Ensuring medication safety is a critical responsibility of novice nurses who are defined as those with less than one year of clinical experience in clinical practice. Understanding factors associated with medication safe...Ensuring medication safety is a critical responsibility of novice nurses who are defined as those with less than one year of clinical experience in clinical practice. Understanding factors associated with medication safety competence is essential for developing effective training programs. This study identified the factors associated with the medication safety competence of novice nurses and examined the relationships between nursing practice readiness, critical reflection competency, and clinical decision-making ability. This study was conducted at a tertiary hospital in Seoul, South Korea. The participants were 263 novice nurses with at least six months of clinical experience, who were recruited through convenience sampling. Data were collected in July 2024 using a questionnaire that included tools measuring medication safety competence, nursing practice readiness, critical reflection competency, and clinical decision-making in nursing. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis. Medication safety competence was significantly correlated with nursing practice readiness (r = .731, < .001), critical reflection competency (r = .704, < .001), and clinical decision-making (r = .444, < .001). Hierarchical regression analysis identified nursing practice readiness (β = .733, < .001) and critical reflection competency (β = .316, < .001) as significant predictors of medication safety competence. The final model explained 58.6% of the variance in medication safety competence. Nursing practice readiness and critical reflection competency are key factors correlated with medication safety competence in novice nurses. Enhancing these competencies through structured pre-employment, on-the-job training, and fostering reflective thinking is crucial for improving medication safety.
: The COVID-19 pandemic was an unprecedented event that spread rapidly and posed a global threat to lives and livelihoods, significantly impacting the healthcare system worldwide, including Indonesia. In response to hosp...: The COVID-19 pandemic was an unprecedented event that spread rapidly and posed a global threat to lives and livelihoods, significantly impacting the healthcare system worldwide, including Indonesia. In response to hospital workforce shortages, internal redeployment practices were implemented. However, the impact of hospital redeployment practices on clinical nurses during the pandemic in Indonesia remains largely unexplored.: The study aimed to explore the perspectives of clinical nurses' staff who underwent redeployment on the COVID-19 unit during the first wave of the pandemic in East Java, Indonesia.: The study design was a qualitative descriptive design. Purposive sampling was used to recruit clinical nurses who had been redeployed to the COVID-19 Unit. Virtual, semi-structured one-on-one interviews were conducted via video conference. Data were analysed using thematic analysis.: A total of nine clinical nurses, who were recruited and included in the analyses, reported deployment from the regular unit into the COVID-19 isolation room (77.8%) and the Intensive Care Unit for COVID-19 (22,2%). Seven key themes were identified: (1) Strategic workforce selection criteria; (2) Intra-hospital staffing reorganisation; (3) Reconfiguration of nursing care delivery; (4) Adaptation of work arrangements; (5) Workforce protection and support measures; (6) Multifaceted challenges of redeployment; and (7) Balancing burden and growth.: Redeployment of nurses during the COVID-19 pandemic in hospital-based setting was an important strategy applied by Indonesian healthcare systems to cope with the surge in patient presentations and demand. In Indonesia, such practice of redeployment reflected both institutional response and the impact of collectivist cultural values on professional behaviour. Recognising these aspects was essential to maintain continuity of services during the pandemic when hospitals faced significant workforce shortages. This study provides actionable insights for hospital leaders and policymakers in designing operational redeployment protocols and supportive environments that sustain nurse wellbeing and performance under crisis conditions.
OBJECTIVE: The objective of this qualitative systematic review is to critically appraise and synthesise the literature regarding the experiences of new graduate registered nurses (NGRN) in their transition to working in...OBJECTIVE: The objective of this qualitative systematic review is to critically appraise and synthesise the literature regarding the experiences of new graduate registered nurses (NGRN) in their transition to working in residential aged care homes (RACHs). INTRODUCTION: New graduate registered nurses who transition into RACHs post qualification may be exposed to an unfamiliar environment. In Australia, pre-registration programs focus on the preparation of graduates to work in acute settings, such as hospitals. Aged care homes have a unique practice and regulatory environment that would be unfamiliar unless the NGRN have worked in these homes before or during their registration program. INCLUSION CRITERIA: Studies that involved NGRN of any age, gender or cultural background, working in RACHs and in their first-year post-registration practice were included. New graduate registered nurses in other healthcare areas such as hospitals, community care, private practice and others were excluded. METHODS: The review followed the methodology of the Joanna Briggs Institute guidance for qualitative systematic reviews. Six databases were searched in November 2023: CINAHL, PubMed, Medline, Embase, PsycINFO, and Scopus. Only qualitative peer-reviewed articles written in the English language were included. Studies meeting the selection criteria were uploaded into Covidence, screened and appraised by two independent reviewers. FINDINGS: A total of 185 articles were selected and screened by title and abstract. Of these, 12 were selected for full-text review and three were selected for inclusion. Common across the three studies was that there was no formal program to support the new graduate registered nurse, nor a senior clinician to offer advice or support, which led to NGRN seeking advice from less qualified staff.
BACKGROUND: There is growing recognition of the need for innovative educational strategies that strengthen critical thinking, clinical decision-making, and readiness for independent practice. Traditional approaches, whil...BACKGROUND: There is growing recognition of the need for innovative educational strategies that strengthen critical thinking, clinical decision-making, and readiness for independent practice. Traditional approaches, while valuable, may not fully prepare nursing learners for the complexity and unpredictability of clinical environments. Interactive clinical decision-making scenarios have the potential to bridge this gap by offering immersive, practice-orientated learning experiences. OBJECTIVES: This study evaluated the effectiveness of interactive clinical decision-making scenarios in supporting the development of critical thinking, clinical decision-making, and collaborative competencies among final-year nursing students. DESIGN: A convergent mixed-methods design was employed to capture both the breadth and depth of student experiences. The quantitative and qualitative components were implemented concurrently, with findings integrated to provide a comprehensive understanding of the scenarios' education value. METHODS: Quantitative data were collected via structured 25-item survey with Likert-scale items assessing students' perceptions of the scenarios. Qualitative data were gathered from open-ended survey responses and semi-structured interviews. Descriptive statistics were used for survey analysis, with qualitative data used to illustrate and enrich the quantitative findings, adding depth and nuance. RESULTS: A total of 141 final-year nursing students completed the survey, and six participated in interviews. The majority (95%) agreed that the scenarios enhanced critical thinking, clinical decision-making, engagement, and collaborative skills. Interview data reinforced these findings, with students emphasising how the scenarios promoted deeper reflection, improved confidence, and better preparation for independent practice. CONCLUSION: Interactive clinical decision-making scenarios represent a promising strategy to strengthen essential clinical competencies. Broader integration into curricula may enhance students' preparedness for safe, effective and independent practice.
AIM: To examine nurses' experiences regarding the use of Mobile Wireless Vital Signs Monitors, evaluate their impacts on nursing work processes and patient care, and make recommendations for future development. DESIGN: A...AIM: To examine nurses' experiences regarding the use of Mobile Wireless Vital Signs Monitors, evaluate their impacts on nursing work processes and patient care, and make recommendations for future development. DESIGN: A descriptive qualitative study. METHODS: Semi-structured interviews were conducted with 12 nurses who had at least two years of experience using wireless vital signs monitors in a university hospital in Turkiye. Data were analysed using Braun and Clarke's thematic analysis method. RESULTS: Five main themes emerged: Workflow Processes (time-saving, workload reduction, documentation processes); Technology Integration (advantages, technical issues); Patient Care (communication, safety, infection management); Adaptation and Education (training adequacy, student nurses' experience); and Development Suggestions (design improvements, advanced technology integration). Nurses reported that monitors enhanced efficiency, reduced workload, improved documentation, and positively affected patient care quality. However, technical limitations, maintenance requirements, and adaptation challenges were noted. CONCLUSION: Mobile Wireless Vital Signs Monitors make significant contributions to nursing practice by improving workflow efficiency, enhancing patient safety, and reducing infection risk. However, technical improvements, user-centred design modifications, and comprehensive training programs are needed to optimize their use. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Understanding nurses' experiences with these devices is critical for improving existing systems and ensuring sustainable digital transformation in healthcare. The findings provide evidence for healthcare administrators and technology developers to enhance device design, integration, and training protocols.
Transitioning from hospital to home signifies a risk for older adults, often resulting in worse health outcomes and increased healthcare utilisation. Frailty, recognised as a critical issue and global health priority in...Transitioning from hospital to home signifies a risk for older adults, often resulting in worse health outcomes and increased healthcare utilisation. Frailty, recognised as a critical issue and global health priority in geriatric care, further compounds these transition risks. There is a need to generate new knowledge of effective interventions for these populations that address this vulnerable period during the transfer home. To evaluate the feasibility and acceptability of a nurse-coordinated discharge intervention for acutely ill complex older adults discharging home. Prospective, non-randomised, single-arm, feasibility and acceptability Phase I trial within a cohort study protocol. Eligible participants are individuals aged 65 years and over, admitted under the Geriatric Services of two metropolitan hospitals, included in the Western Sydney Clinical Frailty Registry and discharged from hospital to home. All participants are provided with the intervention, which includes phone-based patient-centred discharge communication initiated during the transfer from hospital to home. The primary outcome is the feasibility and acceptability of the intervention, assessed by the proportion of participants able to agree and achieve the patient-set priorities. This study will provide valuable insights into the feasibility and acceptability of post-discharge support for hospitalised older adults within this local healthcare context. The findings will directly inform clinical practice and guide the development of a subsequent Phase II trial examining patient-reported outcomes and readmission rates in this vulnerable population. Future research should also focus on refining transitional care interventions to enhance adaptability and effectiveness across diverse healthcare environments.This study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12624000795594. Australian New Zealand Clinical Trials Registry identifier: ACTRN12624000795594.
BACKGROUND: Despite APNs' advanced clinical autonomy, they still face significant role ambiguity and psychological challenges due to their complex professional positioning, and these issues have not been fully synthesize...BACKGROUND: Despite APNs' advanced clinical autonomy, they still face significant role ambiguity and psychological challenges due to their complex professional positioning, and these issues have not been fully synthesized in existing studies. AIM: To clarify the current status of APNs' role experience and congnition. METHODS: Using the scoping review methodology as the framework, a comprehensive search was conducted across multiple databases from the establishment of the databases to July 10, 2024. A total of 1183 studies were imported into EndNoteX9 for screening. Researchers used the thematic analysis method to classify the included studies. RESULTS: Three themes were identified from 14 included studies, including contradictory self-perception, professional self-recognition, and professional development ambiguity. CONCLUSIONS: This review highlighted that despite APNs' strong professional identity, their professional development is significantly constrained by role ambiguity. Additionally, it revealed inadequacies across multiple dimensions, including systemic norms, organizational support, and team support.
BACKGROUND: The United States' population is aging, and those aged 65 years or older are plagued by multiple co-morbidities that require strong community-based care to avoid emergency department visits (ED) or hospitalis...BACKGROUND: The United States' population is aging, and those aged 65 years or older are plagued by multiple co-morbidities that require strong community-based care to avoid emergency department visits (ED) or hospitalisations. The dominance of business-centric healthcare systems and health insurance structures combined with inadequate community-care paradigms are creating care gaps that force patients to rely on the acute care system. Concierge nursing, an innovative nurse-driven solution for acute care overutilisation and systemic cost conservation, has the potential to transform care delivery and improve clinical outcomes. AIM & DESIGN: Drawing on peer reviewed evidence supporting the benefits of the concierge medicine model and validating the role corporately employed nurse navigators play in decreasing ED visits or acute care utilisation, this manuscript discusses the potential advantages of a novel concierge nursing model of care. FINDINGS: Nurses, with their robust clinical knowledge and skills, are poised to innovatively address barriers and restrictions to care imposed by large, corporate health systems, insurance companies, and an inadequate primary care model. Using an entrepreneurial approach, nurses can create solutions that improve care delivery and outcomes. Concierge nursing may circumvent existing barriers to providing the quality of evidence-based care that patients need. Research is needed on implementing a concierge nursing care model under discussion to study its clinical and financial effects.
: This study aims to investigate how barcode-assisted medication administration systems (BCMAs) can affect medication administration errors (MAEs) in non-unit-dose dispensing settings, since unit-dose dispensing practice...: This study aims to investigate how barcode-assisted medication administration systems (BCMAs) can affect medication administration errors (MAEs) in non-unit-dose dispensing settings, since unit-dose dispensing practice can be a confounding variable affecting MAE rates. : We conducted a systematic review of English articles on MEDLINE, EMBASE, EMCARE, CINAHL and Scopus, with the most recent search conducted on 1 February, 2024. Studies were meticulously examined to exclude those with unit-dose dispensing settings.We used ROBINS-I V2 for risk-of-bias assessment and narrative synthesis to summarise findings. : We included 4 papers in the review. The categories of MAEs reported among these studies are heterogeneous. Two studies give weak evidence, and 1 study gives moderate evidence that BCMA can lower some categories of MAEs. 1 study gives weak evidence that BCMA increases the wrong administration time error. : Studies provide weak to moderate evidence that barcode-assisted medication administration can lower certain categories of medication administration errors. However, some reported findings are minimal. : More multi-ward, multi-hospital studies need to be conducted to provide stronger evidence on BCMA's impact on MAEs, especially on dosage-related MAEs, in settings without unit dose dispensing practices.
BACKGROUND: Burnout among healthcare workers (HCWs) is a major occupational health challenge, with detrimental consequences for both staff well-being and patient care. Machine learning (ML) offers potential for early det...BACKGROUND: Burnout among healthcare workers (HCWs) is a major occupational health challenge, with detrimental consequences for both staff well-being and patient care. Machine learning (ML) offers potential for early detection and prevention, but evidence synthesis on its predictive performance and applicability is lacking. AIMS: To systematically evaluate the performance, methodological quality, and clinical applicability of ML models for predicting burnout in HCWs. DESIGN: Systematic review and meta-analysis. METHODS: Ten databases (PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Scopus, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang) were searched for studies published from inception to 13 February 2025. Eligible studies developed or validated ML models for HCW burnout prediction, using clinically validated tools (e.g. Maslach Burnout Inventory). Two reviewers independently extracted data and assessed study quality using the Prediction Model Risk of Bias Assessment Tool for Artificial Intelligence (PROBAST-AI). Pooled area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated using a random-effects model. Subgroup analyses explored heterogeneity. RESULTS: Twenty-two studies met inclusion criteria. The pooled AUC was 0.72 (95% CI: 0.68-0.76), indicating moderate discrimination. Sensitivity was 0.63 (95% CI: 0.53-0.73) and specificity was 0.84 (95% CI: 0.75-0.90). Models performed better when using self-reported data, focusing on nurses, conducted in the Asia-Pacific region, or using MBI-based assessments ( < 0.0001). Key predictors clustered into five categories: demographic/occupational, psychological/behavioral, organizational/social, physiological/wearable, and activity/work patterns. All studies showed high or unclear risk of bias in at least one PROBAST-AI domain. CONCLUSIONS: ML models show promise for predicting burnout in HCWs but are limited by methodological weaknesses, heterogeneity, and lack of external validation. Advancing this field requires rigorous design, transparent reporting, multimodal data integration, and ethical safeguards to enable trustworthy clinical use.
BACKGROUND: A thorough investigation of various medical errors to better understand their underlying causes is the first step toward preventing medication errors and improving patient safety. The causes, types, and rates...BACKGROUND: A thorough investigation of various medical errors to better understand their underlying causes is the first step toward preventing medication errors and improving patient safety. The causes, types, and rates of medication errors can evolve within the healthcare delivery system. In Korea, systematic data on patient safety incidents remains limited, although healthcare institutions are progressively developing comprehensive information sharing systems. OBJECTIVE: This study aimed to analyze factors influencing the risk of adverse events from medication errors in general and tertiary hospitals in Korea using national patient safety statistics (2018-2022). METHODS: A secondary analysis of 8,606 medication error reports was performed to identify risk factors related to hospital and patient characteristics. Firth penalized logistic regression was employed, and sensitivity analyses excluding pandemic years (2020-2021) were conducted. RESULTS: The risk of adverse events from medication errors was 1.5 times higher in general hospitals with ≥500 beds than in those with <500 beds. Emergency rooms and intensive care units demonstrated the highest risks across both hospital types. Day shifts showed protective effects compared to night shifts in both hospital types. Temporal analysis revealed significantly higher risks in earlier years (2018-2020) compared to 2022, suggesting improvements in medication safety systems. Sensitivity analyses confirmed that pandemic years amplified risks in high-acuity areas, and the protective effect of day shifts was particularly critical during this period. In general hospitals, adult age groups (≥20 years) showed elevated risks, with pediatrics demonstrating 1.7 times higher risk than general surgery. CONCLUSIONS: These findings highlight the need for tailored interventions based on hospital type, location, temporal factors, and patient characteristics. Developing department-specific safety strategies for high-acuity care environments, optimizing staffing patterns particularly during night shifts, implementing age-specific medication management protocols, and continuously improving safety systems are essential to prevent medication errors, enhance patient safety, and improve healthcare outcomes.
BACKGROUND: Transitioning into intensive care nursing is complex and emotionally demanding for early career nurses. High attrition and psychological stress underscore the need for education that supports resilience and w...BACKGROUND: Transitioning into intensive care nursing is complex and emotionally demanding for early career nurses. High attrition and psychological stress underscore the need for education that supports resilience and wellbeing alongside clinical competency. AIM: This paper describes the integration of self-care and wellbeing strategies into a redesigned statewide postgraduate Intensive Care Nursing Transition to Specialty Practice (ICN-TTSP) program in New South Wales, Australia. METHODS: Curriculum mapping aligned the existing ICN-TTSP program with national nursing standards, identify gaps in self-care, resilience, and professional identity. A narrative literature review informed pedagogical strategies, including reflective journaling, role modelling, virtual simulation, and work-integrated learning. RESULTS: The reimagined ICN-TTSP program embeds self-care and resilience through multimodal educational strategies, including ePortfolio's, video vignettes, and patient/family experience stories. These strategies normalise self-care as professional wellbeing behaviour. Preliminary evaluation shows strong engagement and improved emotional awareness amongst learners. CONCLUSION: Embedding wellbeing into postgraduate nursing education is essential for workforce sustainablilty. Further evaluation will assess long-term impact..
BACKGROUND: Artificial Intelligence (AI) has the potential to revolutionize healthcare by enhancing diagnostic accuracy, streamlining administrative tasks, and improving patient care. However, the integration of AI into...BACKGROUND: Artificial Intelligence (AI) has the potential to revolutionize healthcare by enhancing diagnostic accuracy, streamlining administrative tasks, and improving patient care. However, the integration of AI into clinical practice faces significant barriers, particularly in nursing. Nurses, like frontline healthcare providers, are uniquely positioned to observe and experience these challenges. Understanding their perspectives can offer valuable insights into the obstacles hindering AI adoption in nursing practice, especially within acute care settings. AIMS: This study aimed to explore the perceptions of nurses regarding the barriers to integrating AI technologies into clinical practice. DESIGN: A qualitative design. METHODS: A qualitative phenomenological approach was employed to capture nurses lived experiences. Twenty nurses were recruited through purposive sampling from 20 healthcare institutions (eight tertiary care hospitals, eleven general hospitals, and one district hospital) in Dhaka, Bangladesh. Data were collected over a three-month period (April to June 2025) using semi-structured interviews and focus group discussions. Transcripts were analyzed using van Manen's reflective methodology. The conceptual framework incorporated the Technology Acceptance Model, emphasizing perceived usefulness and ease of use, while also considering the cultural and infrastructural context. RESULTS: The study identified three major themes: (i) knowledge and awareness gaps, (ii) organizational barriers, and (iii) ethical and interpersonal concerns. Nurses highlighted a lack of AI-focused education, inadequate institutional support, and concerns about privacy and dehumanization of care. Misconceptions about AI's capabilities and exclusion from AI-related decision-making processes further contributed to resistance and skepticism. CONCLUSIONS: The study underscores the need for targeted reforms in nursing education to include comprehensive AI training. Addressing organizational and ethical barriers, such as providing adequate resources, robust privacy measures, and inclusive policies, is crucial. By empowering nurses and fostering interdisciplinary collaboration, healthcare systems can leverage AI effectively while preserving human-centered care.