The global nursing shortage crisis presents a significant challenge to healthcare systems. Digital health technologies, such as communication tools, automation systems, monitoring devices, and information platforms have been proposed as one solution to alleviate the issue by optimizing nursing resources. However, a comprehensive overview of the use and potential of these technologies in optimizing nurses' work and resources is still lacking. The aim of this review is to provide an overview of (a) the digital health technologies used in nursing that may have potential to save nursing resources, (b) which indicators are used to measure the effectiveness of these technologies, and (c) which technologies are found to be effective in terms of saving nursing resources. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews in accordance with the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. The databases PubMed, CINAHL, and Web of Science were searched. Studies were included if they were peer-reviewed, quantitative, addressed nursing professionals, and considered digital health technologies that specifically aimed to save nursing resources. Relevant data were extracted and synthesized narratively, using an emerging framework. A total of 115 studies were included in this review. Digital health technologies fell into four categories: communication, automation, monitoring, and information technologies. All showed potential for saving resources, with monitoring technologies most often reported as having high potential. Indicators used to measure effectiveness focused on temporal, workforce, and workload resources, and related outcomes including quality of care, patient safety, and cost efficiency. Workforce resources were the most frequently optimized, followed by improvements in patient safety and quality of care. While positive effects were predominant, some studies reported adverse and insignificant effects, indicating variability in effectiveness. Digital health technologies offer promising opportunities to alleviate nursing resource shortages, but their potential seem to vary by type. Monitoring technologies showed the most consistent benefits, while communication and information technologies had mixed effects and automation technologies require further research to clarify their potential. Given the wide range of indicators used to measure potential resource savings, defining common, standardized indicators is essential for systematically assessing the impact of digital health technologies on nursing work and resources. This would enable comparability across studies, strengthen evidence-based decision-making and guide implementation strategies.

Nurses' attitudes toward artificial intelligence applications and their clinical decision-making competence: A cross-sectional study.

Digital radiography's wide dynamic range, often leading radiographers to prefer overexposure to avoid noisy images, contributes to "dose creep." The Exposure Index (EI) was introduced as a feedback tool to balance image quality with radiation dose in line with ALARA. Understanding and proper use of the Exposure Index (EI) in digital radiography is vital for optimizing patient safety and image quality. This study aims to assess radiographers' knowledge, understanding, and application of EI in Norway and Singapore. An online survey conducted in 2025 collected 238 responses in Norway and Singapore after institutional ethical exemption approval. A piloted questionnaire was administered via Qualtrics in Singapore and Nettskjema in Norway, and distributed through email, social media, and in-person outreach. Respondents showed intermediate EI understanding, with difficulties differentiating EI from target EI (EIT) and recognising the importance of monitoring EI, particularly with vendor-specific scales. No significant correlations were found between demographics, perception, or clinical application, except for greater experience reduced vendor-specific confusion. Most agreed that EI support patient safety and applied EI primarily for chest imaging, with occasional overexposure more common in Singapore. EI-related image quality concerns varied by country: poor collimation and orthopedic appliances were most cited in Norway, while exposure field recognition was most cited in Singapore. Collaborating with international vendors and educational institutions to standardise terminology and scales can reduce the knowledge gap, leading to safer imaging practices and better patient care. Revising workflows to integrate EI into clinical practice more consistently can address its underutilisation. These findings inform the development of educational training and departmental protocols to improve understanding and correctly applying the EI for ensuring patient safety and improving imaging quality.

Background: Nursing leadership plays a critical role in shaping patient safety culture and influencing the quality of care in healthcare systems, particularly in resource-constrained tertiary hospital settings. Objective: To assess the association between nursing leadership, patient safety culture, and quality of care among nurses working in tertiary care hospitals of South Punjab, Pakistan. Methods: A quantitative cross-sectional study was conducted among 141 nurses selected through convenience sampling from multiple public-sector tertiary hospitals. Data were collected using a structured questionnaire assessing leadership, safety culture, and quality of care. Descriptive statistics, chi-square tests, and Pearson correlation analyses were performed using SPSS version 27, with significance set at p < 0.05. Results: Nursing leadership showed a strong positive correlation with patient safety culture (r = 0.680, p < 0.001) and quality of care (r = 0.610, p < 0.001). Patient safety culture was also significantly correlated with quality of care (r = 0.630, p < 0.001). Chi-square analysis demonstrated significant associations between leadership and safety culture (χ² = 32.45, p < 0.001) and quality of care (χ² = 28.67, p < 0.001). Descriptive findings indicated generally positive perceptions, although gaps were noted in non-punitive error reporting and resource availability. Conclusion: Nursing leadership is significantly associated with improved patient safety culture and quality of care. Strengthening leadership practices and supportive organizational environments may enhance patient outcomes in tertiary healthcare settings.

This study investigates the impact of night shift rotations on nursing performance and medication errors, and examines the mediating role of patient safety and quality of work. A cross-sectional design was used, targeting 350 nurses from a selected hospital in Jordan. The required sample size of 184 participants was calculated using an online sample size calculator. Data were analyzed using descriptive and inferential statistics to explore the relationships between night shift rotations, nursing performance, medication errors, and patient safety quality. The results showed that night shift rotations significantly affected both nursing performance and medication errors. Additionally, patient safety and quality of work were found to mediate these relationships, indicating that higher levels of patient safety and quality of work can strengthen nursing performance and help mitigate medication errors. The results showed that night shift rotations significantly affected both nursing performance and medication errors. Additionally, patient safety and quality of work were found to mediate these relationships, indicating that higher levels of patient safety and quality of work can strengthen nursing performance and help mitigate medication errors.

BackgroundNurses' unprofessional behavior endangers quality of care and patient safety as well as nurses' careers and work communities. Existing knowledge concerning nurses' unprofessional behavior and its effects on patient care should therefore be considered to facilitate early identification and the development of preventive strategies.AimThe aim of this scoping review is to systematically map and summarize existing knowledge about unprofessional behavior among nurses in order to support the development of strategies for its early detection and prevention.MethodA scoping review was performed based on electronic searches of the CINAHL, PubMed, Scopus, Web of Science, and ERIC databases together with manual searches of the reference lists of all publications retrieved in the initial searches. The database searches spanned the period from database creation to October 2024. Only peer-reviewed empirical research papers published in English were considered for inclusion. Publications were selected using predefined inclusion and exclusion criteria, and altogether 40 studies were included. Data was analyzed using descriptive methods.FindingsThe terms used in relation to unprofessional behavior are related to neglect and abuse, unethical behavior, and misbehavior. Types of unprofessional nursing behavior during patient care include neglecting nursing tasks, betraying professional confidence, and violating patient integrity. These behaviors may create risks to patient safety and cause patient dissatisfaction. Reasons for unprofessional behavior included nurses' personal life histories, lack of professional competencies, and factors relating to the work environment and community.ConclusionsOur findings indicate that unprofessional behavior by nurses is an umbrella term, covering various forms of inadequate and unethical behavior. In future, more attention must be paid to nurses' working conditions and ethical skills to protect patients' safety and strengthen the nursing profession.

The healthcare sector faces unique pressures complex regulatory demands, patient safety obligations, escalating cybersecurity threats, and investor expectations making it one of the industries where Governance, Risk, and Compliance (GRC) frameworks offer the greatest potential value. This literature review synthesizes evidence from 25 peer-reviewed studies, systematic reviews, bibliometric analyses, and industry reports published between 2010 and 2026 to answer the question: what added value does applying GRC bring to healthcare organizations? Six distinct value dimensions are identified and examined: (1) firm value and investor confidence, (2) patient safety and care quality, (3) proactive cyber risk management, (4) operational efficiency and cost reduction, (5) regulatory compliance and reputation protection, and (6) strategic resilience and enterprise risk management. Findings indicate that GRC positively affects firm value in healthcare companies, with an explanatory level of 33.8% [14], and that integrated GRC is associated with improved patient safety across multiple health systems [3]. The review also identifies significant barriers to implementation, including cultural resistance, resource constraints, and data privacy concerns, alongside emerging opportunities from artificial intelligence-enabled GRC tools. The evidence consistently demonstrates that GRC value in healthcare is multiplicative rather than additive: governance, risk management, and compliance generate greater combined benefit when integrated than when managed as separate functions.

ABSTRACTBackground and ObjectivesMisophonia is a condition that causes abnormal emotional reactions to certain environmental sounds. The aim of this study was to investigate whether there is a relationship between the responses of nurses working in intensive care units to these sounds and the care provided to the patient.MethodsPersonal Information Form, Misophonia Scale and Caring Behaviours Scale‐24 were used to collect data. Mann Whitney U test and Kruskall Wallis test were used to analyse the data, and pearson correlation coefficient was used to examine the relationship between variables. The significance level was taken as p < 0.05.ResultsIt was determined that the mean scores of the participants on the Caring Behaviours Scale‐24 and the Misophonia Scale were moderate. A moderate negative correlation was found between the Caring Behaviours Scale‐24 and the Misophonia Scale.ConclusionsIn the light of the data we obtained from the study, it is possible to say that nurses exhibiting misophonic behaviours may be adversely affected by the sounds in the intensive care environment and this situation may negatively affect their care behaviours.Relevance to Clinical PracticeNurses with misophonic symptoms should be identified and their personal coping strategies should be strengthened. In this way, the quality of patient care and patient safety can be improved.Patient or Public ContributionDescriptive and cross‐sectional study. After obtaining the necessary permissions for the study, the researcher met with the intensive care nurses in the nurses' work environment, provided information about the study, and obtained written consent forms from those who volunteered to participate in the study. The relevant forms were delivered to the intensive care nurses in envelopes to be filled in and were returned in a sealed envelope at the end of the 2‐day filling period. The study adhered to the STROBE checklist.

This study aimed to develop a structured risk assessment system for postoperative lower extremity deep vein thrombosis (LEDVT) in patients with severe traumatic brain injury (sTBI), and to validate its content and reliability through expert consensus. The system was designed based on evidence from a comprehensive literature review and refined through a two-round Delphi expert consensus process involving 16 multidisciplinary experts. Indicator weights were assigned using an analytic hierarchy process combined with expert scoring. The finalized framework incorporated 6 primary domains-demographic characteristics, trauma-related indicators, coagulation parameters, comorbidities, iatrogenic factors, and venous thromboembolism prophylaxis-encompassing 19secondary indicators. Response rates for two rounds of the expert questionnaire were 100%. The expert authority coefficient was 0.931. The coefficients of variation for the second-round indicators ranged from 0% to 7.01% and Kendall's coefficient of concordance was 0.670 (p < 0.001), indicating a high degree of expert agreement. A comprehensive risk prediction indicator system for LEDVT following sTBI surgery was established. The system is suitable for direct integration into hospital information systems, with weighted indicators reflecting clinical priorities and supporting the development of real-time monitoring modules.By enabling early identification of high-risk patients, this tool can facilitate timely prophylactic interventions, enhance clinical decision-making, and ultimately reduce the incidence of postoperative LEDVT, thereby improving patient safety and overall quality of care.

Workplace violence in healthcare settings has become widely normalized, which obscures its severity and undermines meaningful attempts at prevention. Thousands of healthcare workers a year experience workplace violence-related injuries, and many incidences go unreported altogether. As a result, the true risk and frequency of workplace violence are concealed and unaddressed, leading to inadequate allocation of resources toward prevention. The consequences of workplace violence extend beyond physical injury; lasting psychological harm such as post-traumatic stress symptoms and moral distress is common. State-level responses, including expanded criminal penalties and mandated employer-run prevention programs, have emerged in the absence of enforceable federal standards. Despite being framed as an unavoidable consequence of working in healthcare, workplace violence should be seen instead as an outcome of chronic mistreatment of healthcare workers, poor security infrastructure, and weak regulatory oversight. In hostile and dangerous work environments, patient safety and healthcare quality inevitably suffer. Workplace violence is therefore an urgent patient safety issue, and addressing it is integral to providing quality healthcare.

This article was written to describe the authors' interprofessional collaboration experience with regard to the clinical translation of evidence-based healthcare. Building upon the spirit of evidence-based medicine invoked at the founding of the Cochrane Centre at Oxford University under the United Kingdom's National Health Service in 1992, our institution recognizes nursing as the core driving force supporting the translation of evidence-based healthcare in clinical settings. Using interdisciplinary collaboration mechanisms, systematic education and training, and knowledge translation strategies, the best research evidence is integrated into clinical decision-making and improving care quality, thus deepening the application of evidence-based clinical healthcare. In clinical care, nursing teams have led multiple evidence-based initiatives targeting patient safety and care quality improvement. Issues addressed have included fall prevention, infection control, nasogastric tube dislodgement prevention, hypothermia interventions to improve neurological outcomes in patients with traumatic brain injury, post-operative positioning adjustments, acute-phase COVID-19 pulmonary rehabilitation, and family-centered interventions in intensive care units to reduce the incidence of delirium. These initiatives have been significantly grounded in the findings of systematic literature reviews and outcome evaluations, with results demonstrating a notable reduction in adverse event rates and significant improvements in functional recovery and quality of life in patients. Nursing personnel play an integrative and leading role in assessment-tool development, care process design, outcome monitoring, and the continuous provision of quality feedback, reflecting their professional autonomy in the clinical application of evidence-based practice. In terms of guideline development, the nursing department has taken the lead in constructing guidelines for cancer symptom management and post-curative follow-up care for patients with liver cancer, advocating for an integrated model centered on holistic care, and collaborating with physicians, pharmacists, and dietitians to jointly establish interdisciplinary care standards. Also, the department has actively mentored advanced practice nurses in writing evidence-based clinical care guidelines at an advanced level, strengthening advanced nursing practice competencies and academic output. With regard to shared decision-making and Choosing Wisely initiatives, nursing staff participate in the development of decision support tools and the application of structured communication models to facilitate patient value clarification and engagement in decision-making, while concurrently enhancing healthcare resource-utilization appropriateness and safety. Overall, within the evidence-based clinical system, the nursing profession fulfills multiple functions in the realms of care practice, research participation, education promotion, and knowledge translation, laying a strong foundation for the sustainable development of evidence-based clinical care.

Early detection of patient frustration and delays in admission is imperative for maintaining quality of care, operational efficiency, and patient safety in high-throughput hospital settings. This paper presents the design, implementation, and validation of a real-time natural language processing (NLP)-based warning system that continuously monitors unstructured textual signals and operational admission events. The system ingests live triage notes, patient communications, and admission workflow logs, and performs low-latency inference using a fine-tuned transformer-based clinical language model to identify frustration sentiment, complaint intent, urgency, and delay-related language. Linguistic indicators are fused with real-time operational metrics to generate dynamic risk scores and role-routed actionable alerts for clinical and administrative staff. Validation through historical event replay and live shadow deployment demonstrates a mean end-to-end latency of 18-25 seconds (worst case &lt; 45 seconds), precision of 0.90-0.93 for high-severity frustration detection, and median early-warning lead times of approximately 10-15 minutes prior to formal complaints or critical delay thresholds, while maintaining a controlled alert volume below 6 alerts per 100 admissions. These findings indicate that real-time execution enables earlier intervention and improved operational responsiveness compared with conventional retrospective monitoring approaches.

Medical applications of mathematical modeling, including machine learning models, knowledge graphs, and health digital twins, primarily involve the prediction of patient outcomes. This expert perspective examines how mathematical modeling can contribute to health care quality management. Definitions of procedures, patient outcomes, and quality metrics are provided with a quantitative focus. The emphasis is subsequently placed on 3 categories of patient-centered quality of care, namely, patient safety, procedure accuracy, and procedure efficacy, for which a conceptual and mathematical description is provided. Different levels of modeling tasks essential for managing patient-centered quality of care are identified. This article facilitates a deeper understanding of the topic by assigning relevant publications to these 3 quality categories. Focus is placed on the applicability of graph-based methods, including knowledge graphs and health digital twins, to improve quality management in health care. We have presented a clinical scenario and provided information on methodological limitations, future research directions, and practical implications.

Blood transfusion is vital in healthcare, aiding surgeries, traumatic injuries, and chronic conditions. Enhancements in Transfusion Medicine focus on safe blood products and effective Quality Management Systems (QMS) to minimize transfusion risks. Evaluating key performance indicators (KPIs) is crucial for quality assurance and ongoing improvement in blood transfusion services. Therefore, it is of interest to evaluate a healthcare facility's compliance with NABH standards for blood transfusion services using 11 Key Performance Indicators (KPIs). Findings show Transfusion Transmissible Infections (TTIs) consistently below benchmarks at an average of 2.19%, with all parameters except Syphilis meeting standards. The Adverse Transfusion Reaction Rate (ATRR) averaged 0.36%, indicating robust safety protocols, while blood wastage rates showed significant variation, highlighting the need for better inventory management. Turnaround times for cross-matches met benchmarks, averaging 27.29 minutes for emergencies and delayed transfusions stayed under 15%.Overall, the study highlights areas for improvement, particularly in wastage rates and donor management, underscoring the necessity for ongoing quality assessment and continuous improvement initiatives to enhance patient safety and care quality in transfusion practices. KPI-Dashboard is very helpful in identifying the current lacunae which can be very helpful in improving blood transfusion services. Present study describes a concept of manual dashboard.

Introduction : Electronic Nursing Documentation (END) systems have become a critical component of modern nursing practice, yet their implementation introduces multiple risks that may threaten patient safety and care quality. This study aimed to identify, analyze, and mitigate potential risks associated with END implementation at X Hospital. Method : A descriptive risk management approach was applied using the five-step framework: risk identification, analysis, mitigation, implementation, and evaluation. Data were collected through incident reviews, nurse satisfaction surveys, direct observation, and brainstorming with nursing, IT, and management teams. Risks were analyzed using a 5×5 Risk Matrix and prioritized for mitigation. Result : Ten major risks were identified across technical, clinical, human resource, legal, and organizational domains. The highest-risk events were medication dosage input errors and patient misidentification (risk score 20, “extreme”). Mitigation strategies included user interface redesign, barcode medication administration, auto-logout, patient photo integration, competency-based training, and downtime protocols. After a 12-month phased implementation, expected outcomes included a 75% reduction in END-related incidents, documentation completeness above 95%, and nurse satisfaction improvement to 85%. Discussion : Systematic risk management for END can significantly enhance patient safety and documentation quality. Key success factors include strong managerial commitment, comprehensive nurse training, responsive IT support, and a continuous improvement culture.

To explore the clinical education programs that support new graduate nurses and their impact on confidence, competence, job satisfaction and workforce retention. Nursing workforce turnover is a key issue for healthcare organisations, impacting efficiency, cost-effectiveness, quality of care and patient safety. New graduate nurses are an at-risk cohort who face distinct challenges transitioning into practice, requiring structured and supportive clinical education programs. The JBI methodology for scoping review approach was used. The review was registered and made publicly available in Open Science Framework: https://osf.io/ke5hd. Included studies involved clinical education programs that support new graduate nurses within their first 12 months of employment after completing a bachelor-level degree and their impact on confidence, competence, job satisfaction and retention. The literature search was conducted in March 2025 using CINAHL, Medline and Scopus, with no restrictions on geography or language, and included grey literature across the selected databases. 31 studies met the inclusion criteria of the review, with the majority (n = 27) conducted in a hospital setting. Various terminologies were adopted for clinical education programs in the included studies, such as transition or residency programs, preceptorship programs and critical reflection programs. The duration of these programs was between six weeks to 18 months, with the majority delivered over 12 months (n = 18). Clinical education modalities included education sessions, support strategies, facility orientation, leadership involvement in structured programs, shift pattern rules, reflection, structured feedback and participation in quality improvement projects. This review highlighted the positive impact of providing clinical and social support to this at-risk cohort, and identified that structured clinical education programs resulted in improved confidence, competence, retention and job satisfaction of new graduate nurses. Additionally, the review of these studies revealed organisational challenges, including staffing issues and competing demands between sustaining clinical services, and releasing new graduate nurses for scheduled educational activities required to meet clinical education objectives. The review identified that structured clinical education programs positively impact the transition of new graduate nurses into professional practice. These findings will inform healthcare educators, policymakers and leaders in planning and prioritising responsive strategies to strengthen new graduate clinical education programs and sustain a future-ready nursing workforce.

Despite recent efforts in medicine to minimize diagnostic errors in healthcare, a gap persists in the formal education of pathology trainees in quality improvement and patient safety and error management. This study evaluates a formal curriculum developed and implemented over one year at a pathology residency training program aimed at addressing this educational gap for pathology trainees. A year-long curriculum was developed and implemented involving didactics, small group discussions, and case-based exercises known as error management cases of the week. Pre- and post-curricular surveys assessed trainees' attitudes, beliefs, skills, and confidence related to quality improvement and patient safety. The curriculum's success was measured via participation rates, changes in trainees' attitudes, beliefs, skills, and confidence related to quality improvement and patient safety as measured through surveys, and longitudinal comparisons with national resident survey results. The pre-survey revealed a pressing need for quality improvement and patient safety training, especially among early trainees. Postcurriculum, trainee participants demonstrated significant improvement in confidence and application of quality improvement and patient safety methodologies. This was further supported by an increase in the pathology trainees’ participation in safety event investigations compared to averages from a national survey. The study highlights the effectiveness of a structured quality improvement and patient safety curriculum in enhancing trainee competence and confidence, suggesting a template for wider adoption in pathology residencies. The curriculum's success in shifting attitudes and skills advocates for its integration into national residency programs, promoting a culture of safety and open error management in the field of pathology.

Physician well-being is a multidimensional concept encompassing physical, mental, and social health; life satisfaction; and purpose. Broader than wellness, which focuses on health behaviors, well-being and its importance to patient safety and care quality are well-documented, with poor clinician well-being contributing to burnout, medical errors, and diminished outcomes. Experienced by physicians at higher rates than other professionals, burnout is driven by chronic workplace stress and is amplified by cultural norms in medicine of stoicism and perfectionism. This, in turn, erodes resilience and meaning in medicine. In obstetrics and gynecology, these challenges are compounded by legislative interference and systemic practice pressures, prompting the American College of Obstetricians & Gynecologists (ACOG) to launch a comprehensive National Well-Being Program. Grounded in the Stanford Model of Professional Fulfillment and expanded to meet specialty-specific needs, the program spans six domains: personal wellness, workplace belonging, peer support, practice efficiency, social engagement, and the engagement in arts, as outlined in the ACOG Well-Being Wheel. Program development follows a structured, evidence-informed strategy: cataloging existing resources, conducting gap analyses, and piloting targeted interventions. Foundational program initiatives include the ACOG Well-Being website, the National Well-Being Delegation, and the peer-support program, with future phases focused on scaling programs, measuring effects, and linking physician well-being to patient outcomes and workforce sustainability.

Healthcare facility accreditation, licensing, and quality assurance are critical mechanisms for improving patient safety and service quality. In fragile and conflict-affected settings such as Somalia, these regulatory and quality assurance systems remain weak and poorly institutionalized. This study assessed the status of facility accreditation and associated factors using data from the 2022–2023 Harmonized Health Facility Assessment (HHFA). This study was a secondary analysis of cross-sectional data from the Somalia HHFA 2022–2023, including 1,219 healthcare facilities across Five Federal Member States and Banadir Region. Descriptive statistics summarized facility characteristics and accreditation-related indicators. Bivariate and multivariable logistic regression analyses were conducted using Stata version 17 to identify factors associated with facility accreditation status. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and p < 0.05 was considered statistically significant. Overall, only 18.46% (95% CI: 16.28%–20.64%) of healthcare facilities reported having undergone any accreditation. In the adjusted analysis, accreditation was significantly associated with state and facility type, and with certification and licensing status. Facilities certified for specific services (AOR = 8.49; 95% CI: 3.78–19.07) or licensed/registered facility-wide (AOR = 4.79; 95% CI: 2.03–11.34) had higher odds of accreditation. Facilities with a routine quality assurance process were also more likely to be accredited (AOR = 2.34; 95% CI: 1.51–3.64). Facility accreditation in Somalia remains extremely limited, reflecting major gaps in regulatory oversight and quality assurance. Certification and licensing indicators and the presence of routine quality improvement processes were key factors associated with accreditation. Strengthening national accreditation frameworks and supporting routine quality improvement including context-appropriate accreditation pathways for complex referral facilities are vital to improve healthcare quality and safety in Somalia.

Background: Accurate and complete paediatric nursing documentation is critical for quality care, legal accountability, and patient safety. Despite its importance, paediatric nurses in teaching hospitals in Rivers State, Nigeria, face challenges in documentation proficiency. Aim: This study evaluated the comparative effectiveness of e-learning and face-to-face training on paediatric nurses’ documentation proficiency. Methods: A post-intervention only cluster-randomized controlled trial was conducted. A total of 93 paediatric nurses across three teaching hospitals (UPTH, RSUTH, and PAMOTH) participated. Cluster sampling was used, with hospitals randomly assigned to e-learning, face-to-face training, or control groups, and nurses randomly selected within each cluster. For 5 days, the e-learning group completed a structured online module on paediatric documentation, while the face-to-face group participated in instructor-led sessions covering assessment, diagnosis, care planning, implementation, evaluation, and legal aspects. The control group received no additional training. Documentation proficiency was assessed using the validated Paediatric Documentation Audit Checklist (PDA Checklist). Descriptive statistics summarized participant characteristics and documentation scores. Chi Square and t-tests evaluated differences between groups. Results: At 12 weeks post-intervention, significant differences were observed among the e-learning, face-to-face, and control groups in several aspects of documentation, including clearly outlined nursing assessments (p = 0.008), standardized documentation of nursing diagnosis using NANDA-I taxonomy (p = 0.010), identification of specific and measurable nursing goals (p = 0.020), and evaluation and review of nursing care plans (p = 0.031). Additionally, the e-learning group demonstrated significantly better performance than the face-to-face group in patient identification accuracy and adherence to error-correction protocols (p = 0.049). Conclusion: E-learning and face-to-face training effectively enhance paediatric nurses’ documentation proficiency, but completeness of documentation was better with e-learning. Healthcare institutions should integrate e-learning into continuing professional development to improve documentation skills and address accessibility constraints.