Introduction: Clinical mentoring is essential for nursing education. It facilitates the integration of theory and practice, while promoting the development of clinical, communication, and interpersonal skills. It is becoming increasingly evident that tutors are facing a number of challenges. These challenges are related to the cultural diversity of students and constantly evolving clinical contexts. Despite the emphasis placed on the significance of general and cultural competencies in mentors within the context of international literature, a paucity of studies in Italy exists that evaluate both dimensions employing standardised and validated tools. Objective: This protocol describes a nationwide survey that will assess the mentoring and cultural competencies of Italian nursing tutors. Methods: The study adopts a descriptive cross-sectional observational design, with convenience sampling of approximately 600 tutors active in the academic year 2024–2025. The collection of data will be conducted between July and December 2025 through the utilisation of digital questionnaires. The survey employs two instruments, namely the Mentors' Competence Instrument (MCI) and the Mentors' Cultural Competence Instrument (MCCI), in order to assess these competencies. The MCI has been developed to measure tutors' general skills, including pedagogical, relational and feedback dimensions, while the MCCI has been developed to assess cultural skills and intercultural communication. The collection of sociodemographic data, contextual information and open-ended responses pertaining to the strengths and weaknesses of the tutorial role will also be undertaken. Statistical procedures will include descriptive analyses, using tables and plots to represent the data, as well as inferential analyses such as the Chi-square test, t-test, ANOVA test, Mann–Whitney U test, Kruskal–Wallis test, and correlation analysis. All statistical tests with p < 0.05 will be considered statistically significant. Results: The results of the study will inform the development of targeted training interventions and organisational strategies to enhance the role of the clinical tutor. Conclusions: The survey will contribute to the enhancement of mentoring quality and the professional development of tutors, thereby facilitating the strengthening of the effectiveness of clinical training programmes in Italy.

Introduction: Nurse performance is vital to patient safety and organizational effectiveness. Leadership style is a recognized determinant of performance, influencing consistency, adaptability, and professional growth. Understanding these dynamics is particularly important in multicultural healthcare environments. Objective: This study explored the impact of nurse manager leadership styles on nurses’ job performance at Hamad Medical Corporation (HMC). Methods: A cross-sectional survey was conducted with 980 registered nurses recruited through random sampling. Data were collected using a structured questionnaire including socio-demographic characteristics, the Multifactor Leadership Questionnaire (MLQ-5X), and the Nursing Performance Instrument (NPI). Data analysis was performed using SPSS version 26, applying descriptive statistics, and Spearman’s correlation, Mann–Whitney U, and Kruskal–Wallis H tests. Results: The workforce was predominantly female (72.1%), married (83.7%), and expatriate, with a mean age of 40.4 years. Transactional leadership (2.57 ±085) was the most common style, followed by transformational (2.20±1.05), while passive-avoidant leadership was minimal (1.49±0.97). Transformational leadership demonstrated strong positive associations with consistency of practice and adaptability. Transactional leadership supported compliance but was less effective in stimulating innovation, while passive-avoidant leadership was negatively correlated with performance outcomes. Conclusion: Transformational leadership emerged as the most effective style for enhancing nurse performance, while transactional leadership sustained compliance without fostering long-term growth. Strengthening transformational leadership among nurse managers at HMC may improve clinical outcomes, adaptability, and organizational performance.

Introduction: The increasing prevalence of diabetes is a global public health concern, with foot ulcer prevention techniques, low self-care knowledge, and a lack of confidence contributing to complications like foot ulcers. Methods: This cross-sectional study, conducted between January and December 2022, evaluated foot self-care knowledge, self-efficacy, and self-care behaviors among individuals with diabetes attending public tertiary hospitals in Abeokuta, Nigeria. Data from randomly selected 120 out-patients was collected using a multidimensional questionnaire, and multiple regression analysis was used to assess associations between variables. Results: It was found that participants’ mean age was 44.8±14.65 years. Majority (58.3%) of them did not attend foot self-care education classes and had received a type-2 diabetes diagnosis within the previous 24 months. Many of the patients had low knowledge of foot self-care (55%), low self-care efficacy (55%) and poor self-care behavior (55%). Poor self-care behavior was predicted by low efficaciousness (p<0.0001) and low knowledge of foot self-care (p<0.0001). Conclusion: The study concluded that the extent of knowledge significantly influenced self-care behaviors and the efficacy of foot self-care in averting diabetic foot ulcers. Improving these behaviors requires teaching appropriate knowledge through hands-on self-care treatments and gaining support from policymakers for its sustainability.

Introduction: Although evidence-based practice (EBP) is a core nursing competency, little is known about the extent to which nurses are educated on the five steps of EBP, including the specific educational content within each step, in pre-licensure and in-service education, and how these educational experiences relate to their knowledge and skills. Objectives: To examine the extent of nurses’ experience of receiving specific educational content related to each step of EBP in pre-licensure and in-service education, and to evaluate the associations between these experiences and EBP knowledge and skills. Methods: This cross-sectional questionnaire survey was conducted between June and September 2022 among 2,672 employed hospital nurses in Japan. EBP knowledge and skills were measured using the Japanese version of the EBP Questionnaire. Experience of receiving EBP education in pre-licensure and in-service education was assessed using items developed from EBP textbooks and core competency literature. Analysis of covariance and relative importance analysis were conducted to evaluate the association between the experience of receiving EBP education and EBP knowledge and skills. Results: 718 nurses (26.9%) were included in the final analysis. The findings showed that nurses’ experience of receiving EBP education was generally limited, with fewer than 25% having learned any EBP-education item, except literature databases, in pre-licensure education. Similarly, fewer than 25% have learned each EBP-education item in in-service education. The adjusted mean EBP knowledge and skills score increased progressively with the extent of education received across the five steps of EBP (20.6 for no steps to 35.5 for five steps), showing a consistent dose–response relationship (p for trend < 0.001). Relative importance analysis showed that the Step 4 and Step 5 items were placed toward the upper end of the contribution rankings. Conclusions: To effectively improve nurses’ EBP knowledge and skills, providing a practical, EBP-specific program that comprehensively covers all five EBP steps would be essential. Additionally, developing programs for training educators would also be essential.

Introduction: Autism spectrum disorders (ASD) represent a constantly evolving neurodevelopmental condition that requires specific preparation by the entire multidisciplinary team. However, multiple scientific evidences report little training on ASD in nursing degree courses. The study above aims to assess the level of theoretical knowledge of Italian students regarding autism in pediatric age. Materials and Methods: A multicenter cross-sectional study was conducted on 104 students enrolled in the Nursing degree programme, regularly enrolled in the 2nd and 3rd years of the course at different Italian universities, with or without previous experience in pediatric or mental health services. Knowledge was assessed by administering a validated questionnaire, the Knowledge About Childhood Autism Among Healthcare Workers (KCAHW). Sociodemographic variables and information on training and placement experience with children with ASD were collected. Data were analysed using descriptive and inferential statistics. Results: The average score obtained on the KCAHW was 9.5 out of 19 (SD = 2.78), indicating an insufficient level of knowledge. Scores were significantly higher among students with direct experience with children with ASD (median: 11.0 vs. 9.3; p=0.015) and among female students than male students (mean: 9.9 vs. 8.7; p=0.016). Theoretical training and age were not significantly different. Discussion: The results indicate the existence of a vital training gap. Direct clinical experience proves to be decisive in the improvement of theoretical knowledge. Integrating compulsory modules and structured ASD training in nursing education is recommended to ensure competent, small patient-centred care.

Introduction: Peripheral intravenous catheter (PIVC) insertion is a common clinical procedure, yet achieving successful venous access, particularly at the first attempt, remains a significant challenge. Techniques such as tapping and massage have been proposed to enhance venous dilation and facilitate cannulation. Objective: This study aims to evaluate and compare the effectiveness of tapping and massage each compared to tourniquet-only application, in promoting peripheral venous dilation. Materials and Methods: This study is a systematic review conducted following the PRISMA 2020 guidelines. A systematic search was conducted in PubMed, Scopus, MEDLINE, and CINAHL. All databases were accessed in April 2025 to retrieve studies published between January 2015 and April 2025. Studies were eligible if they involved adult participants, compared tapping and/or massage with standard tourniquet application or control, and reported outcomes related to vein diameter, cross-sectional area, or palpability. Quality assessment was performed using the NIH Quality Assessment Tool and for the risk of bias was used the ROBINS-I. Results: Tapping was associated with modest improvements in vein diameter and palpability in some studies, but not in others. Massage showed improvements in palpability, yet no clear advantage over tapping was consistently demonstrated. No clear clinical advantage of one technique over the other was consistently demonstrated, and no study assessed outcomes such as first-attempt success rate. Methodological limitations included small sample sizes, and lack of randomization. Conclusions: Both tapping and massage may promote venous dilation in young, healthy adults, but the evidence is limited. The generalizability of these findings to broader clinical populations, including elderly patients and those with difficult venous access, is uncertain. High-quality studies involving diverse populations and standardized outcome measures are needed to establish the effectiveness of these techniques in routine clinical practice.

Introduction: Physical assessment is a fundamental clinical skill in nursing practice and crucial to developing effective nursing care plans. Thus, acquiring knowledge and skills in physical assessment is an essential competence for undergraduate nursing students. Objective: This study aimed to investigate the effect of utilizing pre-assignment work and presenting specific cues about a case on the clinical reasoning skills of undergraduate nursing students by comparing an intervention group that received specific cues with a control group that did not. Materials: This randomized controlled trial involved second-year undergraduate nursing students. Participants were randomly assigned to an intervention or control group. Both groups completed a pre-assignment related to heart failure and participated in a 60-minute group case study session. The intervention group received specific cues related to the case during the session, guiding their assessment and care planning. Clinical reasoning skills were evaluated subjectively using the Clinical Reasoning Skills Self-Assessment Scale (CRSS) and objectively by analyzing the students’ responses to the group task. Results: A total of 94 participants were randomly assigned to either the intervention group (n= 47) or the control group (n= 47). While the pre-session CRSS scores were similar between groups, the post-session scores on several items related to information gathering, interpretation, problem identification, and goal setting were significantly higher in the intervention group. Qualitative analysis of narrative responses revealed that the intervention group provided more specific and patient-centered nursing care plans based on the patient's symptoms, whereas the control group offered more generalized interventions. Conclusion: The use of pre-assignment and specific cues enhanced students’ ability to interpret patient information and formulate individualized nursing care plans. This approach effectively improved clinical reasoning skills in physical assessment and may serve as a practical alternative in educational settings lacking simulation-based resources.

Introduction: A laparotomy is a surgical procedure involving an abdominal incision to access the peritoneal cavity, commonly performed for diagnostic and therapeutic purposes, including trauma management and the treatment of gynecological, pelvic, and abdominal conditions. In this context, negative pressure wound therapy (NPWT) serves as an effective adjunct to wound management by applying subatmospheric pressure to the wound bed, thereby promoting granulation tissue formation and reducing local inflammation. Objective: This systematic review will aim to evaluate the efficacy of NPWT compared to standard wound care in adult patients undergoing laparotomy, with specific attention to key clinical outcomes such as wound healing time, surgical site infection rates, wound dehiscence, and overall complication rates. Materials and methods: The systematic review follows the PRISMA guidelines and uses the PICO framework for search terms. The studies will be identified through important databases (PubMed, Scopus, CINAHL and Web of Science). Methodological quality and risk of bias will be assessed with JBI critical assessment tools. This protocol for a systematic review has been registered on PROSPERO (N. CRD420251058825). Results: The results of the systematic search and selection process will be reported using a PRISMA flowchart. The extracted data will include wound healing time, granulation tissue development, infection rates, and adverse events. The quantitative synthesis will be conducted if the homogeneity of the data allows it. Conclusions: This systematic review will synthesize the available evidence on the efficacy of NPWT in the management of laparotomy wounds. The findings will have implications for clinical practice in surgical wound care and may contribute to the development of standardized wound management protocols.

Introduction: Biocontainment transfer represents a complex and delicate phase of care, especially in light of the increased demand for safe handling of patients affected by highly transmissible diseases. The COVID-19 pandemic has highlighted the critical need for structured approaches to ensure quality care and safety during these transfers. Objective: To propose a structured nursing model for managing the care of conscious and communicative patients undergoing biocontainment transport, based on nursing diagnoses and standardized interventions. Methods: A theoretical-conceptual model was developed based on the NANDA-I 2024–2026 taxonomy to identify nursing diagnoses related to perception, cognition, and stress tolerance. These were systematically combined with appropriate interventions from the Nursing Interventions Classification (NIC) and expected outcomes from the Nursing Outcomes Classification (NOC). The model addresses the clinical and psychological needs of patient across the three phases of transport: pre-transport, transport, and post-transport, with particular focus on anxiety management, communication, and adaptation to isolation. Results: In the pre-transport phase, the diagnosis of Excessive Anxiety was addressed with interventions to reduce emotional distress and improve patient cooperation through clear, empathetic communication. During transport, the impairment of verbal communication caused by protective equipment and isolation barriers was mitigated through simplified language, visual aids, and strategies to ensure mutual understanding. In the post-transport phase, the model focused on enhancing the patient's coping capacity and resilience, offering emotional support and structured interventions to manage stress and process the experience. Conclusions: The proposed model provides a comprehensive and systematic framework for nursing care during biocontainment transfers, integrating both clinical and emotional aspects to reduce patient vulnerability and improve the quality of care. As a theoretical model built upon standardized nursing taxonomies, it lays the groundwork for future clinical applications. Prospective and pilot studies will be essential to validate its effectiveness and feasibility in real-world healthcare settings.

Introduction: Inherent in every relationship irrespective of number of people involved is the tendency for conflict to occur, either at the intrapersonal, interpersonal, intra-professional or inter-professional level with positive or negative outcome depending on effective resolution of the conflict and the time of resolving it. Conflict has been known to bring about improved relationship, increased cohesiveness, improved communication and productivity when handled and resolved timely. The aims of the study are to identify perceived causes of workplace conflict among nurses and the resolution methods they employ. Materials and Methods: A cross-sectional research design was used for the study. The sample was 90 nurses on permanent appointment with the hospital drawn using convenient sampling technique. Instruments were validated Rahim Organizational Conflict Inventory (ROCI II) and structured questionnaire on causes of conflicts adapted from Mukeshimana and Asingzwe (2016). Data were analyzed using descriptive statistics of frequencies and percentages and chi-square inferential statistics for causes and resolution methods for conflict at 0.05 level of significance. Results: The outcome of the study revealed that majority of the respondents are registered nurses and registered midwives only 64 (71.1%), 66 (73.3%) were NO I or NO II; only 8 (8.9%) had Masters or higher education. Injustice (95.6%), unreasonable patient and relative expectation (93.3%), and lack of respect from other health professionals and unequal workload and work schedule (91.1% each) were identified as major causes of workplace conflict. Most prominent method of conflict resolution identified was collaboration (x = 69). Conclusion: In conclusion, institution should organize training and retraining of nurses regularly, employ more nurses to prevent burnout and job dissatisfaction that can lead to conflict.