Journal of Clinical Nursing最新文献

{"title":"Implementation Outcomes and Their Determinants for Hospital-Led Care Coordination Interventions Targeting Patients With Complex Care Needs: A Qualitative Systematic Review.","authors":"Mary Malakellis, Anna Wong Shee, Sarah Wood, Laura Alston, Hannah Beks, Margaret Murray, Vincent L Versace, Kevin Mc Namara","doi":"10.1111/jocn.70102","DOIUrl":"https://doi.org/10.1111/jocn.70102","url":null,"abstract":"<p><strong>Aim: </strong>To describe the implementation determinants for care coordination interventions in a hospital context.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Methods: </strong>This review was guided by the Consolidated Framework of Implementation Research (CFIR), assessed for quality using the Mixed Methods Appraisal Tool and reported with the PRISMA guidelines.</p><p><strong>Data sources: </strong>CINHAL Complete, EMBASE, MEDLINE Complete, PsychINFO (between January 1, 2013, and December 31, 2022, and updated May 09, 2024) and a manual reference list search of all included studies.</p><p><strong>Results: </strong>The search returned 5614 articles after duplicates were removed. After title and abstract screening, 264 articles underwent full-text review. Sixteen studies (15 care coordination models) met the inclusion criteria. The CFIR inner setting domain and the implementation process domain were the most prominent domains and 'Partnerships & Connections', 'Work Infrastructure', 'Capability' and 'Reflecting and Evaluating' subdomains emerged as important determinants across the included studies.</p><p><strong>Conclusion: </strong>Inconsistent findings relating to care coordination outcomes are likely to be substantially influenced by the complexity and heterogeneity of the interventions and variations in implementation and contextual factors. Intra- and inter-organisational relationships were important to connect previously disconnected parts of the health system and were facilitated by experienced care coordinators. Continual improvement was also important to increase fit with contextual factors. More high-quality studies are needed to identify commonalities and provide generalisable principles and characteristics associated with high-performance implementation.</p><p><strong>Implications for the profession and/or patient care: </strong>Review findings will provide practitioners, policymakers, and researchers with a comprehensive synthesis of evidence underpinning implementation of effective community care coordination from hospital settings.</p><p><strong>Impact: </strong>These review findings will inform the effective implementation of care coordination interventions in a hospital context for patients with complex multimorbidity.</p><p><strong>Reporting methods: </strong>Preferred Reporting Items for Systematic reviews and Meta-Analysis.</p><p><strong>Trial and registration: </strong>PROSPERO Registration: CRD42022376642.</p><p><strong>Patient or public contribution: </strong>No patient or public Contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Siblings of Children With Cancer and Their Challenges Across Everyday Life Contexts: A Two-Phase Qualitative Study in Denmark.","authors":"Minna Devantier, Mette Asbjoern Neergaard, Marianne Olsen, Ayo Wahlberg, Hanne Bækgaard Larsen","doi":"10.1111/jocn.70106","DOIUrl":"https://doi.org/10.1111/jocn.70106","url":null,"abstract":"<p><strong>Aim: </strong>To explore the familial, emotional, social and school-related challenges experienced by school-aged siblings of children with cancer, focusing on how these challenges intersect across hospital, home and school in their everyday lives.</p><p><strong>Design: </strong>Qualitative, two-phase, multi-site study.</p><p><strong>Methods: </strong>Fieldwork was conducted at two distinct paediatric oncology wards, followed by semi-structured interviews with 11 siblings (aged 7-19 years) and 20 parents, recruited through criterion-based sampling. The data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Analysis showed that siblings were often marginalised in hospital life due to (1) family logistics; (2) hospital-induced restrictions, rules and physical spaces and (3) perceptions of their presence as 'problematic', ultimately limiting their access. In family life, siblings experienced peripheral roles because (1) they were cared for by others, (2) had their needs subordinated and (3) faced shifting expectations. At school, siblings encountered (1) limited understanding from classmates and teachers and (2) insufficient support resources.</p><p><strong>Conclusions: </strong>Siblings of children with cancer face significant, interconnected challenges, often amplified by the structural frameworks of healthcare, family and school contexts.</p><p><strong>Impact: </strong>Siblings of children with cancer are often marginalised in their own lives. In healthcare, a family-centred approach to care should formally and actively include siblings. Nurses are well-positioned to promote this, ensuring whole-family support. Siblings would benefit from coordinated support bridging hospital, home and school.</p><p><strong>Reporting method: </strong>This study adheres to the SRQR Checklist.</p><p><strong>Patient or public contribution: </strong>Parents helped shape the study focus by discussing preliminary observations and potential support needs.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment Letter on \"Longitudinal Analysis of Mental Health Trajectories in Lung Cancer Survivors: A Hierarchical Linear Modelling Approach\".","authors":"Yun Li, Yuanbin Chen","doi":"10.1111/jocn.70104","DOIUrl":"https://doi.org/10.1111/jocn.70104","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting Sustainable Improvement of Nurses' EBP Competency After Receiving an EBP Training Program: A Mixed-Methods Study.","authors":"Sameh Elhabashy, Michiko Moriyama, Mohamed Ahmed Saleh","doi":"10.1111/jocn.70100","DOIUrl":"https://doi.org/10.1111/jocn.70100","url":null,"abstract":"<p><strong>Aim: </strong>To explore the factors affecting the sustainable improvement of nurses' evidence-based practice (EBP) competency after receiving an EBP training program.</p><p><strong>Design: </strong>A sequential mixed-methods study.</p><p><strong>Methods: </strong>Thirty-seven ICU nurses participated from an adult ICU in Egypt. The qualitative phase used a category-generating approach with focus group interviews and content analysis. The quantitative phase followed a cross-sectional descriptive design using self-report questionnaires. The study adhered to the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines and was registered with ClinicalTrials.gov (NCT05941364).</p><p><strong>Results: </strong>Qualitative analysis generated six subcategories, organised into three overarching themes: working environment challenges, job dissatisfaction and organisational obstacles. Quantitative findings revealed low levels of motivation (M = 19.1, SD = 2.2, out of 60), self-efficacy (M = 18.4, SD = 8.66) and self-regulation (M = 124.9, SD = 52.6). The highest mean score was observed for the Sustained Implementation Support Scale (M = 94.7, SD = 5.0, out of 140). These variables showed negative correlations with the sustainability gap. Integration of findings through a joint display demonstrated a convergence of results regarding training program burden and low motivation.</p><p><strong>Conclusions: </strong>Sustaining nurses' EBP literacy requires addressing long-term obstacles such as inadequate job satisfaction, limited workplace support and lack of team cohesion. Sustained organisational support and leadership development are essential for EBP clinical integration.</p><p><strong>Implications for nursing: </strong>The study highlights key strategies for nurses' development to enhance care quality, including improving self-efficacy through mentorship and fostering a supportive work environment. Health policies should establish EBP as a core competency, offer flexible schedules, ongoing training, adequate resources, and empower nurse leaders for successful implementation.</p><p><strong>Impact: </strong>This study addresses the critical challenge of sustaining nurses' competency improvements after EBP training. The findings are crucial for healthcare administrators, policymakers and educators aiming to design effective EBP training programs. By addressing these factors, the study has the potential to improve patient outcomes.</p><p><strong>Patient contribution: </strong>No patient or public contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Paediatric Deterioration Assessment Across Diverse Skin Tones: Insights and Future Directions.","authors":"Tianji Zhou, Xiangling Dong, Hanyang Su","doi":"10.1111/jocn.70105","DOIUrl":"https://doi.org/10.1111/jocn.70105","url":null,"abstract":"<p><strong>Background: </strong>Skin tone can affect clinical signs and device accuracy in paediatric anaemia and deterioration detection, creating risks of inequity.</p><p><strong>Key issues: </strong>Studies show disparities in diagnostic accuracy across different skin tones, supported by community-based evidence.</p><p><strong>Recommendations: </strong>(1) Build multicenter networks with standardised skin-tone data. (2) Validate devices across varied skin tones. (3) Train clinicians in dark-skin sign recognition. (4) Include equity metrics in paediatric quality indicators.</p><p><strong>Conclusion: </strong>Reducing skin-tone bias is essential for equitable paediatric care. Collaborative research across diverse regions is needed.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Nurses' Perspectives on Low-Value Care and Non-Nursing Tasks: A Cross-Sectional Study.","authors":"Wilmieke Bahlman-van Ooijen, Cariline Roosen, Djoeke de Jong, Philip de Reuver, Harry van Goor, Hester Vermeulen, Getty Huisman-de Waal","doi":"10.1111/jocn.70094","DOIUrl":"https://doi.org/10.1111/jocn.70094","url":null,"abstract":"<p><strong>Background: </strong>Low-value care provides little or no benefit to patients, or its risk of harm outweighs the potential benefits. Non-nursing tasks refer to tasks performed by nurses below their scope of practice. With increasing pressure on the global nursing workforce, it is necessary to identify these concepts to deliver fundamental care.</p><p><strong>Aim(s): </strong>To assess the prevalence, influencing factors and associations of low-value nursing care, and to identify non-nursing tasks and potential solutions in surgical hospital care settings.</p><p><strong>Design: </strong>The study followed a cross-sectional study design using a self-developed questionnaire.</p><p><strong>Methods: </strong>A questionnaire on low-value care and non-nursing tasks was distributed to surgical wards in four hospitals in The Netherlands.</p><p><strong>Results: </strong>A total of 302 nurses responded to the survey. Five most prevalent low-value care practices were identified, including routine preoperative fasting (84.8%), taking over blood glucose monitoring (59.3%) and leaving in place any type of venous catheter (42.1%). These practices were mainly performed due to habitual practice, in accordance with an established protocol, or upon physicians' request. Most reported non-nursing tasks were administrative duties and cleaning patient rooms and equipment. Provided solutions included clearly defining responsibilities and taking personal responsibility.</p><p><strong>Conclusion: </strong>Low-value care, provided by surgical nurses, is common in daily practice. This requires targeted de-implementation of each low-value care practice, based on influencing factors. Additionally, 85.8% of nurses perform non-nursing tasks daily or several times a day, underlining the need to re-organise nursing tasks.</p><p><strong>Implications for the profession and/or patient care: </strong>De-implementing low-value care and reducing non-nursing tasks is necessary to ease pressure on the global nursing workforce and to improve fundamental care.</p><p><strong>Impact: </strong>Low-value nursing care and non-nursing tasks persist when nurses lack leadership responsibility.</p><p><strong>Reporting method: </strong>STROBE checklist.</p><p><strong>Patient or public contribution: </strong>No patient contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty-Eight Days Later: Emergency Diagnoses Associated With Increased Risk of Readmission, a Retrospective Observational Study of Older Adults.","authors":"Casey Marnie, Anja Vorster, Claire Harris, A M Margaret Fry, David Lim, Eamon Merrick","doi":"10.1111/jocn.70097","DOIUrl":"https://doi.org/10.1111/jocn.70097","url":null,"abstract":"<p><strong>Aims: </strong>To describe diagnostic categories and comorbidities associated with increased risk of readmission within 28 days among older adults.</p><p><strong>Methods: </strong>Retrospective observational study of all hospital admissions following ED attendance by patients aged ≥ 60 years between July 2020 and June 2023. Index and subsequent 28-day readmission were identified using ED data and hospital discharge records. ED diagnosis, Australian Refined Diagnosis-Related Group (AR-DRG) discharge codes, and ICD-10-AM comorbidities were extracted. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with 28-day readmission. The study and findings have been reported against the STROBE-RECORD guideline.</p><p><strong>Results: </strong>Of the 28,730 initial patient visits, 7.9% re-presented within 28 days. The most common ED diagnoses at initial and readmission were chest pain (5.4% vs. 4.6%), falls (5.2% vs. 4.1%), dyspnoea (3.5% vs. 3.1%), abdominal pain (3.1% vs. 3.3%) and cerebrovascular accident (1.7% vs. 1.7%). The most frequent AR-DRGs were respiratory infections/inflammations, kidney and urinary signs/symptoms, and other digestive system disorders. Key ICD-10-AM codes associated with a higher likelihood of readmission within 28 days were obstructive/reflux uropathy (OR 2.66, 95% CI 1.78-3.96), urinary retention (OR 1.84, 95% CI 1.38-2.46), chronic ischaemic heart disease (OR 1.57, 95% CI 1.10-2.25), delirium (OR 1.35, 95% CI 1.07-1.71) and disorders of fluid, electrolyte, and acid-base balance (OR 1.29, 95% CI 1.09-1.54).</p><p><strong>Conclusion: </strong>Nearly 8% of older adults are readmitted within 28 days. Our described approach offers a potential framework to identify at-risk groups and intervene to reduce avoidable representations and/or admissions.</p><p><strong>Relevance to clinical practice: </strong>The results reported here create the opportunity for clinicians to identify areas for improvement in clinical practice, care coordination, and service delivery. Our approach and methodology can be replicated in other health services.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Telemedicine on Distress, Physical Function and Self-Efficacy in Patients With Cancer: A Meta-Analysis of Randomised Controlled Trials.","authors":"Yawen Su, Shu Zhang, Liyang Duan, Xiaolin Hu","doi":"10.1111/jocn.70089","DOIUrl":"https://doi.org/10.1111/jocn.70089","url":null,"abstract":"<p><strong>Background: </strong>Cancer is a major social, public health and economic problem worldwide, causing physical and psychological distress to patients. The emerging telemedicine model in healthcare delivery has garnered significant interest because of its potential effectiveness.</p><p><strong>Objective: </strong>To assess the effects of telemedicine on distress, physical function, and self-efficacy in cancer patients.</p><p><strong>Design: </strong>This meta-analysis was conducted and reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 checklist.</p><p><strong>Methods: </strong>Six databases were searched for relevant studies published from inception to October 2024. The literature search and data collection were conducted by two separate researchers. The quality of the methodologies in the studies included was evaluated using the Cochrane Risk of Bias Tool. Data analysis was conducted using Review Manager (version 5.4).</p><p><strong>Result: </strong>Compared with the control group, patients who received telemedicine experienced significant reductions in distress (SMD = -0.44, 95% CI: -0.62 to -0.25, p < 0.00001, I² = 46%) and significant increases in physical function (SMD = 0.11, 95% CI: 0.01-0.22, p = 0.04, I² = 0%) and self-efficacy (SMD = 0.46, 95% CI: 0.23-0.69, p < 0.0001, I² = 0%).</p><p><strong>Conclusion: </strong>Telemedicine can effectively enhance the psychological health and physiological function of cancer patients, as well as their self-efficacy, suggesting a sustainable approach to the clinical care of cancer patients. Future studies are needed to further investigate the effectiveness of telemedicine interventions in different types of cancer patients and in different cultural contexts and to conduct long-term follow-up studies to evaluate their long-term effectiveness and cost-effectiveness.</p><p><strong>Clinical relevance: </strong>This systematic review and meta-analysis provides evidence to offer effective and sustainable telemedicine care among cancer patients.</p><p><strong>Patient and public contribution: </strong>No patient or public contribution.</p><p><strong>Trial registration: </strong>This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD42024604929) under the title 'The effectiveness of death education on death anxiety, depression and quality of life in patients with advanced cancer: A meta-analysis of randomised controlled trials'. The full study protocol could be obtained at https://www.crd.york.ac.uk/PROSPERO/view/CRD42024604929.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering the Routine Use of Physical Restraint in Hospitalised Children.","authors":"Gian Domenico Giusti, Federica Piergentili, Fabrizio Faina, Stefano Anticaglia, Nicola Ramacciati","doi":"10.1111/jocn.70099","DOIUrl":"https://doi.org/10.1111/jocn.70099","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent's Process of Escalation of Care for Their Deteriorating Children Admitted to Paediatric Wards: A Grounded Theory.","authors":"Catia Genna, Kiara Ros Thekkan, Immacolata Dall'oglio, Emanuela Tiozzo, Massimiliano Raponi, Corrado Cecchetti, Orsola Gawronski","doi":"10.1111/jocn.70090","DOIUrl":"https://doi.org/10.1111/jocn.70090","url":null,"abstract":"<p><strong>Aim: </strong>Explore the care escalation process initiated by parents concerned about their hospitalised child's deterioration and healthcare providers' response to parental concerns.</p><p><strong>Design: </strong>A qualitative study using Charmaz's constructivist grounded theory.</p><p><strong>Methods: </strong>Participants included healthcare providers, cultural mediators and parents of children hospitalized for ≥ 3 days, who had experienced previous urgent intensive care admission or parental concern during hospitalization, in a tertiary pediatric hospital. Data were collected through focus groups, and analyzed using a grounded theory methodology with NVivo Software.</p><p><strong>Results: </strong>A total of 13 parents, 7 cultural mediators and 68 healthcare providers participated in 16 focus groups. Two main categories were identified: (1) Parents navigating the uncertainty of the escalation system to get a response; (2) Healthcare providers balancing parents' concerns, their own situation awareness, escalation processes and team relations. We developed a Grounded theory called 'Parents Supporting Timely Escalation Processes' (P-STEP). By monitoring their children, parents identify early signs of deterioration and advocate for escalation. Reasons for concern are their child's behaviour, communication failure and admission on an off-service ward. Parents escalate by contacting ward providers, their child's specialist or the most trusted staff and, only selected parents, the Rapid Response Team. Staff escalate parents' concern according to their own situation awareness, parent evaluation and ward escalation practices. Parent's emotions and trust are influenced by the timeliness and type of staff response.</p><p><strong>Conclusion: </strong>While some parents effectively advocate for their child, others face obstacles due to unclear and lack of formal care escalation systems. Understanding how parents escalate care and healthcare providers respond is essential to identify facilitators, barriers, key stakeholders, and implement a formal system for parent-initiated escalation of care.</p><p><strong>Implications for the profession and patient care: </strong>Integrating parents into processes of escalation and rapid response systems could optimise early recognition and improve responsiveness in paediatric deterioration.</p><p><strong>Reporting method: </strong>The study adheres to the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines.</p><p><strong>Patient or public contribution: </strong>Parents and HCPs participated as interview respondents.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}