Nursing Profession Research Articles

Professional nurses’ perspectives on the implementation of integrated chronic disease management model

Background: The integrated chronic disease management (ICDM) model is seen to be a promising strategy as it is gaining global acceptance as an approach to enhance healthcare delivery.Objectives: The study objectives were to explore and describe professional nurses’ perspectives on the model, identify challenges experienced during implementation and identify factors that could improve the model implementation.Method: An explorative, descriptive qualitative design was used, nine professional nurses from three selected facilities were interviewed. Data obtained from semi-structured individual interviews were analysed using thematic analysis and NVivo software.Results: Three main themes emerged: the professional nurses’ perceived benefits of the model, challenges experienced during implementation and recommendations to ensure effective implementation of the model. The perceived benefits of the model included the integration of care, adequate medication and the alleviation of stigma related to diseases. However, the challenges of the model included a shortage of staff, poor infrastructure and patients missing scheduled appointments. The study noted the need for adequate staff, infrastructure and ongoing training for the successful implementation of the model.Conclusion: Despite challenges in the South African healthcare system, professional nurses perceived the implementation of the model positively. The study highlighted the need for adequate staff, adequate infrastructure and ongoing training for staff.Contribution: This study outlined the challenges and recommendations identified, enabling healthcare organisations, policymakers and educators to develop targeted strategies for successful implementation. The findings will also inform future research focussed on optimising the utilisation of the model in the study setting and similar contexts

Motivations for Enrolment and Dropout of First-Year Undergraduate Nursing Students: A Pilot Multimethod Study

Background/Objectives: Higher education institutions must improve the attractiveness and retention of the nursing profession to address the widespread shortage. This pilot multimethod study aimed to preliminarily understand the relationship between motivations for enrolment and dropout among first-year undergraduate nursing students. Methods: A two-step approach was conducted among first-year nursing students from five Italian universities involving: (a) a baseline quantitative online survey collecting their characteristics and motivations for enrolment; (b) a follow-up semi-structured interview qualitative data collection among students who dropped out. Descriptive and inferential statistics were used to describe the motivations for enrolment and differences between universities. Dropout motivations emerged from inductive content analysis, with data categorisation according to Urwin’s framework. Results: A total of 759 students completed the online survey. Primary motivations for enrolment included the desire to be useful (88.8%), help suffering people (84.3%), and find employment (74.2%); 22.3% cited unsuccessful admission to another university as motivation for enrolment. Of the 141 students who discontinued, 31 were interviewed (22%). Eleven categories and three themes were identified. More than half of the participants dropped out due to interest in other courses and lack of aptitude, while a smaller number cited personal circumstances. Other motivations for dropout were related to negative learning environments or feelings and difficulties related to course characteristics. Conclusions: This study provides an initial insight into these complex phenomena that will be instrumental in understanding data from an Italian multicenter cohort study. The findings can inform recommendations and strategies to strengthen the future nursing workforce.

International models of accreditation and certification for hospitals with a focus on nursing: a scoping review.

Quality assurance in hospitals is essential for ensuring patient safety, quality of care and efficiency. The nursing profession is a key contributor to healthcare quality, yet, a comprehensive overview and comparison of the role and scope of nursing as part of accreditation and certification schemes has been lacking. The aim was to identify if and to what extent international accreditation or certification schemes focus on nursing, and to compare their conceptual models and outcome indicators. A scoping review was conducted. A search strategy was developed together with a librarian and carried out in January 2024 in Medline, CINAHL, Web of Science Core Collection, Cochrane Reviews and Google Scholar. Additionally, authoritative websites of accreditation/certification holders were searched. Inclusion criteria were studies on international accreditation or certification schemes for hospital settings with relevance to nursing published in English or German. Screening and data analysis adhered to the Joanna Briggs Institute's methodology, with reporting following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline (PRISMA-ScR). The search identified 17.315 records. After removing duplicates and screening of titles/abstracts, 336 full-texts remained. A total of 124 studies were included, identifying seven international accreditation/certification schemes: European Foundation for Quality Management, Evaluation and Quality Improvement Program, International Organization for Standardization 9001, Joint Commission International®, Magnet Recognition Program®, Pathway to Excellence® Program, Qmentum®. The different schemes ranged from nursing-specific to having no specific focus on, but relevance for, nursing and varied in their topics, focus on structure, process and outcome quality and structure and content of requirements. Additionally, outcome indicators varied, with differences in the extent to which indicators were nurse-sensitive, compulsoriness of data collection, and use of external benchmarking. The seven international schemes show large conceptual variations as to their focus on nursing and differences in the degree of nurse-specific outcome indicators. Hospital and nursing managers, policymakers, patients and the public need to understand the content and outcome dimensions of the schemes when making decisions or assessing hospital quality data.

The Impact of Clinical Practice Stress on Nursing Professional Competence among Undergraduate Nursing Students: A Cross-Sectional Study.

This study aims to explore the impact of undergraduate nursing students' clinical practice stress on nursing professional competence. The research was performed as a cross-sectional study. From January 2023 to February 2023, a total of 114 nursing students in their first clinical practice at a university in Taiwan were included in the survey. Data collection was conducted using the Clinical Practice Stress Scale and the Nurse Professional Competence Scale. Pearson's correlation analysis was used to analyze the relationship between clinical practice stress and nursing professional competence, and multiple regression analysis was used to explore predictors of nursing professional competence. The clinical practice stress of nursing students was at a medium level (37.75 ± 12.24), and the nurse professional competence was at a high level (79.34 ± 10.12). Clinical practice stress was negatively correlated with nurse professional competence (r=-.311, p=.001). Clinical practice stress could predict nursing professional competence (F=3.041, p=.013), which explained 12.3% of the total variance (adjusted R2 = .083, p < .001), among which the stress of taking care of patients in clinical practice had the highest β value (β=-.336, p=< .001). Clinical practice stress can predict nursing professional competence. The stress of taking care of patients in clinical practice is a major predictor of nursing professional competence. Nursing students who experience the stress of clinical practice tend to develop lower nursing professional competence, highlighting the need for effective coping strategies and supportive learning environments for nursing students.

Applying the Concept of Epistemic Injustice as a Philosophical Window to Examine Discrimination Experiences of LGBTQIA+ Migrants With Nurses.

Both stigma and discrimination, defined as a lack of knowledge of and a sense of discomfort in providing care to lesbian, gay, bisexual, transgender, queer, intersex, and + (LGBTQIA+) migrants, was found to manifest in a sample of LGBTQIA+ migrants who received nursing care in a recent study. The study concluded that nurses continue to have a limited understanding of the experiences of LGBTQIA+ migrants in the Canadian context, and that LGBTQIA+ migrants continue to have troubling 'care' experiences with nurses. Miranda Fricker has developed the concept of epistemic injustice drawing on feminist philosophy and social epistemology. Epistemic injustice refers to unfair treatment of a person by judging them as 'not a knower' in a communicative situation. For example, in a few circumstances when LGBTQIA+ migrants were admitted to psychiatric units due to suicide ideations as a direct result of identifying as a LGBTQIA+ migrants, the medical and nursing team responded with 'They are in Canada now. It is safe here!' and 'So, you are [LGBTQIA + ]! What's the big deal?' These unjust statements reflect an epistemic situation in which the hearer is negating what was heard, that is, that the speaker's intersecting identities of LGBTQIA+ and new immigrant has directly led to suicide ideation. The concept of epistemic injustice helps to frame this situation as one where the care provider is not doing justice to the needs of LGBTQIA+ migrants. This article draws on the narrative of an LGBTQIA+ migrant who is not recognised as a credible source of knowledge about their own lives and needs in the context of Canadian nursing care. Epistemic injustice helps to understand how stigma and discrimination is produced in this community by the very nursing profession who ostensibly want to help them.

The Influence of Job Crafting on Nurses’ Intent to Stay: A Cross-Sectional Study

Background/Objectives: The increasing rates of nurse turnover pose significant challenges to healthcare systems, negatively impacting patient outcomes and increasing operational costs. Despite the recognized importance of retaining nursing staff, factors contributing to turnover intentions, such as job dissatisfaction and burnout, remain inadequately addressed. Developing job crafting skills among nurses can be a proactive strategy to mitigate these issues, leading to a more engaged and committed workforce. The aim of this study was to analyze nurses’ job crafting and its relationship with the intention to stay at their working hospitals or to leave the nursing profession. Methods: A cross-sectional, correlational study was conducted with a sample of 284 registered nurses using a self-reported online questionnaire with the standardized Spanish version of the Job Crafting Scale. Mann–Whitney U and Kruskal–Wallis nonparametric tests were used to determine statistically significant differences between two or more different groups for the job crafting variable, respectively. The Spearman correlation coefficient was calculated to explore the relationships between variables. Results: Mean scores obtained for the Job Crafting Scale indicated that nurses in the study had a high level of job crafting. Nurses with lower scores for the ‘Decreasing hindering job demands’ subscale had a significantly lower intention to stay at their workplace. Greater ‘Decreasing hindering job demands’ scores were significantly associated with a lower intention to leave the nursing profession. Lower nurses’ intention to leave the nursing profession was significantly associated with a greater intention to stay at hospitals. Conclusions: Improving ‘Decreasing hindering job demands’ job crafting skills to “decrease hindering job demands” through workload management, time management training, supportive supervision, resource availability, autonomy encouragement, promotion of team collaboration, and mental health support. It could lead to greater retention of nurses in their workplaces and in the nursing profession. Nursing managers and leaders should consider improving the job crafting skill “Decrease Hindering Job Demands” among nurses as a potential strategy for effective retention of nurses to address the challenges of the global nursing shortage.

The effect of the challenges experienced by nurses during the pandemic on their intention to leave work: the mediating role of the performance.

During the COVID-19 pandemic, negative working conditions in the nursing profession have worsened, and nurses have experienced various challenges that have increased their intention to leave work. Findings on the role of nurse performance under such conditions are limited. This study aimed to investigate the role of performance in the effect of the challenges experienced by nurses during the pandemic on their intention to leave work. This descriptive and cross-sectional study was conducted between July 2022 and August 2023 in Turkey using an online survey. A total of 462 nurses participated in the study, which employed the non-probability random and snowball sampling methods. The mediating factors in the effect of the challenges experienced by nurses during the pandemic on their intention to leave work were task performance (β = 0.07), contextual performance (β = 0.05), and counterproductive work behavior (β = 0.12), respectively. This study determined that task performance, contextual performance, and counterproductive work behavior played an important role in the effect of the challenges experienced by nurses during the pandemic on their intention to leave work. The present results may serve as a guide in determining effective strategies to be employed in possible pandemic situations.

Call to Action: Integrating Anti-racist Philosophies in Dismantling Racism and Anti-Black Racism in Nursing Education in Canada.

Despite nursing's stated mandate of health equity and social justice, concrete steps to address racism and anti-Black racism in the profession and nursing education remain mainly non-significant and are often seen as performative. It is crucial to implement tangible measures to dismantle racism and anti-Black racism in nursing education to address racial health disparities. Throughout history, nursing education has been shaped by colonial and Eurocentric ideologies, leading to the silencing and erasure of the knowledge, culture, perspectives, and ways of knowing of Black and other racialized communities. Consequently, urgent action is required to dismantle embedded racism and anti-Black racism in the nursing profession. Drawing on anti-racist philosophies, we argue that dismantling racism in nursing education goes beyond superficial discussions of equity, diversity, and inclusion. Instead, it demands a proactive approach to tackle the underlying causes of racial inequities. In this article, we propose several recommendations and implications for nursing educators, researchers, policymakers, and educational institutions to eliminate racism and anti-Black racism in both nursing education and practice. These recommendations include acknowledging the historical and contemporary impacts of racism and anti-Black racism on the health and well-being of Black individuals, engaging in critical self-reflexivity, integrating and prioritizing Black knowledge and perspectives in nursing education, practice, and research, and intentionally adopting anti-racist pedagogy.

Strengthening Mental Health Though Resilience in Nursing Students: A Protocol for a Comprehensive Scoping Review

Background: Nursing students face unique challenges during their university education, making them vulnerable to mental health problems. Psychological resilience has been identified as a protective factor against these issues. However, previous reviews have identified gaps in the literature on resilience and mental health among nursing students. Objectives: This scoping review aims to identify and map studies on psychological resilience and mental health in undergraduate nursing students, synthesize current evidence on their relationship, identify interventions for enhancing resilience, and highlight gaps in the existing literature. Eligibility criteria: Studies published between January 2019 and April 2024 in English, Portuguese, and Spanish addressing resilience and mental health in undergraduate nursing students will be included. Primary studies, secondary studies, clinical guidelines, and grey literature will be considered. Sources of evidence: Searches will be conducted in multiple databases including EMBASE, ERIC, PubMed, Science Direct, Web of Science, DOAJ, ELSEVIER, EMERALD, and WILEY ONLINE LIBRARY. Grey literature sources will also be searched. Charting methods: Data will be extracted using a standardized form and synthesized narratively. Thematic analysis will be conducted using MAXQDA software ((Verbi GmbH, 24 version, 2023). Quantitative summaries, visual mapping, subgroup analyses, and trend analyses will be performed where appropriate. Results: As this is a protocol, results are not yet available. The review will present a comprehensive map of the current literature on psychological resilience and mental health in nursing students, including identified interventions and research gaps. Conclusions: This scoping review will provide valuable insights to guide curriculum development, support services, and policy-making in nursing education. The findings may support actions to strengthen resilience and prevent mental health problems among future nursing professionals.

COOPERATIVE LEARNING TECHNOLOGIES AS A MEANS OF IMPROVING THE PROFESSIONAL TRAINING OF NURSES IN AUSTRIA

The article examines the use of cooperative learning technologies in the professional training of nurses in Austria. It is emphasized that the nursing profession in Austrian society has a high social rating, a pronounced personal and humanistic orientation, іt is a separate profession, where a nurse is an independent specialist in the health care system. It is emphasized that in the conditions of increasing the range of functional responsibilities and of the professional activity of medical specialists, cooperative learning technologies allow not only to improve practical skills, but also to develop the clinical thinking of future nurses, to adapt them to non-standard situations, to work out all the necessary stages of their activity. It is noted that the advantages of cooperative learning are the improvement of students' academic results, development of their ability to think critically and have non-stereotypical perception of other people, positive psychological climate in the group, studentsʼ desire for cooperation and constructive socialization, the presence of an empathetic reaction, mutual support, sympathy and friendly relations in the team, and positive attitude of students to studies, teachers and educational institution, etc. Unlike traditional forms and methods of educational activity, cooperative learning helps to achieve not only cognitive, but also motivational and emotional goals, develops the ability to take responsibility for oneʼs own learning, that is, the ability to independently organize the learning process.

Practising Safe Care in Critical Care: A Reflexive Thematic Analysis.

AbstractAimTo explore the meaning of ‘safety’ as it applies to critical care nurses during daily care practice in the intensive care setting.DesignA qualitative study design was employed.MethodsThe study enlisted 18 critical care nurses and nurse leaders from three hospitals in Sweden. Interview data were collected in 2017 and in 2024. The data were examined using reflexive thematic content analysis.ResultsThe meaning of safety within critical care settings was illustrated by the themes ‘Sustaining a safety mindset’, ‘Fostering commitment to patient safety’, ‘Showing individual accountability and continuous learning’ and ‘Managing complexity while prioritising safety standards’. Safe care practice in daily practice also involved adaptability and resilience in response to changing circumstances or unexpected events, ensuring thoroughness and allowing for a return to regular routines when conditions permitted, thereby preventing incomplete care. Core competencies in safety encompassed both technical and non‐technical skills, such as the ability to assess and use technology, remain vigilant and thorough, plan ahead, prioritise and identify, and follow through on nursing interventions, all while working in a team and allocating sufficient time for patients.ConclusionSustaining a safe mindset over time is both challenging and essential. Further research should focus on how to foster a sustained safety mindset. A more proactive approach to learning may be achieved by reflecting on and discussing things that have worked well even in challenging circumstances.Implications for the Profession and/or Patient CareThis study enriches our understanding of practising safe care in intensive care. It furnishes the nursing profession with a deeper theoretical grasp of proactive safety efforts, encompassing various factors that can mitigate risks in a technologically advanced environment.

The "Right Kinds of Nurses": Centering LPNs in the Nursing Labor Force.

The nursing profession is currently grappling with an ongoing nursing shortage illuminated during the COVID-19 pandemic. While this burgeoning health and environmental crisis exacerbated this workforce issue, it did not create it. This study seeks to expand the idea of "who is a nurse" by arguing for the use of Licensed Practical Nurses (LPNs) as safe, credentialed persons in the nursing workforce. Archival research using primary and secondary sources highlights the history of the LPN movement. Historical case studies of LPN schools show how LPNs enhanced not only the quantity but also the quality of nursing practice. Case studies also reveal successful collaborations between nurses, communities, and hospitals to enhance the nursing workforce and community well-being. Aspects of this study were either approved by or deemed not human subjects research by institutional review boards. The increased emphasis on the registered nurse in the mid-20th century led to the marginalization of LPNs. Yet, history has revealed that collaborations that enhance diversity in the workforce and improve health-care access for patients, without compromising quality of care, can be formed by engaging LPNs. LPNs must be respected as consistent contributors to the country's health-care workforce. As the AACN commits to diversifying nursing, it is significant that LPNs have added to a more diverse, inclusive nursing labor force. For LPNs who wish to advance their nursing education, pathway programs must be supported-thus increasing diversity in the professional and advanced practice workforce.

Nurses’ knowledge to identify, prevent and manage hypertensive disorder of pregnancy

Background: Hypertensive disorders of pregnancy are major contributors to maternal mortality in South Africa. Preventative strategies in low- and middle-income countries emphasise frequent antenatal visits, symptom identification, patient education and the prophylactic use of calcium and low-dose aspirin to prevent HDP for nurses because they are the frontline workers at antenatal clinics countrywide.Methods: This was a cross-sectional study where a self-administered questionnaire was conducted among nurses (midwives and professional nurses) employed at hospitals and clinics in Durban, South Africa, to assess their understanding and practices regarding identification and initial management of HDP, particularly for eclampsia and PE with severe features. The questionnaires were distributed in person by the researcher.Results: Of the 106 respondents, most (88.7%) worked in the public sector, with over 5 years of experience (64.9%). There was a varied understanding of HDP categories: 72.6% identified gestational hypertension correctly; 49.1%, chronic hypertension; 93.4% PE and 83.0% eclampsia. Knowledge of the recommended treatments for severe PE (55.7%) and eclampsia (66.0%) was moderate with respect to the recommended anticonvulsant and rapid-acting antihypertensive agents, with only 10% recognising the role of aspirin for the prevention of HDP.Conclusion: Substantial knowledge deficiencies existed among nurses in managing HDP.Contribution: Their crucial role in both emergency and preventative care in South African healthcare settings, enhancing educational training on clinical management by providing continuous training and regular updates are imperative to reduce maternal and perinatal complications associated with HDP.

Examining the clinical role and educational preparation of heart failure nurses across Europe. A survey of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP) of the ESC.

To describe the clinical practice and educational preparation of heart failure (HF) nurses across Europe and determine the key differences between countries. A survey tool was developed, in English, by the Heart Failure Association Patient Care committee of the European Society of Cardiology (ESC). It was translated into eight languages, before electronically disseminated by nurse ambassadors, presidents of HF national societies and through social media. A total of 837 nurses involved in the daily care of patients with HF from 15 countries completed the survey. Most nurses, 78% (n = 395) worked within a hospital outpatient setting, and 51% (n = 431) had access to a specialized HF multidisciplinary team. Nurses performed a range of activities including patient education to promote self-care, virtual and in-person symptom monitoring. A third had more than 5-year experience in cardiac care and 22% (n = 182) prescribed HF medications. There was a significant correlation between HF nurses that prescribed HF medications and access to a specialist multidisciplinary team (p = 0.04). A small number of nurses, mainly from Belgium, supported invasive monitoring (n = 68, 8%) with 14% (n = 120) of mostly Danish nurses supporting exercise programmes. The majority of nurses surveyed were committed to further academic professional development, with 41% (n = 343) having completed a HF course. The role of the HF nurse varies across Europe, however involvement in patient education, symptom monitoring and follow-up remain core to their practice. In specific activities including the prescribing of HF medications and involvement in invasive monitoring, practice has advanced with collaboration in the multidisciplinary team. Consequently, harmonization of education, training and career pathways are required to standardize HF care aligned with expert guidelines across Europe.

An exploration of patient safety culture in NICUs: a convergent parallel mixed-method study

BackgroundSafety culture, as a component that improves the quality of safety and health care for neonates, serves as foundation for providing professional and high-quality care by creating positive insight among employees. This study aimed to explore the safety culture concept in neonatal intensive care units (NICUs).MethodsThis convergent parallel mixed-method study included Quantitative, Qualitative, and Integrated parts. In the Quantitative part, the psychometric properties of the Persian version of “Hospital Survey on Patient Safety Culture” were examined among physicians and nurses in NICUs. CFA was performed on the data obtained from 342 participants. The Qualitative section data were collected through in-depth and semi-structured interviews with 24 staff to understand the concept of safety culture. Data were analyzed through the Elo & Kyngäs approach. The interpretation of the results and the convergence of the data was done using the Onwuegbuzie and Teddlie method.ResultsThe initial CFA showed that the 12-dimensional model did not align well with indices. Subsequently, based on T-values, six heterogeneous items were eliminated. The revised 11-dimensional model consisting of 36 items showed an acceptable fit during the second CFA. In the qualitative part, five main categories of “Constructive interactions”, “Management’s commitment to neonatal safety”, “Organizational supportive climate”, “Professional development”, and “Planning and implementation of neonatal developmental care” were obtained. The comparison of the results showed that the dimensions of the quantitative part, except for “Overall perceptions of patient safety”, were also present in the qualitative part, but they were different in some aspects. New findings in the qualitative study such as “Striving for mutual empowerment”, “Constructive criticism in teamwork”, “Efficient supervision procedures”, “Inexperienced staff’ leading” and “Provision of care assistance equipment and facilities” were not found in the dimensions of the quantitative part. The main categories “Acquiring professional competence” and “Planning and implementation of neonatal developmental care” were not align with the dimensions identified in the quantitative study.ConclusionThe findings shed light on previously unexplored aspects of the safety culture concept within the nursing profession, leading to a better understanding and evolution of this concept in Iranian NICUs. The new definition obtained in this study can enhance nursing knowledge on safe care and improve patient safety culture in the NICUs in Iran and globally.

The psychological empowerment and quality of work life among Jordanian primary care nurses and midwives

IntroductionThe healthcare industry, particularly in the context of primary care, presents various challenges to nurses and midwives, influencing their psychological empowerment (PE) and quality of work life (QWL).ObjectiveThis study’s objective is to assess the levels of PE and QWL among Jordanian primary care nurses and midwives and explore the relationship between PE and QWL.MethodsUtilizing a descriptive correlational design, the study included 273 Jordanian primary care nurses and midwives through convenience sampling. The Psychological Empowerment Instrument and Brook’s Quality of Nursing Work Life Survey were used to measure PE and QWL. Data was analyzed using descriptive statistics to describe the study participant’s characteristics and inferential analysis such as Pearson correlation, and multiple regression to examine relationships and identify predictors of study variables.ResultsThe study found that the QWL scale had high reliability (Cronbach’s alpha = 0.954), and similarly, the PE scale demonstrated strong reliability (Cronbach’s alpha = 0.948). Moving on to the core findings, significant positive correlations were identified between PE and QWL, with a correlation coefficient of r = 0.568 (p &amp;lt; 0.01), indicating that higher levels of psychological empowerment were associated with better quality of work life. Furthermore, the regression analysis revealed that PE accounted for approximately 32.3% of the variability in QWL scores. Interestingly, participants holding diplomas reported the highest QWL scores (mean = 136.14), while those contemplating leaving the nursing profession displayed significantly lower QWL scores (mean = 114.14). No significant correlations were found between PE and sociodemographic variables such as age, income, and years of experience.ConclusionThis study reveals a crucial need to enhance PE and QWL. Key findings show moderate PE and QWL levels, with variations based on educational background and workplace. The positive correlation between PE and QWL identifies the benefits of fostering empowerment through professional development, job autonomy, and decision-making. These insights are vital for improving nursing practice and policy and enhancing nurse satisfaction and patient care.

PhD-DNP Collaboration: An Integrative Review of Scholarly Partnerships in Nursing.

Nurses holding terminal degrees, Doctor of Philosophy (PhD), Doctor of Nursing Science (DNS), and Doctor of Nursing Practice (DNP), fulfill different roles in nursing. The continued growth of nursing science and practice is dependent on alliances between these nurses that produce state-of-the-art knowledge and support the translation of evidence to practice. This integrative review described characteristics of scholarly collaborations between nurses holding a research-focused degree, the PhD, and those holding a practice-focused degree, the DNP. Five major nursing, medicine, and education databases were searched for peer-reviewed, original articles addressing or describing the characteristics of PhD-DNP scholarly collaborations, published through March 2023. In total, 15 articles met the inclusion criteria, and an integrative synthesis was conducted using constant comparison and thematic analysis. Findings included one overarching theme, Role Clarification, as well as four subthemes that emerged across the sample, describing key characteristics of collaborative PhD-DNP scholarship: (1) Mutual understanding and appreciation of strengths; (2) Strategic project planning and team building; (3) Clear organizational/administrative directives and guidance; and (4) Shared goals for the nursing profession. Articles describing the collaboration between nurses holding doctoral degrees are limited and provide primarily lower-level research evidence and evidence-based practice outcomes. Despite efforts to foster scholarly collaborations among nurses holding terminal degrees, more research is needed to clarify individual roles, offer tangible strategies for collaboration, and measure outcomes of collaboration benefitting healthcare systems, patient outcomes, and the nursing profession. This integrative review involved only the review of the extant literature.

Inclusivity Requires Intentionality.

Fostering a sense of belonging in the nursing profession is vital.

Abortion is healthcare: In what sense?

In the wake of Dobbs versus Jackson Women's Health Organization, many nursing organizations asserted that “abortion is health care” and access to it must be protected. Such a phrase makes clear claims about the meanings of “health” and “care.” How one defines these terms gives decisive direction to how a nurse must practice regarding not just elective abortion but also myriad interventions that divide bioethicists, including gender affirmative care, cosmetic surgery, and euthanasia. We consider the issue of elective abortion to illustrate the nature of disputes about the scope and limits of professional nursing. We describe two competing intuitions about the nature of health care namely that health care is either for 1) health, objectively defined or 2) well-being, patient defined. We discuss how these intuitions lead to different understandings of the intelligibility of the phrase “abortion is health care” and the implications for ethical discourse within professional nursing.

Benefits of an educational intervention on functional capacity in community-dwelling older adults with frailty phenotype: A randomized controlled trial

BackgroundThere is an urgent demand for nurses to expand their knowledge and skills in managing frailty in primary care. Frailty is a multifaceted condition that is prevalent among older adults and often leads to reduced functional capacity. Currently, there is a limited understanding of the effectiveness of educational interventions aimed at improving functional capacity among community-dwelling frail older adults in a primary care setting. ObjectiveThis study aimed to evaluate the impact of an educational program on functional capacity among pre-frail and frail older adults living in the community. DesignA 12-month, multicenter, randomized controlled trial. SettingsThe FRAGSALUD study was conducted across 14 healthcare centers situated within the regions of Cadiz and Malaga, Spain. ParticipantsA total of 199 frail/pre-frail community-dwelling older adults (74.2 ± 6.4 years). MethodsParticipants who met at least one Fried's criteria were assigned to either the control group (n = 90), which received usual healthcare assistance, or the intervention group (n = 109). The 6-month intervention comprised four group sessions and six telephone calls conducted by professional nurses, sport scientists, and nutritionists. This educational program focused on guidelines for physical activity, nutritional habits, cognition, and psychosocial well-being. Functional capacity was assessed using questionnaires for basic (Barthel Index) and instrumental (Lawton & Brody Scale) activities of daily living. All outcome measures were evaluated at baseline, immediately after the intervention (6-month), and six months after the intervention as a follow-up (12-month). Differences in functional capacity (Barthel Index and Lawton and Brody Scale scores) across the three time points were analyzed using Friedman's ANOVA, with Wilcoxon signed-rank test for pairwise comparisons. ResultsAt both 6-month and 12-month assessments, the control group showed a statistically significant decline in basic and instrumental activities of daily living compared to the intervention group, which maintained similar levels, preventing this age-related decline. ConclusionsThe educational intervention, designed for easy implementation within healthcare systems, especially for nurses, successfully maintained levels of functional capacity in basic and instrumental activities of daily living, while the control group experienced a decline in functional capacity during the 12-month follow-up. Thus, educational interventions are encouraged for preserving the functional independence of frail/pre-frail older adults living in the community. RegistrationThis trial was registered at ClinicalTrials.gov (Identifier: NCT05610605) and the first participant was registered in March 2022.Tweetable abstract: The FRAGSALUD educational intervention prevents the age-related decline in functional independence over 12 months in frail older adults.