International Journal of Nursing Studies Advances最新文献

{"title":"Prevalence and causes for enteral nutrition interruptions in inpatients: A mixed-methods study","authors":"Chen Xin , Yubiao Gai , Yuhong Luo , Guixin Liu , Binru Han","doi":"10.1016/j.ijnsa.2025.100472","DOIUrl":"10.1016/j.ijnsa.2025.100472","url":null,"abstract":"<div><h3>Background</h3><div>Disease-related malnutrition is a prevalent condition among hospitalized patients and is closely linked to adverse clinical outcomes. Beyond malnutrition present at admission, various in-hospital factors can further deteriorate nutritional status. A particularly significant yet often underrecognized factor is the interruption of enteral nutrition, which may occur due to diagnostic or therapeutic procedures, gastrointestinal intolerance, or other clinical concerns. While this issue has been extensively studied in intensive care settings, its prevalence, underlying causes, and clinical impact in the general inpatient population remain poorly understood.</div></div><div><h3>Objective</h3><div>To investigate the prevalence and causes of enteral nutrition interruptions among inpatients in tertiary hospitals in China, and to explore the impact of enteral nutrition interruptions on inpatients.</div></div><div><h3>Design</h3><div>A sequential explanatory mixed-methods design was adopted.</div></div><div><h3>Setting(s)</h3><div>The study was conducted in two tertiary hospitals in Beijing and Qingdao, China. The cross-sectional survey included 2328 inpatients from nine departments, and qualitative interviews included 10 inpatients from seven departments.</div></div><div><h3>Methods</h3><div>Initially, a convenience sampling method was adopted to conduct cross-sectional surveys on two separate days in the two tertiary hospitals, aiming to investigate the prevalence and duration of enteral nutrition interruptions across various departments. Subsequently, an interpretative phenomenological analysis was conducted through one-on-one, semi-structured in-depth interviews with patients from different departments who had experienced enteral nutrition interruptions. The interviews aimed to explore patients’ personal experiences, perceived causes of the interruptions, and their physical and psychological impacts.</div></div><div><h3>Results</h3><div>A total of 2328 inpatients were surveyed, among whom 116 experienced enteral nutrition interruptions, with prevalence rates of 3.30 %, 7.01 %, and an overall prevalence of 4.98 %. We classified the causes of enteral nutrition interruptions into 11 categories, with surgery being the most common (73.28 %) and associated with a mean duration of 31.39 ± 24.74 h. Ten inpatients participated in qualitative interviews, which revealed that enteral nutrition interruptions resulted from various factors, some of which were avoidable, and had negative impacts on physical function, appetite, and psychological well-being.</div></div><div><h3>Conclusions</h3><div>Enteral nutrition interruptions were observed across different clinical departments in Chinese hospitals. Inpatients may experience multiple enteral nutrition interruptions during a single admission, caused by diverse factors, leading to adverse physical and psychological effects. Healthcare professionals could reduce the occurrence of enteral nutri","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100472"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ageism toward older adults among healthcare workers and students: A scoping review","authors":"Quynh Thuong Huynh,&nbsp;Aletheia Xuanyu Lai,&nbsp;Tiow Shen Chua,&nbsp;Yan Ling Phoon,&nbsp;Kang Lynn Wong,&nbsp;Yi En Ng,&nbsp;Margaret Mei Ling Soon","doi":"10.1016/j.ijnsa.2025.100468","DOIUrl":"10.1016/j.ijnsa.2025.100468","url":null,"abstract":"<div><h3>Introduction</h3><div>Ageism, particularly against older adults, is widespread in different settings, including public policies, healthcare institutions, workplaces and media. Its pervasive presence, especially in healthcare settings, has caused a significant impact on the economics and healthcare expenses and has become a growing concern. Older adults' health outcomes are impacted by both positive and negative ageism displayed by healthcare workers and students. Although multiple reviews have studied ageism in healthcare, literature mapping the presence of both positive and negative ageism among healthcare workers and students while synthesizing current interventions remains lacking.</div></div><div><h3>Objective</h3><div>This scoping review aims to map the presence of both positive and negative ageism among healthcare workers and students as well as synthesise the current types of interventions that address ageism among HCWs and students and its outcome.</div></div><div><h3>Methods</h3><div>This scoping review followed Arksey and O’Malley’s five-step methodology. A total of 156 studies were included.</div></div><div><h3>Results</h3><div>The included studies comprise 134 quantitative, 14 qualitative and 8 mixed-method studies. Most studies are conducted in high-income countries, while none of them are conducted in low-income countries. The majority are mainly focusing on the nursing profession and nursing students. Furthermore, almost two-thirds of the included studies are particularly looking at healthcare students. The findings show that almost half of the healthcare workers and students have positive ageism toward older adults. Surprisingly, only about 10 % reported negative ageism. Mixed, neutral and inconclusive presence of ageism are also reported. Various interventions have been adopted to tackle ageism, such as courses and curriculum interventions, clinical experience, intergenerational interaction, mentoring, simulation and psychological training. In addition, this scoping review highlights the need to develop a comprehensive scale to measure ageism accurately and evaluate existing interventions.</div></div><div><h3>Implication</h3><div>Future studies should focus more on underrepresented regions such as low-income countries, Southeast Asia, and Africa. At the same time, to improve comparability across different studies, a widely accepted tool for evaluating both positive and negative ageism needs to be developed.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100468"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing management decisions in fever: a mixed-methods approach to understanding","authors":"Lu-Yen A Chen ,&nbsp;Tonks N Fawcett ,&nbsp;Colin Chandler ,&nbsp;Tzu-Wen Weng","doi":"10.1016/j.ijnsa.2026.100486","DOIUrl":"10.1016/j.ijnsa.2026.100486","url":null,"abstract":"<div><h3>Background</h3><div>Fever is a common symptom among hospitalized patients and often triggers nursing interventions. Although clinical guidelines recommend the use of antipyretics primarily to alleviate patient discomfort rather than to normalize temperature, both pharmacological and non-pharmacological treatments remain routinely employed. However, the rationale behind these interventions in adult care settings remains poorly understood.</div></div><div><h3>Aim</h3><div>This study aims to explore how nurses manage fever in adult patients and examine the rationale underpinning their clinical decisions in fever management.</div></div><div><h3>Methods</h3><div>A sequential explanatory mixed-methods design was employed. Quantitative data on nurses’ fever management and decision-making for patients with fever were collected via an online survey of 177 registered nurses in Scotland. Qualitative data on nurses’ rationale and experience in managing fever were obtained through open-text responses in the online survey and five follow-up interviews. Thematic analysis and descriptive statistics were integrated to interpret findings.</div></div><div><h3>Results</h3><div>Independent nursing judgement was the most frequently cited rationale for fever intervention (49.2 %). However, according to the qualitative finding, clinical decisions were predominantly influenced by habitual routines, institutional norms, and risk-averse thinking. Participants frequently initiated interventions as part of the Sepsis Six protocol, even in the absence of confirmed infection. Fever phobia, defined as exaggerated perceptions of fever-related harm, was evident in both interview and questionnaire data. Comfort was commonly cited as a justification for treatment, yet few participants reassessed patient comfort after administering interventions.</div></div><div><h3>Conclusion</h3><div>Nurses’ fever management is influenced more by embedded routines and clinical culture than by formal knowledge or guideline adherence. Fever phobia and Sepsis Six pressures can contribute to unnecessary intervention, highlighting the need for reflective education and systems-level support for evidence-based practice.</div><div>The result of this study illustrated the potential for overtreatment in fever care and provides actionable insights to support evidence-informed decision-making in nursing practice. Future initiatives should focus on challenging fever phobia, supporting critical reflection, and aligning practice with current evidence through targeted educational strategies.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100486"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and determinants of artificial intelligence (AI) literacy in Chinese nursing students: A cross-sectional study","authors":"Xuefen Lan ,&nbsp;Min Li ,&nbsp;Yu Wang ,&nbsp;Miaoqin Chen ,&nbsp;Heyun Jiang ,&nbsp;Shunfei Lu ,&nbsp;Ying Zhou","doi":"10.1016/j.ijnsa.2026.100482","DOIUrl":"10.1016/j.ijnsa.2026.100482","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Artificial intelligence literacy is essential for nursing students to become competent in navigating contemporary healthcare complexities and to ensure safe patient care. This literacy is needed urgently due to the rapid integration of artificial intelligence into the clinical, educational, and research domains. This integration requires immediate adaptation in order to mitigate ethical risks in tech-driven healthcare.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this study was to examine both the level and determinants of artificial intelligence literacy among nursing students.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A cross-sectional study was conducted from April 1 to April 20, 2025.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting(s)&lt;/h3&gt;&lt;div&gt;This study was conducted at a public higher education institution that offered a Master of Science in Nursing program.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Four hundred and twenty-three nursing students were enrolled in the study using convenience sampling.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Anonymous, self-administered online questionnaires were completed by the participants. Descriptive statistics including means, standard deviations, frequencies, and percentages were computed to characterize the sample. Multivariable linear regression analysis with adjustment for relevant covariates was then performed to examine potential associations between the variables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Moderate but uneven artificial intelligence literacy was observed among the nursing students, with a mean artificial intelligence literacy scale score of 59.67 (SD = 8.52). The ethics dimension was the least developed, in contrast to better performance in operational usage. Significant predictors of artificial intelligence literacy included frequency of artificial intelligence use, attitudes toward artificial intelligence, and digital literacy. Dimension-specific associations were identified and included correlation of awareness with gender, attitudes toward artificial intelligence, interest in artificial intelligence and digital literacy; usage with age, frequency of artificial intelligence use, and attitudes toward artificial intelligence; evaluation with attitudes toward artificial intelligence; and ethics with gender.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study identified key determinants that influenced the artificial intelligence literacy of nursing students and showed that artificial intelligence ethics was the most deficient domain among Chinese nursing cohorts. Notably, the frequency of artificial intelligence use, attitudes toward artificial intelligence, interest in artificial intelligence, and digital literacy collectively shaped the artificial intelligence literacy profiles of nursing students. Practical implications including developing and implementing targeted interventions such as artificial intelligence ethics workshops and digital literacy curricula are necessary to enh","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100482"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult social care nursing: A hybrid concept analysis","authors":"Claire Pryor ,&nbsp;Siobhán Kelly ,&nbsp;Vanessa Heaslip ,&nbsp;Deepa Korea ,&nbsp;Melanie Stephens","doi":"10.1016/j.ijnsa.2026.100491","DOIUrl":"10.1016/j.ijnsa.2026.100491","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The concept of adult social care nursing is poorly articulated in the literature. This study explores and defines adult social care nursing by examining its antecedents, attributes, and consequences. By clarifying this concept, the research aims to enhance understanding among policymakers, educators, service providers, and the public, fostering greater recognition of social care nurses' roles, workplaces, and contributions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A qualitative hybrid concept analysis model was used. This approach combined theoretical examination with empirical inquiry to develop a comprehensive understanding of the concept. The study was structured in four phases: concept identification, literature review, empirical data collection, and integrative analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data sources&lt;/h3&gt;&lt;div&gt;A comprehensive literature search was conducted using CINHAL, Medline, APA PsycInfo, Wiley Online, OVID, and The King’s Fund library. Grey literature was explored through the Department of Health and Social Care’s adult social care collection, expert consultation, and reference handpicking.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Nineteen participants took part via four focus groups, two 2:1 interviews, and one 1:1 interview. Eighteen participants were registered nurses, and one participant was a registered social worker with experience of working with nurses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Using a hybrid concept analysis approach, the study progressed through multiple phases. A preliminary exploration (Phase 1) provided an initial conceptual framework, which was refined through a literature review (Phase 2). Empirical fieldwork (Phase 3) involved focus groups and interviews, thematic content analysis was utilised to identify key attributes, followed by integrative analysis to synthesise findings and refine the conceptual model. The study was not registered in a trial registry given it is a qualitative study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;This study identified that adult social care nursing is present when people have a combination of health and social care needs that require registered nurses’ care. Attributes include a career of choice, independent and autonomous nursing, with professional and business skill development including advanced practice. This supports social care nurses in their goal to be dynamic change agents who empower people to be active participants in their own care, with improved quality of life, being able to live well with their health needs in a social context.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This paper proposes an initial definition of nursing within adult social care, which serves as a foundation for further discussion and development. It highlights nurses' vital role, diverse skill set, and equal partnership in the social care landscape, reinforcing their significant contributions to integrated, person-centred care across diverse settings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;So","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100491"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a transformer-based AI-based application to support incontinence-associated dermatitis and pressure injury assessment, nursing care and documentation: Controlled pilot intervention study","authors":"Hannah Pinnekamp ,&nbsp;Vanessa Priester ,&nbsp;Johanna Steidle ,&nbsp;Khalid Majjouti ,&nbsp;Alexander Brehmer ,&nbsp;Michaela Tapp-Herrenbrück ,&nbsp;Michael Aleithe ,&nbsp;Jens Kleesiek ,&nbsp;Bernadette Hosters ,&nbsp;Uli Fischer","doi":"10.1016/j.ijnsa.2026.100479","DOIUrl":"10.1016/j.ijnsa.2026.100479","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Artificial intelligence (AI) is playing an increasingly important role in nursing care, including wound management. Differentiating pressure injuries from incontinence-associated dermatitis is clinically challenging, often leading to misclassification. Although AI-based wound assessment is advancing, few models specifically address incontinence-associated dermatitis, and clinical evidence remains limited. The KIADEKU project developed and piloted a transformer-based AI app to support care for these wounds.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this pilot intervention study was to assess the impact of the AI-based app on duration of wound assessment, dressing changes, documentation, nursing staff task load, and guideline adherence. Secondary aims included evaluating the AI’s accuracy and app usability compared to standard systems.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;This monocentric, non-randomized controlled study was conducted in two sequential phases: a control phase with conventional wound management, followed by an intervention phase utilizing the AI-based app.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting and Participants&lt;/h3&gt;&lt;div&gt;The study included 88 voluntary nurses caring for pressure injuries and incontinence-associated dermatitis in adult patients on seven participating wards of LMU Hospital.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Wound care was systematically observed, and nurses completed questionnaires on task load, usability, and covariates. Outcomes were measured using standardized protocols, validated tools (NASA Task Load Index (NASA-TLX), Usability Metric for User Experience (UMUX-LITE)) and expert-defined indicators. Statistical analyses included descriptive statistics, group comparisons (t-test, Mann-Whitney U test), and multivariate linear regression adjusting for covariates. An independent wound assessment validated AI-generated predictions, with accuracy evaluated using F1-scores.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 88 wound care sessions were analysed. The intervention group had a statistically significantly longer mean duration of care and documentation (12.84 vs. 9.20 min; p = 0.002; 95 % CI: –5.59; –1.41 min) and higher guideline adherence (mean rank = 50.91 vs. 38.38; p = 0.017). Nurse task load showed no statistically significant group differences. Regression analysis identified AI app use, nurse qualification, and wound severity as statistically significant predictors of care duration, while AI use did not predict task load or guideline adherence. Usability ratings were similar to standard systems. Model performance showed high accuracy in identifying wound types, but lower accuracy in classifying their categories.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This pilot study is the first to evaluate an AI-based app supporting nursing wound management for pressure injuries and incontinence-associated dermatitis. While the app did not reduce care duration or nurse workload, it may have po","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100479"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressure ulcer practice in European hospitals: a scoping review","authors":"Jan Kottner,&nbsp;Ulrike Linstedt,&nbsp;Ahmed Tafesh,&nbsp;Monira El Genedy-Kalyoncu","doi":"10.1016/j.ijnsa.2025.100477","DOIUrl":"10.1016/j.ijnsa.2025.100477","url":null,"abstract":"<div><h3>Background</h3><div>Pressure ulcer prevention and management belong to the core topics of nursing practice and research for decades. Numerous systematic reviews, clinical practice guidelines, and good practice documents are available, but pressure ulcer prevention and treatment may not be conducted following state-of-the-art methods in clinical practice.</div></div><div><h3>Objectives</h3><div>The overall objective was to describe and map the available evidence regarding pressure ulcer prevention and treatment practices in European hospitals.</div></div><div><h3>Methods</h3><div>A scoping review was conducted in the databases Embase and Medline (via OVID) and CINAHL including descriptive empirical studies published between 2014 and 2024. The population included all healthcare professionals, and context was hospitals in the European Union.</div></div><div><h3>Results</h3><div>Forty-six studies from 18 countries were included, describing 33 structure and 32 process aspects. The categories knowledge (<em>n</em> = 19) and attitudes (<em>n</em> = 11) were examined or identified by far the most frequently. Formal education and qualification were mentioned 10 times and personal interest and/or commitment 7 times. At the system level, the availability of and access to clear standards or protocols was mentioned most frequently. Most frequent process aspects included pressure ulcer risk assessment (<em>n</em> = 10), the type of risk assessment (<em>n</em> = 7), skin assessment (<em>n</em> = 10), repositioning (<em>n</em> = 9) and the use of support surfaces (<em>n</em> = 7).</div></div><div><h3>Conclusion</h3><div>More than 60 organizational, structural, and process characteristics were identified as potentially influencing pressure ulcer practice in European hospitals. Individual knowledge and attitudes and the availability of standards/protocols were most often investigated indicating a perceived priority in shaping pressure ulcer practice. Since all studies indicate knowledge deficits and a lack of implementation of basic prophylactic measures, there seems to be high potential to improve pressure ulcer prevention and enhance patient safety.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100477"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing scalable strategies for early essential newborn care: A network-driven qualitative analysis","authors":"Hongxiao He ,&nbsp;Dandan Lv ,&nbsp;Ning Liu ,&nbsp;Jiahe Li ,&nbsp;Junying Li ,&nbsp;Xian Zhang ,&nbsp;Jiasi Yao ,&nbsp;Hong Lu ,&nbsp;Jinbing An ,&nbsp;Xiu Zhu","doi":"10.1016/j.ijnsa.2026.100505","DOIUrl":"10.1016/j.ijnsa.2026.100505","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization's early essential newborn care package is an evidence-based intervention proven to reduce neonatal mortality and improve maternal-newborn outcomes. Nevertheless, a significant evidence-practice gap hinders its implementation in the real world.</div></div><div><h3>Purpose</h3><div>We aimed to demonstrate the application of two analytical approaches to characterize early essential newborn care implementation in China, to identify barriers and facilitators influencing early essential newborn care implementation, and to propose possible strategies for its effective scaling-up and promotion.</div></div><div><h3>Methods</h3><div>In this descriptive qualitative study, we performed semi-structured interviews with 33 healthcare professionals from six tertiary hospitals in China. Data were analyzed through deductive thematic coding based on the consolidated framework for implementation research, followed by computational network analysis to examine the interactions among these factors and identify pivotal implementation strategies.</div></div><div><h3>Results</h3><div>We identified a comprehensive set of 11 barriers and 39 facilitators associated with early essential newborn care implementation across all five domains in the consolidated framework for implementation research. The prominent barriers included safety concerns among healthcare providers, lack of unified implementation standards, resource limitations (staffing and equipment), and incompatibility with existing workflows. The key facilitators comprised knowledge acquisition, positive belief changes, leadership support, and organizational support system. Correspondingly, four key strategies were developed: initial implementation of early essential newborn care, leadership support, unified standards for implementation, and feedback &amp; quality control.</div></div><div><h3>Conclusions</h3><div>The implementation of early essential newborn care is shaped by a complex and interrelated set of determinants. To move from insight to action, this study pinpoints four high-leverage strategies: initiating early essential newborn care, securing leadership support, establishing unified standards, and implementing continuous feedback &amp; quality control. These strategies provide a practical, adaptable framework to overcome implementation challenges, scale up effective care, and ultimately improve outcomes for newborns and mothers.</div></div><div><h3>Study registration</h3><div>Not registered.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100505"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health gains from rehabilitation programs implemented by nurses for older people with impaired mobility and self-care deficit: A scoping review","authors":"Elisabete Alves ,&nbsp;Ana Ramos ,&nbsp;Paula Pereira ,&nbsp;Mauro Lopes ,&nbsp;César Fonseca","doi":"10.1016/j.ijnsa.2026.100484","DOIUrl":"10.1016/j.ijnsa.2026.100484","url":null,"abstract":"<div><h3>Introduction</h3><div>Ageing is a multifactorial and progressive process that leads to a gradual decline in mental and physical function, directly impacting the ability to perform daily living activities and health-related quality of life. Thus, it is essential to develop strategies that prioritize the maintenance of the functional capacity and the enhancement of the quality of life and well-being of older adults.</div></div><div><h3>Objective</h3><div>This scoping review intends to map the rehabilitation programs, used by rehabilitation nurses, for promoting mobility and self-care, among older adults, to identify the main health gains resulting from the rehabilitation programs implemented.</div></div><div><h3>Methods</h3><div>This scoping review follows the JBI methodology and the results obtained are described according to the PRISMA-ScR guidelines, and was registered in the OSF (osf.io/zqkp3/). The electronic databases CINAHL Complete; Complete MEDLINE; Cochrane Central Register of Controlled Trials; Web of Science, Scopus, and Google Scholar, were searched in March 2025, for papers published in the last 10 years. Two researchers independently analyzed the papers for eligibility and extracted the data. Data on health gains whose association with the intervention was described were collected and synthetized, through narrative synthesis.</div></div><div><h3>Results</h3><div>The initial search yielded a total of 15,347 records, and after screening, 12 papers were included. The evaluation of the methodological quality and levels of evidence of the studies, according to the JBI Critical Appraisal Tool, concluded that the average quality score of the studies ranged from 67% to 100%. The results revealed a variety of interventions implemented, targeting different aspects of rehabilitation, with a wide range in the duration (15 to 60 min) and frequency of sessions (three to 56), as well as the use of diverse instruments to assess the effectiveness of the interventions. The health gains associated with the musculoskeletal system were reported most frequently, followed by those related to neurocognitive enhancements. Respiratory and renal gains were only reported by one study each.</div></div><div><h3>Conclusions</h3><div>This scoping review reinforces the evolving vision of nursing rehabilitation as a cornerstone of comprehensive healthcare, demonstrating its significant impact on enhancing health gains at several physiologic systems among older adults. Adopting a multiple physiological system-based framework for the analysis and implementation of these interventions may enhance the precision, accountability, and efficacy of care. Such poses nursing rehabilitation as an essential strategy in the continuum of care, advocating for its integration into healthcare systems and policies to support the health and sustainable recovery of the older population.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100484"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse staffing skill mix and acuity-adjusted provision ratios in Swedish neonatal care: A cohort benchmark study","authors":"Pernilla Dillner ,&nbsp;Katarina E. Göransson ,&nbsp;Mikael Norman ,&nbsp;Maria Unbeck ,&nbsp;Ulrika Förberg","doi":"10.1016/j.ijnsa.2025.100471","DOIUrl":"10.1016/j.ijnsa.2025.100471","url":null,"abstract":"<div><h3>Background</h3><div>The development of neonatal intensive care has substantially reduced infant mortality, still, infants remain at high risk for adverse outcomes. Safe care relies on adequate nurse staffing and an appropriate skill mix, which is especially important in neonatal intensive care as infants are extremely vulnerable to harm when quality lapses occur. Although international guidelines recommend optimal nurse-to-patient ratios for neonatal care, these standards have not been fully implemented, leaving it unclear whether current staffing levels align with recommendations for safe staffing.</div></div><div><h3>Objective</h3><div>To benchmark the acuity-adjusted registered nurse staffing provision ratio in neonatal intensive care and determine the skill mix distribution and variation of nursing staff across shifts.</div></div><div><h3>Method</h3><div>This retrospective cohort study included infant data from a 16-week period in 2022 in three neonatal intensive care units with a common administration at a university hospital. Data were obtained from the hospital’s data repository and the Swedish Neonatal Quality Register, including 609 neonatal admissions and 345 nursing staff members working 1008 shifts. Infants’ daily acuity levels were assessed using an adapted version of the British Association of Perinatal Medicine’s guideline, classifying infants into three levels: intensive care, high dependency care, and special care. Staffing provision was measured as the number of worked hours per shift, staff category, and unit. The registered nurse provision ratio was defined as the number of registered nurse hours provided divided by the recommended hours. A ratio below 1.0 indicates understaffing.</div></div><div><h3>Results</h3><div>The population’s total in-hospital days were 4674, and the mean birth weight was 2843 g (SD 1029), with 57.0 % being boys. The proportion of registered nurses relative to nursing assistants ranged from 22.2 % to 85.7 %, with a median of 46.5 %. Registered nurses with specialist education accounted for a median of 73.0 % of total registered nurse hours. Within each unit, the mean acuity-adjusted number of registered nurses recommended by the British Association of Perinatal Medicine’s standard was relatively consistent across shift types and between weekdays and weekends. However, the required number of registered nurses between individual shifts showed considerable variation, ranging from 2.5 to 10.3. During the inclusion period, 81.2 % of the shifts had a registered nurse provision ratio below 1.0, suggesting that most shifts did not meet the recommendations for staffing levels.</div></div><div><h3>Conclusions</h3><div>This study highlights a shortfall in registered nurse staffing relative to recommended levels. Ensuring adequate registered nurse staffing levels is crucial for maintaining high-quality neonatal care and improving infant outcomes.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100471"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}