Policy, Politics, and Nursing Practice最新文献

{"title":"The Association Between Actual Nursing Care Hours and In-Hospital Mortality in Japanese Acute Care Hospitals: Evaluating a Practical Safety Threshold.","authors":"Kenshi Hayashida, Mutsuko Moriwaki, Genki Murakami","doi":"10.1177/15271544261473221","DOIUrl":"https://doi.org/10.1177/15271544261473221","url":null,"abstract":"<p><p>The specific quantitative relationship between the calculated mean total nursing hours per patient-day (derived from National Health Insurance Form 9) and in-hospital mortality in Japanese acute-care settings remains largely unexamined. This study aims to evaluate the clinical relevance and patient safety impact of actual nursing care hours by identifying practical thresholds below which patient mortality risk substantially increases. This retrospective, multicentre study included 75,708 patients admitted to general hospital beds between April 1, 2019, and March 31, 2020, across nine acute-care hospitals in Japan. Patients from Intensive Care Units and High Care Units were excluded to focus on general ward care. The main outcome measure was in-hospital mortality (dichotomous outcome). The mean daily nursing hours per patient was 3.88 h (median: 3.75 h). Mixed-effects logistic regression analysis showed that while higher nursing hours generally correlated with lower mortality, this risk reduction plateaued beyond 4.5 h. Compared to the 4.5-5.0 h care category (reference), patients receiving less than 4.0 h of care experienced a substantial increase in the odds of in-hospital mortality, with the risk elevating by 34%-52% (adjusted odds ratios ranging from 1.34 to 1.52). Our study provides evidence of a significant inverse association between actual nursing care hours and in-hospital mortality in Japanese acute care hospitals, suggesting that a minimum threshold of 4.0 h of actual daily nursing care may serve as a practical safety boundary for patient survival. These findings suggest that current staffing standards in Japan may warrant careful reconsideration from the perspective of patient safety.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"15271544261473221"},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118345","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 Leaders' Participation in Policy Development in Africa: A Rapid Review.","authors":"Ephraim Senkyire, Gloria Senkyire, Ernestina Asiedua, Rullmann Twi Owusu, Victor Tawose-Adebayo, Magdalena Ohaja","doi":"10.1177/15271544261473872","DOIUrl":"10.1177/15271544261473872","url":null,"abstract":"<p><p>IntroductionActive involvement of nurse leaders in policy advancement is considered crucial, particularly in Africa, where nurses constitute most of the health workforce. This review was conducted to determine factors that influence African nurse leaders' participation in policy development.MethodThe databases CINAHL and MEDLINE were searched to answer the review question. The search parameters were adjusted to include studies in English and between 2012 and 2025. The review partially followed the JBI methodology for evidence synthesis. Two reviewers conducted data extraction and independently assessed all included studies. The PRISMA guideline guided study selection reporting. Results were thematically analysed<b>.</b>ResultsSeven studies were identified. The review reveals a spectrum of challenges and opportunities impacting nurse leaders' involvement in policy development. The main theme that emerged from the included studies was enablers and constraints in health policy development, with four subthemes. Namely: enablers of nurse leaders' engagement, perceived value, knowledge and gendered influences, limited and peripheral participation, structural, organisational and individual barriers.ConclusionPersonal, structural and institutional factors were enablers and bottlenecks that limit involvement of African nurse leaders in health policy. Implementing strategies such as leadership support, education, professional recognition, organisational empowerment, and governmental support could elevate the role of nurse leaders in policy development, contributing to a more robust and inclusive healthcare policymaking landscape in Africa. Additional case studies and longitudinal research are needed to examine the factors influencing nurse leaders' involvement in policy development across different African contexts.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"15271544261473872"},"PeriodicalIF":3.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723268","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":"Medicaid Expansion After the One Big Beautiful Bill Act: Analysis of Community Mental Health Care Impacts in New Hampshire.","authors":"Jamie Bourgeois, Priscilla K Gazarian","doi":"10.1177/15271544261473882","DOIUrl":"https://doi.org/10.1177/15271544261473882","url":null,"abstract":"<p><p>Forty-one states in the United States that adopted Medicaid expansion through the Affordable Care Act reached historically low rates of uninsured that have endured through 2025. The One Big Beautiful Bill Act (OBBBA) signed into law on 4 July 2025 contains numerous provisions that place Medicaid expansion coverage at risk. Resulting changes to Medicaid expansion include work requirements, a decrease in federal match funds for expansion programs, cost-sharing fees for recipients, stricter eligibility requirements, more frequent re-enrollment periods, and limitations on family planning services provided by organizations that also provide abortion services. Because each state with Medicaid expansion has implemented this program differently, states will be impacted differently and with various timelines. The impact of OBBBA on Medicaid expansion in the state of New Hampshire is discussed in detail and examined from the perspective of a community mental health center. Nursing implications are discussed within the framework of Fawcett and Russell's conceptual model of nursing and health policy. Recommendations for advocacy and the nurse's role as an important stakeholder are discussed.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"15271544261473882"},"PeriodicalIF":3.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680938","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":"Missed Care, Readmissions, and Nurse Staffing: Policy Perspectives for the Philippine Healthcare System.","authors":"Rona Celeste Valledor-Pasamonte, Beulah Joy K Damasco","doi":"10.1177/15271544261443215","DOIUrl":"10.1177/15271544261443215","url":null,"abstract":"","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"163-164"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788998","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":"China's No-Companion Care Model: Nursing Policy Reform and Lessons From International Practice.","authors":"Yucen Jiang, Minfeng Hua, Ying Jiang, Yan Chen, Xiaofu Yang","doi":"10.1177/15271544251406549","DOIUrl":"10.1177/15271544251406549","url":null,"abstract":"<p><p>BackgroundIn many Organization for Economic Cooperation and Development (OECD) countries, hospital nursing care is comprehensively provided by professional nurses and multidisciplinary teams, with no reliance on family companions. By contrast, China has historically depended on family caregivers at the bedside, a practice shaped both by deep-rooted cultural traditions of filial piety and by persistent nursing workforce shortages. With the introduction of the <i>Hospital No-Companion Care Servi</i>ce Pilot Work Plan (2025-2027), China is entering a critical reform phase aimed at transitioning from informal family-dependent caregiving toward a more institutionalized, standardized, and professionalized hospital nursing model.MethodsThis study employed a comparative policy analysis combined with a narrative literature review. The review followed PRISMA guidelines for transparent literature selection and applied Walt & Gilson's Policy Triangle Framework to examine policy context, content, processes, and actors. Sources included PubMed, Web of Science, <i>China National Knowledge Infrastructure</i> (CNKI), <i>Organization for Economic Cooperation and Development</i> (OECD), <i>World Health Organization</i> (WHO), and Chinese government policy documents, ensuring both international and domestic perspectives were incorporated.ResultsFindings indicate that China's model addresses demographic aging and nursing shortages through hybrid approaches combining nurses with supervised assistants. Compared with OECD systems, China faces lower nurse density (2.9 vs. 9.2 per 1,000) and lower nurse-to-bed ratios (0.6:1 vs. 1.4:1). Preliminary pilot outcomes suggest notable improvements in patient safety, fall prevention, and satisfaction levels. However, they also reveal ongoing financing challenges, regulatory gaps, and varying degrees of cultural acceptance among patients and families, reflecting the tension between traditional caregiving norms and new institutional practices.ConclusionChina's no-companion model is both an innovative reform and a transitional stage in health system transformation. Long-term sustainability requires systematic investment in expanding nurse education, gradual integration of no-companion services into medical insurance coverage, and deliberate efforts to foster cultural adaptation through patient and family engagement strategies. China's experience offers lessons for low- and middle-income countries seeking professionalized care models under resource constraints, highlighting how institutional restructuring can respond to workforce shortages while respecting cultural contexts. This study provides policy insights into how professional nursing reform can balance workforce capacity, cultural expectations, and institutional accountability in the context of China's hospital no-companion care initiative.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"201-212"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835205","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":"Recruiting and Retaining Older Healthcare Professionals: Evidence-Based Strategies for a Resilient Workforce.","authors":"Mira Kramer, Tilmann Kramer","doi":"10.1177/15271544251404041","DOIUrl":"10.1177/15271544251404041","url":null,"abstract":"<p><p>The global shortage of healthcare professionals is a critical challenge driven by demographic changes, workforce attrition, and increasing healthcare demands. Older professionals contribute valuable experience and interpersonal skills but are often underutilized due to stereotypes, health concerns, and challenges in adapting to new technologies. This systematic review, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 reporting guideline, examined strategies to recruit and retain older healthcare professionals and to promote intergenerational collaboration. A comprehensive literature search was performed in PubMed, Medline, and Google Scholar for studies published before March 2025 that addressed recruitment and retention strategies, workplace diversity, and collaboration across generations. Of 224 records initially identified, 84 met the inclusion criteria and were synthesized narratively. Effective recruitment strategies included community-based outreach and flexible work arrangements, while retention measures such as phased retirement, mentoring programs, and workplace health initiatives supported knowledge transfer, job satisfaction, and workforce stability. Digital knowledge management and structured mentoring programs further facilitated intergenerational collaboration. A structured approach to workforce planning that integrates diversity and inclusivity can help mitigate healthcare workforce shortages by leveraging the strengths of different generations. Ensuring adaptable working conditions, intergenerational collaboration, and continuous knowledge exchange can strengthen workforce resilience and support the sustainability of healthcare systems. Future research should evaluate the long-term effects of these strategies on workforce stability and patient outcomes.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"184-200"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823449","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":"Get out the Vote.","authors":"Christine Kovner","doi":"10.1177/15271544261461407","DOIUrl":"https://doi.org/10.1177/15271544261461407","url":null,"abstract":"","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":"27 3","pages":"159"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383267","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":"Challenges and Perceptions of Graduating Nursing Students to Develop the Competence-Based National Nursing Examination in Finland: A Qualitative Study.","authors":"Floro Cubelo, Arja Rantala, Satu Elo, Kirsi Koivunen, Reetta Saarnio, Pia Mäenpää","doi":"10.1177/15271544251396550","DOIUrl":"10.1177/15271544251396550","url":null,"abstract":"<p><p>Competence-based education is an emerging trend in nursing education. Finland has initiated a pilot program for a national exam designed to evaluate the knowledge of graduating nursing students. However, research concerning students' perspectives on exam quality and implementation remains scarce. The aim of this study was to explore graduating nursing students' experiences and identify key areas for improvement in the organizational implementation of competence-based national nursing examination in Finland. This study employed Elo and Kyngäs' qualitative content analysis, which examined a set of 109 mentions to open-ended questions from 106 graduating nursing students. The results revealed that students wanted better content validation, exam clarity, preparation resources, and flexibility in exams. The students also required explicit instructions and a structured framework for drug calculations. A competence-based national examination ensures compliance with standards, and it is essential to validate test questions and equip educators. Students need early preparation, and practice tests and materials should be improved for readiness.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"171-183"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783583","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":"Redirecting Public Investment: Strengthening Capacity in Philippine State Universities.","authors":"Richard Ian Mark T Necosia, Joanne Vivien B Necosia","doi":"10.1177/15271544251396095","DOIUrl":"10.1177/15271544251396095","url":null,"abstract":"","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"161-162"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566244","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":"Expanding HPV Vaccination in the United States Through Policy Action: A Call for Legislative Support.","authors":"Grace K Kyei, Evans K Kyei","doi":"10.1177/15271544251404015","DOIUrl":"10.1177/15271544251404015","url":null,"abstract":"<p><p>Human papillomavirus (HPV) vaccination remains significantly underutilized despite its proven efficacy in preventing cancer. As of 2022, only 38.6% of children ages 9 to 17 years have received one or more HPV vaccine doses, with particularly low coverage among younger children (7.3% for ages 9-10 years) who would benefit most from early vaccination. This results in approximately 36,000 preventable HPV-related cancer cases annually, with an economic burden exceeding $1.7 billion. Significant disparities exist between metropolitan (39.4%-41.1%) and nonmetropolitan areas (30.0%). This brief presents evidence-based policy recommendations for state legislators to increase HPV vaccination rates through school-entry requirements, enhanced funding for equitable access, and provider education targeting children and adolescents aged 9 to 17 years. Implementation of these measures could prevent 90% of cervical cancers and substantially reduce five other HPV-related cancers, saving thousands of lives annually while lowering healthcare costs by an estimated $3.5 billion over a decade. Immediate action is essential to protect the current generation from future cancer risk.</p>","PeriodicalId":53177,"journal":{"name":"Policy, Politics, and Nursing Practice","volume":" ","pages":"165-170"},"PeriodicalIF":3.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775312","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}