Background Evidence-based practice (EBP) integrates research evidence, clinical expertise, and patient values to optimize healthcare outcomes. Despite widespread recognition, sustainable EBP implementation in nursing remains inconsistent globally. Aim This integrative review synthesized contemporary literature (2004–2026) on EBP implementation in nursing, examining multi-level barriers, enablers, and innovations to bridge the evidence–practice gap. Methods Following Whittemore and Knafl’s five-stage methodology, a systematic search of PubMed, CINAHL, Scopus, PsycINFO, and Cochrane Library was conducted. The search was conducted in November 2025 and included articles published or available online ahead of print by that date; several articles subsequently assigned a 2026 publication year were therefore eligible based on their online availability. Studies addressing EBP implementation, barriers, facilitators, education, technology, or innovation in nursing were included. The Mixed Methods Appraisal Tool (MMAT) was applied to 21 empirical primary studies; the remaining 26 systematic/scoping reviews and methodological papers were appraised using review-appraisal criteria. Thematic synthesis for qualitative data and narrative synthesis for quantitative findings were employed, with independent coding by two reviewers. Results Forty-seven studies were synthesized. The most pervasive barriers were time constraints and unsupportive organizational cultures. Key enablers included transformational leadership, integrated EBP curricula, clinical decision support systems, implementation science frameworks, stakeholder partnerships, and cultural adaptation. Conclusion Sustainable EBP implementation requires coordinated, multi-level strategies addressing individual, organizational, and technological factors. Findings provide a roadmap for data-driven, patient-centered nursing practice. Future research should prioritize AI-driven decision support, implementation strategies in resource-limited settings, and stakeholder engagement models.
Background Ventilator-associated pneumonia (VAP) remains an important healthcare-associated infection among mechanically ventilated patients and requires consistent application of preventive measures. Intensive care unit (ICU) nurses play a central role in implementing VAP prevention bundles; however, adherence may differ across hospital sectors. Aim This study aimed to compare ICU nurses’ knowledge and observed adherence to VAP prevention bundles in government and private hospitals in the southern West Bank, Palestine. Methods A comparative cross-sectional study was conducted between January and March 2025 among 160 ICU nurses recruited through convenience sampling from nine ICUs. Data were collected using a validated structured knowledge questionnaire and an observational checklist assessing adherence to VAP prevention practices. Knowledge scores ranged from 0 to 30. Descriptive statistics, independent-samples t tests, Fisher’s exact tests, and Pearson’s correlation analysis were used, with significance set at p < .05. Results Knowledge scores did not differ significantly between nurses in government hospitals ( M = 23.70, SD = 3.20) and private hospitals ( M = 23.30, SD = 3.50), p = .60. Conversely, adherence scores were significantly higher among private hospital nurses ( M = 47.00, SD = 6.10) than government hospital nurses ( M = 40.30, SD = 5.80), p < .001, with a large effect size (Cohen’s d = 1.12). No statistically significant correlations were identified between knowledge and adherence scores, and demographic variables were not significantly associated with outcomes. Conclusion ICU nurses demonstrated comparable knowledge of VAP prevention across hospital sectors, whereas observed adherence was higher in private hospitals. Because staffing, workload, resource availability, infection control governance, and organizational structure were not assessed, this difference cannot be interpreted causally. Future studies should evaluate these factors to inform appropriate quality-improvement strategies for Palestinian ICUs.
Background Emergency nurses operate in unpredictable, high-pressure environments where they are routinely exposed to emotional, psychological, and physical stressors. Despite their critical role in frontline healthcare, limited research exists on how they psychologically adapt and maintain resilience, especially in resource-limited settings. Aim This study aimed to explore emergency nurses’ experiences of occupational stress and the coping and resilience processes they used in resource-limited tertiary hospitals. Methods A qualitative descriptive design within an interpretivist paradigm was guided by Lazarus and Folkman’s Stress and Coping Theory. Twenty-eight emergency nurses from three government tertiary hospitals were recruited through maximum-variation purposive sampling. Bangla interview transcripts were analyzed using team-based codebook thematic analysis organized through Braun and Clarke’s six phases. Trustworthiness was supported through participant reflection, reflexive journaling, investigator triangulation, comparison of transcripts with field notes, and an audit trail. Results Five themes described occupational demands, situated coping responses, relational resources, personal and experiential resources, and recovery outside work. Nurses moved among problem-focused, emotion-focused, and distancing responses according to perceived control and available resources. Peer and supervisor support, professional identity, spirituality for some participants, accumulated experience, family connection, everyday activities, and rest were described as resources that shaped coping and perceived resilience. Conclusion Participants described perceived resilience as a dynamic, context-dependent process shaped by appraisal, coping resources, recovery, and organizational conditions. Their accounts suggest potential value in piloting supportive supervision, voluntary peer support, protected recovery opportunities, reliable work resources, and confidential psychological support. These strategies require local evaluation; workforce retention and patient outcomes were not assessed in this study.
Introduction Depression is a common comorbidity among individuals with visual impairment, including those with myopia. Functional limitations, reduced quality of life, and psychosocial challenges associated with vision loss may increase the risk of depressive symptoms. Objectives To assess the prevalence of depressive symptoms and associated factors among adult myopic patients attending a tertiary eye care center in northwestern Ethiopia. Methods A cross-sectional study was conducted among 418 adult myopic patients from June 10 to September 10, 2024. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Data on demographic and clinical factors were collected using systematic random sampling. Binary logistic regression analysis was performed, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated. Statistical significance was set at p < .05. Results The prevalence of depressive symptoms was 31.6% (95% CI: 27.1%–36.1%). Older age (AOR = 1.85, 95% CI = 1.32-2.69), lack of formal education (AOR = 2.86, 95% CI = 1.46-3.60), severe visual impairment (AOR = 3.08, 95% CI = 1.66-4.77), high daily screen time (AOR = 2.15, 95% CI = 1.58-2.26), and high myopia (AOR = 3.09, 95% CI = 1.65-5.83) were significantly associated factors. Conclusion Relatively higher magnitudes of depressive symptoms were observed among adult myopic patients. Factors such as high myopia, severe visual impairment, advanced age, and no formal education were significantly associated with depressive symptoms. Routine screening and early psychological support should be incorporated into eye care services, with special attention to high-risk groups such as elderly, less-educated, and severely visually impaired patients. However, the clinic-based sample of newly diagnosed patients with no previous history of spectacle use may limit the generalizability of these findings to the broader myopic population, particularly those with established myopia and long-term experience with refractive correction.
Background Nurses’ readiness to adopt Electronic Health Records (EHRs) is important for successful digital health transformation. Cybersecurity perception and work motivation may be associated with EHR readiness; however, the interrelationships among these factors remain insufficiently understood. Aim To examine the associations among cybersecurity perception, work motivation, and nurses’ readiness to adopt EHRs and to assess the hypothesized indirect association between cybersecurity perception and EHR readiness through work motivation. Methods A descriptive, cross-sectional study was conducted in 2024 among 330 nurses from three tertiary hospitals in Egypt. Data were collected using validated self-administered questionnaires assessing cybersecurity perception, work motivation, and EHR readiness. An observed-variable path analysis within the Structural Equation Modeling (SEM) framework was used to examine the hypothesized direct and indirect associations among the variables. Results Cybersecurity perception was positively associated with work motivation (B = 0.205, p < 0.001) and EHR readiness (B = 0.225, p < 0.001). Work motivation was positively associated with EHR readiness (B = 0.150, p = 0.004). A significant indirect association between cybersecurity perception and EHR readiness through work motivation was observed (B = 0.031, 95% bias-corrected bootstrap CI: 0.022–0.180, p < 0.001), consistent with the hypothesized mediation model. The total association between cybersecurity perception and EHR readiness was B = 0.256 (p < 0.001). Conclusions Cybersecurity perception and work motivation were positively associated with nurses’ readiness to adopt EHRs. The observed indirect association through work motivation was consistent with the hypothesized mediation model; however, given the cross-sectional design, the findings do not establish temporal ordering or causal mediation. These findings highlight cybersecurity perception and work motivation as relevant factors to consider in strategies aimed at supporting nurses’ readiness for EHR adoption.
