The COVID-19 pandemic has made long-standing nursing workforce challenges apparent on an international scale. Decision-makers must develop multi-pronged approaches to foster the development and maintenance of a strong nursing workforce to support health systems. These approaches require attendance to recruitment and retention initiatives that show promise for stabilising the nursing workforce now and into the future.

Searches were conducted across MEDLINE, Embase, CINAHL and Scopus from January 2014 up to 11 March 2024. This rapid umbrella review protocol is guided by the Joanna Briggs Institute scoping review methodology and adheres to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The research question guiding this review is: what structures have healthcare systems put in place to stabilise, support and sustain the nursing workforce? This review will include existing reviews of nursing workforce initiatives with outcomes that impact nursing recruitment and retention. Results will support local health transformation including the development of a jurisdictional nursing workforce stabilisation strategy. Findings from this review will be relevant for the design, refinement and implementation of nursing workforce sustainability strategies in countries around the globe and may apply to strategies for other healthcare workers.

Institutional research ethics board exemption was received. The research team is supported by an advisory group that includes provider and patient partners. The results from this study will inform the Nursing Workforce Strategy for the province of Nova Scotia as part of a larger Canadian Institutes of Health Research-funded project. They will also inform broader planning and strategy in Canada through integration with other evidence-generation activities such as comparative policy analyses and workforce planning exercises. Finally, the results will be published in a peer-reviewed journal.

Registered through Open Science Framework: https://doi.org/10.17605/OSF.IO/CUJYK

To compare outcome data of hemicolectomy patients before and after the establishment of a preoperative anaesthesia assessment clinic (PAC).

This observational study was conducted retrospectively through an electronic health record review covering periods before (2014–2017) and after (2017–2022) the PAC was established.

An acute care hospital in Norway.

A total of 612 patients undergoing elective open or laparoscopic hemicolectomy were included, of whom 338 (55.2%) had attended the PAC.

The primary outcome was the rate of cancellation of planned surgeries, and the secondary outcomes were length of hospital stay (LOS), unanticipated intraoperative anaesthesia-related events and the presence of documentation relevant to the planning of anaesthesia in the patient’s medical records preoperatively.

Compared with the after-PAC cohort, the before-PAC cohort was numerically more likely to have their planned surgery cancelled (OR=1.97, 95% CI (0.84 to 4.61); p=0.12). The before-PAC cohort also had a numerically lower rate of unanticipated intraoperative anaesthesia-related events (18.6%) than the after-PAC cohort (22.5%; p=0.240). However, neither of these differences was statistically significant. Median LOS was significantly shorter in the after-PAC cohort (4.79 days, IQR (3.80–6.12)) than in the before-PAC cohort (5.16 days (4.09–7.18); p=0.001). Moreover, the presence of documentation relevant to the planned anaesthesia in the medical records was significantly more common for after-PAC patients.

The establishment of the PAC reduced the rate of planned surgery cancellations but increased the rate of recorded intraoperative anaesthesia events. Patients who attended the PAC had a significantly shorter LOS and more anaesthesia-related information in their medical records.

NCT05520229.

Factors associated with multimorbidity, polypharmacy and Medication Regimen Complexity Index (MRCI) may vary across countries. However, such data are lacking in the present study setting. This study aimed to identify factors associated with multimorbidity, polypharmacy and MRCI among adults living with hypertension in public hospitals of South Gondar Zone.

Multicentred cross-sectional design

Public hospitals of Comprehensive Specialised and Primary Hospitals, Ethiopia.

Adults living with hypertension who had follow-up visits at outpatient clinics and were selected by systematic random sampling from 1 December 2021 to 28 February 2022.

Medication regimen complexity was assessed using a 65-item medication regimen complexity tool. Sociodemographic data were collected through an interview, while polypharmacy and clinical characteristics were documented using a checklist. Data were entered into SPSS V.26 and analysed using STATA V.17. A binary logistic regression model was used to determine the AOR of factors associated with multimorbidity and polypharmacy. For factors influencing MRCI, an ordinal logistic regression was used.

We found participants from Nefas Mewucha Hospital (AOR = 0.3, 95% CI 0.15 to 0.59) and Mekane Eyesus Hospital (AOR = 0.17, 95% CI 0.07 to 0.38), compared with Debre Tabor Comprehensive Specialised Hospital, polypharmacy (AOR = 5.52, 95% CI 1.49 to 20.39), medium (AOR = 19.76, 95% CI 5.86 to 66.56) and high MRCI (AOR = 120.32, 95% CI 33.12 to 437.07) were associated with multimorbidity. Multimorbidity (AOR = 25.4, 95% CI 7.48 to 86.23), controlled blood pressure (AOR = 0.43, 95% CI 0.19 to 0.92) and duration of hypertension therapy 5 years or more (AOR = 2.12, 95% CI 1.08 to 4.16) were associated with polypharmacy. Whereas controlled BP (AOR = 0.48, 95% CI 0.32 to 0.72) and multimorbidity (AOR = 14.55, 95% CI 9.00 to 23.52) were significantly associated with high MRCI. The prevalence of multimorbidity, high MRCI and polypharmacy was found in 46.1%, 35.22% and 12.29% of participants, respectively.

A considerable proportion of participants with hypertension experienced multimorbidity, polypharmacy and high medication complexity. Polypharmacy, primary hospital setting and high MRCI were independent variables associated with multimorbidity. On the other hand, multimorbidity and controlled BP were associated with polypharmacy and MRCI. Hypertension care should consider multimorbidity, polypharmacy and medication complexity.