Introduction Canadians, particularly those in Newfoundland and Labrador (NL) and Nova Scotia (NS), face ongoing challenges in accessing primary care. To address this concern, many jurisdictions have adopted team-based primary care that enables nurses, physicians, and other providers to collaborate in delivering care. Virtual care has been widely integrated to promote efficiency and quality across team-based primary care. Nurses in primary care teams (i.e., nurse practitioners, registered nurses, licensed practical nurses) deliver care virtually; however, details of their role enactment remain unclear. Objective To explore virtual nursing practice within team-based primary care settings in two Canadian provinces, namely NL and NS. Methods This study was part of a larger multiple case study that was carried out in accordance with COREQ guidelines. The researchers explored the phenomenon of virtual care delivery by nurses within urban and rural primary care teams in NL and NS, including perspectives from nurses, other team members, administrators, policymakers, and nurse regulators. They used two data sources, including qualitative interviews and documents, and performed qualitative content analysis. Results Nurses adapted their roles using virtual care approaches across urban and rural primary care teams in NL and NS. Roles were organized into four categories: triage and assessment, care coordination, health promotion and prevention, and follow-up. Sub-categories comprised unique activities illustrating each role. Nurses assessed patients’ needs/concerns; arranged patient care with the interdisciplinary team; provided education/support to promote health and prevent disease; and followed up with patients regarding treatment plans and laboratory/diagnostic tests. Most roles were carried out via telephone, though other modalities were used. Potential activities for nurses to expand their use of virtual care within primary care teams were also identified. Conclusion There was high variability in the enactment of virtual care by primary care nurses. Virtual care role enactment varies by activity, province, and community type.
Background Despite positive attitudes toward organ donation in Saudi Arabia, the donation rate remains insufficient to meet the growing demand. This study explored Saudi citizens’ perceptions of posthumous organ donation and examined the motivations and barriers affecting donor registration. Methods This study included 16 participants from Riyadh and the Eastern Region of Saudi Arabia. Participant perceptions were explored using a hybrid descriptive qualitative approach. Data from interviews and a focus group were analyzed using NVivo. Results Modeling behavior, altruism, and ease of registration were identified as key facilitators of organ donation. Conclusion The findings indicate that altruistic values and Islamic teachings can influence perceptions of organ donation. Integrating these values into targeted awareness campaigns may help address misconceptions, improve knowledge, and increase donor registration rates.
Introduction Maternal and child healthcare utilization is critical to reducing adverse health outcomes, yet the use of the term utilization in the literature and for measurement fails to represent contemporary health priorities. For instance, existing research limits maternal and child healthcare utilization to quantitative metrics such as the number of clinic visits, without particular attention to initiatives such as Sustainable Development Goal three (SDG 3) and the World Health Organization’s (WHO) maternal health quality standards. Objective The researchers aimed to clarify the definition, defining attributes, antecedents, and consequences for maternal and child healthcare utilization, and to identify empirical referents that support its operationalization in research, policy, and practice. Concept Description The Walker and Avant’s eight-step method was used to guide this concept description and analysis. A comprehensive literature search across PubMed, Cumulative Index for Nursing and Allied Health Literature, Web of Science, and PsycINFO via EBSCOhost identified 25 published records that informed the definition of the concept. Discussion Three core behavioral attributes, including engagement, continuity, and adequacy/timeliness, characterize observable patterns of maternal and child healthcare utilization. Two normative attributes, patient-centeredness and quality of care, distinguish meaningful utilization from nominal contact. Six antecedents emerged: system availability and responsiveness, equitable access, socioeconomic status, cultural beliefs, policy interventions, and individual experience. Consequences included improved maternal and neonatal outcomes, enhanced equity, reduced costs, and strengthened health systems. Existing empirical referents capture important dimensions but do not fully reflect evolving expectations for comprehensive maternal and child health utilization. Conclusion This analysis positions maternal and child healthcare utilization as both a behavioral process and a reflection of system capability. This refined conceptualization is consistent with evolving global health priorities, including SDG 3 and WHO maternal health quality standards, strengthens theoretical coherence, enhances measurement, and supports the development of patient-centered, and quality maternal and child health care interventions.
Background Colostomy, a surgically necessary procedure, requires rigorous self-care to prevent complications and improve patients’ quality of life. In Ethiopia, the rising demand for colostomies is met with a lack of localized data on patient self-care knowledge, leading to insufficient support and increased stoma-related complications and healthcare burdens. Objectives This study aimed to assess self-care knowledge and its associated factors among adult patients with colostomy in Northwest Amhara Comprehensive Specialized Hospitals, Ethiopia October-November 2024. Methods A hospital-based cross-sectional study involving 423 adult patients (aged ≥18) who were consecutively recruited from five hospitals (October 15– November 10, 2024) was conducted. Data were collected via structured interviews. Multivariable binary logistic regression was employed to identify factors associated with knowledge. Because participants were recruited from five hospitals, hospital site was considered as a potential clustering variable; its effect was examined in sensitivity analyses. Results Only 39.24% (95% CI: 34.57–43.92) of the participants (n=423, 68.3% male) demonstrated good colostomy self-care knowledge. Factors significantly associated with better knowledge included colostomy education (AOR = 8.72; 95% CI: 4.58–16.60), higher educational status (Elementary AOR = 3.48; Secondary AOR = 2.58; College and above AOR = 2.04), private employment (AOR = 3.45), and medium social support (AOR = 2.48). Government employment was associated with lower odds of good knowledge (AOR = 0.38). In a sensitivity analysis using stricter knowledge cut-off (≥6 of 9 items correct), only secondary education, colostomy education, and medium social support remained statistically significant, indicating that the findings for occupation and the remaining educational categories were not stable across alternative cut-offs. Conclusion Despite 75.4% of patients receiving preoperative teaching and 60.76% receiving colostomy-specific education, the prevalence of good self-care knowledge is suboptimal. Educational status, colostomy-specific education, and social support are significantly associated with self-care knowledge; however, only secondary education, colostomy education, and medium social support remain robust across alternative cut-offs, whereas the associations of occupation and other educational categories depended on the chosen threshold. These findings necessitate targeted, culturally sensitive educational programs to bridge knowledge gaps and improve patient outcomes in this resource-limited setting.
Background As AI becomes increasingly embedded in healthcare systems, nursing governance faces new challenges involving ethical accountability, professional autonomy, data stewardship, and institutional oversight. Existing reviews highlight fragmented understanding of how these changes impact the nursing profession. Aim This umbrella review aimed to synthesize ethical and policy dimensions related to the integration of artificial intelligence (AI) within nursing governance and regulatory frameworks. Methods Following JBI guidance and PRISMA 2020, five databases were searched for reviews published from January 2010 to December 2025. Reviews were appraised and synthesized by purpose, quality, nursing specificity, and primary study overlap, which was quantified using a citation matrix and Corrected Covered Area (CCA). Findings Thirty-one reviews included 23 evidence syntheses and eight evidence maps. Privacy or data stewardship appeared in 29 reviews, transparency or explainability in 27, bias or fairness in 25, accountability or liability in 25, consent or autonomy in 18, leadership, education, or oversight in 14, and safety or human oversight in nine. Among 23 reviews with enumerable, extractable study lists, the CCA was 0.54%, indicating slight overlap. Nursing-specific concerns involved professional judgment, representation, oversight, regulatory variation, and ethical preparedness. Conclusion AI creates linked governance concerns involving data, fairness, transparency, autonomy, and accountability. Auditable responsibilities are needed across clinical, institutional, and regulatory levels while preserving nursing judgment and patient advocacy. Evidence for specific regulatory models remains limited.
Introduction:The coronavirus disease 2019 (COVID-19) pandemic has imposed substantial psychological and physical burdens on nursing professionals, particularly in Asia, where anxiety, depression, and burnout are common. In Japan, stigma may intensify distress, highlighting the need to assess symptoms and perceived workload. However, most studies were conducted at a single time point and cannot show how these burdens differ across changing infection rates, policies, and vaccination status. Objective:To compare psychological distress and subjective work-related burden among three independent samples of Japanese hospital nursing professionals during the COVID-19 pandemic. Methods:A repeated cross-sectional survey was conducted during three pandemic phases, with an independent sample at each: December 2020 (pre-vaccination), July 2022 (seventh infection wave), and November 2023 (post-reclassification). Web-based surveys were administered at 138 hospitals in one Japanese prefecture. Psychological distress was measured using the K6 scale and subjective mental and physical burden using one original item each. Differences among waves were examined using one-way analysis of variance, effect sizes (η2), and Steel-Dwass post hoc comparisons. Results:A total of 4,194 participants were analysed. Psychological distress and subjective burden differed significantly among waves, although effect sizes were small (η2 = .008-.012). Mean K6 scores were higher in July 2022 than in December 2020 or November 2023. The proportion with psychological distress (K6 ≥ 5) ranged from 59.3% to 67.9%, and that with severe distress (K6 ≥ 13) from 14.1% to 23.9%. Mental burden was highest in December 2020 and lowest in November 2023; physical burden showed the opposite pattern. In 2020, participants with COVID-19 care experience reported higher distress, but no such difference was observed in 2022 or 2023. Conclusion:Sustained psychological support for nursing professionals remains essential beyond acute crises. Tailored interventions should address mental strain and cumulative physical fatigue to strengthen workforce resilience.
Introduction Deep vein thrombosis affects millions of people worldwide each year and requires timely interventions because it causes life-threatening, preventable complications. Nurses play a pivotal role in the prevention of this health problem. Objectives This study aimed to assess nurses’ knowledge, attitudes, practices, and associated factors regarding deep vein thrombosis prevention at comprehensive specialized hospitals in northeastern Ethiopia, 2022. Methods A cross-sectional study was conducted from June 1 to August 30, 2022, employing a structured, self-administered questionnaire among 404 nurses. Study participants were selected through a simple random sampling technique. The data were entered into EpiData version 3.1 and exported to SPSS 25 for analysis. A binary logistic regression model was utilized to determine outcome variables and associated factors, and multivariable logistic regression was applied to control for potential confounders. Results A total of 404 nurses participated in the study, giving a response rate of 97.8%. In this study, 56.7% (95% CI [51.8%, 61.5%]), 59.0% (95% CI [54.0%, 63.7%]), and 59.4% (95% CI [54.6%, 64.2%]) of nurses had adequate knowledge, favorable attitudes, and satisfactory practices, respectively. Age ≥ 36 years (AOR = 2.73, 95% CI [1.18, 6.31], p = .02), using standard guidelines (AOR = 2.05, 95% CI [1.25, 3.33], p = .001), deep vein thrombosis education (AOR = 1.97, 95% CI [1.15, 3.38], p = .01), and training (AOR = 2.85, 95% CI [1.69, 4.8], p = .001) were significantly associated with knowledge. Monitoring system (AOR = 4.06, 95% CI [2.50, 6.59], p = .001), deep vein thrombosis education (AOR = 1.88, 95% CI [1.14, 3.10], p = .01) and adequate knowledge (AOR = 1.68, 95% CI [1.03, 2.72], p = .04) were associated with practice. Educational status (AOR = 1.79, 95% CI [1.16, 2.77], p < .001) and work experience (AOR = 1.85, 95% CI [1.02, 3.42], p = .04) were factors independently associated with attitude. Conclusion Slightly more than half of the nurses demonstrated adequate knowledge, favorable attitudes, and satisfactory practices. Deep vein thrombosis education, training, availability of guidelines, and educational status were significantly associated with nurses’ knowledge of deep vein thrombosis prevention. Work experience, workload and educational status were associated with attitudes, while monitoring, deep vein thrombosis education and adequate knowledge had a significant association with practices.
Background Nursing students experience significant academic and clinical stress, which contributes to psychological distress. Their ability to establish effective therapeutic communication (TC) with patients is also essential for high-quality patient care and patient satisfaction. Given the increasing use of yoga as an intervention for stress, this study investigated its effect on the therapeutic communication and psychological distress of nursing students in southeastern Iran. Methods This quasi-experimental study recruited 90 eligible nursing students via convenience sampling and allocated them to either the yoga or control group using simple random allocation by drawing lots. Eighty students completed the study (yoga = 39, control = 41). The intervention was an offline yoga program consisting of 12 sessions (over a one-month period). Psychological distress was assessed using the General Health Questionnaire-28 (GHQ-28), and TC was measured using the Nursing Student Therapeutic Communication Questionnaire (NSTCQ). Data were collected before and after the intervention. Statistical analyses included paired t-tests (within-group), independent t-tests or Mann-Whitney U tests (between-group), and analysis of covariance (ANCOVA) controlling for baseline scores and age. Results The mean psychological distress score in the yoga group showed a significant reduction following the intervention (p = 0.002), and a significant difference was observed between the yoga and control groups post-intervention (p = 0.001). Similarly, the mean therapeutic communication score increased significantly in the yoga group after the intervention (p = 0.03). However, there was no statistically significant difference in therapeutic communication scores between the two groups post-intervention (p = 0.079). Conclusion The findings suggest that yoga reduces psychological distress and may enhance therapeutic communication skills among nursing students. Yoga may therefore be considered a complementary strategy to support nursing students’ psychological well-being and professional communication.
Introduction The nursing process (NP) is a framework for planning and documenting nursing care. Standardized nursing language (SNL), including NANDA-I, NOC, and NIC, supports consistent documentation and demonstrates nursing contributions to patient outcomes. Understanding students’ use of NP and SNL is important for improving nursing education and care quality. Objectives This study evaluated the quality of undergraduate nursing students’ NP documentation, including the use of NANDA-I, NOC, and NIC, and explored perceived barriers to implementing NP and SNL in clinical practice. Methods This explanatory sequential mixed-methods study was conducted in 2024 at a Faculty of Nursing and Midwifery. In the quantitative phase, NP documentation in Pediatric Nursing clinical logbooks, completed after a 17-hour case-based course on NANDA-I, NOC, and NIC, was evaluated using a researcher-developed checklist. Nursing diagnoses were classified according to NANDA-I Taxonomy II domains, and data were analyzed using descriptive statistics in SPSS version 29. In the qualitative phase, purposively selected students participated in semi-structured interviews to explain the quantitative findings. Data were analyzed using conventional content analysis based on Graneheim and Lundman’s approach. Results A total of 121 clinical logbooks were analyzed. The mean NP documentation score was 3.52 ± 1.05 (out of 5). Students performed best in documenting NIC interventions and lowest in documenting NANDA-I diagnoses and NOC outcomes. Among 633 documented diagnoses, Safety/Protection, Elimination and Exchange, and Nutrition were the most frequent domains, whereas Self-Perception was least represented; no diagnoses were recorded in the Sexuality, Life Principles, or Growth and Development domains. Eighteen students participated in interviews, yielding two themes: education-related and student-related barriers. Conclusion Students demonstrated greater proficiency in documenting interventions than in formulating standardized diagnoses and outcomes. The predominance of physiological diagnoses suggests limitations in comprehensive assessment. Strengthening diagnostic and outcome reasoning and promoting holistic NP-based care should be emphasized in nursing education.
Introduction Most people with dementia in Norway live at home, and maintaining physical, social and spiritual activity remains a basic need. Yet research has focused on women as caregivers rather than women living with dementia. Consequently, more knowledge is needed into what women receiving home care service consider important in daily life to tailor health care services and to understand how these women experience participating in activities. Objective The aim of this study was to describe what women with dementia who receive home care service consider important in their daily lives. Methods This study employed an exploratory–descriptive design. Data were collected using individual semi-structured interviews with eight older women with dementia with mild to moderate cognitive impairment who received home care service. Data were analysed using manifest qualitative content analysis. Results The data analysis identified three categories: The need to be physically active and spend time outdoors, The need to staying socially connected and The need for meaningful activities. Conclusion This study provides insight into what women with dementia who receive home care service consider important in their daily lives. The need for meaning in daily life can be met in different ways, and it is important to tailor activities for women with dementia.
Background Breastfeeding is strongly recommended for infant and maternal health, and the Baby-Friendly Hospital Initiative (BFHI) aims to improve breastfeeding-supportive care; hence, teaching nursing students to adopt BFHI concepts is critical. Aim To explore nursing students’ experiences and perspectives of BFHI training, with attention to communication and cultural sensitivity. Methods A phenomenological qualitative design was used. Thirty undergraduate nursing students (13 males, 17 females) who completed BFHI-related learning participated in individual semi-structured interviews. The interviews were audio-recorded, transcribed, translated into English, and analyzed using thematic analysis with independent coding by two researchers. Results Six themes were identified: (1) training was experienced as structured, clear, and educational; (2) readiness and confidence improved through supervision, feedback, and skills practice—especially simulation; (3) permission-based, professional communication was central to breastfeeding education; (4) male identity created initial culturally influenced discomfort that improved with adaptation and professionalism; (5) team-based support—particularly involving female staff—and indirect teaching tools increased acceptability; and (6) real-clinical barriers (e.g., access, patient preference, role ambiguity) led to recommendations for clearer roles, more simulation, and culturally sensitive guidance. Conclusion When combined with structured curriculum, supervised practice, and simulation, BFHI training can boost students’ confidence and communication skills. To deepen learning and improve clinical application, male trainees in culturally sensitive settings require explicit advice on consent-based communication, boundaries, teamwork (including female staff assistance), and role clarification.
Background and aim Needlestick and sharp injuries (NSIs) are prevalent among registered nurses and nursing students. Although NSIs are a multifactorial phenomenon, the relationship between sleep problems and NSIs remains unclear. The aim of the present study was to examine the association between sleep-related problems and NSIs among nursing students. Methodology Cross-sectional study of n = 584 nursing students from two Ecuadorian universities. Sociodemographic and academic data as well as information on NSIs in the previous three months were obtained through an online questionnaire. Self-reported insomnia, sleepiness, sleep hygiene practices and emotional well-being were explored using validated questionnaires. The relationship between all variables and the occurrence of NSIs was explored using logistic regression analyses. Findings In total, 23.6% of the students (n = 138) reported at least one NSI in the previous three months. Those reporting NSIs used hypnotics more frequently ( p < 0.05), were younger and reported higher levels of insomnia, sleepiness, depression, anxiety and stress and poorer sleep hygiene (all p < 0.01). Logistic regression revealed that younger students (OR = 0.931, CI: 0.884-0.982, p < 0.01) and those reporting insomnia symptoms (OR = 1.064, CI: 1.016-1.114, p < 0.01) had higher odds of reporting NSIs. Conclusion Having insomnia symptoms and being younger were associated with an increased likelihood of reporting NSIs among nursing students. There is an urgent need to develop preventive strategies that address the potential role of sleep problems and other individual and organizational factors to reduce the occurrence of NSIs among students and healthcare professionals.
Introduction The use of the World Health Organization’s Early Essential Newborn Care (EENC) guidelines may reduce neonatal morbidity and mortality. The knowledge of EENC among healthcare professionals is closely tied to their clinical practice. However, there is a lack of research assessing the knowledge of healthcare professionals in Saudi Arabia. Objective To assess the level of knowledge of healthcare professionals regarding EENC in Saudi Arabia. Methods A cross-sectional descriptive study was employed with a convenience sample of 123 healthcare professionals working in six units that provide care for neonates at a private hospital in Jeddah City, Saudi Arabia. Data were collected using a self-reported questionnaire that was administered online. Data were analyzed for frequencies, percentages, means, and standard deviations. Independent t-test and one-way analysis of variance (ANOVA) were used to find differences in knowledge across demographic characteristics. The significance level was set at < 0.05. Results The mean knowledge of healthcare professionals regarding EENC was 59% ± 10%. Professionals working in the nursery had higher knowledge of EENC compared to other departments ( p < 0.05). Conclusion The overall knowledge of healthcare professionals regarding EENC was low. These results highlight the need for targeted, department-specific educational interventions to strengthen EENC knowledge and improve the overall quality of neonatal care.
Introduction Nursing care plans are fundamental learning tools for assessing students’ clinical judgment, yet documentation quality is influenced by resource accessibility and information-seeking competence. Despite growing emphasis on evidence-based practice and digital literacy, limited research examines how nursing students identify, evaluate, and apply information sources—particularly artificial intelligence—when developing care plans during clinical placements. Objectives To examine undergraduate nursing students’ online information-seeking behaviours when developing nursing care plans during clinical placements, including their use of artificial intelligence tools. Methods Convergent mixed-methods study at a single Saudi university. Eligible undergraduate nursing students were engaged in clinical courses requiring care plan development. Sixteen final-year students were purposively sampled for four focus groups, and all 192 eligible students were invited to a cross-sectional survey; 157 responded (81.7%). The survey used a validated 17-item information-seeking assessment tool. Qualitative and quantitative strands were collected concurrently, analysed separately—thematically and via descriptive statistics—and integrated at interpretation; no inferential tests were performed. Results Qualitative findings revealed persistent challenges including time constraints and variable clinical staff collaboration; students used cross-checking and peer consultation to ensure credibility, though concerns about artificial intelligence reliability persisted. Quantitatively, students reported high confidence in online information-seeking (aggregate mean 4.14/5.0), drawing on multiple sources including professional databases and artificial intelligence tools. Conclusions While nursing students demonstrate confidence as information seekers, gaps exist between perceived competence and actual critical appraisal skills. Although derived from a single Saudi university using a descriptive design, findings may be transferable to programmes facing similar challenges in integrating digital health literacy and emerging technologies into clinical training.
Background Despite strategies and policies, congenital musculoskeletal and limb anomalies (CMLAs) remain a public health issue for infants in low-income countries. However, the true burden of these anomalies is not well documented in resource-limited settings. Objective This study aimed to quantify the non-fatal and fatal health impacts of CMLAs in the Eastern Sub-Saharan African (ESSA) region from 1990 to 2023. Methods The Global Burden of Diseases (GBD) 2023 methods and tools were used. Prevalence, incidence, and years lived with disability (YLDs) were estimated by using the Bayesian meta-regression tool for disease modeling (DisMod-MR 2.1), whereas mortality and years of life lost (YLLs) rates were quantified in the cause of death ensemble model (CODEm). Results In the ESSA region, there were an estimated 1606 prevalent cases of CMLAs (95% UI: 1112, 2299), 2120 new cases (95% UI: 1472, 3016), 4 deaths (95% UI: 2, 10), 389 YLLs (95% UI: 186, 858), 241 YLDs (95% UI: 140, 400), and 630 DALYs (95% UI: 383, 1069) per 100,000 infants in 2023. Somalia had the highest non-fatal rates, while Mozambique had the highest fatal rates. The lowest YLLs rate was among males in Ethiopia. Between 1990 and 2023, the rates remained similar across the region. However, there was a 6% decline in the incidence rate (95% UI: -10, -1). The non-fatal health outcomes increased in Kenya. Conclusion This study revealed that the fatal and non-fatal outcomes of CMLAs were high and remained similar across most countries in the ESSA region over the past 34 years, indicating the need for targeted interventions to mitigate the burden. Implementing community-based screening, treatment, and counseling programs; establishing dedicated pediatric surgical care and rehabilitation centers; and strengthening comprehensive surveillance systems may be recommended to reduce the premature mortalities and disabilities.
Introduction Breast cancer is the leading cause of cancer among women globally, with Sub-Saharan African countries leading breast cancer mortalities worldwide. Breast self-examination (BSE) is a cost-effective intervention for detecting breast cancer in low-resource settings. Objective This study aimed to assess the awareness and practice of BSE among pregnant women attending antenatal clinics in Ghana. Methods A cross-sectional study design with convenience sampling was used to survey 536 pregnant women attending antenatal clinics at two facilities in Kumasi City, Ghana. Data was collected using a structured, self-administered questionnaire. Data was analysed using descriptive statistics (frequencies and percentages) to assess BSE awareness and practice. Logistic regression was used to assess association between sociodemographic data and levels of awareness and practice of BSE, with statistical significance established at p < .05. Results The study revealed a high level of awareness of BSE (84%) among pregnant women. Over half (57.4%) of respondents practiced BSE, with (58.5%) of women performing BSE following education received at the antenatal clinic. Women with moderate BSE awareness level had significantly lower odds of practicing BSE than those with high BSE awareness level (aOR = 0.20, 95% CI: 0.11, 0.36, p <.01). Respondents with secondary level education had significantly lower odds of having high BSE awareness level than those with tertiary education (aOR = 0.38, 95% CI: 0.17–0.84, p < .01). Similarly, women with secondary level of education had significantly lower odds of practicing BSE compared to those with tertiary education (aOR = 0.53, 95% CI: 0.33–0.84, p < .01). Conclusion The study revealed a gap between awareness and practice of BSE among pregnant women in a low-resource country. The findings demonstrate the need for stakeholders to intensify breast awareness and BSE campaigns within hospitals, schools, and community to bridge this gap.
Nurse migration is a defining feature of health workforce dynamics in the Eastern Mediterranean Region (EMR), which functions as both a source and destination for internationally mobile nurses. Persistent workforce shortages, increasing healthcare demands, demographic changes, and sociopolitical instability in some countries have intensified cross-border mobility, raising concerns about workforce sustainability and equitable access to nursing care. This paper examines evolving patterns of nurse migration in the EMR and identifies policy priorities to support a sustainable nursing workforce. Drawing on findings from a recent global nurse migration report and relevant regional and international literature, the paper critically synthesizes evidence on migration trends, workforce distribution, and policy responses, with particular attention to governance, nursing education, and recruitment practices. The review highlights contrasting migration patterns across the region. Several middle-income countries continue to experience significant outward migration driven by economic opportunities, career advancement, and working conditions, whereas high-income countries rely extensively on internationally educated nurses to address workforce shortages and support health system expansion. Although initiatives promoting ethical international recruitment, workforce monitoring, and national workforce development are increasing, important challenges remain, including fragmented governance, inconsistent regulatory frameworks, limited educational capacity, sociocultural barriers to nursing careers, and difficulties retaining experienced nurses. Strengthening workforce sustainability in the EMR will require coordinated national and regional workforce planning, greater investment in nursing education, effective retention strategies, enforcement of ethical recruitment practices, and enhanced regional collaboration. These measures can strengthen local nursing capacity, improve workforce stability, and support resilient health systems capable of delivering high-quality, equitable patient care.
Introduction Sudden cardiac arrest (SCA) remains a significant cause of in-hospital mortality and morbidity in Ghana, with increasing incidence in the Central Region of Ghana. Although nurses are continuously present at patients’ bedsides, their ability to recognize and manage cardiac arrest using basic life support (BLS) is under scrutiny. Objective The study evaluated the impact of a structured BLS training programme on nurses’ knowledge and practical application of BLS. Methods A one-group pretest-posttest quasi-experimental design was used. Using a simple random sampling technique (lottery method), 101 nurses were selected. A seven-point Likert scale questionnaire adapted from the American Heart Association (AHA) 2020 guidelines was used to assess BLS knowledge, while practical skills were evaluated using the BLS task checklist from the Nursing and Midwifery Council of Ghana. Data were analyzed using Wilcoxon signed-rank test and linear regression. Results Significant post-training increases were observed in BLS knowledge (W = 4753, p < .001; 95% CI: 1.25 to 1.59) and BLS practice (W = 5151, p < .001; 95% CI: 63.50 to 65.50). In the regression analyses, pretest knowledge was positively associated with posttest knowledge (β = 0.74, p < .001). However, pretest practice and posttest knowledge showed negative regression coefficients in models predicting posttest practice. These regression findings were interpreted cautiously because of restricted variability and possible ceiling effects in posttest scores. Conclusion In-service BLS training significantly enhanced both the knowledge and practical skills of nurses. Routine implementation of such programme should be organized at regular interval.
Introduction Nursing presence, a critical component of patient-centered care, is intrinsically linked to the quality of healthcare services and patient satisfaction. Objective This cross-sectional study aimed to investigate the relationship between nursing presence and the perceived quality of nursing care among hospitalized patients in teaching hospitals in Kermanshah, western Iran. Methods A descriptive-analytical cross-sectional study was conducted involving 347 inpatients at teaching hospitals in Kermanshah, Iran. Participants were selected using a proportional quota sampling design to ensure the sample reflected the distribution of patients across different hospital units, with convenience sampling used to recruit participants within each quota. Data were collected using demographic forms and validated questionnaires: the Nursing Presence Scale (PONS) and the Quality Patient Care Scale (QUALPAC). Statistical analysis included descriptive statistics, Pearson and Spearman correlation tests, the Kolmogorov–Smirnov test for normality, as well as Mann-Whitney U and Kruskal-Wallis tests for group comparisons, performed using SPSS version 25. Results The present study demonstrated a high level of nursing presence (mean ± SD: 350.8± 66.4) and a satisfactory level of nursing care quality (mean ± SD: 157.4 ± 35.9). A significant positive correlation between nursing presence and the overall quality of nursing care (r = 0.555, p < 0.001). As well as, significant positive correlations were observed between nursing presence and the psychosocial (r = 0.443, p < 0.001), communicative (r = 0.487, p < 0.001), and physical (r = 0.529, p < 0.001) dimensions of nursing care quality. Conclusion The findings indicate that while hospitalized patients in Iranian teaching hospitals reported a strong sense of nursing presence, their perception of the overall quality of nursing care was only moderately satisfactory. These results highlight the need to strengthen specific aspects of clinical care and technical proficiency to complement the established interpersonal strength of nursing presence.
Introduction Professional values in nursing are shaped by a combination of individual characteristics and work-related factors. Nurses frequently encounter ethical challenges while delivering patient care, and assertiveness is recognized as a critical competency for addressing these challenges effectively. Objective This study aimed to explore the relationship between professional values and assertiveness among nurses in teaching hospitals. Methods A correlational, descriptive-analytic design was employed, with 590 nurses from 14 teaching hospitals selected via stratified random sampling. Data were collected using a demographic questionnaire, the Nurses Professional Values Scale–Revised ( Weis & Schank, 2009 ), and the Assertiveness Scale ( Begley & Glacken, 2004 ). Data analysis was conducted in SPSS-23 using independent t -tests, Pearson correlation coefficients, and one-way ANOVA, with significance set at p < 0.05. Results Most nurses demonstrated desirable levels of professional values and assertiveness. While no significant association was found between the overall scores of professional values and assertiveness (p=0.23), the professional values score showed a significant positive correlation with two assertiveness dimensions: self-denial (p=0.00) and negative assertiveness (p=0.02). Additionally, the assertiveness score correlated significantly with the trust and professionalism dimensions of professional values (p=0.01). Conclusion While the association between the overall scores of professional values and assertiveness was not significant, some of dimensions of professional values had significant and positive association with assertiveness. These results highlight that enhancing certain assertiveness skills can strengthen nurses’ professional values and improve their ethical performance when facing clinical challenges. Therefore, educational and empowerment programs should be designed and implemented to promote these particular assertiveness competencies and support the development of professional values among nurses.
