradigms to cater to individual learning styles. Subsequently, the translation of knowledge gained to hands-on practice, deepens understanding and enhances caregivers' practical skills competency. Finally, confidence is built through providing opportunities and platforms for repeated practice, leading to mastery and increased confidence over time.
While specific learning pedagogies were not highlighted in the literature, the instructional approaches summarised in the existing literature closely resembled an existing teaching pedagogy: Peyton's Four-Step Approach. This approach is a stepwise teaching framework that has been widely used in healthcare teaching. The approaches used in the studies align with this approach and future interventions should consider designing their training accordingly to enhance its efficacy.
A well-designed training programme fosters caregiver resilience and preparedness, enabling them to navigate challenges effectively and sustainably. Future research could focus on creating an all-encompassing caregiver training that integrates the various approaches. Its feasibility and effectiveness in improving the caregiver preparation process could then be assessed.
No patient or public contribution.
Critical thinking has been identified as a key requirement for safe and competent practice for Nurse Practitioners. It has been suggested that it is the foundation for the development of clinical reasoning, diagnostic reasoning, and clinical judgement. Poorly developed critical thinking is linked to negative patient outcomes, diagnostic error, cognitive bias, and poor information processing. There is little literature that studies the teaching and learning activities that can be used in the development of critical thinking in Nurse Practitioners. The aim of this rapid review was to identify teaching and learning activities that promote critical thinking in Nurse Practitioners.
A rapid review was conducted to identify studies that examined different teaching and learning activities that promoted the development of critical thinking or any of its subthemes such as clinical reasoning, diagnostic reasoning or clinical judgement. Four databases were systematically searched: CINAHL, Medline, Embase and ERIC. The methodology used was guided by the Cochrane Rapid Review Methods Group. Eligible papers included peer-reviewed publications that evaluated the efficacy or effectiveness of teaching or learning strategies used for the development or promotion of critical thinking or its components. The included populations were faculty teaching in a Nurse Practitioner programme, Nurse Practitioners, Nurse Practitioner students or graduate level nursing students.
The search yielded 6421 article titles and abstracts. Of these, 12 were included in the final rapid review. Teaching and learning activities were divided into three themes: classroom, simulation, and written. Classroom activities included problem-based learning, unfolding case scenarios, self-explanation, and Socratic inquiry. Simulation was in the form of high fidelity using standardised patients, computer-based programmes, escape rooms and virtual reality. Written activities included concept mapping, evolving case studies and illness scripts. Study participants noted that using a combination of teaching and learning activities had the greatest impact on their development of critical thinking.
There is limited knowledge on the effects of teaching and learning strategies on the development of critical thinking in nurse practitioners. This review offers a perspective on strategies that were most impactful for student nurse practitioners in their development of the different aspects of critical thinking. Simulation activities were the most researched and using it in combination with other activities was preferred by study participants.
No patient or public contribution as this is a literature review.
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.
FreshRSS 