Nurse Training Research Articles

The Effectiveness of I-CARE-based Self-Efficacy Nurses Training for the Development of Organizational Commitment at Panti Rapih Hospital Yogyakarta

The Effectiveness of I-CARE-based Self-Efficacy Nurses Training for the Development of Organizational Commitment at Panti Rapih Hospital Yogyakarta

Attitudes, knowledge and practices concerning delirium among paediatric intensive care unit nurses: a multisite cross-sectional study in Sichuan, China.

Delirium is an acute mental state associated with poor outcomes. The incidence of delirium is high, especially in the paediatric intensive care unit (PICU). It is important for staff, particularly nurses, to understand delirium and implement interventions to prevent it. We performed a survey with the aim of evaluating and analysing the factors influencing the knowledge, attitudes and behaviour of PICU nurses towards delirium. This cross-sectional descriptive study included 215 PICU nurses in 6 PICUs from five teaching hospitals in Sichuan Province, China. An online survey about the knowledge, attitudes and practices related to delirium care was conducted among PICU nurses used a self-made and validated questionnaire. The data were analysed using descriptive statistics; differences between groups were compared using t tests, ANOVA and rank-sum tests. Variables with a significance level of 0.05 in the univariate analysis were entered into the multivariable regression analysis to identify predictors. Only 14.4% of the nurses had a good understanding of delirium, and 40.9% had received relevant training. The mean knowledge score was 9.01 ± 3.86, and the overall passing rate of knowledge was 49.8%. The mean attitude and behaviour scores were 40.95 ± 5.62 and 40.33 ± 8.01, respectively. Among the hospitals, different delirium assessments for children and specific training were performed, explaining approximately 10% of the variability in knowledge scores (F = 6.152), approximately 10% of the variability in attitude/belief scores (F = 5.908), and approximately 17% of the variability in practice scores (F = 10.767). PICU nurses have poor knowledge of delirium, particularly regarding its clinical manifestations, influencing factors and medications used, and they have adequate attitudes and confidence and good behaviour regarding delirium in children. To better prevent delirium, we suggest that PICU departments routinely assess delirium and conduct delirium training for nurses. Not applicable.

Effects of open-label sesame oil applied to cardiac surgery patients in preventing amiodarone-induced phlebitis: A randomized controlled trial.

Amiodarone is a prophylactic rhythm-regulating drug used to prevent arrhythmia; However, especially during infusion, it has the potential to cause a number of complications, especially phlebitis. The aim of the study is to determine the effects of sesame oil, which has the potential to prevent phlebitis that may occur during amiodarone infusion administered to patients after cardiac surgery. This prospective, two-arm (1:1), block randomized controlled interventional study. This study was conducted with 44 patients treated in the coronary intensive care unit of a university hospital, who received parenteral infusion of amiodarone. Sesame oil was applied superficially by applying 10 drops to a 10 cm perimeter of the cannula for 10 min. This application was repeated every 8 h during the 24-h amiodarone infusion. No intervention was made to the patients in the control group. However, standard nursing care measures and a standard transparent dressing were applied to the patients in both groups during the peripheral catheter application phase. Patients in the intervention and control groups were evaluated in terms of phlebitis at the end of every 24 h using the Visual Infusion Phlebitis Scale. The study was reported according to the CONSORT declaration. Phlebitis symptoms occurred in 15/22 (68.2%) of the patients in the intervention group on the first day, 3/22 (13.6%) on the second day and 2/22 (9.1%) of the patients on the third day, while in the control group, 20/22 (90.9%) of the patients had phlebitis on the first day and 2/22 (9.1%) on the second day. The incidence of phlebitis was 20/22 (90.9%) in the intervention group and 22/22 (100%) in the control group. There was no statistically significant difference in phlebitis symptoms between groups. The research results showed that the application of sesame oil did not significantly reduce the frequency of phlebitis. However, a trend indicating delayed onset of phlebitis symptoms was observed in the sesame oil group. Nevertheless, larger sample studies are needed. These studies are expected to assist in determining the effects of sesame oil on phlebitis more precisely and provide stronger support for the results. Training of nurses on non-pharmacological methods should be supported and opportunities should be given for their application.

Nursing Students’ Perception and Compliance with Clinical Nursing Placement at a Selected University Teaching Hospital in Nigeria

Aim: To investigate nursing students’ perceptions of their clinical training at a selected university teaching hospital in Nigeria. Method: This was a descriptive cross-sectional design. A simple random sampling technique was used to select 198 nursing students at Babcock University in Ilishan-Remo, Ogun State, Nigeria. An interviewer-administered questionnaire was used to collect data from the respondents. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS Version 25) and presented in tables and charts. Results: This study reveals that 73.23% of the respondents had high knowledge of clinical nursing training, and 78.8% of the respondents had a good perception of clinical nursing training. Furthermore, respondents often complied with clinical posting (mean = 3.35, STD = 0.768), and the study shows that factors relating to clinical supervision and the support accessible during clinical placement influence nursing students’ compliance with clinical nursing practice (mean = 4.06, STD = 1.031). Conclusion: The findings from the study conclude that the perception of nursing students towards clinical nursing training was positive, though some factors affected compliance with clinical nursing practice. Hence, the study recommends the implementation of preclinical orientation, explicit dissemination, and clarification of clinical learning objectives to enhance compliance rates among students during their clinical placements.

Las prácticas profesionalizantes: innovación curricular en la formación de enfermeros. Evaluación y propuesta en el Instituto Superior "Cruz del Sacrificio" (Asociación de Trabajadores de la Sanidad Argentina, filial Córdoba)

This research, from a participatory, reflective, and constructive perspective, focused on the assessment and the development of transformative proposals for Professional Practices (I, II and III) in the Nursing program, considering the relevance of these curricular spaces in the training of future nurses. Its methodological development was grounded in the qualitative approach, centered on action research, taking as reference a Higher Education institution in the City of Cordoba (Argentina). The diagnosis revealed issues related to congruence, integration, and didactics aspects. The action plan and its implementation facilitated a cooperative participation among students, teachers, and directors in the planning and execution of twelve curricular innovations with an impact on institutional strengthening. The assessment showed positive results due to the improvement in learning outcomes, thanks to the provision of infrastructure and technological equipment to facilitate the articulation between theory and practice.

Content of medicine prescription and clinical practice training for haematology advanced practice nurses in China: A modified Delphi study

AimTo explore the scope and form of prescriptions for blood and hematopoietic drugs that future advanced practice nurses (APNs) in the Department of Haematology and to establish a medicine prescription training content in China. BackgroundBecause the increasing number of doctors cannot meet the increasing demand for medical care with the population growth, many countries have begun to explore the medical team structure and practice areas, among which nurse prescribing rights have been the most effective. However, China's higher nursing education system still lacks education and training on nurse prescription. DesignOn the basis of literature research and semi-structured interviews, a set of nursing prescription content, education, training and practice system suitable for Chinese nurses was jointly created. MethodsTwo rounds of expert consultation between 23 haematology nursing experts and clinical experts determined the training content of blood system drugs and medicine prescriptions. Additionally, on the basis of the 23 experts，13 experts engaged in clinical and education, teaching and training experts were involved. Two rounds of expert consultation with 36 experts identified a general clinical practice training program for advanced practice nurses in China. ResultsRegarding contents and forms of hematopoietic drugs, the study concluded that advanced practice nurses in haematology department can prescribe anti-anemia drugs, anti-coagulant drugs and anti-thrombotic drugs in 2 categories and 16 drugs. Of these, four kinds of drugs should be prescribed in the form of protocol prescription. One kind of drug should be prescribed in the form of extended prescription and 11 drugs should be prescribed in the form of independent/extended or agreed/extended prescription. Regarding training content, the study obtained the training content of nurses' medicine prescriptions in eight clinical circumstances and the medicine prescription training content for common diseases of the blood system. The required specifications and the medicine prescription decision skills of nurses were sorted out according to different prescription types. ConclusionsThe degrees of expert authority were both higher in consultations. Moreover, the results after consultation were reliable. It was recommended that haematology APNs could prescribe anti-anaemic drugs and anti-coagulation and anti-thrombotic drugs. Furthermore, most drugs should be prescribed in the form of independent/extended or agreed/extended prescriptions. The establishment of a medicine prescription training content for haematology APNs is expected to provide a reference for clinical practice education and training for drug prescriptive authority applicants for blood and hematopoietic system nurses in China.

Therapeutic patient education and treatment intensification of diabetes and hypertension in subjects with newly diagnosed type 2 diabetes mellitus: a longitudinal study.

The aim of this study is to prospectively evaluate whether individual and group Therapeutic Patient Education (TPE) can reduce the need to intensify treatment of diabetes and hypertension in newly diagnosed type 2 diabetic patients. A total of 937 patients were recruited and followed-up for 42.7 ± 21.5 months. TPE was a structured comprehensive education delivered by trained nurses: 322 patients received individual TPE (ITPE), 291 underwent group TPE (GTPE), and 324 were in Usual Care (UC). The primary endpoints were intensification of diabetes treatment and intensification of hypertension treatment. The rate of diabetes treatment intensification was 40.1% in patients receiving ITPE, 47.8% in patients undergoing GTPE, and 64.2% in patients in UC (p < 0.001). The rate of hypertension treatment intensification was 24.2% in patients following ITPE, 31.3% in patients receiving GTPE, and 41.0% in patients in UC (p < 0.001). Multivariate analysis showed that both ITPE and GTPE were associated with reduced intensification of diabetes (ITPE: HR:0.51; 95% IC:0.40-0.64; p < 0.001 - GTPE: HR:0.46; 95% IC:0.44-0.70; p < 0.001) and hypertension medication (ITPE: HR:0.45; 95% IC:0.34-0.61; p < 0.001 - GTPE: HR:0.49; 95% IC:0.38-0.65; p < 0.001). The association was independent of age, sex, BMI, HbA1c, and presence of hypertension at baseline. TPE, delivered as both individual and group sessions, represents an effective tool to reduce the need to intensify treatment of both diabetes and hypertension. Therefore, it can ensure better control of diabetes and hypertension with fewer medications. This could reduce adverse effects and costs and improve quality of life and medication taking in patients with type 2 diabetes.

Working effectively with consumers: Perspectives from students, teachers, nurses, and consumers.

Preparing enrolled nurses (ENs) to effectively work with mental health consumers is crucial to meeting Australia's healthcare demands. This qualitative study aimed to explore various stakeholders' perceptions regarding the mental health knowledge, skills, and attributes (KSAs) required by ENs to engage with individuals experiencing mental health issues, thus guiding future training priorities. The sample comprised 44 participants including 18 students, 3 graduate ENs, 5 experienced ENs, 5 registered nurses (RNs), 4 nurse unit managers (NUMs), 5 teachers, and 5 consumers of mental health services. Focus groups were used to collect data from the students, whilst individual interviews were conducted with all other participants. A thematic analysis revealed communication was the most vital skill for effectively working with mental health consumers. Skills such as critical thinking and clinical reasoning were also deemed crucial, given the volatile nature of the mental health inpatient environment, necessitating effective responses to acute escalations to prevent adverse outcomes for both staff and consumers. Essential knowledge components included understanding mental health disorders, symptoms, and treatments, particularly medications used for mental health issues. Participants also emphasised the importance of attributes like confidence and empathy in supporting and caring for consumers, who often experienced trauma and vulnerability. These findings provide valuable insights into the content that should be incorporated into the diploma of nursing (DN) training to produce competent graduate ENs.

Effectiveness of Mentorship Using Cognitive Behavior Therapy to Reduce Burnout and Turnover among Nurses: Intervention Impact on Mentees.

Mentoring programs can improve nurses' mental health. This study examined the effects of a staff training program based on cognitive behavior therapy for burnout in which mentors provided intervention to their mentees. The principal investigator served as a facilitator and conducted staff training in cognitive behavior therapy. An original cognitive behavior therapy manual was presented to trained nurses (mentors), and lectures were provided on using the manual, ways of implementing cognitive behavior therapy, and other important points. The study participants included 35 mid-career nurses (mentors) and 34 young nurses in their first to third year (mentees) working in acute care hospitals. Groups of five mentees were formed in which two mentors provided cognitive behavior therapy based on the manual. Changes in mentees' stress, burnout, and turnover intention at pre-intervention, post-intervention, and follow-up (3 months after the intervention) were objectively evaluated using an evaluation index. The intervention significantly reduced the following evaluation indicators: total strain, conflict with other nursing staff, nursing role conflict, qualitative workload, quantitative workload, conflict with patients, problem avoidance due to irrational beliefs, escape-avoidance, emotional exhaustion of burnout, desire to change hospitals or departments, and turnover intention. Implementation of cognitive behavior therapy by mentors effectively reduced mentees' stress, burnout, and turnover.

Training nurses in an international emergency medical team using a serious role-playing game: a retrospective comparative analysis

BackgroundAlthough game-based applications have been used in disaster medicine education, no serious computer games have been designed specifically for training these nurses in an IEMT setting. To address this need, we developed a serious computer game called the IEMTtraining game. In this game, players assume the roles of IEMT nurses, assess patient injuries in a virtual environment, and provide suitable treatment options.MethodsThe design of this study is a retrospective comparative analysis. The research was conducted with 209 nurses in a hospital. The data collection process of this study was conducted at the 2019-2020 academic year. A retrospective comparative analysis was conducted on the pre-, post-, and final test scores of nurses in the IEMT. Additionally, a survey questionnaire was distributed to trainees to gather insights into teaching methods that were subsequently analyzed.ResultsThere was a significant difference in the overall test scores between the two groups, with the game group demonstrating superior performance compared to the control group (odds ratio = 1.363, p value = 0.010). The survey results indicated that the game group exhibited higher learning motivation scores and lower cognitive load compared with the lecture group.ConclusionsThe IEMT training game developed by the instructor team is a promising and effective method for training nurses in disaster rescue within IEMTs. The game equips the trainees with the necessary skills and knowledge to respond effectively to emergencies. It is easily comprehended, enhances knowledge retention and motivation to learn, and reduces cognitive load.

Experiences of cardiac care nurses related to the management and delayed removal of trans-radial band of patients at a private tertiary care hospital, Islamabad.

To explore the experiences of cardiac care nurses in managing transradial band of patients in a tertiary care setting. The exploratory, descriptive, qualitative study was conducted at a private-sector tertiary care hospital in Islamabad, Pakistan, from March to September 2021, and comprised registered cardiac care nurses with >6 months of relevant experience. Data was collected through face-to-face interviews using a semi-structured interview guide. Data was analysed qualitatively using the Creswell and Creswell framework. Of the 10 nurses, 5(50%) were males and 5(50%) were females. In terms of age, 5(50%) were aged <25 years. Cardiac specialisation had been done by 2(20%) nurses, and none of the subjects had formal training related to transradial band. The main theme that emerged from the data was nurses' management of patients with transradial band, and the three categories were nurses' knowledge and practices about transradial band, reasons for delayed transradial band removal, and strategies to minimise complications. To minimise transradial band-related complications, in-service training of nurses and ensuring a safe nursepatient ratio are necessary.

Application, knowledge and training needs regarding comprehensive geriatric assessment among geriatric practitioners in healthcare institutions: a cross-sectional study

BackgroundThis study aimed to investigate the actual application, knowledge, and training needs of comprehensive geriatric assessment (CGA) among geriatric practitioners in China.MethodsA total of 225 geriatric practitioners attending the geriatric medicine or geriatric nursing training were recruited for this cross-sectional study. The questionnaire included demographics, healthcare institution characteristics, the actual application, knowledge, training needs, and barriers to CGA and geriatric syndromes (GS).ResultsPhysicians and nurses were 57.3% and 42.7%, respectively. 71.1% were female, with a median age was 35 years. Almost two-thirds (140/225) of geriatric practitioners reported exposure to CGA in their clinical practice. The top five CGA evaluation items currently used were malnutrition risk (49.8%), fall risk (49.8%), activity of daily living (48.0%), pain (44.4%), and cognitive function (42.7%). Median knowledge scores for the management procedures of GS ranged from 2 to 6. Physicians identified medical insurance payment issues (29.5%) and a lack of systematic specialist knowledge and technology (21.7%) as the two biggest barriers to practicing geriatrics. Nurses cited a lack of systematic specialist knowledge and technology (52.1%) as the primary barrier. In addition, physicians and nurses exhibited significant differences in their knowledge of CGA-specific evaluation items and management procedures for GS (all P < 0.05). However, there were no significant differences in their training needs, except for polypharmacy.ConclusionsThe rate of CGA application at the individual level, as well as the overall knowledge among geriatric practitioners, was not adequate. Geriatric education and continuous training should be tailored to address the specific roles of physicians and nurses, as well as the practical knowledge reserves, barriers, and training needs they face.

Impact of specialized training for emergency department nurses screening or undetected HIV infection: the "Urgències VIHgila" project experience.

To evaluate the impact of specialized training for nurses on selective screening for undetected HIV infection in the emergency department. The intervention group was comprised of 6 emergency departments that had been participating in a screening program (the "Urgències VIHgila" project) for at least 3 months. Nurses on all shifts attended training sessions that emphasized understanding the circumstances that should lead to suspicion of unidentified HIV infection and the need to order serology. Two studies were carried out: 1) a quasi-experimental pre-post study to compare the number of orders for HIV serology in each time period and measures of sensitivity, and 2) a case-control study to compare the changes made in the 6 hospitals where specialized training was provided (cases) vs 6 control hospitals in the HIV screening program where no training was given. A total of 280 HIV serologies were ordered for the 81015 patients (0.3%) attended during the period before training; 331 serologies were ordered for the 79620 patients in the period after training (0.4%). The relative increase in serologies was 20.3% (95% CI, 2.9% to 34.5%; P = .022). The relative increase in measures of sensitivity ranged between 19% and 39%, consistent with the main comparison. Serologies in the control group decreased between periods, from 0.9% to 0.8%, indicating a relative decrease of 15.7% (95% CI, -25.1% to -6.2%; P = .001). The absolute number of patients tested in the training group was 0.2% higher in the training hospitals (95% CI, 0.11% to 0.31%; P .001) than in the control hospitals. Training nurses to screen for undetected HIV infection in the emergency department increased the number of patients tested, according to the pre-post and case-control comparisons.

User satisfaction with information and communication technologies in nursing and midwifery schools in sub-Saharan Africa: A systematic review

Background and objective: Information and communication technologies are often used in universities in sub-Saharan Africa to train nurses and midwives. However, user satisfaction with information and communication technologies in nursing and midwifery schools in sub-Saharan Africa has not been well documented. The objective of this study is to synthesize user satisfaction with information and communication technologies in nursing and midwifery schools in sub-Saharan Africa.Methods: A systematic review was conducted. Three electronic databases (PubMed, CINAHL, and ERIC) were consulted. Two reviewers independently conducted the selection of eligible publications based on the inclusion and exclusion criteria. Data were extracted and quality assessed by four team members. Qualitative, quantitative, or mixed studies conducted in sub-Saharan African countries published from 2018 to 2021 were included.Results: The majority of students used smart mobile phones. Access to the internet connection was via their mobile phone or tablet. In terms of their ability to use mobile devices, the majority of students were good users. The rest were divided between experts in mobile use and limited users. The majority of teachers were open to the use of word processing, PowerPoint presentations, and blended learning. Other reasons for satisfaction include the use of information and communication technologies during clinical placements, online assessments, the creation of discussion forums, and live discussions with colleagues.Conclusions: Students are satisfied with the use of information and communication technologies. The administration must equip itself with the means to use them in teaching by motivating and supporting teachers. To do this, it must take into account the results of regular assessments to provide a better learning environment. Using information and communication technologies could become a quality criterion for a high-performance university.

Nursing roles in disaster zones: Experiences and lessons from Turkey's 2023 earthquakes.

Disasters affect human health and well-being globally. Nursing plays a vital role in disaster preparedness and response, ensuring efficient early care coordination and delivering effective field treatment. This study investigates the challenges an Israeli humanitarian delegation encountered during their response to major earthquakes in Turkey in 2023. It explicitly focuses on difficulties in preparation, operations, and collaboration with local teams. The study further analyzes the findings and extracts valuable lessons from the mission. Using a qualitative descriptive design, 22 out of 32 nurses involved in delegation participated in three focus group discussions within two months of returning to Israel. The discussions were recorded, transcribed verbatim, and analyzed thematically. The study followed the COREQ guidelines, ensuring comprehensive reporting and methodological rigor in qualitative research. The study's main findings spanned predeparture preparation, mission challenges in the disaster zone, and postmission lessons, each highlighted by subthemes and participant quotations. A strong sense of mission was evident among the participants, along with frustration at inefficient time management prior to deployment. Many participants noted additional challenges, related to the difficulty of working in multiple languages and across cultures, and the opportunities for resolution. Finally, participants called for better psychological support following the mission. Nurses in disaster zones offer valuable insights to enhance preparation, cross-cultural communication, and postmission implementation. Nurse managers and healthcare policymakers can utilize this study's findings to develop future nursing training programs in disaster-related skills. Additionally, it can help foster collaboration among international healthcare teams.

Nurses’ Perspectives on a Novel Stroke Nurse Training Program in Lusaka, Zambia (P1-15.001)

Nurses’ Perspectives on a Novel Stroke Nurse Training Program in Lusaka, Zambia (P1-15.001)

Strategies for nursing care of critically ill multicultural patients: A scoping review.

In society, people live in a social reality where multiculturalism is an increasingly relevant and prevalent topic in their contexts. Facing this, caring for multicultural patients in an emergency service or intensive care unit setting requires a high level of cultural competence due to the complexity, vulnerability of the patient, rapid changes in hemodynamic status, involvement of the family, their informational needs. To map the strategies for nursing care of critically ill multicultural patients. A Scoping Review was conducted following the Joanna Briggs Institute's recommendations, with the research question: What are the strategies for nursing care of critically ill multicultural patients? The study was guided by PRISMA. The research was conducted through the EBSCOHost platform, SciELO, Portugal's Open Access Scientific Repository, the Virtual Health Library and a search in grey literature. This was achieved by combining the descriptors DECS/MESH: cultural competence; critical care; emergency room; intensive care; and natural words: cultural care; nurs* interventions; nurs* strategies; within the time frame from 2012 to 2024. The study screening was performed by three independent reviewers through the reading of titles, abstracts and full texts, applying exclusion criteria. The study results were then subjected to content analysis, from which categories emerged. The selected articles highlight various strategies that contribute to the improvement of nursing care for critically ill multicultural patients, focusing on care practice and cultural diversity training for both nurses and nursing students. Nurses with cultural competence possess more knowledge and strategies to provide tailored care for multicultural critically ill patients, thereby enhancing the quality of care delivered and contributing to the humanization of healthcare. Nurses need to have knowledge of existing strategies for caring for multicultural critically ill patients. No direct patient or public contribution to the review.

The Continuing Training of Nurses and their Impact on their Organizational Commitment

Objective: The purpose of this research was to investigate the effect exerted by nurses' participation in lifelong nursing education programs on their levels of organizational commitment. Theoretical Framework: Discusses the importance of lifelong learning in the nursing profession, highlighting how continuous development of knowledge and skills is essential due to rapid advances in medicine and healthcare. It stresses that continuing education is a critical part of lifelong learning, necessary for the improvement of patient care and adaptation to socio-economic, technological and demographic changes. Method: This is primary quantitative research. The sample consists of 121 Greek nurses, employed in Attica. The response rate was 48%. The research instrument was a structured questionnaire sent via e-mails. SPSS version 23 was used for statistical analysis. In descriptive statistics, means and standard deviations were presented, and in inductive statistics, Pearson's correlation test and regression analysis were performed. Results and Discussion: The results showed a positive and statistically significant correlation between four of the five categories of nurses' participation motivations: "Professional Service", "Collegial Learning and Interaction", "Personal Benefits and Job Security" and "Personal Commitment and Reflection". Well-targeted programmes can strengthen organisational loyalty, suggesting that continuing education is fundamental to personal and professional development, as well as benefiting the quality of patient care and job satisfaction. Research Implications: The practical and theoretical implications of this research are discussed, providing insights into how the results can be applied or influence practices in the field of nursing and continuing education programmes. These implications could encompass the professional performance and post-graduate training and work attitudes of staff working in the public health sector. Originality/Value: This study contributes to the literature by exploring how nurses' continuing education impacts their organisational commitment in Greece. The relevance and value of this research are evidenced because it shows how continuing nursing education improves the quality of patient care and the overall functioning of health care organisations.

Nurses' perspectives on shared decision-making in the daily care of hospitalized patients with dementia: An exploratory qualitative study.

Gain insight into the process of shared decision-making (SDM) in daily hospital care for patients with dementia from nurses' perspectives. Explorative qualitative design. In-depth digital interviews were conducted with 14 registered nurses between June and November 2022. A phenomenological approach was applied using Colaizzi's seven-step method. Five themes were identified in the data: (1) SDM in daily care: How shared decision-making is applied; (2) Nurses' perceptions and competence: How nurses perceive and manage SDM; (3) Nurses' roles and advocacy: The evolving roles of nurses and their advocacy efforts, (4) Recognition of dementia and its impact: How nurses recognize and manage dementia; and (5) Interventions to support SDM: Strategies and interventions to facilitate SDM. This study highlights the complexity of SDM in patients with dementia. It demonstrates the importance of the involvement of relatives, omission of patient goals in discussions and perceived deficiencies of nurses. The early identification of dementia, evaluation of nuanced capacity and targeted communication are essential. Further research and enhanced training are required to improve care in this context. Potential areas for further research on SDM in nurses involving patients with dementia include investigating the effects of integrating goal discussions into SDM training for nurses, overcoming barriers to SDM competence, and challenging the idea that SDM is solely the responsibility of physicians. These findings highlight the need for policies that encourage interdisciplinary collaboration, address misconceptions and recommend training programmes that focus on applying SDM to the daily care of patients with dementia, thereby improving the overall quality of patient care. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used for reporting. No patient or public contribution.

School as a space for nursing: a review of health literacy

Objective: To understand the role of school nursing in the context of child and adolescent health literacy. Methods: An integrative review using the Web of Science, MEDLINE/Pubmed, Scopus, Cinahl, Virtual Health Library databases, and search terms related to child and adolescent health, health literacy, and school nursing. No time or language limits were considered. Results: 419 articles were identified and, after excluding duplicates and applying the eligibility criteria, seven articles made up the final sample, none of them developed in Brazil. Despite being a field of research that is still little studied, the results revealed the positive impact of nursing in the school context in promoting physical and mental health literacy, preventing preventable illnesses, and managing chronic non-communicable diseases. This evidence leads to reflections on the recognition of school nursing in Brazil. Conclusion: Nurses are references in the implementation of health literacy programs and in the construction of health literate organizations. In the Brazilian context, there is an urgent need to expand the training of nurses trained to work in schools.