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Evaluate change in ventilator associated pneumonia (VAP) and nurse's attitudes, beliefs post implementation of an evidence based practice (EBP) oral hygiene protocol. Descriptive pre and post test design in two critical care units in a Level One Trauma Community Hospital. Oral hygiene protocol data was reanalysed to examine effects in medical surgical and trauma subgroups. Oral care practices, attitudes and beliefs among nurses, and VAP rates according to Centers for Disease Control and Prevention guidelines. Trauma rates increased from 6.4% to 10.0% (p=0.346), and medical/surgical rates decreased from 3.3% to 1.0% (p=0.042). Results revealed changes in nurses’ beliefs regarding pre-admission colonisation (p=0.027) and having adequate training. Nurses’ perception of facility support improved, by having suitable equipment and readily available supplies. Foam swabs with moisture agents at 4hours or less was 88.6% and toothbrush use at 12hours or less was 71%, with significant changes in frequency of oral care post intervention. Trauma patients present with unique characteristics which compromise oral care. Understanding risk and prognostic factors, mechanisms of transmission and systemic inflammatory response are important when implementing EBP protocols. Nurses’ attitudes, beliefs are important, and staff adherence considered when initiating EBP changes.

Hospice care is a multidisciplinary approach that focused on patients' quality of life, and nurses allocate more of their time with patients and patients' families than those nurses working in other disciplines. Nurses' knowledge of and attitudes toward hospice care can affect the quality of hospice care. At present, China's hospice care institutions are suffering from an obvious shortage of nursing staff. Since clinical nurses are the main force behind the future provision of hospice care, their knowledge of, attitudes and willingness to practice can greatly promoted the growth of hospice care, however, available data on clinical nurses' willingness to practice hospice care are limited. A cross-sectional descriptive study design was employed to collect data from 1833 nurses working in tertiary or secondary general hospitals in Guangxi, China. We examined nurses' demographic characteristics and scores on the Chinese version of the hospice care knowledge scale, the Chinese version of the Bradley Attitude Assessment Questionnaire, and a brief quiz concerning their willingness to practice hospice care in the future. Descriptive, single factor, multiple regression analyses and logistic regression analyses were used for data analysis. Nurses displayed moderate mean scores for both knowledge of and attitudes, and only 505 (27.5%) nurses expressed their willingness to practice hospice care, 1329 (72.5%) of nurses sampled expressed their unwillingness or uncertainty. Multivariate regression analyses showed that education, professional qualification, monthly income, whether they had been trained in hospice care, and willingness to practice hospice care were the main influencing factors of knowledge; education, whether they lived with someone aged >60 years, and whether they had been trained in hospice care were main factors influencing attitudes. Additionally, logistic regression analyses showed that hospice care knowledge, whether they had been trained in hospice care, and whether they had clinical experience affected the nurses' willingness to practice hospice care. This study highlighted a knowledge gap and moderate attitudes toward hospice care among nurses, and most nurses did not prefer to practice hospice care. Having been trained in hospice care was the main common factor of nurses' knowledge of, attitudes toward, and willingness to practice hospice care in the future, indicating the necessity to provide nurses with more targeted hospice care training.

The aim of this study was to describe, evaluate and synthesise the literature on registered nurses’ knowledge, attitudes and beliefs towards end-of-life care in adult non-specialist palliative care settings. Little is known about the knowledge, attitudes and beliefs of Registered Nurses working in non-specialist palliative care settings about end-of-life care. A mixed-methods systematic review and narrative synthesis was conducted (PROSPERO Registration No: CRD4202148114). Five databases (Medline, CINAHL, PubMed, PsycINFO and Web of Science) were searched from inception to August 2020. Study quality was assessed using the Mixed Methods Appraisal Tool. Nineteen studies met the inclusion criteria. Registered nurses in non-specialist palliative care settings demonstrated good knowledge of pain symptoms and management and positive attitudes towards caring for dying patients and their families. Knowledge deficits were identified in the psychosocial and spiritual aspects of end-of-life care and registered nurses reported negative attitudes towards communication about death. Only five of the included studies explored registered nurses’ beliefs towards end-of-life care. There is a need to enhance palliative care education in clinical practice settings and in undergraduate programs to improve registered nurses’ knowledge, attitudes and beliefs about end-of-life care. Future studies that use reliable and validated methods to measure registered nurses’ beliefs about end-of-life care should be conducted. RNs in non-specialist palliative care settings want more education on pain management & greater knowledge on communicating about death/dying.

Background Continuing professional development (CPD) is central to nurses’ lifelong learning and constitutes a vital aspect for keeping nurses’ knowledge and skills up-to-date. While we know about the need for nurses’ continuing professional development, less is known about how nurses experience and perceive continuing professional development. A metasynthesis of how nurses experience and view continuing professional development may provide a basis for planning future continuing professional development interventions more effectively and take advantage of examples from different contexts. The aim of this paper is to conduct such a metasynthesis, investigating the qualitative research on nurses’ experiences of continuing professional development. Methods A metasynthesis of the qualitative literature was conducted. A total of 25 articles fulfilled the inclusion criteria and were reviewed. Results We determined five overarching themes, Organisational culture shapes the conditions, Supportive environment as a prerequisite, Attitudes and motivation reflect nurse’s professional values, Nurses’ perceptions of barriers and Perceived impact on practice as a core value. This metasynthesis highlights that nurses value continuing professional development and believe that it is fundamental to professionalism and lifelong learning. Moreover CPD is identified as important in improving patient care standards. Conclusions Based on the metasynthesis, we argue that access to continuing professional development could be made more attainable, realistic and relevant. Expediently, organizations should adequately fund and make continuing professional development accessible. In turn, nurses should continue to actively engage in continuing professional development to maintain high standards of nursing care through competent practice. This paper highlights the perceived benefits and challenges of continuing professional development that nurses face and offers advice and understanding in relation to continuing professional development. We believe that this metasynthesis contributes with insights and suggestions that would be valuable for nurses and policy makers and others who are involved in nurse education and continuing professional development.

Background Newly graduated registered nurses leaving the nursing profession in the early stages of their career have enormous financial and time implications for nursing organizations and affect the quality of nursing care. Objective To identify the factors influencing newly graduated registered nurses’ intention to leave the nursing profession over the past 10 years. Methods The framework developed by Whittemore and Knafl was used to conduct this integrative review. An electronic search was conducted for English articles to identify research studies published between 2011-2022 using the following databases of PubMed, MEDLINE, CINAHL, PsycINFO, and Scopus. Eligible publications were critically reviewed and scored using the Critical Appraisal Skills Program Checklist and the Center for Evidence-Based Management appraisal. Results Twenty-one studies were analyzed. The main factors affecting newly graduated registered nurses’ intention to leave the nursing profession included demographic factors (age, educational level, year of experience, professional title, employment status, health status, shift, hospital location and size), supervisor and peer support, challenges in the workplace, cognitive and affective response to work, work environment (collegial nurse-physician relations, insufficient staffing level, person-work environment fit), gender stereotypes, autonomous motivation, role models, and resilience. Conclusions The factors affecting newly graduated registered nurses’ intention to leave the nursing profession are multifaceted and should receive continuous attention from nurse managers. The findings provide more comprehensive for nurse administrators to develop intervention strategies to mitigate newly graduated registered nurses’ turnover intention.

In healthcare facilities, patient deaths are a common occurrence, exposing nurses to diverse behavioral and emotional reactions, particularly within the context of resource constraints in Kenyan healthcare settings. This study aimed to investigate the experiences of nurses at AIC Kijabe Hospital in Kenya regarding patient death and their coping strategies. The focus group discussions sought to understand factors influencing nurses’ reactions to death, assessing the adequacy of their basic training in preparing them for coping, exploring the determinants of their coping strategy choices, and gathering recommendations for enhancing coping mechanisms. Employing qualitative research, six focus group discussions were conducted with 50 nurses from various hospital departments, including the emergency department, medical and surgical wards, intensive care unit, and maternity ward. After data collection, the information was transcribed verbatim and analyzed using a thematic analysis approach with inductive coding. Two researchers independently coded the data. A code was an identifying term for a specific part with emphasis on the aspect being investigated. Subsequently, the research team met to compare the codes and reached a consensus on the best interpretation of the data codes. The coding was then categorized into themes and Subthemes. The study findings revealed four overarching themes: individual process, institutional process, work team relationships, and educational gaps. In the individual process, nurses disclosed factors influencing their reactions to and feelings about death, encompassing Stress injuries, views of life (pessimism or optimism), cultural background, religious beliefs, and self-drive/self-management. Nurses expressed immediate emotional responses to the word “death” and conveyed the emotional toll of losing patients. The institutional process delved into how the hospital assisted nurses in coping with patient deaths, revealing a lack of support or guidance in selecting coping mechanisms. Nurses advocated for psychological support, support groups, and counseling sessions. Work relationships and educational gaps were also featured, with nurses emphasizing the deficiency in training on the emotional and psychological aspects of coping with death. They advocated for enhancements in educational preparation to better equip nurses for the emotional challenges intrinsic to their profession.

One of the primary challenges within the health system is improving nurses' motivation and attitude toward participation in the continuous education program. This study was conducted aim to investigate the effect of gamification on medication knowledge, performance and satisfaction of nurses in continued medical education (CME). The study was conducted as a quasi-experimental design from November 1, 2022, to February 1, 2024. Participants were 128 nurses with a minimum of 6 months of work experience who were randomly assigned to two groups, intervention and control groups via a colored card. Baseline assessments of medication knowledge and drug administration practices were conducted one week prior to the intervention. Education in both groups consisted of five 2-hour sessions. In the control group, education was delivered using the lecture method, while in the intervention group, the competitive software (Kahoot!) was used. One week after the completion of the training sessions, participants' knowledge, drug administration skills, and satisfaction were evaluated. The participants' average (standard deviation) age was 30.34 (5.34), with 49 male (38.35%) and 79 female (61.7%). Wilcoxon signed-rank test results demonstrated statistically significant difference in the knowledge and performance within both groups (p < 0.001). Mann-U-Whitney test findings revealed a significant difference between the two groups of participants in performance and satisfaction with the educational approach education (p < 0.001). The gamification method enhanced nurses' satisfaction and medication performance. Using Kahoot as a game-based competitive application has been shown to enhance nurses' knowledge of pharmacology as well as increase participants' satisfaction with educational programs. Therefore, it is recommended that nursing educators and administrators integrate gamified approaches and strategies-such as Kahoot!-to enrich learning experiences and motivate participation in ongoing professional development.

Background Artificial intelligence (AI) technology has recently seen rapid advancement, with an expanding role and scope in nursing education and healthcare. This study identifies the influence of AI ethics awareness, attitude toward AI, anxiety, and self-efficacy on nursing students’ behavioral intentions to use AI-based healthcare technology. Methods The participants included 189 nursing students in Gyeonggi-do, with data collected from November to December 2021 using self-reported questionnaires. We analyzed the data using the SPSS/WIN 26.0 program, including a t-test, Pearson’s correlation coefficient, and hierarchical multiple linear regression. Results The results revealed that AI ethical awareness (t = − 4.32, p  < .001), positive attitude toward AI (t = − 2.60, p  = .010), and self-efficacy (t = − 2.65, p  = .009) scores of the third and fourth-year nursing students were higher, while their anxiety scores were lower (t = 2.30, p  = .022) compared to the scores of the first and second-year nursing students. The factors influencing behavioral intention included a positive attitude toward AI (β = 0.58) and self-efficacy (β = 0.22). The adjusted R 2 was 0.42. Conclusion It is necessary to inculcate a positive attitude toward AI and self-efficacy by providing educational programs on AI-based technology in healthcare settings.

Innovative behavior is essential in nurses, driving continuous improvement and operational efficiency, significantly enhancing patient outcomes and overall healthcare quality. This study aims to evaluate the psychometric properties of a specific, theory-driven inventory for measuring nurses' innovative behavior in Iran. A methodological study was conducted from November 2022 to April 2024. The conceptualization phase involved a qualitative study and a comprehensive literature review to define the concept of nurses' innovative behavior and identify its key dimensions. The subsequent psychometric evaluation assessed face validity, content validity, construct validity, and structural validity (using exploratory and confirmatory factor analyses) on a sample of 572 clinical nurses. Reliability was evaluated through internal consistency and the test-retest methods. Additionally, responsiveness and interpretability were examined according to the COSMIN checklist. The construct validity of a five-factor structure (nurses' competencies, idea validation, clinical idea implementation, promoting innovation, and generating care ideas), identified during the conceptualization phase, was confirmed. Confirmatory factor analysis yielded a X2/df ratio of 1.88 for the NIBI five-factor structure. The goodness of fit indices indicated suitable values (CFI = 0.916, AGFI = 0.817, IFI = 0.917, PCFI = 0.709, and RMSEA = 0.057), with all factor loadings greater than 0.5 and statistically significant. Both convergent and divergent validities were demonstrated. The Cronbach's alpha and omega coefficients ranged from 0.74 to 0.88 and 0.75 to 0.88, respectively. Additionally, the ICC for the entire inventory was 0.975 (CI 0.95-0.98, P < 0.001). The findings revealed that the Nurses' Innovative Behavior Inventory (NIBI) is both valid and reliable, making it a suitable tool for assessing and evaluating innovative behavior in nurses.

Background Artificial intelligence (AI) is becoming increasingly important in healthcare, with a significant impact on nursing practice. As future healthcare practitioners, nursing students must be prepared to incorporate AI technologies into their job. This study aimed to explore the associated factors with nursing students’ intention to use AI. Methods Descriptive cross-sectional multi-centre design was used. A convenience sample of 1713 university nursing students from Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Oman, Palestine, Saudi Arabia and the United Arab Emirates completed a self-reported online instrument divided into five sections covering: (1) demographic sheet, (2) knowledge, (3) attitude, (4) perception and (5) intention questionnaire. Results Most nursing students in Arab countries have moderate levels of knowledge, attitude, perception and intention towards the use of AI. There was a significant positive association between knowledge, attitude, perception and intention towards the use of AI. A multivariate regression analysis revealed that understanding of AI technologies, self-perception as tech-savvy, age, clinical performance in previous semesters and knowledge of AI were significant and positively correlated with intention. Conclusion The findings highlight the importance of targeted educational interventions and customised strategies to support AI integration within nursing education settings across Arab countries, equipping future nurses with the necessary skills and knowledge to use AI effectively in their practice.