Journal Of Advanced Nursing[JOURNAL]
Sun
200 papers
Reflections and Projections: The Next 50 Years of Priorities in Nursing Education.
Timmins F
J Adv Nurs · 2026 Jul · PMID 41879465 · Full text
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The Practice of Nurse Managers, Their Support Needs and the Importance of Shared Leadership: A Multicentre International Qualitative Research.
Déry J, Paquet M, Lavigne G … +5 more , Fournelle S, Bolduc J, Lucien H, Folch N, Vasserot K
J Adv Nurs · 2026 Mar · PMID 41860143 · Publisher ↗
AIM: To shed new light on the management practice and needs for support, mentoring and continuous education of nurse managers (head nurses and assistant head nurses) during and since the COVID-19 pandemic to identify the...
AIM: To shed new light on the management practice and needs for support, mentoring and continuous education of nurse managers (head nurses and assistant head nurses) during and since the COVID-19 pandemic to identify the innovative strategies they put in place to mobilise teams and foster a healthy work environment. DESIGN: A multi-centre exploratory descriptive study with a qualitative descriptive exploratory design was used. METHODS: 10 focus groups held between December 2021 and July 2022, five from a Canadian healthcare centre and five from a Swiss healthcare centre, were conducted with 35 nurse managers. The data were analysed using thematic analysis. RESULTS: Six central themes emerged: (1) A difficult context to navigate: Continuous adaptation necessary to navigate through difficulties and a rapidly changing context, (2) Maintaining a visible presence and engaging in active listening with team members to promote commitment, motivation and mobilisation, (3) Frequent short meetings, instant and transparent communication, (4) Role legitimacy and recognition, along with continuous professional development, (5) Integration and cohesion among team members, and the quality of care and (6) Shared leadership: A key strategy to prioritise. CONCLUSION: The present study offers unique insights into the innovative strategies nurse managers have put in place to ensure the optimal functioning of their care team, to foster a positive work climate, and to ensure the commitment, motivation and mobilisation of their teams. A shared leadership approach appears to be a key lever of action to optimally tackle the present and future needs and challenges of nurse managers. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study highlights key managerial strategies that can be beneficial in all contexts or during future crises, ultimately helping healthcare organisations and nurse managers have a better understanding of their role and influence. REPORTING METHOD: Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
Pluralising Scholarship: Repositioning Doctor of Nursing Practice Faculty Through Boyer's Framework: A Discursive Paper.
Kimani RW
J Adv Nurs · 2026 May · PMID 41858160 · Full text
AIM: To critically examine the structural exclusion of Doctor of Nursing Practice (DNP)-prepared faculty from academic advancement and promotion pathways and to propose reforms grounded in Boyer's model of scholarship. B...
AIM: To critically examine the structural exclusion of Doctor of Nursing Practice (DNP)-prepared faculty from academic advancement and promotion pathways and to propose reforms grounded in Boyer's model of scholarship. BACKGROUND: The DNP is a practice-focused doctorate established in the United States, distinct from the research-oriented PhD. Similar professional doctorates in the United Kingdom and Australia share the goal of integrating clinical expertise with scholarly inquiry. Despite the rapid growth of DNP programs and the increasing recognition of applied scholarship, many universities continue to privilege traditional research metrics in academic tenure and promotion. This narrow focus on discovery-based outputs marginalises the contributions of DNP faculty in implementation science, systems leadership, and education. DESIGN: Discursive position paper. DATA SOURCES: Analysis of policy reports, faculty promotion guidelines, AACN Essentials, and peer-reviewed literature on doctoral education, professional doctorates, and academic equity, 2000-2025. IMPLICATIONS FOR DOCTORAL EDUCATION: Current academic evaluation systems sustain hierarchical norms that undervalue practice-based scholarship. This misalignment restricts the career trajectories of DNP-prepared faculty and constrains nursing's leadership in applied innovation. Reframing scholarly legitimacy through Boyer's model of discovery, integration, application, and teaching enables recognition of diverse expertise without compromising academic rigour. CONCLUSION: Fully integrating professional doctorates into academic structures requires deliberate reforms in evaluation frameworks, mentorship programs, and institutional policies. Such changes would advance equity, reflect the realities of modern nursing, and align doctoral education with the evolving needs of healthcare systems. IMPACT: This paper contributes to the international discourse on the future of doctoral education by offering a practical model for inclusive faculty advancement. It also advocates adopting pluralistic definitions of scholarship to support diverse academic career paths in nursing. NO PATIENT OR PUBLIC CONTRIBUTION: No patients, service users, caregivers, or members of the public were involved in the development of this discursive paper. The analysis synthesises existing scholarship, policy documents, and theoretical frameworks and does not draw on primary data requiring patient or public involvement.
Justice-Oriented Scholarship: Naming and Framing a Critical Imperative in Nursing.
Jackson D, Power T, Moorley C … +4 more , Wilson D, West R, Jones D, McCormack B
J Adv Nurs · 2026 Mar · PMID 41858159 · Publisher ↗
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From Wage Dissatisfaction to Union Expectations: The Mediating Role of Union Perception Among Nurses.
Tosun S, Cerev G, Sariipek DB
J Adv Nurs · 2026 Mar · PMID 41852306 · Publisher ↗
AIM: This study examines the relationships between wage satisfaction, union perceptions, expectations, and union membership among Turkish nurses, identifying factors associated with union participation. DESIGN: Sequentia...
AIM: This study examines the relationships between wage satisfaction, union perceptions, expectations, and union membership among Turkish nurses, identifying factors associated with union participation. DESIGN: Sequential explanatory mixed-methods design. METHODS: This two-phase study (January-July 2023) included: (1) a quantitative survey of 210 nurses assessing wage satisfaction, union perceptions, and expectations, analysed using regression and PROCESS Macro (Model 4); and (2) qualitative interviews with 22 nurses, including 15 with union leadership experience, analysed through thematic analysis using MAXQDA. RESULTS: Quantitative findings indicated that wage satisfaction was associated with nurses' perceptions of unions but did not independently predict union expectations. The study hypothesises that union perception functions as a key mediating mechanism, translating wage dissatisfaction into expectations for union action. Qualitative findings supported this pattern, showing that although wage dissatisfaction was widespread, nurses' expectations were primarily shaped by perceptions of unions' transparency, political independence, democratic participation, and representational capacity rather than by wages alone. CONCLUSIONS: Union participation among nurses is influenced by both economic conditions and normative evaluations of unions. While wage dissatisfaction provides an important contextual background, expectations and engagement are mainly driven by perceptions of union credibility, fairness, and representational effectiveness. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE: Nursing unions should prioritise transparent governance, democratic participation, and political independence to enhance trust, member engagement, workforce stability, and quality of care. IMPACT: This study addresses persistent wage dissatisfaction alongside declining union membership and trust. The findings demonstrate that union engagement depends not only on economic dissatisfaction but also on perceived representational fairness. The results are particularly relevant for nursing unions, professional organisations, and policymakers aiming to strengthen union legitimacy and workforce engagement in healthcare systems. REPORTING METHOD: Compliant with COREQ guidelines and mixed-methods reporting standards. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
Psychological Safety of Culturally and Linguistically Diverse Nurses in Healthcare Work Environments-Systematic Review of Mixed-Methodology.
Yabal J, Kamau S, Tomietto M … +1 more , Mikkonen K
J Adv Nurs · 2026 Mar · PMID 41845941 · Publisher ↗
BACKGROUND: The international mobility of nurses is a significant component of healthcare systems worldwide, resulting in the global recruitment and adaptation of culturally and linguistically diverse nurses into diverse...
BACKGROUND: The international mobility of nurses is a significant component of healthcare systems worldwide, resulting in the global recruitment and adaptation of culturally and linguistically diverse nurses into diverse work environments. CALD nurses face integration challenges, which can potentially compromise their well-being and adjustment to the new setting. Psychological safety is a key component to promoting individual well-being and effective organisational integration. OBJECTIVE: This systematic review aimed to identify the current evidence on the psychological safety of culturally and linguistically diverse nurses in healthcare work environments and the factors associated with it. METHODS: This systematic review was conducted using JBI guidelines. PiCo/PEO format was utilised for inclusion and exclusion criteria, including English/Finnish, without time limitations. The screening process was conducted by two independent researchers, with a third researcher resolving the conflicts. The PRISMA checklist was utilised in reporting. Data were analysed using content analysis for qualitative and data synthesis for quantitative. DATA SOURCES: CINAHL, PubMed, ProQuest, Scopus and Medic. SEARCH PERIOD: 24.10.2024-23.1.2025. RESULTS: The systematic review yielded 15 qualitative, one mixed-methods and one quantitative article. The content analysis produced 270 codes, 67 subcategories, seven categories and two main categories. Professional growth and acceptance captured inclusion, professional competence and support from colleagues and managers in creating job satisfaction. Marginalised disempowerment reflected factors linked to low psychological safety, contributing to reduced job satisfaction in the workplace. CONCLUSION: Healthcare organisations should confront existing inequities on psychological safety in culturally diverse healthcare environments that are structured around professional inequalities to create equitable spaces for CALD nurses. More research is needed to understand psychological safety experiences from the CALD nurse perspective, exploring the equitability of facilitating factors amid systemic disadvantages in the healthcare workplace. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement. TRIAL REGISTRATION: Prospero registration: CRD42024581860.
Culturally and Linguistically Diverse Fathers' Experiences of Early Parenting: A Qualitative Study.
Elmir R, Ormsby S, Leahy-Warren P … +3 more , Philpott LF, Kothari A, Schmied V
J Adv Nurs · 2026 Mar · PMID 41841749 · Publisher ↗
AIM: This study aimed to explore culturally and linguistically diverse (CALD) fathers' early parenting support needs in the perinatal period in Australia. DESIGN: A qualitative descriptive research study. Participant fat...
AIM: This study aimed to explore culturally and linguistically diverse (CALD) fathers' early parenting support needs in the perinatal period in Australia. DESIGN: A qualitative descriptive research study. Participant fathers were recruited using purposive and snowball sampling who self-identified as CALD. METHODS: Data were collected through semi-structured telephone interviews with 15 Australian fathers aged between 29 and 56 years in July-November 2022. Data were analysed using Braun and Clarke's six stages of thematic analysis to code, categorise and identify themes from the data. FINDINGS: Four major themes and six sub-themes emerged from the data, 'Under pressure', 'Slipping through the cracks', 'Gaining knowledge and support by health professionals', and 'Path ahead: changed roles and being supported by peers' that encompassed fathers' early parenting experiences and support needs in the perinatal period. CONCLUSION: Culturally and linguistically diverse fathers experience challenges in navigating maternal health care settings and at times interactions with health professionals. However, findings from this study showed that fathers were determined to navigate resources, services and networks that supported their transition to fatherhood in the early postpartum weeks. There is a need for maternity settings to be a 'father-inclusive' environment where informational and practical support is readily available to them. Legislation reform is needed that recognises fathers as parents who require adequate 'paid' parental leave entitlements that foster family relationships and recognises the role fathers play in the development of their child. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study provides insights into the support needs of CALD fathers in the perinatal period. Findings from this study have the potential to shape and design culturally appropriate health services and interventions tailored to CALD fathers that meet their nuanced needs through the lens of cultural competence and trauma informed maternity care. IMPACT: What problem did the study address?: The study explored the support needs of CALD fathers in the perinatal period. What were the main findings?: The findings revealed CALD fathers feel a sense of responsibility and pressure to live up to socio-cultural expectations and support the family unit while engaging in paid employment to earn a living. At times fathers were not encouraged to be parenting partners by health professionals, and there was an expectation that they would be familiar and have knowledge about pregnancy, labour, birth and the transition to fatherhood. Some fathers struggled with their transition to parenthood either due to lack of paid parental support or limited to no family support. However, some fathers found alternatives to manage and adjust in the early weeks postpartum, which included peer support groups and online information. Where and on whom will the research have an impact?: The research has the potential to impact all fathers, as the findings may be transferrable across a number of communities. The research also has the potential to influence cultural competence training for health care professionals and inform policy development that employs a family centred model of maternity care inclusive of culturally diverse families. REPORTING METHOD: The paper has adhered to the EQUATOR COREQ reporting guideline. NO PATIENT OR PUBLIC INVOLVEMENT: This study did not include patient or public involvement in its design, conduct or reporting.
Artificial Intelligence Technologies in Nursing Clinical Decision-Making: An Umbrella Review.
Cant R, Ryan C, Chugh R
J Adv Nurs · 2026 Mar · PMID 41841218 · Publisher ↗
AIM: To describe contemporary peer-reviewed literature on artificial intelligence in nurses' clinical decision-making. METHODS: An umbrella review of literature reviews. DATA SOURCES: Four major databases were searched f...
AIM: To describe contemporary peer-reviewed literature on artificial intelligence in nurses' clinical decision-making. METHODS: An umbrella review of literature reviews. DATA SOURCES: Four major databases were searched for reviews published between 2019 and 2024. RESULTS: Sixteen literature reviews reported on 965 nursing artificial intelligence primary studies. The studies focused on technology development and emerging performance evaluations, whilst real-world testing or implementation in nursing clinical settings was rare. Rigorous comparative analyses were lacking. While artificial intelligence demonstrates promise in decision-making, challenges such as a lack of controlled studies, algorithmic bias, limited reproducibility and insufficient clinical trials hinder its practical impact. Ethical concerns, transparency and patient data privacy issues pose barriers to AI integration in nursing practice. Ethical and legal guidelines for patient privacy are needed and should be taught along with AI literacy training for nurses. CONCLUSIONS: Artificial intelligence has the potential to enhance clinical nursing decision-making, although evidence is limited by too few examples of nurse participation during development. Underutilisation in administrative nursing functions hinders implementation. Nurses should assume a central role in the design and development of AI applications to ensure that these technologies address the realities of nursing practice. With such improvements, artificial intelligence can transform nursing practice, improve nurses' clinical decision-making and ultimately enhance consumer healthcare outcomes. PATIENT OR PUBLIC INVOLVEMENT: No Patient or Public Involvement. REPORTING METHOD: While there is no reporting checklist for umbrella reviews, the PRISMA guide for systematic reviews was followed.
Delayed Admission to the Intensive Care Unit Is Associated With Increased Mortality Risk in Critically Ill Patients: A Prospective Cohort Study.
Anagi S, Chamberlain D, Barr N … +6 more , Mehdi A, Perez WP, Pusapati R, Shaw DT, Jennings C, Lin F
J Adv Nurs · 2026 Mar · PMID 41825944 · Publisher ↗
AIM: To examine the impact of delays in intensive care unit (ICU) admission on patient outcomes, specifically clinical deterioration and mortality among patients transferred from the emergency department (ED) or general...
AIM: To examine the impact of delays in intensive care unit (ICU) admission on patient outcomes, specifically clinical deterioration and mortality among patients transferred from the emergency department (ED) or general wards following acute deterioration in an Australian public hospital. DESIGN & METHODS: This prospective cohort study was conducted over a 12-month period (15 April 2022-14 April 2023) in a 209-bed regional hospital. It included adult patients (aged ≥ 18 years) admitted to the ICU from ED or general wards following acute deterioration. Primary outcomes measured were duration of delay in ICU admission, ICU and hospital mortality and changes in Sequential Organ Failure Assessment (SOFA) scores over time to assess organ dysfunction and progression. RESULTS: A total of 403 patients were included. Of these, 276 (68.5%) experienced delays in ICU admission, ranging from 25 min to 347.25 h (median: 7.13 h). Delayed ICU admission was associated with increased mortality. Each one-point increase in the highest recorded SOFA score was linked to a 7.5% rise in mortality odds, while each one-point increase in the initial or 24-h SOFA score corresponded to a 6.8% increase. CONCLUSIONS: Delayed ICU admission was significantly associated with increased mortality, particularly in patients with elevated SOFA scores, indicating worsening organ dysfunction and clinical instability. IMPLICATIONS FOR PRACTICE: These findings highlight the urgent need for improved triage systems, early warning protocols and streamlined escalation pathways to expedite ICU transfers for deteriorating patients. Timely intervention is essential to reduce harm and improve outcomes. IMPACT: This study reinforces the clinical risks of delayed ICU admission and supports timely escalation of care in emergency and ward settings across Australian public hospitals. REPORTING: Conducted in accordance with STROBE guidelines. PATIENT/PUBLIC CONTRIBUTION: No direct patient or public involvement. The study used routinely collected clinical data to evaluate systemic and clinical outcomes.
Scope of Nursing Work and Models of Service Delivery in Australian Primary and Secondary Schools: A Scoping Review.
Moyes A, Williams C, Rankin E … +3 more , Hoodcamp I, Potter EJ, Hayward BA
J Adv Nurs · 2026 Mar · PMID 41825923 · Publisher ↗
AIM: To map the scope of nursing work and models of service delivery in Australian primary and secondary schools for children aged 3-18 years. DESIGN: Scoping Review. DATA SOURCES: A search of CINAHL, Medline, PsycINFO,...
AIM: To map the scope of nursing work and models of service delivery in Australian primary and secondary schools for children aged 3-18 years. DESIGN: Scoping Review. DATA SOURCES: A search of CINAHL, Medline, PsycINFO, ERIC, Informit and Google was conducted in August 2024 for peer reviewed, non-peer reviewed and grey literature giving insight into nursing work in primary and secondary Australian schools in urban, regional and remote areas of all Australian states and territories. METHODS: The review employed Johanna Briggs Institute methodology for scoping reviews and reported the findings in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. RESULTS: One hundred and forty-two sources were included. Findings indicate that nurses working in Australian schools conduct a wide range of activities which vary by jurisdiction, education sector, employer and school type. Models of nursing service delivery are similarly varied and range from full-time school-based nurses to nurses who visit schools on an occasional basis. CONCLUSION: The varied scope of nursing work and models of service delivery provide evidence that the nursing workforce in schools is adaptable and flexible, but unequal access to nursing services raises important questions about equity. There is an urgent need for a national approach to nursing work in Australian schools. IMPACT: This is the first review to map the scope of nursing work and models of service delivery in Australian primary and secondary schools.
Advance Care Planning Intention and Associated Factors Among People With Dementia: A Mixed-Methods Study.
Zhang X, Wang J, Chen F … +2 more , Hu X, Qu Y
J Adv Nurs · 2026 Mar · PMID 41823305 · Publisher ↗
AIM: To explore the current status and associated factors of advance care planning intentions among people living with dementia in China. DESIGN: An explanatory sequential mixed-methods design was adopted. METHODS: The r...
AIM: To explore the current status and associated factors of advance care planning intentions among people living with dementia in China. DESIGN: An explanatory sequential mixed-methods design was adopted. METHODS: The research is guided by the knowledge-attitude-practice model and the theory of planned behaviour. Quantitative surveys were used to assess advance care planning intentions and associated factors in people living with dementia, followed by qualitative semi-structured interviews to delve into participants' perceptions and feelings about advance care planning. Quantitative data were analysed using multiple linear regression, while qualitative data were analysed using thematic analysis. RESULTS: The overall advance care planning behavioural intention was at a moderately high level. The quantitative results revealed that higher education level, certain religious beliefs, greater advance care planning knowledge, positive behavioural attitudes and stronger subjective norms were significantly positively associated with advance care planning intentions. Qualitative analysis identified three themes: positive attitude but limited ACP awareness, supportive relationships enable early ACP consideration and cultural norms shape willingness to engage in ACP. CONCLUSION: Advance care planning intentions among people living with dementia are shaped by a combination of social, familial and individual factors. Increasing public awareness, addressing cultural challenges and establishing professional teams are crucial to promoting advance care planning practices. Future research should focus on larger, multicenter studies to enhance intervention strategies. IMPLICATIONS: Although the attitude toward advance care planning is more positive, various factors need to be carefully considered in the process of constructing relative intervention strategies. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct or reporting.
Disabled Nurses in an Ableist Profession: Lessons From the Past and Directions for the Future.
Valdez AM
J Adv Nurs · 2026 Jul · PMID 41821251 · Publisher ↗
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Experiences and Responses to Cancer-Related Anorexia Across Patients, Caregivers and Healthcare Professionals: A Qualitative Meta-Synthesis.
Sun X, Zhang Z, Tang C … +4 more , Hu X, Wu L, Zhao Q, Cheng S
J Adv Nurs · 2026 Jul · PMID 41817211 · Publisher ↗
AIM: To synthesise qualitative evidence on how patients, caregivers and healthcare professionals perceive and respond to cancer-related anorexia (CRA), and to develop a multi-level framework for improving CRA care. DESIG...
AIM: To synthesise qualitative evidence on how patients, caregivers and healthcare professionals perceive and respond to cancer-related anorexia (CRA), and to develop a multi-level framework for improving CRA care. DESIGN: A qualitative meta-synthesis using the Joanna Briggs Institute (JBI) methodology, informed by the Social Ecological Model (SEM). METHODS: Seven databases were searched for qualitative studies from inception to April 2025. Studies were assessed using the JBI Critical Appraisal Checklist. Meta-aggregation was used to synthesise findings, and the ConQual method assessed confidence levels. DATA SOURCES: PubMed, Embase, CINAHL, PsycINFO, Cochrane Library, CNKI and WanFang. RESULTS: Seventeen studies from 10 countries were included, reflecting the perspectives of patients, caregivers and healthcare professionals. Four synthesised findings were identified. At the individual level, CRA was linked to physical decline, emotional distress and changes in identity. The interpersonal level involved feeding-related tensions and caregiver burden. Organisational barriers included delayed care and poor cultural responsiveness. Policy-level factors such as limited insurance coverage and rural access further impeded care. Overall confidence in these synthesised findings was low to moderate. CONCLUSION: CRA is not solely a biological condition but a multidimensional experience. Addressing CRA requires integrated and context-sensitive strategies across personal, relational, organisational and policy domains. IMPLICATIONS: Nurses and clinicians should address not only physical symptoms but also the emotional and social dimensions of eating. Structured support for caregivers and improved service access, particularly in underserved settings, are needed. IMPACT: This study provides a multi-level understanding of CRA. The findings support better patient care, caregiver support and more equitable healthcare policy design. REPORTING METHOD: JBI methodology and ENTREQ guideline. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. TRIAL REGISTRATION: PROSPERO Database: CRD420251041265.
Dangerous Times, Deliberate Acts: A Talk on Violence, Agency and Some Possibilities for Response.
Varcoe C
J Adv Nurs · 2026 Mar · PMID 41814536 · Publisher ↗
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Responding to Gender-Based Violence in a Changing World: Prevention, Advocacy and Action.
Patch M, Garinger C, Jack SM
J Adv Nurs · 2026 Mar · PMID 41814523 · Publisher ↗
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Special Issue: 26th Nursing Network on Violence Against Women International (NNVAWI) Conference Proceedings, 6-8 October 2025.
J Adv Nurs · 2026 Mar · PMID 41814521 · Publisher ↗
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Ten-Year Update of Nurse Practitioner Service Impact on Patient and Health Service Outcomes in Emergency Care Settings-A Systematic Review.
Fox A, Williams S, Jennings N … +4 more , Tomkins EM, Glynn R, Dunningham C, Tori K
J Adv Nurs · 2026 Mar · PMID 41808331 · Publisher ↗
AIMS: To provide a 10-year update on the best available evidence evaluating the impact of nurse practitioner services on cost, waiting times, patient satisfaction, representation rates, and length of stay in emergency an...
AIMS: To provide a 10-year update on the best available evidence evaluating the impact of nurse practitioner services on cost, waiting times, patient satisfaction, representation rates, and length of stay in emergency and urgent care settings. DESIGN: Systematic review. DATA SOURCES: The search was completed on January 28, 2025, in Embase (Elsevier), Medline (EBSCOhost), CINAHL (EBSCOhost), Cochrane Library (Wiley), Emcare (Ovid), Web of Science Core Collection (Clarivate) and Scopus (Elsevier). The data range (2014-2024) was used to limit the search. METHODS: The search was conducted with results imported into Covidence. In Covidence, two reviewers conducted screening, data extraction, and quality appraisal of articles, and findings were analysed using a narrative synthesis approach. Eligible studies examined nurse practitioner services in emergency or urgent care settings, reporting outcomes of cost, waiting times, patient satisfaction, representation rates, and length of stay. RESULTS: Title and abstract screening were performed on 2329 records. Of these, 236 full-text articles were reviewed, and 17 underwent critical appraisal and data extraction. Narrative analysis of outcome measures yielded mixed results, with both favourable and unfavourable findings reported regarding nurse practitioner services. CONCLUSIONS: Global evaluation of nurse practitioner services in emergency care remains inconsistent. Nevertheless, emerging evidence supports their positive impact, particularly in improving patient outcomes. To effectively inform policy, workforce planning and clinical integration, there is a need for professional benchmarks that provide clear frameworks for the evaluation of patient-centred outcomes and operational impacts in emergency departments. IMPLICATIONS: Evidence related to nurse practitioner services in emergency and urgent care clinics highlights the positive impact of nurse practitioner services on patient wait times and satisfaction; however, there is limited and variable evidence of impact on health care costs and outcomes. IMPACT: This paper recommends that evaluating emergency nurse practitioner services requires homogeneous research using consistent professional benchmarks and evaluation frameworks. REPORTING METHOD: This systematic review follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting. TRAIL REGISTRATION: PROSPERO 2025 CRD420250645148.
Matrescence and Missed Care in Nursing: Implications for Practice and Workforce Sustainability.
Watson AL, Jackson D, Bond C
J Adv Nurs · 2026 Mar · PMID 41808321 · Publisher ↗
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Adapting to a Shrunken World: A Grounded Theory of Resident Adaptation to Life in Residential Aged Care.
FitzGerald J, Wells YD, Mills J
J Adv Nurs · 2026 Mar · PMID 41808315 · Publisher ↗
AIM: To develop a grounded theory explaining the psychosocial processes older adults use when adapting to life in residential aged care. DESIGN: An evolved grounded theory methodology was used. METHODS: Semi-structured i...
AIM: To develop a grounded theory explaining the psychosocial processes older adults use when adapting to life in residential aged care. DESIGN: An evolved grounded theory methodology was used. METHODS: Semi-structured interviews were conducted with 20 residents and three staff members across four residential aged care homes in Victoria, Australia, supplemented with ethnographic observations. Theoretical sampling continued until theoretical saturation was achieved. RESULTS: The theory of Adapting to a shrunken world comprises three categories: realising the need for care; facing a life in care; and living with loss. Adaptation is an active, ongoing process shaped by accumulating losses. Positive adaptation requires residents to recognise and accept care needs while ceding aspects of independence, autonomy and control. This theory extends transition-focused accounts of adaptation by showing that, while early phases of adjustment and acceptance are important, adaptation to life in residential aged care remains an active, ongoing, psychosocial process shaped by continual change and accumulating loss across residents' lives in care. CONCLUSION: Adaptation continues throughout residents' lives in care. Acceptance of care needs is critical, as perceived losses of independence and control can lead to resistance or resentment that inhibits adjustment. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This theory provides a framework for person-centred policies and practices that support positive adaptation. Healthcare professionals can recognise early signs of maladaptation and implement interventions that foster acceptance while maintaining resident autonomy. IMPACT: This study addresses gaps in understanding long-term adaptation to residential care, informing nursing practice, aged care policy and care models internationally. REPORTING METHOD: Data were analysed using grounded theory methods. The COREQ checklist was applied to guide transparent reporting of study design, data collection and analysis. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct or reporting.
Trajectories of Nursing Care During the Critical and Intensive Phases After Coronary Artery Bypass Graft Surgery: A Retrospective Observational Study.
Lee Y, Sung S
J Adv Nurs · 2026 Mar · PMID 41795158 · Publisher ↗
AIM: To examine the trajectories of nursing care during the critical and intensive phases after coronary artery bypass graft surgery, using standardised electronic nursing records. DESIGN: Retrospective observational stu...
AIM: To examine the trajectories of nursing care during the critical and intensive phases after coronary artery bypass graft surgery, using standardised electronic nursing records. DESIGN: Retrospective observational study. METHODS: The electronic nursing records of 122 patients who underwent coronary artery bypass graft from a tertiary hospital were collected between September 2021 and September 2023. Among the 287,360 extracted nursing statements, the 427 most frequent statements were mapped to SNOMED CT. Nursing data were categorised into pre- and postoperative phases, and a heatmap was used to visualise daily nursing care trends during the first 8 days post-surgery. RESULTS: In total, 287,360 nursing statements were extracted and semantically mapped, with 90.9% linked to pre-coordinated SNOMED CT concepts. The results showed that in the acute postoperative phase, clinical priorities included respiratory management and surgical drain care. As recovery progressed, priorities expanded to include pressure injury prevention, safety monitoring, and effective interdisciplinary communication. CONCLUSIONS: The analysis using standardised nursing records identified dynamic care patterns after coronary artery bypass graft surgery and supports the development of disease-specific, evidence-based nursing practice guidelines. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Support for evidence-based nursing care for patients undergoing coronary artery bypass graft surgery. IMPACT: This study addressed the limited development of nursing-focused clinical practice guidelines by demonstrating how real-world nursing data can be leveraged to develop disease-specific, evidence-based guidance. By mapping electronic nursing records to international standard terminology, the study advanced a methodological approach for systematically capturing and analysing nursing care trajectories over time. The findings reveal dynamic patterns of nursing interventions during postoperative care and provide empirical support for developing standardised, data-driven nursing guidelines, ultimately strengthening evidence-based practice in acute and critical care settings. REPORTING METHOD: Strengthening the Reporting of Observational Studies in Epidemiology guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.
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