Surgical safety is a core patient-safety goal. In our hospital, the rate of accuracy among operating room nurses in preparing for fat grafting surgeries was only 55.4%. The main factors found to influence this issue were: reliance on verbal, experience-based teaching; unfamiliarity with processes and complex instruments; lack of operating manuals and checklists; inadequate in-service education; and lack of standardized operating protocols. This project was developed to establish a systematic education and training program and standardized workflow to improve the accuracy of operating room nurses in preparing for fat grafting surgeries. Following the ADDIE (analysis, design, development, implementation, and evaluation) instructional model, the interventions implemented in this project included: compiling a preparation manual and mind map, planning structured in-service education, producing an interactive e-book, and holding simulation workshops. Also, a preparation-accuracy checklist and knowledge test were used to track outcomes in 20 nurses. In addition, the Objective Structured Assessment of Technical Skill instrument was used to provide real-time feedback during the simulation courses, and maintenance follow-up was conducted from April through May 2025. After the intervention, the preparation accuracy rate increased from 55.4% to 96.5% and the knowledge accuracy rate increased from 45.0% to 94.5%. Notably, the preparation accuracy rate was 100% during the maintenance follow-up period. Conclusions: Combining the ADDIE instructional model with multiple strategies may be an effective strategy for improving preoperative preparation accuracy and professional competence in nurses. Regular interprofessional consensus meetings should be held to allow rolling revisions to be made to the workflow and, accordingly, develop surgical care guidelines as references for clinical practice to further strengthen nursing quality and patient safety.

This study aims to assess the self-perceived competence of novice nurses in emergency response to armed conflict within Middle Eastern countries. Armed conflicts in the Middle East have placed immense strain on healthcare systems, where novice nurses frequently serve as frontline responders. Despite the development of disaster nursing frameworks, there is limited research examining the competencies of newly trained nurses operating in such high-risk conflict zones. A descriptive cross-sectional study was conducted between November 2024 and June 2025 among 465 novice nurses from Iraq, Syria, Yemen, Palestine, Saudi Arabia, and Lebanon. A validated questionnaire assessing 47 distinct nursing self-perceived competence in armed conflict zones was utilized. Findings showed statistically significant differences in self-perceived competence across countries, departments, education levels, and experience. Nurses from Syria and Palestine reported the highest self-perceived competence, while those from Lebanon and Saudi Arabia reported the lowest. This study provides valuable insights into the self-perceived competencies of nurses, particularly novice nurses, in armed conflict areas in the Middle East. The variations in self-perceived competence across countries highlight the importance of context-specific training and standardized approaches to nursing education in conflict zones.

Previous research has analysed advanced practice nursing education and nurse educators' roles. However, limited attention has been paid, and a gap remains in understanding educators' experiences delivering the APN programme and their readiness to focus on their teaching roles. To enhance our understanding of nurse educators' experiences in becoming APN educators before and after participating in the APN educators' intensive course and additionally describe how participants evaluated this course. A pretest-posttest intervention study. A total of 19 APN educators from the Nordic and Baltic countries completed both pre- and post-surveys. Fourteen respondents answered the course evaluation questionnaire. This intensive course intervention appeared to increase APN educators' readiness and competence. Although the overall results were not statistically significant, the subgroup analyses highlighted that prior clinical experience, higher education and teaching experience influenced competency development. The course evaluation results indicate that the international intensive course was perceived as successful. This study provides new insights into the readiness and competencies of APN educators in the Nordic and Baltic countries. The research findings can contribute to understanding APN educators' teaching readiness and competence and offer directions for future development in education for APN educators.

Medication safety competence is a critical component of patient safety, particularly in emergency departments (EDs), where high-acuity conditions and workflow instability increase vulnerability to medication-related errors. Despite extensive research on medication safety, limited attention has been given to how medication safety competence is enacted within emergency department settings. A convergent mixed-methods design was employed. Data were collected between July and September 2024 from two large urban tertiary teaching hospitals. Quantitative data were obtained from 122 emergency nurses using the Medication Safety Competence Scale and were analyzed using descriptive statistics, independent t-tests, and one-way analysis of variance. Qualitative data were collected through structured written open-ended questions and analyzed using inductive content analysis. Integration was conducted through joint display analysis of quantitative and qualitative findings. Statistically significant differences were observed only in the patient-centered medication management subdimension, where nurses aged 30-39 years and those with ≥ 5 years of experience reported higher scores (p < .05). No significant differences were identified in the total scale score or other subdimensions. Mean item scores were generally high across all subdimensions, with the highest scores observed in patient-centered medication management, followed by responsibility in nursing. Qualitative analysis generated three themes: (1) self-assessment-based learning and development, (2) developing a medication safety culture, and (3) efficient organizational management. Integration revealed that although self-reported medication safety competence was high, its consistent enactment was influenced by cognitive workload, workflow interruptions, and the prevailing error reporting climate. Medication safety competence in emergency nursing is not solely an individual attribute but a context-dependent capacity shaped by professional development, collaborative culture, and organizational conditions. Strengthening medication safety competence therefore requires integrated educational and system-level interventions that enable its consistent enactment in emergency clinical practice.

Competence assessment is essential for professional growth, workforce planning, and quality improvement in long-term care (LTC). However, the wide range of instruments, their limited differentiation based on various qualification levels, and the lack of standardized frameworks hinder effective use. This scoping review aimed to map international evidence on competence assessment instruments used in residential LTC nursing, broadening the scope to include acute care, community-based, and mixed-care settings to enhance the relevance and transferability of findings. A scoping review was conducted following the Joanna Briggs Institute guidelines. Peer-reviewed and grey literature in English and German were searched across two databases (PubMed and CINAHL) between 2014 and 2024. Inclusion criteria focused on instruments assessing nursing competence through self-assessment or external evaluation, targeting various qualification levels and care contexts. Twenty instruments were identified. The review addressed two key research questions: (1) A wide range of self-assessment tools with generally sound psychometric properties were found, predominantly developed for registered nurses and validated in acute settings; however, few differentiated by qualification level, and no validated instruments were identified for healthcare assistants. (2) Validated peer or external evaluation instruments were scarce, highlighting a reliance on self-perception and a lack of objective assessment. Instruments for specialized domains (e.g., dementia, palliative care) demonstrated higher contextual relevance but lacked robust testing in LTC. This review highlights significant variability and identifies a crucial gap in tools available for healthcare assistants and multi-method assessments. Future efforts should focus on creating modular, theory-informed, and context-sensitive instruments that are validated across various qualification levels and care sectors. These tools are essential to support individualized learning, ensuring equitable staffing, and fostering sustainable quality improvements in long-term care.

Educational interventions to improve electrocardiogram interpretation competence among nurses: A systematic review.

Disaster response presents significant challenges to the competence of nurses. Virtual reality simulation (VRS) offers innovative opportunities for nursing administrators and educators in the field of disaster nursing education and training. This study aimed to explore the use and effectiveness of virtual reality simulations in disaster nursing education and training. A scoping review was conducted using the Arksey and O'Malley framework, extended by Levac. The following databases were systematically searched from inception to August 30, 2024: PubMed, Embase, CINAHL, Web of Science, Cochrane Library, CNKI, Wanfang Database and CBM. Two researchers independently screened the identified articles and extracted relevant data. This scoping review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. The review included thirteen studies published between 2013 and 2024. Of these, seven studies employed a quasi-experimental design, six utilised a randomised controlled trial (RCT) design and one study used a longitudinal experimental design. The disaster nursing education and training content covered six main areas: triage training, on-site first aid training, infectious disease prevention and control, disaster response skills training, emergency response training for nursing staff and post-disaster psychological recovery training. The reported outcomes primarily focused on Kirkpatrick's Level 1 (participant satisfaction with the training experience) and Level 2 (measuring the benefit to participants from the training). This scoping review identified the research progress and trends of virtual reality simulation technology in the process of cultivating disaster nursing talents at home and abroad and provides a reference for disaster nursing managers and educators to conduct disaster nursing training based on virtual reality simulation technology. This is a review article based on a review of the literature, with no patient participation.

BackgroundInterprofessional education (IPE) is essential for preparing healthcare students to collaborate effectively in clinical practice. However, empirical evidence on IPE outcomes among nursing and pharmacy students in Saudi Arabia remains limited.ObjectiveTo evaluate the impact of a structured interprofessional problem-based learning (PBL) activity on nursing and pharmacy students’ interprofessional attitudes, teamwork behaviors, and knowledge in addition to exploring students’ reflections on the learning experience.MethodsA quasi-experimental study was conducted with 201 intermediate-level students at King Saud University. Students participated in a one-hour interprofessional PBL session built around a shared clinical case, preceded by a recorded briefing and ice-breaker activity. The following assessment strategies were employed: The Interprofessional Attitudes Scale (IPAS), the Individual Teamwork Observation and Feedback Tool (iTOFT), knowledge and retention assessments, and students’ reflective evaluations of the experience.ResultsIPAS scores indicated generally positive attitudes toward interprofessional collaboration, although lower scores in interprofessional bias suggested that some stereotypes persisted. iTOFT ratings showed high levels of effective teamwork. Thematic analysis of reflections revealed perceived gains in communication, understanding of roles and responsibilities, teamwork, and ethical practice. Students also identified challenges related to timing, group size, and logistical organization, and recommended clearer instructions, smaller groups, better scheduling, and inclusion of additional health professions. Knowledge scores were high immediately post-activity but showed a modest decline at three months, with one item related to understanding professional roles improving over time.ConclusionA single, structured interprofessional PBL activity may foster positive interprofessional attitudes, support observable teamwork behaviors, and enhance understanding of professional roles. Nonetheless, residual biases, partial knowledge decay, and logistical challenges highlight the need for longitudinal, well-integrated IPE activities involving multiple disciplines. These findings may support the ongoing attempts for integration and enhancement of IPE within health professions curricula that may prepare students to better collaborative, and patient-centered care.

BackgroundWorkforce needs are growing in older people care, exacerbated by the aging population. Technological solutions offer potential means to address this challenge. However, their effects on work and worktime management remain unclear, especially in the setting of assisted living services. Our aim was to assess the potential of two established technologies, automatic medicine dispensing and night‐time monitoring, in alleviating workforce needs in Finnish assisted living facilities.MethodsThe effects of the two technologies on workforce needs were studied using a convergent mixed‐methods design, incorporating quantitative time and motion analysis and qualitative analysis of two open‐ended survey questions. Linear regression analysis and data‐driven thematic analysis were employed. The quantitative and qualitative results were integrated and compared afterward.ResultsOur quantitative results indicated that medicine dispensing technology can streamline medicine management and administration, but effects on direct care time were not found. Use of night‐time monitoring technology was associated with more direct care during nights and reduced nightly staffing. The qualitative analysis highlighted medicine dispensers freeing up time for other work and night‐time monitoring reducing the need for nightly rounds. However, several technology‐related problems and a loss of medication competencies were perceived. Our results converged on several positive workforce effects, notably optimizing medication management and promoting individualized care during nights.ConclusionTechnology use could be promoted in assisted living services, when it demonstrably streamlines care work, increases work efficiency, allows for reduced staffing, or promotes individualized and patient‐centered care. National care policy can incentivize the use of similar technologies, for example, through staffing level legislation. However, care unit management should prepare for potential technology‐related errors and acute emergencies by upkeeping both technology and medication competencies of nurses and ensuring the presence of sufficient staff. Importantly, the potential efficiency gains must not come at the expense of quality or safety of care.

IntroductionMoral sensitivity is a core component of ethical competence in nursing. However, the role of personal psychological and existential resources particularly psychological capital and spiritual well-being in shaping this sensitivity remains underexplored among nursing students. This study aimed to examine the relationships between psychological capital, spiritual well-being, and moral sensitivity, and to identify their predictive value among nursing students.MethodsA cross-sectional study was conducted in 2023 among 200 nursing students with census sampling. Validated scales were used to measure psychological capital (PCQ), spiritual well-being (SWBS), and moral sensitivity (MSQ). Hierarchical regression analysis was performed to assess the independent and combined effects of the predictors.ResultsParticipants showed relatively high levels of psychological capital (M = 111.5, SD = 14.2) and moral sensitivity (M = 94.2, SD = 12.0), and moderately high spiritual well-being (M = 82.7, SD = 12.2). Strong positive correlations were found between all main variables (r = 0.51–0.61, p < 0.001). Hierarchical regression revealed that both psychological capital (β = 0.38, p < 0.001) and spiritual well-being (β = 0.31, p < 0.001) were significant independent predictors of moral sensitivity, collectively explaining 45% of its variance.ConclusionPsychological capital and spiritual well-being appear to be closely related to moral sensitivity in nursing students. This suggests that educational efforts focused on strengthening these inner resources could help foster ethical competence. Future interventional studies are needed to test this possibility.

Street Nursing 101: Caring for the Homeless Population.

Comprehensive self-report scales to measure nurse competence: A scoping review.

The effectiveness of VR combined with aging simulation training on junior nurses' geriatric care competency: A randomized controlled trial.

This study aimed to elucidate the relationship between pediatric ward nurses' anxiety and physicians' expectations when responding to sudden changes in children's conditions by integrating findings from two previous qualitative studies. Core and higher-order categories extracted from two studies titled "Pediatric nurses' anxiety about responding to sudden changes in children's condition" and "Pediatricians' expectations of pediatric nurses on sudden changes in children's condition" were qualitatively synthesized and compared. The relationships among the categories were mapped and interpreted to identify convergences and divergences in emphasis. Nurses' anxiety about practical competence differed in nature from physicians' expectations regarding organizational task execution, suggesting a contrast between nurses' individual/affective concerns and physicians' behavioral expectations. Anxiety related to patient/family engagement and environmental conditions aligned with physicians' expectations, indicating shared priorities across all professions. The identified relationships underscore the importance of family centered care and interprofessional teamwork in pediatric ward settings. Targeted educational programs and organizational support are recommended to address differences in emphasis between nurses and physicians, and strengthened interprofessional understanding and collaboration are necessary to address the environmental conditions. An effective response to sudden changes in pediatric wards requires improving the practical competence of nurses and promoting team-based care grounded in mutual understanding with physicians.

Development and psychometric validation of the trauma-informed care competency scale for nurses.

Strengthening Holistic Nursing Competence Among Emergency Nurses in the Digital Era: The Roles of Clinical Governance, Digital Empathy, and Artificial Intelligence Attitude.

Effect of crossword puzzle on nursing students' willingness to work with older adults and gerontological nursing competence: A waiting list randomized controlled trial.

the development of digital technology has changed the paradigm of health care, including in the practice of Telenurse, where nurses are required to have sufficient digital competence to provide remote services effectively. Purpose: This study purpose to determine the effect of digital technology training on the competence of nurses in Telenurse services. Methods: this study uses quasi-experimental quantitative design with pretest-posttest approach. The sample consisted of 20 purposively selected nurses at Hermina Hospital Pekanbaru. Data were collected using the nurse digital competency questionnaire and analyzed using the Wilcoxon test to determine significant differences in competency before and after training, because the sample size is relatively small and the data is not always normally distributed. Results: the results showed a significant increase in nurse competence after training, with an average pretest value of 60.5 increased to 82.3 on the posttest (p &lt; 0.05). These improvements include aspects of mastering Telenurse applications, digital communication with patients, and technical troubleshooting. Conclusion: digital technology training effectively improves the competence of nurses in Telenurse services, thus enabling more efficient, accurate, and responsive services. The implications of this study emphasize the importance of continuous training programs for nurses to master digital technology, as well as hospital management support in the provision of adequate facilities and Telenourse systems to improve the quality of health services.

Triage competency requires sophisticated cognitive processing. The mechanisms through which critical thinking and intuition influence specific competency dimensions remain unclear. The objective of this study is to examine mediating pathways through which critical thinking disposition and intuitive expertise influence triage competency in emergency nurses. A cross-sectional study with 145 Korean emergency nurses used structural equation modeling with bootstrap resampling (5000 iterations) to examine mediation pathways. Critical thinking exerted strong indirect effects through all 3 mediators. Clinical judgment served as the primary pathway, accounting for 94% of total effect (β =.478, 95% CI [0.337, 0.624]). Significant indirect effects occurred through timely decision (β =.324) and expert assessment (β =.265). Intuitive expertise showed positive but nonsignificant relationships. Critical thinking enhances triage competency primarily through clinical judgment. Educational interventions should prioritize critical thinking development and clinical judgment training.

Inhaled therapy is critical for treating chronic airway diseases, yet the competency of respiratory nurses in providing guidance remains inconsistent. Few studies have explored the systemic competency disparities that are driven by a hierarchical distribution of healthcare resources. The aim of this study is to assess self-reported inhaled therapy guidance (ITG) competency among respiratory nurses across multiple-tier healthcare institutions, as well as to explore factors that affected such competency. A total of 962 respiratory nurses at multilevel hospitals in Jiangsu Province, Eastern China were investigated. We developed an ITG competency scale and evaluated its reliability and validity. Nurses rated themselves on a structured questionnaire that was designed to collect data on ITG competency in this population. The associated factors were determined using a descriptive statistical analysis, a correlation analysis, and a hierarchical multiple regression analysis. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies. The ITG competency average score for respiratory nurses was (73.90 ± 9.42). Significant competency disparities were observed across all hospital tiers (p < 0.001), with the primary hospitals demonstrating higher rates of poor and lower proportions of good ratings than secondary/tertiary hospitals. For the knowledge dimension, tertiary hospitals had the fewest poor ratings, while primary hospitals exhibited the highest prevalence of poor ratings, although the proportion of good skill ratings remained comparable across all tiers (p > 0.05). Educational attainment, hospital grade, and training methodologies were associated with respiratory nurses' competency at ITG. The respiratory nurses exhibited moderate levels of ITG competency, with a notable gap between their knowledge and skills. This gap was more pronounced in primary hospitals, suggesting an association with institutional resource contexts. These results highlight the need for training strategies tailored to each hospital tier, as well as enhanced resource support from tertiary centers to primary care. This would help promote more standardized training programs and reduce competency disparities across hospital tiers.