Survivorship after critical illness is often characterised by fragmented recovery and lingering cognitive, psychological, and physical impairments collectively described as post-intensive care syndrome. Current recovery frameworks and follow-up models remain inconsistently delivered, poorly standardised, and rarely address survivors' and families' need to make sense of the intensive care unit (ICU) experience in a transparent, inclusive, and sensitive way. The Critical Illness Survivorship Programme is proposed to humanise post-intensive care by integrating generative artificial intelligence technologies with co-designed, person-centred recovery strategies. This discussion paper provides the theoretical foundation for the proposed Critical Illness Survivorship Programme, which intends to humanise post-intensive care recovery through ethically governed, artificial intelligence-enabled narrative approaches. The Critical Illness Survivorship Programme redefines recovery as both a biological and narrative process. Drawing from interpretive nursing inquiry, narrative medicine, cognitive rehabilitation, and responsible artificial intelligence design, the Critical Illness Survivorship Programme is designed to generate personalised intensive care unit journey summaries that translate complex health-record data into accessible, emotionally attuned stories, visualisations, and audio outputs. These narratives aim to support sense-making, memory integration, and emotional recovery while promoting transparency, inclusivity, and cultural sensitivity. The proposed Critical Illness Survivorship Programme will offer a conceptual pathway for developing ethically governed, artificial intelligence-enabled tools that bridge digital innovation and human connection in survivorship care. It emphasises interdisciplinary collaboration, trauma-informed communication, and co-design as essential safeguards for compassionate technology integration. Future research should examine the feasibility, ethical oversight, and educational implications of the Critical Illness Survivorship Programme within clinical pathways. By reframing technology as a partner in empathy and understanding, the Critical Illness Survivorship Programme proposes a potential model of recovery - one that restores coherence, dignity, and meaning in life after critical illness.

Despite the proven efficacy of labor epidural analgesia, its utilization in China remains suboptimal, particularly among primiparous women. Providing relevant health education during routine prenatal care appears to be a viable approach. To examine the effects of an online and offline prenatal labor epidural analgesia education program on labor epidural rates in primiparas. A single-blinded, parallel-group randomized controlled trial. A total of 196 couples (primipara and spouse) were recruited from a tertiary hospital in Shenzhen, China. The couples were randomly allocated to the intervention or control groups with usual care only. The intervention comprised a series of web-based educational modules covering fundamental aspects of labor epidural analgesia, such as indications and contraindications, along with four weekly WeChat reminders. Additionally, participants received one group face-to-face education session lasting 30min and one individual consultation of 10-15min. Study outcomes included the rate of labor epidural analgesia, primiparas' intention to use labor epidural analgesia, fear of childbirth, and epidural analgesia-related misconceptions among couples. Data were collected at baseline (T0), immediately post-intervention (T1), and 12weeks post-intervention (T2). The effects of the intervention were evaluated using generalized estimating equation models. The intervention group had a significantly higher labor epidural analgesia rate than the control group after childbirth (P=0.001). Primiparas in the intervention group showed significantly greater improvements in intention to use labor epidural analgesia at T1 (P<0.001) and T2 (P=0.014), compared with the controls. In addition, primiparas in the intervention group demonstrated a significantly greater reduction in misperceptions of labor epidural analgesia at T1 (P<0.001) and T2 (P=0.040) compared with the control group. Decreased primiparas' fear of childbirth and spouses' misperceptions of epidural analgesia were found in the intervention group, but no significant group-by-time effect was detected. The online and offline prenatal labor epidural analgesia education program was effective in increasing labor epidural analgesia rates and in reducing misconceptions about labor epidural analgesia. However, the program had limited effects on reducing primiparas' fear of childbirth and correcting spousal misconceptions about labor epidural analgesia. We recommend that midwives and obstetric nurses provide online-offline labor epidural analgesia education during routine prenatal visits. Chinese Clinical Trial Registry (ChiCTR2400079767).

Graduating nursing students frequently encounter a disconnect between academic preparation and the realities of clinical practice, often feeling underprepared, overwhelmed, and emotionally vulnerable. Contributing factors include inconsistent curricula, variable teaching quality, and limited access to high-fidelity simulation and mentorship. This fragmented preparation framework undermines resilience and readiness for today's complex healthcare environments. The aim of this scoping review is to identify and map the existing gaps in nurse education that impact the preparedness of student nurses entering professional practice. A scoping review conducted in December 2024 and December 2025 mapped the existing literature on nursing education to identify research gaps. The review comprised a comprehensive search of CINAHL, Informit, ProQuest, PsycINFO, PubMed, Scopus, and Web of Science, followed by analysis of the 81 relevant studies. The PRISMA-ScR guidelines ensured a systematic and transparent approach to the selection and inclusion of studies. The review identified overarching domains (curriculum, teaching, simulation, clinical education and student readiness) where specific barriers were evident, including the theory-practice gap, inconsistent supervision and feedback, limited evaluation transparency, and transition shock. Evidence suggests that integrating practice-proximal education (simulation and longitudinal placements) with structured supports (Dedicated Education Units, mentorship/residency programs) and robust feedback mechanisms provides a coherent pathway to strengthen graduate readiness and early-career outcomes. Nursing students face persistent challenges in achieving clinical readiness due to fragmented curricula, inconsistent pedagogy, and limited academic-clinical integration. Addressing these issues requires a future-focused, evidence-informed education model, such as the Professional Readiness and Education for Practice Framework, which embeds authentic clinical experiences, structured mentorship, cultural safety, and digital health competencies to prepare graduates for the realities of contemporary healthcare practice.

'Failure to rescue' remains a critical challenge in acute care globally. Despite the implementation of rapid response systems and early warning scoring tools, adverse outcomes persist especially out-of-hours - defined as night and weekends - when patient morbidity and mortality is higher. The underlying causes of this disparity remain poorly understood. Timely recognition and escalation of clinical deterioration are essential to prevent harm, with nursing staff playing a vital role. However, significant gaps persist in understanding the determinants to escalation out-of-hours. To synthesise existing literature addressing the question: What are the determinants of nursing staff escalating care for clinically deteriorating patients out-of-hours? Embase, Medline, PsycINFO and CINAHL. A systematic mixed-methods review was conducted, covering studies published up to May 2025. Eligible studies examined nursing staff recognition and response to clinical deterioration out-of-hours in adult inpatient wards. Quality appraisal used Critical Appraisal Skills Programme, Newcastle-Ottawa Scale, and the Mixed Methods Appraisal Tools. Data synthesis followed the Joanna Briggs Institute Convergent Integrated Approach. Of 3085 records screened, 26 studies met inclusion criteria (n=18 quantitative, n=7 qualitative, n=1 mixed methods). Most were of moderate to high quality, though limitations in recruitment and reporting were noted. No study exclusively examined the determinants of nursing staff behaviour in escalating care out-of-hours, making this the first comprehensive review on the subject. Five key determinants of behaviour were identified: (1) The unique challenges and workarounds of the 'hospital at night', (2) Workforce composition and team dynamics out-of-hours, (3) Organisational oversight and adaptive strategies, (4) Clinical nursing workflow and supporting resources, (5) Individual determinants of behaviour, strengths and limitations. This review underscores the complex interplay of determinants influencing nursing staff escalation out-of-hours, highlighting the urgent need for targeted interventions to enhance patient safety. Increasing psychological safety, integrating automated vital signs monitoring technologies, and redesigning communication pathways may strengthen clinical decision-making and teamwork. Staffing models and skill-mix require reassessment to reflect out-of-hours challenges. Future research should prioritise feasible, context-sensitive interventions informed by behavioural and human factors science. By advancing these strategies, healthcare organisations can mitigate out-of-hours risks and deliver safer, more effective patient care. https://www.crd.york.ac.uk/PROSPERO/ CRD42024500837, registered 10/January/2024.