Current Issue : July-September Volume : 2026 Issue Number : 3 Articles : 5 Articles
Background: Clinical practice guideline (CPG) is essential for improving the quality and consistency of care. However, gaps between guideline recommendations and nursing practice remain, contributing to adverse patient outcomes. A theory-based tool is needed to systematically assess factors that influence nurses’ implementation of CPG. Objective: To develop and validate the Clinical Practice Guideline Implementation Influencing Factors for Nurses (CPGIF-N) scale for identifying factors affecting CPG implementation among nurses. Methods: Items were generated through a scoping review and refined via two-round Delphi reviews. A pilot survey with 40 nurses and a cross-sectional survey with 1005 nurses from eight tertiary hospitals were conducted. Both classical test theory (CTT) and item response theory (IRT) analyses were performed. Results: A total of 637 valid responses were analyzed. Content validity indices were high (I-CVI: 0.93–1.00; S-CVI/Ave: 0.99). The IRT analysis indicated that the final items demonstrated good discrimination (a = 1.278–4.579), ordered threshold parameters (b1 to b4), and acceptable to excellent average information (range: 0.700–2.161). Confirmatory factor analysis revealed acceptable-fit indices (χ2/df = 1.956, RMSEA = 0.055, CFI = 0.935, TLI = 0.929). Average variance extracted values (0.818, 0.632, and 0.815) and composite reliability values (0.973, 0.941, and 0.982) confirmed convergent validity. The scale demonstrated excellent internal consistency (Cronbach’s α = 0.972; McDonald’s Omega = 0.982). Conclusions: The CPGIF-N scale is a reliable and valid instrument, with strong psychometric properties, offering a practical tool to evaluate factors influencing CPG implementation among nurses in China....
Background: With the intensifying global trend of population aging, the importance of geriatric nursing is becoming increasingly prominent. Understanding how nursing students develop professional identity within the context of geriatric care can help foster their interest and competence, thereby ensuring the quality of care services in an aging society. Aim: This study aims to explore, from a life course perspective, the multiple factors that influence the formation of professional identity in geriatric nursing among nursing students. Methods: An exploratory descriptive qualitative design was employed. Semistructured interviews were conducted with 16 undergraduate nursing students. Thematic analysis was used to identify key themes related to the formation of professional identity. Results: Four main themes emerged from the data: (1) Early life experiences shaping emotional connection and basic impressions of older adults, (2) cognitive construction and challenges in geriatric nursing during education, (3) professional identity development and obstacles during clinical and volunteer experiences, and (4) realistic considerations and societal influences in career planning. Conclusion: Nursing students’ professional identity is dynamically constructed through the interplay of multidimensional experiences over the life course. Enhancing early exposure, enriching educational content, strengthening clinical support, and optimizing the broader social environment are crucial to promoting positive identification with geriatric nursing and advancing the development of a specialized workforce in this field....
This study explores how hospital location (rural/non-rural) may moderate the nurse staffing ratio’s impact on three hospital-acquired infections. This study used data from 2022 to 2024 on nurse staffing and hospital characteristics from the American Hospital Association Annual Survey and data on hospital-acquired infection rates from the Medicare Care Compare dataset provided by the Centers for Medicare and Medicaid Services. After removing missing values, the final dataset included 7997 hospital-year observations across the US. Independent variables include rural hospital designation, nursing hours per patient day, and RN FTE per adjusted day. The dependent variables included infection rates of Central Line-Associated Bloodstream Infection, Catheter-Associated Urinary Tract Infection, and Methicillin-Resistant Staphylococcus aureus. Multiple regression was performed in Stata 18. Our research found that across all three infection types, an increase in nursing hours per patient day is significantly associated with a decrease in the infection rate, and that impact was not moderated by hospital rurality. Extra time spent with patients in either a rural or non-rural hospital decreased hospital-acquired infection rates. While RN FTEs were included in the model, total nursing hours per patient day emerged as the more consistent predictor of lower hospital-acquired infection rates....
Ethics education constitutes a fundamental component of nursing development, shaping practitioners capable of sound moral judgment, responsible action, and ethically grounded clinical decision-making. Despite long-standing written ethical codes within the nursing profession, substantial gaps persist between theoretical instruction and real-world practice, leading to fragmented moral competence among nursing students and nurses. This discussion paper synthesizes evidence from the “Promoting a Morally Competent Nurse” project, insights derived from an international blended intensive program to examine the multifaceted challenges that hinder effective nursing ethics education, and expert contributions. Identified challenges include complexity of ethics theories; inconsistencies in the nursing curricula; the misalignment between formal and hidden curriculum; lack of resources and time dedicated to ethics education; inconsistencies in the training methods; and issues related to ethical leadership. The paper argues that cultivating moral competence requires more than the transmission of theoretical knowledge -it demands experiential learning, role modelling, and ethically supportive environments. A roadmap is proposed outlining complementary roles for academic nurses and nurse managers in strengthening ethics education across educational and clinical settings. Enhancing ethical leadership, harmonizing curricula, and investing in educator preparation are critical steps toward building an ethically resilient nursing workforce The paper concludes that ethical competence is not a static achievement but a lifelong developmental process that must be nurtured through intentional, coordinated, and context-sensitive strategies....
Background: Nitrous oxide/oxygen (N2O/O2 50%/50%) is an effective and safe technique for procedural sedation in paediatric settings; however, the knowledge, use and perspectives of healthcare professionals regarding N2O/O2 remain limited. Aim: To investigate the knowledge, use and perspectives of healthcare professionals regarding N2O/O2 in maternal–infant and emergency units. Study Design: A cross- sectional study was conducted (March to December 2024) using (i) a sociodemographic information tool and (ii) a 16- item questionnaire assessing knowledge, clinical use, perceived barriers and willingness to adopt N2O/O2. Descriptive and multivariate analyses were performed. Results: Of 113 respondents, 40.7% reported currently using N2O/O2 in their clinical units, while 91.0% of non- users expressed willingness to adopt it. Barriers included lack of equipment (92.9%) and training (84.1%). 91.1% considered N2O/O2 ethically acceptable, consistent with principles of beneficence, non- maleficence and child comfort. Employment in emergency units and holding a three- year nursing degree were significant predictors of N2O/O2 use. Conclusions: Limited Use of N2O/O2 in Italian Paediatrics Contrasts With Strong Professional Interest. Improving Training and Resources Could Enhance Access to Safe Paediatric Sedation. Relevance to Clinical Practice: Training, equipment and guidelines are needed to translate willingness into real clinical practice, improving the safety and consistency of paediatric sedation....
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