BACKGROUND: The key step in evaluating the quality of clinical nursing practice education lies in establishing a scientific, objective, and feasible index system. Current assessments of clinical teaching typically measure hospital learning environments, classroom teaching, teaching competency, or the internship quality of nursing students. As a result, clinical evaluations are often insufficient to provide focused feedback, guide faculty development, or identify specific areas for clinical teachers to implement change and improvement. Therefore, the purpose of our study was to to construct a scientific, systematic, and clinically applicable evaluation index system of clinical nursing practice teaching quality and determine each indicator\'s weight to provide references for the scientific and objective evaluation of clinical nursing practice teaching quality.
METHODS: Based on the \"Structure-Process-Outcome\" theoretical model, a literature review and Delphi surveys were conducted to establish the evaluation index system of clinical nursing practice teaching quality. Analytic Hierarchy Process (AHP) was employed to determine the weight of each indicator.
RESULTS: The effective response rate for the two rounds of expert surveys was 100%. The expert authority coefficients were 0.961 and 0.975, respectively. The coefficient of variation for the indicators at each level ranged from 0 to 0.25 and 0 to 0.21, and the Kendall harmony coefficients were 0.209 and 0.135, respectively, with statistically significant differences (P < 0.001). The final established index system included 3 first-level, 10 second-level, and 29 third-level indicators. According to the weights computed by the AHP, first-level indicators were ranked as \"Process quality\" (39.81%), \"Structure quality\" (36.67%), and \"Outcome quality\" (23.52%). Among the secondary indicators, experts paid the most attention to \"Teaching staff\" (23.68%), \"Implementation of teaching rules and regulations (14.14%), and \"Teaching plans\" (13.20%). The top three third-level indicators were \"Level of teaching staff\" (12.62%), \"Structure of teaching staff\" (11.06%), and \"Implementation of the management system for teaching objects\" (7.54%).
CONCLUSIONS: The constructed evaluation index system of clinical nursing practice teaching quality is scientific and reliable, with reasonable weight. The managers\' focus has shifted from outcome-oriented to process-oriented approaches, and more focus on teaching team construction, teaching regulations implementation, and teaching design is needed to improve clinical teaching quality.

BACKGROUND: The prevalence of risk prediction models for skin tears in the elderly is growing; however, there is still debate regarding the usefulness and suitability of these models for clinical use and additional study.
OBJECTIVE: The purpose of this work is to perform a systematic review and meta-analysis of published research on skin tear risk prediction models in the elderly.
METHODS: We conducted a comprehensive search of various databases, including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, PubMed, Web of Science, MEDLINE, Scopus, The Cochrane Library, Wanfang Database, China Science and Technology Journal Database (VIP), and China National Knowledge Infrastructure (CNKI), from the beginning until November 27, 2023. Data extraction from the chosen studies encompassed various elements, such as study design, sample size, outcome definition, data source, predictors, model development, and performance. The assessment of bias and applicability was conducted using the Prediction Model Risk of Bias Assessment Tool (PROBAST) checklist. The Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) checklist was utilized to assess the transparency in reporting the prediction models-a meta-analysis of the most common predictors to assess predictor reliability. In addition, a narrative synthesis was carried out to provide an overview of the qualities, bias risk, and effectiveness of the current models. The reporting procedures of this meta-analysis conformed to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement.
RESULTS: Out of the initially retrieved 1499 studies, this review included eight prediction models from eight selected studies. All the studies employed logistic regression to develop prediction models for skin tears. The prevalence of skin tears in the elderly varied from 3.0% to 33.3%. Senile purpura and a history of previous skin tears were the most commonly utilized predictors. The reported values for the area under the curve (AUC) ranged from 0.765 to 0.854. All the studies exhibited a high risk of bias, primarily due to inadequate reporting in the outcome and analysis domains. Furthermore, serious questions concerning their applicability were highlighted by four studies.
CONCLUSIONS: Based on the PROBAST checklist, the current models for predicting skin tears in the elderly showed a high risk of bias. The development of new prediction models with bigger sample sizes, appropriate study designs, and external validation from multiple sources ought to be the primary focus of future research.
UNASSIGNED: There was no patient or public contribution to this systematic review.
BACKGROUND: PROSPERO registration number: CRD42023494387.

BACKGROUND: One of the psychosocial factors recognized for its positive impact on health outcomes among patients with heart disease, is social support provided by network members. However, an increasing number of patients report to experience loneliness. This study addresses the gap in research on the feasibility of an individually structured social support intervention targeting patients treated for cardiac disease who experience loneliness.
METHODS: A feasibility trial of a 6-month social support intervention targeted patients treated for cardiac disease who experienced loneliness. The intervention involved providing the patient with an informal caregiver, either a person from the patient\'s social network or a peer, in the long-term rehabilitation phase. Furthermore, the intervention included nurse consultations and motivational text messages. Feasibility was assessed in terms of acceptability and adherence.
RESULTS: During October 2022-July 2023, n = 464 patients were screened for loneliness and 28 (6.0%) screened positive of which 17 (60.7%) accepted to be contacted and receive additional information about the social support intervention. Of these, 2 (11.8%) accepted participation. The low recruitment rate did not meet the predetermined acceptability criterion of 25%.
CONCLUSIONS: This individually structured social support intervention targeting patients treated for cardiac disease who experience loneliness was non-feasible. The study highlights the complexities of engaging lonely patients in a social support intervention program and contributes with valuable insights for future research aiming to develop effective social support interventions tailored to the needs of cardiac patients who experience loneliness.
BACKGROUND: The trial is registered on clinicaltrials.gov (NCT05503810) 18.08.2022.

Background It is essential to provide evidence-based practice (EBP) courses for undergraduate nursing students. For this reason, students\' beliefs and intentions to implement EBP should be measured to ensure that EBP courses are effective. Aim The aim of this study is to evaluate Saudi nursing students\' EBP beliefs (EBPB) and implementation before they enroll in an EBP course. Methods A descriptive cross-sectional study was conducted. Two scales were used: the EBPB scale and the EBP implementation (EBPI) scale. The questionnaire was available for completion a single time before the second-year nursing students were introduced to the EBP course. Results The study revealed that the mean age for students is 20 ± 0.83. Nearly two-thirds (61.54%) of students are female. It can be noted that 71.5% have not attended any EBP programs. Additionally, 65.38% of students understand the concept of EBP, and 68.46% are willing to apply EBP nursing care. Therefore, there is a positive correlation between the EBPB scale variable and the EBPI scale. Conclusion This study highlights the positive attitude of undergraduate nursing students toward EBP. Nursing education programs must place more emphasis on integrating EBP curricula into their teaching strategies, with a focus on developing students\' knowledge, skills, and values in EBP.

OBJECTIVE: To explore the role of health communication in Shared Decision-Making (SDM) between nursing staff and older people in the community setting.
BACKGROUND: Society and healthcare services are marked by an exponentially ageing population, leading to a significant proportion of patients being older adults with highly demanding care needs. Scientific literature supports shared decision-making as a process that engages patients in their care. However, the increasing use of technology and the consequences of the COVID-19 pandemic have influenced how nurses communicate with older patients. Therefore, it is crucial to understand how to develop health communication to reach effective, shared decision-making processes.
METHODS: Whittemore and Knafl\'s integrative review method, the literature search comprised five databases: PubMed, CINALH, Web of Science, Scopus and PsycINFO.
RESULTS: The 12 included studies were synthesised into three study patterns: (1) nurse-older patient health communication relationship, (2) older patients\' perspectives and (3) nontherapeutic communication in end-of-life care.
CONCLUSIONS: This review underscored the crucial role of effective health communication in shaping SDM dynamics between nursing staff and older people in the community setting. Key elements included transparent information exchange, establishing trust and maintaining communication channels with informal caregiving networks. SDM actions were aligned with preserving older people\'s autonomy, but communication challenges persisted, particularly in end-of-life situations. Advanced care planning was recommended to address these shortcomings and improve communication among older people, healthcare professionals and families.
CONCLUSIONS: Implementing educational measures based on verbal and nonverbal health communication in nursing training could be beneficial. Nursing research could continue to develop and refine specific communication strategies adapted to the social determinants of health for diverse clinical situations regarding older adults in the community setting.
UNASSIGNED: The authors have adhered to relevant EQUATOR guidelines through the PRISMA 2020 checklist. No Patient or Public Contribution.

UNASSIGNED: Clinical nursing competence includes ethics, cooperation with other professionals, and management, in addition to nursing abilities and responding per situation. Therefore, it may vary depending on one\'s experience and the work environment. However, there is a lack of studies exploring the competence for different experience levels. Therefore, this study aimed to clarify the association between clinical nursing competence and the work environment by experience groups.
UNASSIGNED: Anonymous self-administered questionnaire surveys were conducted on 717 nurses in regional core hospitals from December 2017 to March 2018. Clinical nursing competence was measured using the Clinical Nursing Competence Self-Assessment Scale (CNCSS). Association of CNCSS with experience and work environment was examined.
UNASSIGNED: Responses from 231 nurses with 1-10 years of experience were analyzed. Compared with those in the 2-year experience group, those in the 3-5- and 6-10-year experience groups assessed their \"planned development of nursing care\" and \"assessment of care\" competencies to be higher. Additionally, compared with those in the 2-year experience group, those in the 6-10-year experience group assessed their \"clinical judgment\" and \"care coordination\" competencies to be higher. Nurses with 1 year of experience showed significant positive correlations between clinical nursing competence and \"good interpersonal relationship,\" \"clarity about the organization\'s vision,\" and \"ease of taking time off\"; and those with 6-10 years of experience showed significant positive correlations between clinical nursing competence and \"support from superiors and senior coworkers\" and \"established and easily accessible support system for taking time off for childcare and caregiving.\"
UNASSIGNED: The relationship between clinical nursing competence and the work environment differed according to years of experience. Interventions to improve clinical nursing competence should be developed for each experience group considering the associations.

OBJECTIVE: To investigate the effects of \"Timing It Right (TIR)\" nursing on clinical outcome and psychological resilience in lung cancer patients undergoing radical thoracoscopic surgery.
METHODS: In this retrospective study, 60 patients from January 2022 to June 2023 were studied. Among them, observation group received TIR intervention (n = 34), while control group received routine nursing intervention (n = 26). The self-care ability, psychological resilience, quality of life (QoL), postoperative recovery, postoperative complications, and postoperative pulmonary function recovery were compared between the two groups.
RESULTS: The scores of ESCA (Exercise of Self-Care Agency) and CD-RISC (Connor-Davidson Resilience Scale), lung function, and QoL-C30 in observation group were significantly higher than those in control group after discharge, while the incidence of postoperative complications in observation group was significantly lower than that in the control group (all P<0.05). Furthermore, time to first bedtime activity and chest drain removal, and the length of postoperative hospitalization in the observation group were obviously shorter than those in the control group (all P<0.05).
CONCLUSIONS: TIR nursing can effectively enhance the self-care ability of lung cancer patients undergoing radical thoracoscopic surgery, improve their psychological elasticity, enhance their quality of life, shorten the hospitalization time, and reduce the incidence of adverse reactions.

Our purpose was to develop and evaluate the clinical outcomes of a nursing plan as a rooming-in practice for enhanced recovery of women with preeclampsia following a cesarean section. The authors developed a postoperative enhanced recovery nursing plan as a rooming-in practice for women with preeclampsia based on summarizing evidence-based best practices. The authors used convenience sampling to select women with preeclampsia after a cesarean section from the obstetrics department of a Class A tertiary hospital in Nanjing, China, as the participants in our study. There were 30 women in the experimental group. The postoperative enhanced recovery nursing care plan was formulated for five postoperative time points and incorporated management of blood pressure, temperature, and fluids, as well as monitoring of complications, pain management, activity and rest, diet management, and breastfeeding. The control group consisted of 30 women who received routine nursing care and health education. The authors compared levels of maternal self-efficacy, breastfeeding efficacy, anxiety, pain scores, and deep vein thrombosis (DVT) prevention compliance before and after the intervention. Women in the experimental group had a self-efficacy score of 7.5 ± 0.63, which was higher than that in the control group (5.4 ± 0.85); they had a higher breastfeeding efficacy score of 7.13 ± 0.68 when compared to the control group (4.23 ± 0.86); the anxiety score was 6.7 ± 1.62, which was lower than that in the control group (10.03 ± 1.87); and the pain score was lower at 3.26 ± 0.52 when compared to the control group (3.83 ± 0.83). All the differences were statistically significant (P < 0.05). Postoperative blood pressure was controlled within the target range, and the rate of DVT prevention compliance increased in the experimental group. The implementation of a postoperative enhanced recovery nursing intervention for women with preeclampsia as part of the rooming-in practice was effective in helping manage the blood pressure, pain, and fluids of women with preeclampsia, improved their postoperative self-management ability and breastfeeding efficacy, reduced their anxiety levels, improved their compliance with the prevention of related complications, and ultimately promoted enhanced postoperative recovery, thereby guaranteeing the safety of mothers and newborns.

UNASSIGNED: Virtual reality (VR) has shown promising levels of effectiveness in nursing education, pain management, and rehabilitation. However, meta-analyses have discussed the effects of VR usage in nursing unilaterally and inconsistently, and the evidence base is diffuse and varied.
UNASSIGNED: We aimed to synthesize the combined evidence from meta-analyses that assessed the effects of nurses using VR technology on nursing education or patient health outcomes.
UNASSIGNED: We conducted an umbrella review by searching for meta-analyses about VR intervention in clinical nursing practice on Web of Science, Embase, Cochrane, and PubMed, and in reference lists. Eligible studies were published in English between December 1, 2012, and September 20, 2023. Meta-analyses of ≤2 intervention studies and meta-analyses without 95% CI or heterogeneity data were excluded. Characteristic indicators, population information, VR intervention information, and 95% CIs were extracted. A descriptive analysis of research results was conducted to discern relationships between VR interventions and outcomes. I2 and P values were used to evaluate publication bias. AMSTAR (A Measurement Tool to Assess Systematic Reviews) 2 and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) checklist were used to appraise literature quality.
UNASSIGNED: In total, 768 records were identified; 74 meta-analyses were included for review. The most reported VR study conditions were neuronursing (25/74, 34%), pediatric nursing (13/74, 18%), surgical and wound care (11/74, 15%), oncological nursing (11/74, 15%), and older adult nursing (10/74, 14%). Further, 30% (22/74) of meta-analyses reported publication bias, and 15% (11/74) and 8% (6/74) were rated as \"high\" based on AMSTAR 2 and the GRADE checklist, respectively. The main outcome indicators among all included meta-analyses were pain (37/214, 17.3%), anxiety (36/214, 16.8%), cognitive function (17/214, 7.9%), balance (16/214, 7.5%), depression (16/214, 7.5%), motor function (12/214, 5.6%), and participation in life (12/214, 5.6%). VR treatment for cognition, pain, anxiety, and depression was effective (all P values were <.05), while the utility of VR for improving motor function, balance, memory, and attention was controversial. Adverse effects included nausea, vomiting, and dizziness (incidence: range 4.76%-50%). The most common VR platforms were Pico VR glasses, head-mounted displays, the Nintendo Wii, and the Xbox Kinect. VR intervention duration ranged from 2 weeks to 12 months (typically ≥4 wk). VR session length and frequency ranged from 5 to 100 minutes and from 1 to 10 times per week, respectively.
UNASSIGNED: VR in nursing has positive effects-relieving patients\' pain, anxiety, and depression and improving cognitive function-despite the included studies\' limited quality. However, applying VR in nursing to improve patients\' motor function, balance, memory, and attention remains controversial. Nursing researchers need to further explore the effects and standard operation protocols of VR in clinical practice, and more high-quality research on VR in nursing is needed.

BACKGROUND: The expansion of the role of the rheumatology nurse specialist led to the instigation, in 1999, of the first Masters programme in rheumatology nursing, with the aim of supporting clinical advancement with evidence-based practice. This study explored the experience of rheumatology nurses undertaking postgraduate study at Masters level.
OBJECTIVE: (1) To explore the perceptions and experiences of clinical nurse specialists undertaking a Masters programme in Rheumatology Nursing, including perceptions of impact. (2) To identify future educational needs.
METHODS: Ten rheumatology nurses who had completed a Masters degree in rheumatology nursing participated in a semi-structured video link or telephone interview conducted between 17th March 2021-17th May 2021. Interpretive phenomenological analysis was undertaken by two researchers and two public contributors.
RESULTS: Four themes were identified: (i) Increased confidence and the development of new clinical skills. (ii) The perceived impact on the organisation; (iii) Benefits of face-to-face learning; and (iv) Continuing evolution of the rheumatology nurse specialist role. Participants reported increased confidence in clinical skills and felt that their learning had benefited their employing organisation. However, lack of time and insufficient managerial support could impede the implementation of new skills. Learning examination techniques, engagement in learning and peer support were seen as advantages of face-to-face learning. Future educational needs focused on diagnostic and prescribing skills.
CONCLUSIONS: Participant learners perceived that completing a face-to-face Masters in rheumatology increased confidence in delivering new clinical skills and fostered peer networks, whilst also benefiting their employing organisations. There is a need for organisational support to apply learning to the clinical setting.