OBJECTIVE:To assess the impact of an educational intervention on pressure injury (PI) prevention practices in critical care units in Saudi Arabia. METHOD:The study was conducted across three hospitals using a pre- and post-intervention approach, complemented by qualitative evaluation. It was structured into four phases, guided by the Knowledge to Action framework. The research involved collecting data on PI prevalence, surveying nurses about their knowledge and attitudes towards prevention practices, and implementing an educational intervention. Subsequently, phase 1 findings were re-evaluated. Qualitative interviews were conducted to identify barriers and facilitators to prevention practices, and to evaluate the study's effectiveness. RESULTS:Data were collected pre-intervention from 87 patients and 190 nurses. The initial PI prevalence rate was 60.9%, while the initial knowledge and attitude scores of nurses were 43.22% and 74.77%, respectively. A tailored group-based educational intervention engaged 294 nurses across all research sites. Post-intervention data were gathered from 94 patients and 195 nurses. The PI prevalence rate reduced significantly to 28.7%. Nurses' knowledge scores increased to 51.22%, and attitudes improved to 79.02%. Qualitative interviews with nine nurses identified three themes related to barriers and facilitators: 'Workforce and resource issues'; 'Training and preparedness' and 'Managing complex conditions'. The project's success was attributed to three themes: 'Delivering an adaptable and personalised intervention'; 'Impact of attention to detail' and 'Significance of contributing to positive change'. CONCLUSION:The findings of this research underscores the crucial role of nurses in preventing PIs in critical care units. Tailored group-based educational programmes have proved effective in reducing PI rates, bolstering nurses' knowledge and attitudes, and overcoming prevention barriers.

Safety culture is an important characteristic of healthcare settings as it influences the quality of care provided and patient outcomes. Nurses make up the largest proportion of the healthcare workforce and their attitudes towards safety are known to impact patient outcomes. To the best of our knowledge, this is the first systematic review and meta-analysis focused on nursing safety culture in Saudi Arabia. This study aimed to systematically synthesize the available evidence on nursing safety culture in healthcare settings in Saudi Arabia. A systematic search of the literature was conducted in accordance with guidance from the Joanna Briggs Institute (JBI). Four databases were searched: Medline, CINAHL, Scopus, and Web of Science. Meta-analysis of the effect size was conducted using Jamovi version 2.3, and SPSS version 29 was used for subgroup analysis. The results are reported using the Preferred Reporting Items for Systematic Review and Meta- Analyses (PRISMA) guidelines. Thirty cross-sectional studies with a total of 8,910 nurses were included in this review. The meta-analysis included 24 studies with a total of 7,115 nurses. The pooled estimate of positive responses across the 12 subscales of the Hospital Survey on Patient Safety Culture score were 55.47

INTRODUCTION:Stabilised hyaluronic acid (sHA) gel can be used as a breast cancer tumour bed marker. This study aimed to assess the gel on post-treatment surveillance mammography (MMG) and breast ultrasound (USS). METHODS:Patients who underwent breast-conserving surgery and adjuvant radiotherapy, with sHA gel markers (0.3-0.5 mL drops) in breast tissue had their routine 1- and 2-year post-treatment MMG and USS undergo central review by one experienced radiologist. The central review questionnaire included whether the gel was visible, description if visible, and whether it impacted diagnostic assessment of the images using a 5-point Likert scale. The images were also standardly reported by radiologists who were blinded to the gel history. RESULTS:Of the 33 patients eligible for evaluation, sHA gel was visible on the 1-year post-treatment MMG in 3% of patients, described as well circumscribed nodules adjacent to the surgical scar. sHA gel was visible on the 1-year post-treatment USS in 38% of patients, described as simple round cystic lesions near the surgical bed. sHA gel was still visible on the same patient's 2-year post-treatment MMG (3%) and was visible on the 2-year post-treatment USS in 19% of patients. In all cases, the gel was rated 'unlikely' or 'very unlikely' to impair diagnostic assessment of the images and did not lead to any additional investigations. The blinded radiologists reported the gel as non-suspicious appearing cysts without clinical concern. CONCLUSION:sHA gel used as breast tumour bed marker was not visible in most patients' post-treatment MMG and USS and did not affect diagnostic assessment.

AIM:To gain consensus and prioritise barriers to effective pressure injury prevention for at-risk patients and to collaboratively generate, discuss and recommend intervention strategies that could address these prioritised barriers in the acute medical-surgical hospital context. DESIGN:Nominal Group Technique. METHODS:Participants involved in pressure injury prevention across acute medical-surgical services in a tertiary hospital in Australia were purposively sampled. Pre-reading materials informed the discussion on barriers to prevention. Participants ranked 11 barriers that were collaboratively developed and identified practical context-specific solutions. Data were analysed using inductive content analysis. RESULTS:Nine multidisciplinary participants prioritised three final barriers to effective pressure injury prevention: inadequate skin assessment and monitoring, competing priorities and workflow pressures and insufficient education and inconsistent knowledge. Proposed solutions focused on developing concise, accessible decision support tools such as quick reference flowcharts to enhance confidence, consistency and timeliness of appropriate pressure injury prevention practices. CONCLUSIONS:The Nominal Group Technique enabled consensus-building, guided the development of actionable priorities and informed targeted intervention strategies to address key barriers in acute care nursing practice. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:Findings from this study offer nurse leaders and researchers practical insights to co-create an intervention that drives evidence-based pressure injury prevention practice change in acute medical-surgical settings. Adoption of these targeted approaches may enhance hospital patient safety through pressure injury prevention implementation. REPORTING METHOD:Reporting guideline for PRIority Setting on health research (REPRISE). PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.

INTRODUCTION:A Radiographer Comment and Alert (RCA) Model of Care (MoC) was piloted across five Australian hospitals for timely communication of abnormal general X-ray appearances to Emergency Department (ED) referrers. Participating stakeholders were surveyed to identify patient benefits, challenges/risks and to determine the model's continuity and sustainability. METHODS:Surveys were designed using a Qualtrics XM survey tool using binary, 4-point Likert Scales and open-ended questions. Surveys were distributed to participating radiographers, ED physicians and radiologists at pilot sites in 2023 and analysed with SPSS v29.0. RESULTS:Thirty-four survey responses were received. The radiographer response rate was 27.5 % (19/69) and ED physicians 11.2 % (13/116). Two radiologist responses were excluded due to insufficient sample size. Radiographers identified "patient advocacy" as the greatest benefit (89.5 %; 17/19) and "time constraints" as the main challenge (57.9 %; 11/19). ED physicians ranked "increased interprofessional teamwork with radiographers" the highest (78 %,7/9), followed by "case prioritization" (67 %; 6/9). Six of nine (66.6 %) ED physicians had no concerns about the model's risks. Overall, 96.2 % (25/26) of combined respondents supported the model's sustainability, and continuity was similarly endorsed; 96.2 % (24/26). DISCUSSION:Both radiographers and ED physicians supported continuity and sustainability of the RCA MoC. We believe this was driven by a paradigm shift in radiographer confidence and their desire for improved inter and intra-professional teamwork and patient advocacy. ED respondents supported the model for improved collaborative teamwork and workflow efficiencies. The key radiographer barrier of "time constraints" needs to be addressed locally by exploring intrinsic motivators such as highlighting patient benefits amongst radiographers. CONCLUSIONS:Positive results supporting the continuity and sustainability of this practice will help strengthen its ongoing implementation and potential benefits for patients. Allied health practitioners, such as radiographers, can work confidently at their full scope of practice by providing a written comment on detected general X-ray abnormalities for EDs.

INTRODUCTION:To evaluate insertion feasibility of a stabilised hyaluronic acid (sHA) gel rectal spacer in gynaecological cancer high dose rate brachytherapy (GynBT). METHODS:This single institution prospective study included patients with gynaecological cancers receiving magnetic resonance imaging (MRI)-guided GynBT. Feasibility was assessed by technical success, clinician user experience, spacer visibility on MRI and spacer stability over the GynBT course. RESULTS:Twelve patients were included in this study. Insertion of sHA gel into the rectovaginal space was achieved in all 12 patients without spacer-related complications. Clinicians reported sHA gel as easy to use, with high visibility on TRUS (rated 4-5) and excellent visibility on MRI. Target-to-rectum distance increased with sHA spacer insertion (mean 7.82 mm, 95% CI: 5.27-10.36, p < 0.001). During GynBT, there was a reduction in sHA gel spacer volume (mean 1.75 cc, 95% CI: 0.57-2.93, p = 0.007) and craniocaudal distance (mean -3.87 mm, 95% CI: -7.37 to -0.36, p = 0.034). However, there were no significant changes in target-to-rectum distance (p = 0.490) and spacer level measurements (p > 0.2). CONCLUSION:Insertion of sHA gel rectal spacer is technically feasible and safe in GynBT, increasing the separation between the target and rectum. The sHA gel spacer is easy to use, highly visible on both TRUS and MRI, and stable during the entire GynBT course. Further studies are required to ascertain patient suitability, dosimetric comparison, patient-reported outcomes, toxicities, and optimal technique. TRIAL REGISTRATION:The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12625000167460).

Background: Postgraduate leadership education is increasingly recognised as essential for preparing nurses to navigate the complexities of contemporary healthcare. However, there remains limited empirical understanding of how nurses integrate leadership learning into everyday clinical practice and the contextual factors that shape its enactment. Aims: This paper examines the practical impact of a postgraduate leadership course on Registered Nurses’ clinical practice. Methods: Clandinin and Connelly’s three-dimensional narrative inquiry space guided this study. Eleven Registered Nurses who had completed a postgraduate leadership course participated in two semi-structured interviews. Data were analysed using cross-narrative comparison to identify recurring threads and divergent experiences. Results: The practical impact of postgraduate leadership education was reflected in three interconnected narrative threads. ‘Identification of a skills gap’ described participants’ recognition of previously limiting leadership deficits. ‘Using the resources provided’ showed how leadership tools, frameworks and strategies were applied in practice. ‘Challenges of enacting education into practice’ highlighted contextual constraints that limited some participants’ ability to apply their learning despite strong motivation. Conclusion: Postgraduate leadership education can strengthen nurses’ clinical practice by enhancing leadership capability and readiness. However, organisational hierarchies, role clarity and structural support significantly influence the extent to which leadership learning can be enacted in practice.

BACKGROUND:Ensuring effective pain assessment and management in intensive care units (ICUs) is crucial for promoting the well-being of patients. PURPOSE:To develop and investigate the psychometric properties of an instrument designed to measure nurses' readiness for implementing the Critical-Care Pain Observation Tool in ICUs in Saudi Arabia. DESIGN:This study involved instrument adaptation and psychometric testing. PARTICIPANTS AND SETTINGS:A convenience sample of 160 ICU nurses, head nurses, in-charge nurses, and nurse educators. METHODS:This study comprised two phases. Phase 1 focused on modifying the Acceptability to Intervention (AIM) Intervention Appropriateness Measure (Williams et al., 2010), and Feasibility Intervention Measure (FIM), measuring the content validity and pilot testing the modified tool. Phase 2 involved the psychometric testing of the modified tool and assessing the nurses' readiness for implementing pain assessment in the ICU. RESULTS:The modified instrument was termed the Acceptability and Feasibility tool (mAFt). Academic and clinical expert panel feedback indicated satisfactory content validity. Exploratory factor analysis of the tool resulted in two factors: acceptability (10 items) and feasibility (5 items). The tool demonstrated high internal consistency with Cronbach's alpha values of 0.986 for acceptability and 0.951 for feasibility. The construct validity of the mAFt was supported as ICU nurses with higher education levels exhibited higher readiness scores. CONCLUSIONS:The results offer empirical support for the tool's credibility in gauging its readiness for implementation. However, further, psychometric assessments should be conducted with different nurse groups to validate the tool's effectiveness in diverse contexts.

Background: Inpatient mortality is a critical outcome measure for healthcare services. Improving patient outcomes and ensuring high-quality healthcare outcomes requires an understanding of the factors that contribute to inpatient mortality.Aim: This study aimed to investigate the impact of safety culture, quality of care, missed care, and nurse staffing on inpatient mortality rates and nurse-reported inpatient death frequency.Methods: A cross-sectional survey and an administrative dataset on inpatient mortality were used in this study. A web-based survey was conducted among nurses from 34 units in five acute public hospitals. Inpatient mortality data between 2018 and 2021 were collected from participating units. The study variables were analyzed using generalized linear models.Results: Safety culture scores were less than positive in all hospitals, and most nurses reported missed care during their last shift. However, nursing units that had strong subscale scores for teamwork climate, safety climate, and safety behavior had lower incidence rates of inpatient mortality and fewer nurse-reported inpatient deaths in their units.Conclusion: The study's findings highlight the importance of teamwork climate, safety climate, and safety behaviors on safety culture and the role nurses play in reducing inpatient mortality rates and lowering nurse-reported inpatient death frequency.

Mixed-methods research is increasingly used in healthcare to understand complex issues, yet integration of qualitative and quantitative findings remains challenging, particularly for novice researchers. This paper provides a practical guide for nursing researchers to integrate survey and interview data effectively. Using a sequential explanatory design exemplar with an embedded quasi-experimental component, we demonstrate key integration strategies, including joint displays and narrative weaving. The paper emphasizes that robust integration must be planned from the outset, with clear goals specifying how data types will address research questions. We illustrate how purposeful integration points, carefully constructed joint displays, and narrative synthesis of meta-inferences can generate deeper insights than either method alone. By providing concrete examples and step-by-step guidance, this resource equips novice researchers with essential skills for achieving rigorous, cohesive integration in mixed-methods studies.

Background Miscommunication in health care is a major source of poor health outcomes, complaints about health care professionals, and poor patient satisfaction. Recordings from real-life consultations provide valuable data for communication research and education. Additionally, recordings from simulation-based education of health care students can provide valuable data for health care education research. Objective The Digital Library is a data repository supporting high-quality health care communication research. This is the single-source citation for all projects that use the Digital Library in Australia. Methods This protocol outlines the logistics and consent process for recording and safely storing the recordings of health care consultations and simulation-based education. The processes are outlined for primary health care settings and health care educational settings as well as for health care narratives from consumers. The repository will be used to answer research questions about health care communication and provide a valuable resource for health care education. Results Data collection for the Digital Library commenced in 2023 and is ongoing at the time of submission of this protocol. The Digital Library has been approved by Monash University’s Human Research Ethics Committee. Conclusions The Digital Library will provide a national resource for the study of health care communication in community settings, general practice, and other environments. The health care narratives may be a valuable resource for sharing the patient perspective when living with different conditions. The research that uses this repository will be shared through regular academic channels as well as the community-based dissemination strategies of the National Centre for Healthy Ageing. International Registered Report Identifier (IRRID) DERR1-10.2196/67910

AIM:To systematically explore research on nurses' clinical decision-making and factors influencing pressure injury prevention in hospitalised patients. DESIGN:Scoping review. DATA SOURCES:Medline full text, Cumulative Index to Nursing and Allied Health Literature Plus with full text, and Scopus. METHODS:Arksey and O'Malley's five-step framework guided this scoping review. Studies published prior to 11 July 2024 were included. RESULTS:Thirty-eight studies were included. The factors influencing nurses' decision-making in pressure injury prevention included: 'support systems', 'knowledge and attitudes', 'barriers to implementing prevention practices' and 'risk assessment tools and clinical judgement'. Limited research was conducted on nurses' clinical decision-making about implementation of pressure injury prevention interventions. CONCLUSION:More research on nurses' clinical decision-making related to pressure injury prevention is needed to enhance education, support effective care and reduce the incidence of pressure injuries. IMPACT:Nurses recognise the importance of preventing pressure injuries, however implementation of pressure injury prevention interventions are inconsistent, and pressure injuries remain common in hospitals. Limited research exists on the processes nurses use to make clinical decisions about pressure injury prevention for hospitalised adults at risk of pressure injury. REPORTING METHOD:This scoping review adhered to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) checklist. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.

Background: Numerous interventions for pressure injury prevention have been developed, including care bundles. Objective: To systematically review the effectiveness of pressure injury prevention care bundles on pressure injury prevalence, incidence, and hospital-acquired pressure injury rate in hospitalised patients. Data sources: The Medical Literature Analysis and Retrieval System Online (via PubMed), the Cumulative Index to Nursing and Allied Health Literature, EMBASE, Scopus, the Cochrane Library and two registries were searched (from 2009 to September 2023). Study eligibility criteria: Randomised controlled trials and non-randomised studies with a comparison group published in English after 2008 were included. Studies reporting on the frequency of pressure injuries where the number of patients was not the numerator or denominator, or where the denominator was not reported, and single subgroups of hospitalised patients were excluded. Educational programmes targeting healthcare professionals and bundles targeting specific types of pressure injuries were excluded. Participants and interventions: Bundles with >= 3 components directed towards patients and implemented in >= 2 hospital services were included. Study appraisal and synthesis methods: Screening, data extraction and risk of bias assessments were undertaken independently by two researchers. Random effects meta-analyses were conducted. The certainty of the body of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation. Results: Nine studies (seven non-randomised with historical controls; two randomised) conducted in eight countries were included. There were four to eight bundle components; most were core, and only a few were discretionary. Various strategies were used prior to (six studies), during (five studies) and after (two studies) implementation to embed the bundles. The pooled risk ratio for pressure injury prevalence (five nonrandomised studies) was 0.55 (95 % confidence intervals 0.29-1.03), and for hospital-acquired pressure injury rate (five non-randomised studies) it was 0.31 (95 % confidence intervals 0.12-0.83). All non-randomised studies were at high risk of bias, with very low certainty of evidence. In the two randomised studies, the care bundles had non-significant effects on hospital-acquired pressure injury incidence density, but data could not be pooled. Conclusions and implications of key findings: Whilst some studies showed decreases in pressure injuries, this evidence was very low certainty. The potential benefits of adding emerging evidence-based components to bundles should be considered. Future effectiveness studies should include contemporaneous controls and the development of a comprehensive, theory and evidence -informed implementation plan. Systematic review registration number: PROSPERO CRD42023423058. Tweetable abstract: Pressure injury prevention care bundles decrease hospital -acquired pressure injuries, but the certainty of this evidence is very low. (c) 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

AIM:To explore pressure injury prevention practices and evaluate the impact of an educational intervention on PI prevalence before and after an educational intervention. DESIGN:A multi-centre observational study. METHOD:Data were collected at two time points in May 2021 and April 2022 using a Qualtrics® online form. Two Registered Nurses at each site collected observational data at each time point by diagnosing and staging any identified pressure injuries as part of a prevalence study. Patients admitted to participating units were included. RESULTS:A total of 181 patients in critical care units were included at the two-time points. Pressure injury prevalence was 60.9% at the outset, with 52.9% hospital-acquired, 37.9% unit-acquired and 23.0% medical device-related. Post-intervention prevalence decreased significantly to 28.7%, including 21.3% hospital-acquired, 14.9% unit-acquired, and 8.5% medical device-related. Pressure injuries were prominent in the sacral region, head area, and heels. Stages I and II pressure injuries were the most common. Increased age and longer ICU stays are linked to a heightened risk of pressure injury development in critically ill patients, whereas higher haemoglobin levels show an inverse relationship with the development of both pressure injury and severe stages in the univariate analysis. The predictive models revealed that increased age and longer ICU stays are predictors for both pressure injury development and progression to severe stages, while Braden scores predict the likelihood of developing severe stages of pressure injuries. CONCLUSIONS:This study has identified a benchmark for pressure injury prevalence in critical care units in Saudi Arabia. The results demonstrate that pressure injuries can be prevented in critically ill patients when evidence-based education strategies are implemented. PATIENT CARE IMPACT:Pressure injuries are an important issue for critically ill patients and can be prevented with proper investments. Strategies to prevent pressure injuries from admission will result in fewer pressure injuries. REPORTING METHOD:Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and the Template for Intervention Description and Replication (TIDieR) checklist. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.

AIM:To synthesize existing literature describing the impact of intentional rounding on patient outcomes among hospitalized adults. BACKGROUND:Intentional rounding has been described as purposeful therapeutic communication between nurses and patients during regular checks with patients using standardized protocols. Despite the widespread adoption of intentional rounding, the current understanding of the benefits of these structured interactions between nurses and patients is limited. INTRODUCTION:The critical role of nurses in ensuring high-quality and safe care in acute hospitals is often noted only when things go wrong. This was highlighted by investigations into the reasons for the failures in patient care at the Mid Staffordshire National Health Services. METHODS:A scoping review was performed and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review guidelines. FINDINGS:Sixteen studies were included in the final review. Various rounding models were noted among different clinical settings; four studies reported a significant reduction in falls, and a further three reported a decrease in pressure injuries. Two studies reported a reduction in call bell usage. Significant improvements in patients' satisfaction with intentional rounding were reported in three studies. DISCUSSION:Promoting intentional rounding without solid evidence of its acceptability, feasibility, and suitability in different clinical settings could compromise nurses' ability to provide safe care. CONCLUSION AND IMPLICATIONS FOR NURSING:There is weak evidence of the effectiveness of intentional rounding on patient outcomes because of the diversity of methods employed and methodological limitations in many studies. Our findings identify the need for robust studies to explore the acceptability and feasibility of a rounding protocol that can be implemented in different clinical settings.

ImportanceThe effectiveness of in-room air purification for the reduction of acute respiratory infections (ARIs) in residential aged-care facilities (RACFs) is unknown.ObjectiveTo investigate the effectiveness of in-room air purifiers with high-efficiency particulate air (HEPA)–14 filters in reducing the incidence of ARIs among residents of RACFs.Design, Setting, and ParticipantsThis randomized clinical trial used a multicenter, double-blind, 2-period, 2-treatment crossover design for 6 months from April 7 to October 26, 2023, in 3 RACFs with a bed capacity of 50 to 100 in New South Wales, Australia. The purposive sampling approach included permanent residents in private rooms in the enrolled RACFs. Data collection was performed every 2 weeks and required no additional follow-up beyond the final data collection on October 31, 2023.InterventionAn air purifier containing a HEPA-14 filter was placed in rooms of participants in the intervention group, and an air purifier without a HEPA-14 filter was placed in rooms of the control participants. The groups crossed over after 3 months.Main Outcomes and MeasuresThe primary outcome was the incidence of ARIs, assessed with logistic mixed-model regression.ResultsAmong 135 participants randomized (70 to the intervention-first group and 65 to the control-first group), 78 (57.8%) were female; mean (SD) age was 85.2 (8.6) years. In the intention-to-treat analysis, the use of air purifiers with HEPA-14 filters did not reduce ARIs compared with the control (OR, 0.57; 95% CI, 0.32-1.04; P = .07). Among the 104 participants who completed the entire study, the intervention reduced ARI incidence from 35.6% (37 participants) in the control group to 24.0% (25 participants) in the intervention group (OR, 0.53; 95% CI, 0.28-1.00; P = .048).Conclusions and RelevanceIn this clinical trial investigating use of air purifiers with HEPA-14 filters for reducing ARIs, no significant between-group difference was found in the intention-to-treat analysis. However, a significant reduction in ARIs was identified among participants who completed the entire study. These findings may help inform future large-scale studies of respiratory infectious diseases.Trial RegistrationANZCTR identification: ACTRN12623000347662

Introduction Papua New Guinea (PNG) experiences widespread health inequity and shortage of health professionals, exacerbated by poverty, isolation, gender-based violence and limited infrastructure, transport and accessible services. Nurses and community health workers (CHW) represent 72% of health workforce. However, health professional education programs are outdated and not aligned with national health priorities. We aimed to explore the adequacy of current curricula for nurses and CHWs by examining graduate competencies and preparedness for practice. Methods Cross-sectional study with four cohorts: 1) 130 new nurse graduates, 2) 75 nurses who supervised them, 3) 105 new CHW graduates and 4) 65 CHW supervisors. We surveyed perceptions of recent graduates’ clinical competence and compared graduates’ and supervisors’ ratings using chi-squared analysis. Results Graduates and supervisors differed significantly in perceptions of graduate competency, for both nurses and CHWs. Despite asserting their competence, graduates identified skills gaps and needs for additional learning support after graduation, including national priority areas (pregnancy, maternal-child health, infection control, emergency health management). Conclusion This study among health professionals in PNG, a country with very limited data on human resources for health, found gaps in graduate preparedness for practice, offering insights into skill deficits that should be addressed in upcoming curriculum review.