Applied Nursing Research最新文献

{"title":"Organizational change fatigue among nurses and its impact on work engagement: A qualitative study","authors":"Hui Duan ,&nbsp;Dongmei He ,&nbsp;Yanli Zeng ,&nbsp;Xiaolin Ma ,&nbsp;Qian Li ,&nbsp;Xinxu Zhou","doi":"10.1016/j.apnr.2025.152018","DOIUrl":"10.1016/j.apnr.2025.152018","url":null,"abstract":"<div><h3>Aim</h3><div>To explore how organizational change fatigue influences nurses' work engagement based on their lived experiences in tertiary hospitals in China.</div></div><div><h3>Background</h3><div>Organizational change fatigue undermines nurse engagement, a factor consistently linked to patient safety and workforce retention. Nurses are frequently positioned at the center of hospital reforms and must adapt to structural, technological, and policy-driven changes. These transitions often create cumulative stress, yet little is known about how nurses subjectively experience change fatigue or how it shapes their professional engagement. Addressing this gap is essential, as understanding lived experiences can inform leadership and policy strategies to sustain nurse well-being and ensure safe, high-quality patient care.</div></div><div><h3>Methods</h3><div>A descriptive phenomenological design was employed. Semi-structured interviews were conducted with 12 registered nurses from three tertiary hospitals using purposive sampling. Data were analyzed using Colaizzi's seven-step method, and reporting followed the Consolidated Criteria for Reporting Qualitative Research.</div></div><div><h3>Results</h3><div>Four themes were identified: perceptions of organizational change, emotional and behavioral responses, coping strategies and perceived support, and impact on work engagement. Nurses described a cyclical trajectory from emotional fatigue to disengagement, with the potential for re-engagement when supported by psychologically safe and inclusive environments.</div></div><div><h3>Conclusions</h3><div>Organizational change fatigue erodes nurses' motivation, professional commitment, and care quality. However, recovery is possible through relational leadership, transparent communication, and recognition of emotional labor. These findings highlight the need for human-centered change strategies to maintain engagement and ensure workforce sustainability during continuous healthcare reform.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152018"},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of sense of coherence, self-efficacy, social support and perceived stress on postpartum depression during the transition to motherhood: A path analysis.","authors":"Lebeza Alemu Tenaw, Fei Wan Ngai, Ka Wai Katherine Lam","doi":"10.1016/j.apnr.2025.151998","DOIUrl":"https://doi.org/10.1016/j.apnr.2025.151998","url":null,"abstract":"<p><strong>Background: </strong>The transition to motherhood is a women's life event that, while often joyful, can present challenges leading to postpartum depression. Understanding the roles of sense of coherence, self-efficacy, and social support in mitigating postpartum depression is crucial, particularly among Ethiopian mothers, where cultural practices may influence these dynamics.</p><p><strong>Objectives: </strong>The objective of this study to evaluate the effect of sense of coherence, self-efficacy, social support, and stress on postpartum depression during the transition to motherhood.</p><p><strong>Methods: </strong>This cross-sectional study involved 200 mothers recruited from Woldia Comprehensive Specialized Hospital, Ethiopia. The data collection conducted by two BSc midwives from 10 to 30 November 2024. Path analysis using Maximum Likelihood Estimation was performed to evaluate the effects of sense of coherence, self-efficacy, social support, and perceived stress on postpartum depression. Model fit evaluated using indices such as the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root-Mean-Square Error of Approximation (RMSEA).</p><p><strong>Results: </strong>The modified path model demonstrated a good fit with the data, indicated by χ² = 1.64 (p > 0.44), CFI = 1.00, TLI = 1.02, RMSEA <0.001, and SRMR = 0.02. The model explained 29.8 % of the variance in postpartum depression. A higher sense of coherence significantly predicted lower levels of postpartum depression, with a path coefficient of β = -0.15 (p = 0.02). Similarly, sense of coherence was associated with lower perceived stress (β = -0.21, p = 0.02), while perceived stress was a significant positive predictor of postpartum depression (β = 0.49, p < 0.001). The model also demonstrated that both social support and self-efficacy were inversely related to postpartum depression.</p><p><strong>Conclusions: </strong>Sense of coherence plays a direct role in preventing postpartum depression, while the effects of social support and self-efficacy on depressive symptoms are mediated through sense of coherence and perceived stress levels.</p>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"151998"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The chain mediating effects of psychological resilience and organizational commitment on the association between workplace incivility and job withdrawal among Chinese oncology nurses: A cross-sectional study.","authors":"Jiaxun Kang, Rui Zhao, Qiushi Zhang, Wenbo Jing, Hui Xu, Shanshan Wang","doi":"10.1016/j.apnr.2025.151999","DOIUrl":"https://doi.org/10.1016/j.apnr.2025.151999","url":null,"abstract":"<p><strong>Background: </strong>Workplace incivility experienced by nurses has a substantial impact on job withdrawal, psychological resilience and organizational commitment also show certain associations with both incivility and work withdrawal. However, the specific mechanisms underlying these factors remain unclear.</p><p><strong>Aim: </strong>This study aimed to identify the relationship between workplace incivility and job withdrawal and the chain mediating effects of psychological resilience and organizational commitment.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with oncology nurses working in 7 hospitals using a convenience sampling method, which were all situated in central China, comprising four hospitals in Henan Province, two in Hunan Province, and one in Shandong Province. Demographic questionnaire and four validated and reliable scales were utilized for assessing demographic and occupational characteristics, workplace incivility, job withdrawal, psychological resilience, and organizational commitment. Participants (N = 1442) completed the survey.</p><p><strong>Results: </strong>The effects of workplace incivility, job withdrawal, psychological resilience, and organizational commitment were interrelated (all p < 0.01). Workplace incivility influenced job withdrawal through three statistically significant indirect pathways: (a) the mediating effect of psychological resilience (β = 0.017; SE = 0.003; 95 % CI: 0.012, 0.022); (b) the mediating effect of organizational commitment (β = 0.011; SE = 0.002; 95 % CI: 0.006, 0.015) and (c) the chain mediating effect between psychological resilience and organizational commitment (β = 0.001; SE = 0.004; 95 % CI: 0.001, 0.002).</p><p><strong>Conclusion: </strong>This study further elucidated the intrinsic connection between nurses' experiences of workplace incivility and their job withdrawal. This suggested that improving the working environment, reducing instances of uncivilized behavior in the workplace, enhancing psychological resilience and organizational commitment may contribute to reducing nurses' job withdrawal, thereby improving the quality of nursing care and ensuring patient safety.</p>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"151999"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of light intervention on daytime sleepiness, fatigue, and sleep quality among female shift-working nurses - A randomized control trail","authors":"Shu-Fen Niu ,&nbsp;Yu-Ying Lu ,&nbsp;Yu-Chieh Lin ,&nbsp;Kuei-Fen Liu","doi":"10.1016/j.apnr.2025.152017","DOIUrl":"10.1016/j.apnr.2025.152017","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances and fatigue are prevalent among female shift-working nurses, adversely affecting their health and job performance.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the effectiveness of light intervention in reducing daytime sleepiness, fatigue, and improving sleep quality among female shift-working nurses.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted at a medical center in northern Taiwan with 80 female nurses assigned to either an experimental or control group. Baseline assessments included demographics, work characteristics, and measures using the Epworth Sleepiness Scale (ESS), Brief Fatigue Inventory (BFI), and Pittsburgh Sleep Quality Index (PSQI). The experimental group used a wearable light device (<em>Re</em>-Timer®) for 30–40 min daily over four weeks, while the control group continued their usual routines. Follow-up assessments occurred on day 14 (T1) and day 28 (T2).</div></div><div><h3>Results</h3><div>Results from Generalized Estimating Equations (GEEs) analysis showed significant reductions in sleepiness (ESS) at T2 and improvements in sleep quality (PSQI) at T1 and T2 in the experimental group compared to the control (<em>p</em> &lt; .05). No significant changes were found in fatigue (BFI).</div></div><div><h3>Conclusions</h3><div>The study supports light intervention as a safe, low-cost, and non-pharmacological approach to reduce daytime sleepiness and enhance sleep in shift-working nurses, suggesting its integration into occupational health programs for healthcare providers.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152017"},"PeriodicalIF":2.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multidimensional assessment of vibration and cold for venipuncture pain in children aged 7 and above: A randomized controlled trial","authors":"Hu Long-yi ,&nbsp;Zhou Zi-yun ,&nbsp;Wang Ming-li ,&nbsp;Zhou Le-shan","doi":"10.1016/j.apnr.2025.152012","DOIUrl":"10.1016/j.apnr.2025.152012","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the effects of cold and vibration on venipuncture pain in children aged 7 and above, evaluating outcomes through subjective and objective child measures, parental feedback, and nurse assessments.</div></div><div><h3>Method</h3><div>This randomized controlled trial enrolled 120 children aged 7 and above undergoing venipuncture between July and November 2023. Participants were allocated into four groups using a random number table: cold, vibration, cold combined with vibration, and a control group. After procedure, pain and parental anxiety were assessed using a self-reported Numerical Rating Scale. Child anxiety was evaluated with the Children's Anxiety Meter Scale, while children's cooperation was evaluated by the operating nurse.</div></div><div><h3>Results</h3><div>External cold, vibration, and cold combined with vibration significantly reduced changes in children's pulse and pain (<em>p</em> &lt; 0.05). Multiple comparisons indicated that the cold and vibration combination group exhibited the smallest pulse changes and the lowest pain scores(<em>p</em> &lt; 0.05). However, it cannot yet be concluded that external cold and vibration effectively reduce children's anxiety, relatives' anxiety, or the cooperation of the children (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Cold and vibration significantly reduced pain and physiological responses during venipuncture in children aged 7 and above, though no benefits were found for anxiety or cooperation. Future multicenter studies with larger sample sizes are recommended to further explore its role in pediatric pain management.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152012"},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep quality and predicting factors among patients undergoing hemodialysis: A descriptive cross sectional study","authors":"Eman A. Badr ,&nbsp;Fahad M. Alhowaymel ,&nbsp;Abdulaziz F. Abaoud","doi":"10.1016/j.apnr.2025.152016","DOIUrl":"10.1016/j.apnr.2025.152016","url":null,"abstract":"<div><h3>Background</h3><div>Many patients with end-stage renal disease (ESRD) undergoing hemodialysis encounter sleep disturbances. This study aimed to assess the quality of sleep and identify the factors predicting it among patients undergoing hemodialysis.</div></div><div><h3>Methods</h3><div>A descriptive, cross-sectional design was used. The study was carried out in the hemodialysis unit at Zagazig University Hospitals. A convenient sample of 81 patients who were receiving hemodialysis was selected. Data collected by using Patient Interview Questionnaire, Factors Affecting Sleep Pattern Questionnaire, and Pittsburgh Sleep Quality Index (PSQI). ANOVA test was utilized for data analysis.</div></div><div><h3>Results</h3><div>93.8 % of patients exhibited poor sleep quality (PSQI &gt;5). The mostly reported factors that could affect patients' sleep pattern were daytime napping (67.9 %), sharing a room with others (79 %), pruritus (79 %), muscle cramps (79 %), chronic pain (79 %), and feel of weakness (86.4 %). There was a statistical significant relation between sleep quality and comorbidity (<em>P</em> = 0.004), skin problems (<em>P</em> = 0.001). A strong positive statistical significant correlation was found between sleep quality and age, dialysis duration, schedule/week, session/h, health problems, and factors affecting sleep pattern with (P = 0.001). Health problems, education, age, and occupation were statistically significant predictors affecting sleep quality detected by the step wise multiple linear regression.</div></div><div><h3>Conclusion</h3><div>Sleep quality is poor among the majority of patients. The reported factors that may affect their sleep pattern were daytime napping, sharing a room with others, skin itching, muscle cramps, persistent pain, and feel of weakness. The predicting factors affecting sleep quality were health problems, education, age, and occupation.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152016"},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating role of self-efficacy in the relationship between spirituality and burnout among intensive care unit nurses: a pathway analysis","authors":"Fatin Lailatul Badriyah ,&nbsp;Mundakir Mundakir ,&nbsp;Tita Rohita ,&nbsp;Bih-O Lee ,&nbsp;Santo Imanuel Tonapa","doi":"10.1016/j.apnr.2025.152005","DOIUrl":"10.1016/j.apnr.2025.152005","url":null,"abstract":"<div><h3>Background</h3><div>Burnout is a critical issue among intensive care unit (ICU) nurses, impacting both their well-being and excellence in care. Spiritual wellbeing and self-efficacy have been identified as potential protective factors against burnout, yet their interrelationships remain unclear, particularly in the Indonesian nurse's context.</div></div><div><h3>Objectives</h3><div>This study examines the role of spirituality and self-efficacy in burnout and explores the mediating effect of self-efficacy.</div></div><div><h3>Methods</h3><div>A cross-sectional correlational design with convenience sampling was conducted among 410 ICU nurses in public hospitals in East Java, Indonesia. Participants completed validated measures of burnout, spirituality and self-efficacy. Partial least squares structural equation modelling was employed to test direct and indirect relationships between variables.</div></div><div><h3>Results</h3><div>Most participants were female, with a mean age of around 31 years and more than two years of ICU experience. Higher workload significantly predicted greater burnout (β = 0.21, <em>p</em> &lt; 0.001), while spirituality (β = −0.17, <em>p</em> = 0.001) and self-efficacy (β = −0.24, <em>p</em> &lt; 0.001) negatively predicted burnout. Mediation analysis confirmed that self-efficacy mediated the relationship between spirituality and burnout (β = −0.13, <em>p</em> &lt; 0.001), indicating that ICU nurses with higher levels of spiritual wellbeing reported stronger self-efficacy, which in turn predicted lower burnout.</div></div><div><h3>Conclusion</h3><div>The findings reveal that self-efficacy is a key mechanism through which spirituality mitigates burnout among ICU nurses. These insights may inform the development of healthy work environment initiatives that incorporate spiritual support and self-efficacy training through structured mentorship and organisational systems, ultimately reducing burnout and enhancing nurses' resilience in high-stress settings.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152005"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse-led implementation of evidence-based bundles to reduce CAUTIs in an academic acute care hospital: A four-year longitudinal quasi-experimental study","authors":"May Mei-Sheng Riley DNP, MSN, MPH, RN, ACNP, CCRN, CIC, FAPIC ,&nbsp;Wei-Chen Tung Ph.D., RN, FAAN ,&nbsp;Chris Tofanelli MSN, RN, CNS, PCCN","doi":"10.1016/j.apnr.2025.152004","DOIUrl":"10.1016/j.apnr.2025.152004","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to evaluate the effectiveness of evidence-based catheter bundles, guided by the Plan-Do-Check-Act model, in reducing catheter-associated urinary tract infections (CAUTIs) and catheter usage at a 643-bed academic hospital.</div></div><div><h3>Background</h3><div>Despite previous efforts, our facility's CAUTI rates remained high, leading to increased morbidity, extended hospital stays, and higher costs. A four-year project was initiated to implement targeted interventions.</div></div><div><h3>Method</h3><div>This quasi-experimental study used a four-year strategy, including catheter insertion and maintenance bundles, a nurse-driven removal protocol, and extensive education. We compared pre- and post-intervention data on Standardized Infection Ratios (SIRs) and Standardized Utilization Ratios (SURs) with a goal of greater than 10 % reduction in both metrics; catheter reinsertion rates monitored as a secondary endpoint.</div></div><div><h3>Results</h3><div>Among 2448 catheterized patients, CAUTI cases declined from 66 to 60. The SIR decreased from 0.93 to 0.58 post-intervention, a 38 % reduction in CAUTI risk (<em>p</em> = .007). Catheter SURs fell from 0.75 to 0.67, an 11 % reduction in utilization risk (<em>p</em> &lt; .001). Reinsertion rates decreased by approximately 6 %.</div></div><div><h3>Conclusions</h3><div>Nurse-led, evidence-based prevention bundles successfully reduced both CAUTIs and catheter use beyond the 10 % target. These findings underscore the critical role of nursing in driving practice change and improving patient safety.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 152004"},"PeriodicalIF":2.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144924939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience as a mediator between empathy and professional grief among nurses in high-mortality services","authors":"Ozkan Uguz ,&nbsp;Ozan Ozkol ,&nbsp;Dilay Gungor ,&nbsp;Zeynep Ozcan","doi":"10.1016/j.apnr.2025.152003","DOIUrl":"10.1016/j.apnr.2025.152003","url":null,"abstract":"<div><h3>Background</h3><div>Nurses working in high-mortality clinical services, such as intensive care, oncology, and palliative care units, frequently witness patient deaths. This repeated exposure places them at a high risk of bereavement reactions; however, limited research has explored how individual emotional traits, particularly empathy and resilience, shape this experience.</div></div><div><h3>Aims</h3><div>This study aimed to investigate the mediating role of resilience in the relationship between empathy and bereavement reactions—both short-term emotional reactions and long-term cumulative effects—among nurses working in high-mortality services.</div></div><div><h3>Methods</h3><div>A cross-sectional design was used. Data were collected online from 238 purposively sampled nurses working in a tertiary public hospital in northwestern Turkey. Standardized tools were used to measure empathy, resilience, and professional bereavement.</div></div><div><h3>Results</h3><div>Nurses reported moderate levels of bereavement reactions following patient deaths. Empathy was positively associated with both short-term bereavement reactions (β = 0.253, p = 0.001) and long-term cumulative effects (β = 0.359, p &lt; 0.001). Resilience partially mediated these associations, reducing the impact of empathy on both short-term bereavement reactions (β = 0.071, 95 % CI [0.017, 0.133]) and long-term cumulative effects (β = 0.137, 95 % CI [0.084, 0.193]).</div></div><div><h3>Conclusion</h3><div>Nurses in high-mortality services are particularly vulnerable to experiencing bereavement. While higher empathy intensifies bereavement reactions, resilience plays a protective role. Interventions aimed at strengthening resilience may help mitigate the negative effects of bereavement and promote emotional well-being, job sustainability, and improved patient care outcomes in these emotionally demanding settings.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 152003"},"PeriodicalIF":2.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributing factors to missed nursing care: A systematic review with clinical implications for practice and patient safety","authors":"Federica Breno ,&nbsp;Daniele Marchetti ,&nbsp;Daniela Cattani ,&nbsp;Simone Cosmai ,&nbsp;Stefano Mancin ,&nbsp;Diego Lopane ,&nbsp;Beatrice Mazzoleni","doi":"10.1016/j.apnr.2025.152002","DOIUrl":"10.1016/j.apnr.2025.152002","url":null,"abstract":"<div><h3>Objectives</h3><div>Missed Nursing Care (MNC) is increasingly recognized as an indicator of care quality and a potential contributor to adverse events. This systematic review aimed to explore the correlation between MNC and adverse events in hospitalized patients across public and private settings.</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to PRISMA 2020 guidelines. Searches were performed in PubMed, Embase, CINAHL, Scopus, and TripDatabase between January and February 2025. Included studies were quantitative, published in English or Italian, and focused on acute hospital settings. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist; risk of bias was evaluated with ROBINS-I.</div></div><div><h3>Results</h3><div>Seven studies met the inclusion criteria, involving 13,619 nurses and 902 patients. Study designs included four cross-sectional, two observational (one correlational), and one secondary data analysis. Five studies reported a positive association between MNC and adverse events, while two found inverse or non-significant relationships. Common adverse outcomes included falls, infections, pressure ulcers, and medication errors.</div></div><div><h3>Conclusions</h3><div>Despite methodological heterogeneity and limitations—such as the use of non-validated tools or contextual differences—the evidence suggests a consistent association between MNC and adverse events. These findings underscore the importance of addressing missed care as a patient safety concern. Further longitudinal studies are needed to confirm causality and inform predictive models.</div></div><div><h3>Implications for nursing practice</h3><div>Recognition of the link between MNC and adverse events should prompt healthcare organizations to address care omissions through staffing optimization, safety culture, and clinical governance. Targeted interventions may reduce preventable harm and improve care quality.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 152002"},"PeriodicalIF":2.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}