Journal of Nursing最新文献

{"title":"[Using Interactive Teaching Materials to Enhance Medication Knowledge in Post-Liver Transplant Patients].","authors":"Ting-Hsien Chen, Shu-Han Liu, Pa-Ru Shi, Ching-Chuan Chuang, Wan-Lan Tang","doi":"10.6224/JN.202510_72(5).10","DOIUrl":"https://doi.org/10.6224/JN.202510_72(5).10","url":null,"abstract":"<p><strong>Background & problems: </strong>Liver transplant recipients require lifelong polypharmacy to maintain graft viability and prevent rejection. However, nurses frequently receive patient complaints regarding the inconvenience of carrying printed educational materials, which are often described as unengaging, text-heavy, and difficult to read due to small font size and unclear images. In addition, patients report difficulties retaining information from verbal counseling sessions, often due to rapid delivery and lack of reinforcement, leading to suboptimal medication literacy. These issues highlight the need for an improved, patient-centered education approach and provided the impetus for this quality improvement project.</p><p><strong>Purpose: </strong>This project was designed to assess current medication education practices and barriers among post-liver transplant patients and then implement targeted interventions aimed at improving patient medication comprehension and self-management capabilities.</p><p><strong>Resolutions: </strong>The results of the problem analysis confirmed the inadequacy of using current paper-based manuals as educational tools. Therefore, new educational videos on medication were recorded, an \"E-learning New Liver Baby Medication Log\" was established, a \"New Liver Timetable Medication Identification Card Set\" and \"New Liver Pop Quiz Medication Identification Card Set\" were created, a \"New Liver Baby Q&A\" was added, and a monitoring mechanism was established.</p><p><strong>Results: </strong>Patient medication knowledge increased from 67.2% pretest to 94.8% posttest and patient satisfaction increased from 79.2% pretest to 98.5% posttest, achieving the project goals.</p><p><strong>Conclusions: </strong>Using the new educational videos, E-learning medication log, liver timetable and pop quiz medication identification card sets, and liver baby Q&A can improve patient medication knowledge, increase their medication adherence, help maintain transplanted organ functions, and improve quality of life.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 5","pages":"80-89"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207805","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":"[Analysis of the Current Nursing Workforce Landscape: Policy Impacts and Future Directions].","authors":"Shao-Jun Sun, Lu-Yen Anny Chen","doi":"10.6224/JN.202510_72(5).05","DOIUrl":"https://doi.org/10.6224/JN.202510_72(5).05","url":null,"abstract":"<p><p>The persistent nursing workforce shortage faced in Taiwan negatively impacts healthcare system stability and patient care quality. This article was conducted to analyze national nursing workforce data and trends from 2015 to 2024 in terms of population aging, domestic and international policy shifts, and key clinical practice challenges. Despite a gradual increasing number of practicing nurses, gaps between licensure, willingness to remain, and actual nursing education enrollment numbers highlight the existence of two crises in terms of 1) nurses obtaining licenses but not entering practice and 2) the high rate of attrition among early-career nurses. In this paper, related initiatives implemented by the Executive Yuan and Ministry of Health and Welfare are examined; Taiwan's response is compared to that of other countries; and gaps in nursing role development, compensation structures, and career advancement are identified. The findings call for implementing an integrated, cross-ministerial, and evidence-based nursing policy framework alongside stronger academic-to-clinical transitions and workplace retention strategies. The policy-relevant insights given may be referenced by decision-makers and healthcare administrators aiming to sustain and strengthen Taiwan's nursing foundation.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 5","pages":"27-33"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207848","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":"[Entrustment: Innovation and Practice in Nursing Education].","authors":"Chia-Chuan Chang","doi":"10.6224/JN.202508_72(4).01","DOIUrl":"https://doi.org/10.6224/JN.202508_72(4).01","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The World Health Organization has projected a global shortage of 5.7 million nurses by 2030 (World Health Organization, 2024). However, the International Council of Nurses warns that, in light of the COVID-19 pandemic and ongoing workforce shortages, this gap could escalate to as many as 13 million over the same timeframe (International Council of Nurses, 2021). With nursing personnel shortages, rising disease complexity, and aging populations, healthcare systems around the world, including Taiwan, are faced with considerable challenges. To address the challenges faced specifically by the nursing workforce in Taiwan over the next decade, the Ministry of Health and Welfare and the National Health Research Institutes convened a national forum in 2021, bringing together dozens of nursing experts to propose forward-looking strategies and policy recommendations. The forum emphasized the urgent need to reform nursing education and workforce development in order to expand capacity through innovation. Key proposals stressed the importance of enhancing both the quality and quantity of the nursing workforce, aligning educational curricula with real-world demands, and bridging the persistent theory-practice gap that currently impedes new graduates from transitioning smoothly into clinical roles. The aim was to cultivate competent and practice-ready professionals capable of delivering safe, high-quality patient care and contributing to public health (National Health Research Institutes, 2022). This issue turns the spotlight on Entrustable Professional Activities (EPAs) as a new and potentially effective framework for nursing education and workforce preparation. EPAs refer to key professional tasks that a trained professional can be entrusted to perform independently (ten Cate, 2020). Successful implementation of these activities requires trainees' contextual competence in integrating canonical knowledge (including foundational medical science, clinical reasoning, physical assessment, and professional and ethical standards) into actual clinical settings (ten Cate et al., 2024). EPAs emphasize real-world tasks at their core. By directly observing trainees' performance in completing tasks within real situations, educators can evaluate their readiness for independent responsibility, make informed, competence-based entrustment decisions, and appropriately delegate patient care duties (ten Cate et al., 2024; ten Cate & Taylor, 2021). EPAs bridge competencies and tasks, embodying an outcomes-oriented, practical approach to teaching and evaluation (ten Cate & Favier, 2022). This model is rapidly gaining traction globally as a viable approach to cultivating independent and practice-ready nursing professionals (Pietsch et al., 2025). Given the complex and multifaceted nature of nursing tasks, proficiency in isolated skills or knowledge areas alone is insufficient to ensure task readiness. Effective clinical practice demands the integration of knowledge, technica","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 4","pages":"4-6"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754563","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":"[Relationship Among Personality, Self-Efficacy, and Perioperative Nursing Competence in Operating Room Nurses].","authors":"Ru-Yu Yan, Wei-Ting Lin","doi":"10.6224/JN.202508_72(4).07","DOIUrl":"https://doi.org/10.6224/JN.202508_72(4).07","url":null,"abstract":"<p><strong>Background: </strong>Perioperative nursing competence encompasses six core areas: foundational knowledge and skills, leadership, proficiency, empathy, professional development, and collaboration. These competences directly affect clinical practice and patient care outcomes.</p><p><strong>Purpose: </strong>This study was designed to explore the relationship among personality, self-efficacy, and perioperative nursing competence in operating room nurses.</p><p><strong>Methods: </strong>A cross-sectional correlational design was used and study data were collected from 119 operating room nurses working at a medical center in southern Taiwan. The instruments used included the Work Locus of Control Scale, the General Self-Efficacy Scale, and the Perceived Perioperative Competence Scale-Revised Short Form. The data were analyzed using Pearson's correlation, linear regression, and logistic regression via SPSS version 20.0.</p><p><strong>Results: </strong>Educational level, professional rank, years of experience, and locus of control personality traits were identified as not significantly related to clinical competence. However, clinical competence was found to correlate positively and significantly with self-efficacy (r = .54, p < .001), explaining 28% of the variance. Moreover, knowledge competence was found to correlate positively and significantly with both educational level (odds ratio, OR = 42.29, p < .001) and years of experience (OR = 1.18, p < .001).</p><p><strong>Conclusions / implications for practice: </strong>Clinical competence may be improved by enhancing self-efficacy, and knowledge competence is positively associated with higher educational levels and more years of experience. In light of these findings, education and training on perioperative nursing competence should be incorporated into advanced training programs and educational curricula in clinical settings. Further research on the factors related to core competencies in Taiwan and appropriate revisions to relevant scales to meet domestic contexts are also recommended to improve professional and educational quality.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 4","pages":"49-58"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754566","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":"[The Anesthetic Management of Postpartum Hemorrhage].","authors":"Shu-Chen Wu","doi":"10.6224/JN.202508_72(4).12","DOIUrl":"https://doi.org/10.6224/JN.202508_72(4).12","url":null,"abstract":"<p><p>Postpartum hemorrhage, classified as either primary or secondary, is a leading cause of maternal mortality worldwide and a common and potentially life-threatening obstetric complication. Successful management of this condition is largely dependent on early detection and timely, appropriate intervention. In assessing the risk of postpartum hemorrhage, factors such as placental abnormalities and hereditary coagulopathies must be considered. The administration of uterotonic agents may reduce the risk of severe hemorrhage, and surgical facilities should be equipped with hybrid operating rooms with angiographic capabilities. In cases of unexpected emergency postpartum hemorrhage, a multidisciplinary approach is essential, involving obstetricians, anesthesiologists, surgical teams, laboratory hematology staff, and interventional radiologists able to perform procedures such as arterial embolization. Effective communication and coordination within these teams are crucial for optimal patient outcomes. Pre-anesthetic preparation should take into account physiological, psychological, and pathological changes associated with pregnancy. The results of related studies indicate that postpartum hemorrhage within 24 hours is not significantly affected by the use of neuraxial anesthesia during vaginal delivery. However, general anesthesia has been shown to increase the risk of postpartum hemorrhage by 8.15 times compared to when regional anesthesia is used. The close monitoring of blood loss, clinical signs, fluid and blood transfusions, electrolyte balance, and acid-base status is essential to maintaining hemodynamic stability. Endotracheal intubation may be necessary, with postoperative extubation risks carefully assessed. Furthermore, clinicians should monitor for complications such as transfusion-related acute lung injury or circulatory overload. In severe cases, patients should be transferred to the intensive care unit for further management.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 4","pages":"98-103"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754567","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":"[A Study of Fatigue and Associated Factors in Hemodialysis Patients].","authors":"Mei-Ling Yeh, Fang-Wen Hu, Kuei-Ying Wang","doi":"10.6224/JN.202508_72(4).08","DOIUrl":"https://doi.org/10.6224/JN.202508_72(4).08","url":null,"abstract":"<p><strong>Background: </strong>Fatigue, one of the most common and burdensome symptoms faced by hemodialysis patients, affects quality of life and increases mortality risk. Although previous studies in Taiwan have explored the factors associated with fatigue and its predictors in dialysis patients, they are limited in terms of number and are largely outdated and do not reflect recent advancements in dialysis care quality. Thus, further investigation is warranted.</p><p><strong>Purpose: </strong>The aim of this study was to explore fatigue and its related factors in a population of hemodialysis patients.</p><p><strong>Methods: </strong>A cross-sectional, correlational research design was used and data were collected from medical records and two structured questionnaires, namely the Hemodialysis Patient Fatigue Scale and the Taiwanese Depression Questionnaire. Inferential statistics were performed using independent sample t-tests, one-way ANOVA, Pearson's correlation, and multiple regression analysis.</p><p><strong>Results: </strong>The participants were primarily females and unemployed. The average age was 63.59 years (SD = 10.29), the mean dialysis duration was 83.70 months (SD = 63.46), and the average fatigue score was 22.74 (SD = 12.34). Significant correlations were found between fatigue level and, respectively, age (r = .185, p = .024) and albumin levels (r = -.245, p = .003). Fatigue levels differed significantly based on number of chronic diseases (F = 7.48, p = .001). Depressive mood and albumin levels were identified as significant predictors, explaining 68.5% of the total variance (F = 157.308, p = .001), with depressive mood being the primary predictor.</p><p><strong>Conclusions / implications for practice: </strong>The findings of this study provide assessment and care guidelines to clinical healthcare professionals for patients identified to be at high risk of hemodialysis-related fatigue. Through professional education and training, these professionals can gain the skills necessary to offer effective psychological support and clinical resources. In addition, monitoring the nutritional indicators of patients and providing them with individualized nursing guidance are similarly important. The findings of this study can inform clinical education and serve as a reference for future research in the field of patient care.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 4","pages":"59-69"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754607","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":"[Entrustable Professional Activities in Advanced Nursing Education: Implications for Curriculum Design and Clinical Competency Development].","authors":"Lilu Chang","doi":"10.6224/JN.202508_72(4).04","DOIUrl":"https://doi.org/10.6224/JN.202508_72(4).04","url":null,"abstract":"<p><p>Entrustable professional activities (EPAs) represent a structured framework for competency-based assessment that operationalizes clinical competencies into observable and measurable clinical activities or tasks. Thus, delineating the activities considered core or critical to practice in a particular profession is critical, with the expectation that trainees will achieve a level of competence sufficient to perform each activity independently and with a high degree of trust. In the context of advanced nursing education, developing EPAs involves identifying the key responsibilities and critical tasks that advanced practice nurses (APNs) must carry out autonomously in specific clinical settings. These tasks are aligned with relevant core competencies to inform the design of educational curricula and assessment standards. EPAs thus provide a practical, competency-oriented approach to evaluating clinical performance in professional training. Integrating EPAs into advanced nursing education not only helps define the roles and scope of APNs but also clarifies the core competencies needed to meet the demands of clinical practice. This alignment helps bridge the gap between education and clinical practice, offering a structured pathway for the professional development of APNs. However, the use of EPAs in nursing education remains in its early stages. In this article, the author reviews key concepts of competency-based education and explores strategies for developing EPAs, with a focus on the anticipated advantages and challenges associated with implementing this framework to advance nursing education.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 4","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754562","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":"[The Application of Entrustable Professional Activities in Developing Nursing Students' Learning and Clinical Competence].","authors":"Li-Fen Chao, Mei-Ling Wu, Fan-Feng Chung","doi":"10.6224/JN.202508_72(4).03","DOIUrl":"https://doi.org/10.6224/JN.202508_72(4).03","url":null,"abstract":"<p><p>The evolving global healthcare environment and increasing diversity in patient needs have necessitated a shift in nursing education from a traditional subject-based approach to a competency-based approach. The implications of applying entrustable professional activities (EPAs) in nursing education are explored in this study and practical strategies are proposed for cultivating clinical competencies and designing curriculum assessments. EPAs emphasize task-based learning, integrating knowledge, skills, and attitudes to prepare learners to perform professional roles independently and reliably. In this study, an actual medical-surgical nursing course is used to illustrate how to establish developmental milestones based on student learning stages and how to implement task-oriented learning and assessments using high-fidelity simulation and evaluation tools. Leveraging modular curriculum design and formative feedback mechanisms, EPAs strengthen students' clinical reasoning, communication and collaboration skills, and sense of professional responsibility. However, implementing EPAs in current teaching practice faces challenges, including incomplete curriculum frameworks, lack of consensus among faculty regarding related concepts and methodologies, and limited readiness among students to engage with the integrated and self-directed learning models. EPAs offer a clear structure for teaching and assessment, helping nursing students gradually develop clinical competence and professional identity and ultimately prepare them to become trustworthy nursing professionals.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 4","pages":"15-22"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754568","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":"[Keeping Children Away From Precocious Puberty: A Nursing Perspective].","authors":"Hsiu-Fan Yang, Huey-Ming Sophie Guo, Chiung-Yun Chang, Chen-Chen Chang, Yu-Hsuan Lin","doi":"10.6224/JN.202508_72(4).11","DOIUrl":"10.6224/JN.202508_72(4).11","url":null,"abstract":"<p><p>Supporting healthy growth in children is a core objective of health care systems. However, numerous factors in modern society can expose children to risks such as precocious puberty, which may further lead to harm to their physical and mental health. In this article, we summarize the state-of-the-art of knowledge on precocious puberty, including its definition, stages, comprehensive influencing factors, natural environmental hormones, and environmental endocrine disruptors (e.g., plasticizers and plastic products). Additionally, we introduce the treatment and strategies for preventing this condition and highlight how nurses can optimize the care of children at risk in precocious puberty. In sum, the knowledge provided here will help nurses be better equipped to disseminate information regarding precocious puberty to children families.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 4","pages":"88-97"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754564","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":"[Application of Entrustable Professional Activities in Clinical Nursing Education].","authors":"Fang-Chun Wei, Chia-Ting Chang, Jui-Yuan Chung","doi":"10.6224/JN.202508_72(4).05","DOIUrl":"https://doi.org/10.6224/JN.202508_72(4).05","url":null,"abstract":"<p><p>Traditional competency-based education models are no longer adequate to address the practical training needs of nursing education. The concept of entrustable professional activities (EPAs) has been introduced to bridge the gap between theoretical knowledge and clinical practice. EPAs offer a task-based, competency-integrated framework for both instruction and assessment, transforming abstract competencies into observable and assessable clinical tasks. This paper explores the origin and theoretical foundation of EPAs, their structured components, and their practical application in clinical nursing education. Evidence suggests EPAs enhance teaching quality and clinical learning outcomes while fostering professional autonomy and sense of responsibility in learners. It is recommended nursing educators develop training in EPA-based instructional design and that standardized assessment tools and trust-based decision-making mechanisms be developed. These efforts can support professional growth and enhance the alignment between nursing education and clinical practice.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"72 4","pages":"31-38"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754609","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}