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Background It is estimated by the year 2050, 80% of the global elderly population will be from the low-and middle income countries. Elderly care requires health workers with skills associated with an understanding of the biological, psychological, social and cultural theories related to aging. Nurses with better knowledge, skills and positive attitudes towards elderly care are highly needed and critically important for better healthcare and wellbeing of the elderly population. Therefore the objective of this study was to assess the level of knowledge and attitude of nursing students towards elderly care in Zanzibar Island. Methods A cross-sectional study was conducted in Zanzibar involving three out of five nursing training institutions. Participants were selected by systematic random sampling. Facts on Aging Quiz 2 and Kogan’s Attitudes Toward Old People scale were used to assess the level of knowledge and attitude towards elderly care among the students respectively. Simple and multivariable logistic regressions were applied to determine the predictors of knowledge and attitude among the participants. Results A total of 393 students participated in this study. Only 17% (69) of the participants had good level of knowledge and about 67.9% (267) had positive attitude towards elderly care. Living in an extended family and with an elderly person at home were both associated with good level of knowledge and positive attitude towards elderly care. Furthermore, living in a rural area (adjusted odds ratio = 2.23; 95% confidence interval: 1.22, 4.10) and studying at public institution (adjusted odds ratio = 2.59; 95% confidence interval: 1.41, 4.63) were associated with positive attitude towards elderly care. Conclusion This study has shown that the majority of nursing students in Zanzibar have positive attitude but poor level of knowledge towards elderly care. The current findings have demonstrated that past experience with an elderly person can help in influencing good knowledge and shaping positive attitudes towards elderly care. Low level of knowledge shown in the study suggests for further research on adequacy of nursing curriculum and/or its implementation.

There is a considerable amount of literature describing how nurses’ knowledge contributes to their attitudes and practices related to patient physical restraint. However, whether or not there have been any improvements in nurses’ knowledge levels, attitudes or practices regarding physical restraint during the past few years is unknown. A survey was conducted on nurses (n = 133) in one psychiatric hospital in Hong Kong (n = 98, response rate = 74%). The data were analyzed using independent t-tests, ANOVA, a Mann–Whitney U test, a Kruskal–Wallis test and Spearman’s rho. In general, nurses had good restraint-related knowledge with satisfactory attitudes and practices, although their knowledge levels, attitudes, and practices regarding restraint varied. Having a higher age, seniority, and education level contributed to a higher restraint-related knowledge level. Male nurses demonstrated more desirable practices (i.e., care of restrained patients), while nurses with a higher education level were more likely to avoid restraint. Nurses’ restraint-related knowledge positively correlated with restraint practices. Although nurses’ knowledge levels, attitudes, and practices regarding restraint were found to be satisfactory, more training efforts should focus on young nurses working in psychiatric settings with less work experience and lower education levels. As some nurses seem to favor the use of restraint with limited reflection, more studies are needed to verify nurses’ emotions and how their emotions influence the use of restrictive practices.

Background Evidence-based practice (EBP) is an important competency of undergraduate nursing students which should be cultivated before graduation by increasing future healthcare providers’ knowledge, skills and attitudes towards EBP. This study aimed to describe nursing students’ competencies (attitudes, knowledge, skills) in Evidence-based practice (EBP) and to determine factors predicting EBP competency. Methods A descriptive cross-sectional study was conducted at the Higher School of Health Sciences and Techniques of Sousse (Tunisia) among 365 nursing students. Data were collected using the validated Evidence Based Practice Competencies Questionnaire (EBP-COQ). Multiple linear regression was performed to determine factors predicting EBP competencies. Results The overall score of EBP-COQ questionnaire was 3.26 ± 0.53 out of 5. The attitude, skills and knowledge subscales received 4.04 ± 0.41; 3.05 ± 0.77 and 2.70 ± 0.74 as mean scores respectively. Multiple linear regression analysis (table 4) revealed that significant related factors were academic level (β = 0.271, p  = 0.001), English-language reading skills (β = 0.435, p  < 0.001), facing staff resistance in implementing a new evidence-based procedure (β = − 0.081, p  = 0.035) difficulties in obtaining full-text papers (β = − 0.127, p  < 0.001) and training in methodology (β = 0.232, p  < 0.001) and also in statistics (β = 0.205, p  < 0.001). Conclusions These results help to understand students’ attitudes, knowledge and skills in EBP and can be therefore a starting point to develop effective strategies for EBP curricula.

To explore the effectiveness of an immersive educational strategy based on the Community of Inquiry (CoI) framework in enhancing nurses’ knowledge retention and learning satisfaction in pressure injury prevention. Traditional digital learning alone may not ensure sustained knowledge or engagement in clinical training. The CoI framework provides an effective model for integrating cognitive, social and teaching presence to enhance learning outcomes. A single-blind, two-group quasi-experimental study with pre- and post-intervention assessments. Participants were registered nurses from a regional hospital in Taiwan, assigned to either the traditional group or the intervention group. Both groups received digital self-directed learning, while the intervention group additionally engaged in multimedia modules, LINE@ asynchronous discussions and an in-person workshop. Knowledge was assessed at three time points and learning satisfaction was measured post-intervention. Generalized Estimating Equations were used for analysis. Both groups showed significant knowledge improvement over time (p < .001). The intervention group exhibited greater immediate posttest gains than the traditional group (B = 1.500, p = .023), but the difference was not sustained at three months (p = .881). Learning satisfaction was significantly higher in the intervention group, particularly in comprehension and job relevance (p < .05). The CoI-based multimodal strategy effectively enhanced nurses’ short-term knowledge and satisfaction through cognitive, social and teaching presence. However, its long-term effects appear limited, indicating the need for continuous reinforcement and extended evaluation to sustain knowledge retention in clinical education. •Multimedia teaching strategy with LINE@ interaction improved nurses’ pressure injury knowledge.•The CoI framework enhanced cognitive, social, and teaching presence in clinical education.•LINE@ interactions aligned with nurses’ digital habits and enabled flexible, learning.•The intervention group achieved higher immediate knowledge gains than the control group.•Participants reported greater satisfaction improved job-related competencies.

Background Loneliness and depression in older people are increasing worldwide. Proficient nursing practice requires the continuous and long-term development of clinical knowledge. Lifelong learning is essential and enhances clinical nursing practice. Nursing includes various functional areas that illustrate registered nurses’ wide range of responsibilities to ensure healthcare quality. Registered nurses are committed to working comprehensively, observing patients and identifying symptoms of both physical and mental ill-being. The aim of this study is to explore how registered nurses perceive their clinical competence in observing signs of loneliness and depression in older people in home care, and which barriers in home care services prevent quality improvement. Methods Fifteen registered nurses from home care units in Norway were individually interviewed, and the interviews were analysed using qualitative content analysis. Results The analysis revealed three themes in accordance with the study aim: I) Uncertainty about knowledge of mental health, II) Lack of opportunities to meet the patients’ needs regarding mental ill-being, III) Feelings of guilt for not doing enough for patients. Conclusions Lack of education and training in mental health creates uncertainty and limits registered nurses’ ability to effectively address signs of loneliness and depression. Registered nurses often feel unprepared to handle psychological aspects of care. Organizational barriers hinder effective care. Additionally, the emotional toll on registered nurses, who experience guilt and moral distress due to their limited ability to provide sufficient care, highlights the impact of these systemic issues on patients. The study underscores the need for improved training, better collaboration, and stronger leadership to prioritize mental health and ensure that registered nurses have the necessary resources and support to meet the needs of older people with signs of mental ill-being in home care.

To evaluate: (a) the effectiveness of an infographic poster compared with an e-learning program on general practice nurses’ knowledge about chronic kidney disease risk factors and best practice screening procedures and (b) the effectiveness of an infographic poster compared with an e-learning program on general practice nurses’ learning time and learning efficiency. The screening and early detection of chronic kidney disease is essential in reducing its burden on the health system and those affected by it. General practice nurses are well-positioned to assist in its early detection. Parallel-group, single-blinded, pre-post interventional randomised control design. This study was reported in accordance with the Consolidated Standards of Reporting Trials (CONSORT). Participants were registered or enrolled nurses working in general practice settings across Australia. The intervention group (n = 173) received an infographic poster about chronic kidney disease risk factors and best practice screening procedures, whereas the control group (n = 170) received an interactive e-learning program. Data were collected using an 8-item pre-post knowledge evaluation instrument. Time spent learning were collected through a self-reported log and a login/logout method. The overall intervention effect demonstrated no statistical significance in knowledge scores from the baseline scores between the intervention and control group. The intervention group demonstrated higher learning efficiency in comparison to the control group. The study demonstrated an infographic poster is as effective as an e-learning program on improving knowledge scores. However, in comparison to an e-learning program, an infographic poster is a more efficient way of learning. Infographic posters can be an efficient educational modality to enhance healthcare professionals’ knowledge and could be used as public health campaigns in clinical settings to educate the community.

Heart failure (HF) nurses play an important role in heart failure management. This study aimed to assess the knowledge of HF nurses in Poland regarding HF management. 97 nurses from Poland provided their consent and completed an online questionnaire comprised of 20 questions. The study was conducted from January 2023 to May 2023. The questionnaire was divided into three parts: general information, practical issues, and the impact of the Polish online educational platform on clinical practice. The inclusion criteria were: a registered nursing license, age under 60, and participation in the Association of Heart Failure of Polish Cardiac Society's online learning platform course for HF nurses. The study group was divided into two subgroups: cardiovascular (CV) nurses (n = 37) and non-CV nurses (n = 60). Statistical analysis was performed using STATISTICA software, with p < 0.05 considered statistically significant. CV nurses showed a higher initial level of education and greater involvement in hospital settings and patient education in comparison to non-CV nurses. Knowledge levels regarding HF management were similar in both groups. Significant differences were found in the work settings and engagement in patient education between CV and non-CV nurses. The study highlights the importance of the HF nurse educational program in Poland, emphasizing the role of CV nurses and the impact of an online educational platform. Findings contribute to ongoing efforts to enhance HF management and improve the quality of care for patients with heart failure.

Background Warfarin therapy is commonly used to prevent thromboembolic events and cardiovascular disorders, but its effectiveness can be influenced by interactions with drugs and foods. Nurses play a crucial role in managing warfarin therapy and counseling patients on these interactions. This study aimed to assess the predictors of nurses’ knowledge regarding warfarin-nutrient and drug interactions and their competence in counseling patients on warfarin therapy. Methodology : A cross-sectional study design was used to evaluate nurses’ knowledge and counseling practices related to warfarin therapy across various healthcare institutions in Amman, Jordan. Participants included 176 registered nurses with at least one year of experience, recruited through convenience sampling from governmental, private, and educational hospitals. Data were collected through a self-administered questionnaire that assessed demographic characteristics, work-related factors, exposure to health education, and knowledge of warfarin-drug and food interactions, as well as counseling practices. Results The study found that most participants were female (58.6%) and held a bachelor’s degree (72.7%). Nurses demonstrated moderate knowledge of warfarin–drug interactions, with a mean score of 8.76 ± 2.26 out of 26. Knowledge was better for cardiac agents like atenolol (53.4%) and gastrointestinal agents (53.4%), but gaps were observed for anti-inflammatory and CNS drugs. The mean score for knowledge of warfarin–food interactions (out of 18) was 12.27 ± 3.84, with strong knowledge of non-interfering foods, but gaps in understanding foods like leafy greens, high in vitamin K. Nurses’ knowledge of counseling practices for warfarin therapy was moderate, with a mean score of 8.07 ± 2.31 out of 15. While knowledgeable about diet and adherence, gaps existed in counseling patients on missed doses and dietary restrictions. Regression analysis identified key predictors of knowledge, including education, work experience, direct patient care, self-confidence, exposure to health education, and anticoagulant training, explaining 35% of the variance in knowledge scores. A postgraduate degree, work experience, and confidence in warfarin care positively impacted knowledge, while demographic factors like age, gender, and job position had no significant effect. The findings highlight the need for educational programs and confidence-building initiatives. Conclusion The study highlights significant gaps in nurses’ knowledge of warfarin interactions, particularly with certain drugs and foods, and underscores the need for targeted education and training. However, the study is limited by its reliance on self-reported data and a convenience sampling approach, which may impact generalizability. Strengthening nurses’ understanding of warfarin management, especially regarding high-risk interactions, is essential for improving patient safety and the efficacy of anticoagulant therapy. Future initiatives should focus on structured educational programs, introducing interactive e-learning modules, regular workshops, and case-based training, as well as promoting multidisciplinary teamwork to enhance nurses’ competency in warfarin counseling and patient care.

Background Managing hemodynamic instability in critically ill patients due to cardiovascular disease or, in particular, coronary artery disease requires an integrated and responsive approach. The complexity lies in simultaneously addressing the underlying cardiovascular pathology and managing its systemic effects. The complexity described above involves a careful balance of interventions, including fluid and electrolyte management, pharmacological support, and, in some cases, mechanical circulatory support. The dynamic nature of hemodynamic instability necessitates constant vigilance and rapid adaptation of treatment strategies to align with the evolving clinical picture. So, this study aims to investigate the knowledge, attitude, and practice of Palestinian critical care nurses about hemodynamic instability in patients with cardiovascular diseases. Method A cross-sectional design was conducted on 300 nurses in 30 hospitals in the West Bank and East Jerusalem of Palestine. Data were collected using a self-administered questionnaire composed of four sections covering the socio-demographics, knowledge, attitudes, and practices of the sample. Quantitative statistical analysis was done using Statistical Package for Social Sciences (SPSS) software. Results The nurses demonstrated an almost low overall level of knowledge about hemodynamic instability, with a mean score of 2.7 on a 7-points scale. Additionally, nurses generally expressed a high positive attitude toward their practice, with a mean score of 3.8 on a 5-point scale. Although; Palestinian nurses showed a low level of knowledge about hemodynamic instability but expressed positive attitudes toward their practice. The practice level was also moderate with a mean score of 2.3 on a 5-point scale. Significant differences were found with a higher attitude of male nurses and higher knowledge with bachelor or higher educational levels. Other variables showed non-significant differences. Conclusions Several challenges were identified, including lack of training and resources, within this study context. Educational interventions and improved access to resources could improve nurses’ knowledge and practice in managing hemodynamic instability.

Delirium, a multifactorial condition with an acute onset and diverse clinical manifestations, poses a significant challenge in the care of hospitalized individuals aged 65 years and older. This study aimed to evaluate the level of knowledge among nursing healthcare personnel regarding the diagnosis, recognition of complications, and treatment of delirium. A paper questionnaire consisting of 18 multiple-choice questions was distributed to nurses in twelve operational units located in four facilities within a local hospital in a specific geographical region under the jurisdiction of the Romagna Local Health Authority in Italy. Out of 194 respondents, the overall acceptance rate was 64.2%. The findings revealed an insufficient understanding of delirium among the nursing staff, with more than 40% of respondents answering incorrectly to five out of nine questions related to delirium knowledge, diagnosis, prevention, and treatment. Notably, gender emerged as a significant determinant, with female participants exhibiting a substantial odds ratio (OR) of 3.50 (p = 0.011 and CI95% = 1.34–9.16) compared to their male counterparts, indicating a higher likelihood of receiving delirium training among females. Furthermore, prolonged tenure within the same work context was associated with a reduced likelihood of receiving delirium training compared to those with less than two years of experience (OR = 0.21, p = 0.034, and CI95% = 0.05–0.89 for 6–10 years of tenure; OR = 0.22, p = 0.038, and CI95% = 0.05–0.92 for over 10 years of tenure). This study underscores the urgent need for enhanced delirium education and improved strategies among nurses to effectively manage patients with delirium. The results advocate regular educational sessions utilizing diverse formats to comprehensively address knowledge gaps among nursing staff. This study was not registered.