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Health professions educators widely agree that inquiry must be fostered in trainees, yet fundamental questions remain about how to cultivate it as a habit. This scoping review examined instructional approaches to teaching inquiry in medicine and nursing through the lens of John Dewey's philosophical framework, which conceptualizes inquiry as comprising both a five-phase method and a psychological attitude toward inquiry methods. Our analysis of 103 articles describing inquiry-focused educational interventions in medical and nursing education shows that, beyond clinical reasoning and evidence-based practice, current approaches predominantly emphasize research participation, focusing on building knowledge and skills in inquiry methods while largely neglecting two critical components of Deweyan inquiry. First, interventions rarely engage learners in the initial phase of recognizing and experiencing uncertainty-the crucial starting point that drives authentic inquiry. Second, despite well-established links between attitudes and behavior, promoting positive attitudes toward inquiry methods was rarely an explicit educational objective. We conclude that teaching inquiry purely as a method, without attending to the formative experiences of uncertainty and attitude development, falls short of cultivating inquiry as a sustained professional habit. Future educational interventions can be strengthened by explicitly designing for awareness of uncertainty, including clear attitudinal objectives, and measuring not only the skills acquired but also the attitude formed toward inquiry methods.
This article examines the development of modern nursing education in China through a case study of the Xiangya School of Nursing in Changsha between 1909 and 1926. Founded in 1911 by the Yale-in-China Association, a non-denominational mission, Xiangya was among the earliest nursing schools in China to promote undergraduate nursing education and public health nursing. Drawing on archival materials, published primary sources, and Chinese and English historiography, we analyze the cultural, political, and gendered challenges that shaped the school's development under the leadership of American nurse Nina Gage. While Gage initially sought to implement an Americanized model of nursing education, she and her colleagues adapted admission policies, educational goals, and curricula to local social and cultural conditions. Recognizing the need for Chinese nursing leadership, they prioritized the establishment of a Bachelor of Science degree to prepare nurses for teaching, administration, and public health roles. By 1926, Xiangya had trained approximately 16% of China's qualified nurses and had become one of only two schools in China offering university-level nursing education. This history highlights the interplay of transnational influence, cultural adaptation, and gendered reform in the professionalization of nursing in early 20th-century China.
Nursing education institutions have sought to incorporate health equity and social justice into curricula. However, nursing students report limited opportunities to engage with these perspectives during their studies. In a campus-based clinical learning environment, efforts have been made to support students in the advancement of health equity and social justice by integrating a norm-critical approach. This study aimed to explore how nursing students made sense of norm-criticism in a campus-based clinical learning environment. The design of the study was qualitative, informed by narrative inquiry and a Goffmanian theoretical framework. The study was carried out in a campus-based clinical learning environment for nursing education in a mid-sized university college. The participants of the study consist of 14 undergraduate nursing students. This study adopted a narrative methodology where the data was analyzed both structurally and thematically. This study demonstrates that students made sense of norm-criticism by framing it in three distinct phases. First, students encounter norm-criticism through norm-critical photographs, then they engage in critical reflection on norm-criticism, both in collaboration with peers and through personal reflection on their own positionality, and lastly, they find meaning in norm-criticism as a tool to change unequal nursing practices and provide person-centered nursing care. This study highlights that, by mechanisms of impression management and reframing, nursing students regard and use norm-criticism as a reflective tool that empowers them to change healthcare structures and supports them in understanding how to provide person-centered care.
Academic practice partnerships facilitate a shared focus between practice and academic settings that encourages nursing leadership in both settings to work towards improving patient outcomes, facilitating new knowledge and optimizing the organizational aspects of clinical care. The purpose of this report is to describe a 17-year academic-practice partnership with a focus on research, referred to as the University of Maryland Nursing (UMNursing) Research Program. The goal of the academic research partnerships was to create collaborative research opportunities for faculty at the school of nursing and nursing staff at the academic medical center. Since 2007, 17 academic-partnership research grants were funded by the UMNursing Research Program and half of these pilot studies resulted in submissions to the National Institutes of Health for R21, R01 and center-level grants. A total of 9 manuscripts have been published. Academic-practice partnerships for research, such as the one described in this report, can be an alternative solution to alleviating national funding cuts while continuing to facilitate nursing research and building clinically relevant nursing knowledge. Sustained academic-practice partnerships can enhance nursing research capacity, leverage limited funding, and promote clinically relevant scholarship.
The graduation rate of Black undergraduate students in nursing programs remains lower than that of their peers despite a notable increase in enrollment. Without disaggregated data, anecdotal and emerging evidence suggests student attrition rates are associated with unreasonable demands and unmet learning needs. Black nursing students experience systemic anti-Black racism from instructors, nurses, peers, and patients, which also contributes to their slow progress. These experiences impact equity, diversity, and inclusion in higher education and nursing. We explored the experiences of Black students in the two undergraduate nursing programs in Saskatchewan, Canada, to deepen our understanding of their needs and inform strategies for addressing anti-Black racism in nursing education. Using focused ethnography grounded in critical race theory and intersectionality, N = 26 individual interviews with current and former Black students from Saskatchewan nursing programs were analyzed using thematic analysis. Racist experiences reported by study participants were more prominent in clinical than classroom settings. Five main themes were identified. This paper focuses on Theme 1, "Racism is part of the culture in nursing," and its subthemes, namely racial microaggressions, racial stereotyping and accent bias, isolation and exclusion, unfavorable environment, and impact on mental health and well-being. Support and accountability measures in nursing education are needed to facilitate social justice.
Cybernetics describes how systems regulate performance through feedback control by setting goals, monitoring current states, comparing against a standard, and adapting actions to reduce discrepancies. In teaching, this feedback-loop logic can be operationalized as structured cycles of goal clarification, guided information seeking, peer sense-making, and formative feedback. However, evidence on a cybernetic-based instructional approach (CBI) for undergraduate nursing achievement remains limited in low-resource higher-education settings. To compare the effects of Cybernetic-Based Instruction and the traditional lecture method on the academic achievement of undergraduate nursing students in maternal and child health nursing. A quasi-experimental, non-equivalent group pretest-posttest study was conducted among fourth-year nursing students at Bayero University, Kano, Nigeria. Two intact cohorts from successive academic sessions received the same course content over a 13-week module. The 2024/2025 cohort received CBI (objective-driven inquiry, explicit credibility appraisal, peer synthesis, and iterative instructor/peer feedback), while the 2023/2024 cohort received conventional didactic lectures (PowerPoint/whiteboard with scheduled Q&A). Achievement was measured using a 50-item Maternal and Child Health Nursing Achievement Test (MCHNAT) administered pre- and post-instruction under supervised conditions. Analyses used within- and between-group tests and ANCOVA adjusting for pretest scores (α = 0.05). Both groups improved significantly from pretest to posttest (p < 0.001). The CBI cohort achieved higher post-test scores and larger gains than the lecture cohort (73.12 ± 8.96 vs 60.62 ± 4.49; p < 0.001) and greater mean gain (31.59 ± 8.37 vs 17.94 ± 4.54; p < 0.001), and the adjusted between-group difference remained significant after controlling for baseline scores. ANCOVA confirmed a significant adjusted advantage for CBI (B = 13.13; 95% CI: 11.30-14.97; p < 0.001; partial ηp2 = 0.554; R2 = 0.605). A structured cybernetic feedback-loop approach was associated with higher short-term achievement than lecturing. Further multi-site studies should examine longer-term retention and transfer, and strengthen internal validity where feasible.
Moral distress has become one of the most prominent ethical constructs in contemporary nursing, widely used to describe nurses' experiences of constraint, frustration and ethical unease. While moral distress scholarship continues to retain important ethical and structural dimensions, the broader operationalisation of moral distress within healthcare organisations and professional discourse may influence how ethical conflict is understood and managed within healthcare organisations. This paper argues that such framings can have unintended consequences for nursing's moral authority and professional standing. Adopting a critical theoretical and conceptual synthesis, and drawing on feminist theory, Foucauldian analyses of power and contemporary nursing scholarship, this paper reconceptualises moral distress as functioning within conditions of subordination by design, understood as organisational, discursive and material arrangements that may systematically constrain nursing authority while influencing the conditions under which ethical dissent is manageable and non-disruptive. Within this framework, this paper advances three related concepts: moral containment, referring to organisational responses that absorb and redirect ethical dissent; ethical erosion, describing the cumulative diminishment of nurses' moral agency over time, and ethical laundering, naming the institutional process through which ethical harm may be acknowledged yet rendered politically inert. Rather than rejecting moral distress scholarship, the paper situates moral distress within a broader architecture of organisational power, contributing to contemporary debates regarding nursing voice, professional authority and the structural conditions under which nursing ethics can be meaningfully enacted.
The nursing process (NP) is a systematic, patient-centred framework fundamental to professional nursing practice, yet its implementation remains suboptimal, particularly in low- and middle-income countries (LMICs). This narrative review examines the global implementation of the NP, with a focused case analysis of evidence from Pakistan (n = 2 studies) and other LMICs, and identifies barriers, facilitators, and research gaps. Pakistan was selected for focused analysis due to the authors' direct knowledge of its healthcare system and the absence of any previous synthesis of NP implementation evidence in this context. This narrative review employed a literature search across PubMed, CINAHL, and Google Scholar using Boolean operators with keywords including "Nurses' Perceptions," "Nursing Process," "Barriers," and "Facilitators." Inclusion criteria captured original research and reviews published between January 2017 and September 2023, with seminal older studies included for theoretical context. editorials, commentaries, non-English publications, and studies without original data on NP barriers or facilitators. The search prioritized evidence from LMICs, with additional Pakistan-specific database searching. Twenty-six studies were included in the final synthesis. The synthesis reveals a stark disparity in NP implementation. While high-income countries report adoption rates exceeding 80%, implementation in LMICs including Ethiopia, Ghana, and Nigeria is inconsistent (approximately 50-60%). Key facilitators identified included supportive supervision (reported in 4 studies), availability of documentation tools (6 studies), and continuing education (5 studies). Thematic analysis identified critical barriers across four domains: (1) systemic and resource-related factors, (2) educational and knowledge-based factors, (3) administrative and socio-cultural factors, and (4) nurse-related individual factors. In Pakistan, two studies suggest good theoretical knowledge among nurses (86.7-89.5%), but practical application is hindered by similar systemic barriers. The nursing process remains a cornerstone of high-quality care, yet its potential is unrealized in many resource-constrained settings. To address the implementation gap, strategic investments in administrative support, continuous professional development, and resource allocation are needed. This review identifies an urgent need for qualitative inquiry in Pakistan to explore nurses' lived experiences regarding NP implementation in clinical settings-specifically, how contextual factors (workload, supervision, resource availability) shape daily practice decisions. Not applicable.
Palliative care nursing practice supports individuals and their caregivers through the end-of-life by emphasizing a person-centered approach. However, in practice, nurses must navigate ongoing tensions between organizational norms, professional responsibilities, and the diverse values and wishes of patients, raising questions about how care can remain responsive within complex and constraining contexts. Despite recognition of these challenges, the mechanisms through which palliative care nursing practice sustains meaningful living at the end-of-life remain insufficiently understood. This study examined the mechanisms through which palliative care nursing enables patients to live a meaningful life until death. Using an interpretive descriptive design informed by Sen's capability approach, the study combined three qualitative methods: co-construction of practice narratives with three home-based palliative care nurses, reflexive writing of a personal narrative by the main researcher, and analytical questioning. The analysis identified four interrelated mechanisms that characterize palliative care nursing practice: navigating between patients' valued lives and norms; recognizing patients as simultaneously capable and vulnerable; reflexively engaging with one's own practice; and being creatively present through sensitive and slow actions tailored to each situation. Together, these mechanisms depict a reflexive, relational, and context-sensitive nursing practice oriented toward expanding patients' real possibilities for living a meaningful life until death.
Nursing scholarship has extensively documented the harms of inequity within healthcare systems, including racism, bias, and structural exclusion affecting patients and the nursing workforce. Less examined, however, is a foundational ethical question: what does ethical care require of the caregiver within inequitable systems? This paper argues that wellbeing should be understood not merely as an outcome shaped by justice, but as a professional and organizational capacity necessary for ethical, relational, and accountable nursing practice in its presence. We introduce the concept of implicit conditioning to shift analytic attention from individual moral deficiency to the systemic imprinting of perception and response under chronic strain. From this perspective, inequitable care can be understood as a predictable expression of conditioned responses within environments of depletion. Wellbeing, therefore, functions as ethical infrastructure, supporting regulation, reflection, and accountability without defensiveness. We examine implications for nursing education and organizational ethics, contending that institutions play a decisive role in cultivating or constraining the capacities ethical practice requires. Reframing wellbeing as foundational to ethical nursing practice clarifies responsibility across individual and structural levels and expands what becomes possible for equitable care within inequitable systems.
Black women's participation in nursing in Canada has been marked by a long history of discrimination and exclusion, even after they were formally permitted to enter the profession in the mid-1940s. Examining mainstream Canadian newspaper coverage, this study traces anti-Black racism in Canadian nursing from the 1940s to 2020. Newspaper database keyword searches using contemporary and contextually employed descriptors identified 13 newspapers with substantial coverage across the 80-year period. Thematic analysis of relevant articles generated four narrative frames: (1) 1940s-1950s: claims of "no barriers" to nursing education; (2) 1960s-1970s: clear acknowledgment of racism against Black nurses; (3) 1980s-1990s: incipient recognition of systemic nature of discrimination; and (4) 2000s-2020: deepening understandings of systemic racism in nursing. The extent and nature of coverage within and across timeframes varied, influenced by each newspaper's editorial stance and ideological leanings. Some outlets highlighted the lived experiences of racism reported by Black nurses; others downplayed or denied that racism existed. Overall, the findings show that despite some progress and growing public recognition of anti-Black racism, systemic discrimination remains deeply embedded within Canadian nursing. Addressing these longstanding inequities requires sustained, multi-level action. Although this study is Canada-focused, the methodological approach and findings have broader relevance for other societies with histories of anti-immigrant and racial discrimination. Trial Registration: N/A.
Self-care occupies a central, often taken-for-granted and normatively privileged position in contemporary nursing discourse, consistently framed as a marker of empowerment, autonomy and responsible health behaviour. Although critical scholarship has contested this framing through work on relational care, feminist critiques of individualism and the neoliberal responsibilisation of health, the normative work self-care performs within nursing's own conceptual frameworks remains insufficiently examined. This paper offers a theoretical analysis of self-care as a subject-forming discourse. It revisits Orem's Self-Care Deficit Nursing Theory as a conceptual baseline in which vulnerability and dependence are ethically acceptable conditions that legitimately call forth nursing intervention, and traces how neoliberal health discourse has reconfigured self-care from capacity into obligation. Building on existing structural critiques, the paper argues that a further, subjective transformation warrants attention: self-care discourse contributes to the formation of subject positions in which responsibility is internalised, vulnerability experienced as inadequacy and care-seeking as personal failure. These subject positions are unevenly taken up across class, gender, age and health status, and may be resisted or reinterpreted. Drawing on Byung-Chul Han's account of the achievement subject, the paper conceptualises this dynamic here as the self-care paradox and considers what it asks of nursing theory.
This manuscript explores critical pragmatism as a philosophical paradigm for nursing research. Critical pragmatism integrates the action-oriented focus of pragmatism with the emancipatory aims of critical paradigms, offering a perspective that is both practically grounded and oriented toward social transformation. We outline the paradigm's philosophical foundations, including its roots in pragmatism and critical paradigms. Drawing on the doctoral work of R.G. and M.K. as illustrative examples, we conceptualize critical pragmatism as a continuum that accommodates diverse perspectives with shared ontological, epistemological, and axiological commitments. We present critical pragmatism as a promising paradigm for nursing research, with the potential to strengthen the relevance, applicability, and impact of nursing scholarship in both practice and academic contexts.
Neonatal intensive care units (NICUs) concentrate ethically complex decision-making, yet the leadership behaviours supporting nurses' ethical agency remain insufficiently understood, particularly outside Western contexts. To explore how moral leadership is experienced and enacted in shaping ethical decision-making among NICU nurses. Qualitative narrative inquiry, reported in accordance with COREQ and SRQR. Twenty-four registered nurses were recruited through purposive maximum-variation sampling across four Level III NICUs in northern Saudi Arabia. Narrative interviews (52-97 min; mean ≈ 74 min) were conducted over an eight-month period, from June 2025 to January 2026, and analysed using a narrative analysis approach integrating thematic and structural elements. Trustworthiness was supported through participant review of narrative summaries (14 of 24 participants provided substantive feedback), peer debriefing, reflexive journaling, and inter-coder agreement (κ = 0.83). Five themes and 15 subthemes were identified. Moral recognition was narrated as active, affectively mediated, and culturally embedded. A recurrent gap between moral judgment and moral action was attributed to hierarchical suppression of nursing voice and limited psychological safety. Servant leadership behaviours, empathic listening, moral mentoring, and ethical role modelling, as cumulative relational formation, functioned as moral scaffolding enabling ethical voice and action. Three emergent subthemes extended the framework: ethical role modelling as identity-level formation, spiritually grounded motivation rooted in Islamic accountability, and culturally sanctioned disclosure silence as a source of moral dissonance. Moral leadership in Saudi NICUs is a relational, contextually conditioned practice shaped by leadership behaviours, institutional structures, and cultural frameworks. Strengthening ethical infrastructure through leadership development, nurse-accessible ethics support, and competency frameworks embedding moral leadership as a professional standard is a priority for neonatal nursing in Saudi Arabia and comparable settings. Not applicable.
Punitive culture in nursing education has been documented for over four decades. Interventions have proliferated, yet the problem persists. This paper argues that persistence is not an implementation failure but an epistemic one. Drawing on nursing's own critical tradition, particularly Roberts's application of Freire's oppressed group behavior model and the Foucauldian scholarship of Gastaldo, Holmes, and their successors, I trace three historically specific disciplinary logics that converge in a professional epistemology experienced as natural rather than constructed: religious moral formation, which naturalized obedience as virtue; biomedical hierarchical subordination, which naturalized hierarchy as scientific authority; and gendered labor discipline, which naturalized self-sacrifice as caring. These logics persist through what Bourdieu termed habitus: durable dispositions transmitted through intergenerational socialization, the hidden curriculum, and clinical evaluation structures. Behavioral interventions fail because they target outputs without making the generating logics visible. What is needed is not better behavioral management but genealogical consciousness: the capacity to recognize the profession's disciplinary inheritance as historical construction rather than natural order.
BackgroundIntimate partner violence (IPV) is a pervasive public health and human rights issue, yet survivors' agency is often framed narrowly within linear victim-survivor narratives that overlook how intersecting identities and structural constraints shape their options and responses. Objectives: To explore how women who have experienced IPV negotiate agency and reclaim voice within intersecting social, cultural, and personal borderlands of experience.DesignQualitative narrative inquiry informed by intersectionality and borderlands theory.MethodsTwo women living in a Canadian city, who self -identified as having experienced IPV and had been out of violent relationships for at least three years, participated in biweekly narrative conversations from August to December 2023. Analysis attended to intersecting social locations (including Indigeneity, sexuality, socioeconomic position, and professional roles) and to liminal in-between moments of safety and danger, love and abuse, dependence and resistance, silence and voice.ResultsAnalysis identified three interrelated movements in women's agency over time, regressive transformation, hibernation, and progressive transformation, operating simultaneously rather than sequentially. For example, Aila's parenting decisions revealed agency constrained by child welfare surveillance yet oriented toward intergenerational change, while Artemisia rediscovered her pre-abuse self through old journals and art, illustrating hibernated agency gradually re-emerging.ConclusionThis study challenges linear victim-survivor models of recovery by conceptualizing agency as a dynamic, relational process shaped by intersectional locations and borderland spaces. Intimate partner violence (IPV) is abuse by a current or former partner. It affects millions of people worldwide and causes serious, lasting harm to physical and mental health. Much of what has been written about this issue focuses on the moment a survivor leaves an abusive relationship, as if that single decision defines their experience. But surviving abuse is far more complicated than that. This study shares the stories of two women in Canada, called Aila and Artemisia, who experienced IPV. Over five months, each woman had in-depth conversations with the researcher about their relationships, how they coped, and how they rebuilt their lives. Their stories were analyzed paying close attention to how factors like race, sexuality, economic situation, and personal history shaped their experiences in unique ways. Three patterns emerged from both women’s stories. First, over time, abuse gradually wore down their confidence, independence, and sense of self. Second, both women went through periods of going quiet and suppressing their feelings and opinions. This was not out of weakness, but as a way to stay safe. Third, both women slowly began to rediscover themselves, often through small acts like setting a boundary, speaking up, or imagining a different future. Importantly, these were not neat, one-after-another stages. The women moved back and forth between all three at different times and in different parts of their lives. This research challenges the idea that recovery is a straight line from victim to survivor. It shows that strength looks different for every person. Support services need to respect that complexity rather than expecting women to follow a single path to healing.
Reproductive autonomy, the power to make decisions about and to control matters related to contraceptive use, pregnancy, and childbirth, is essential for women to attain their sexual and reproductive health and rights. We explored barriers and facilitators of reproductive autonomy among adolescent girls in western Uganda, a region marked by high rates of adolescent pregnancy and HIV prevalence. This qualitative inquiry involved 31 in-school and out-of-school adolescent girls aged 15 to 19 years, purposively selected from diverse communities within Fort Portal city, western Uganda. Data were collected through individual interviews between September and November 2024 and analysed using framework thematic analysis guided by the three dimensions of reproductive autonomy: decision-making, communication, and freedom from coercion. The findings show an intricate interaction of individual, relational, and structural factors that shape adolescent girls' reproductive autonomy, with commonalities and uniqueness based on schooling status. Key barriers included control by parents and partners in communication and decision-making, limited knowledge of girls on sexual and reproductive health, low self-efficacy to decide and implement decisions, financial dependence, and lack of life basics. Conversely, supportive relationships and schooling emerged as critical facilitators. In conclusion, enhancing reproductive autonomy requires multi-level and multi-faceted interventions to address the barriers while leveraging the facilitators. These should include household economic empowerment, parenting support programs, and policies that promote universal access to education. We studied what helps and what makes it harder for adolescent girls in western Uganda to make their own free choices about using contraceptives, engaging in sex, getting pregnant, and giving birth. We held interviews with 31 adolescent girls in the age range of 15–19 years from September to November in 2024. Eleven girls were attending school while twenty were not. These girls were selected from different communities in Fort Portal city, western Uganda. We found a number of issues that affect these girls’ ability to make decisions about their Sexual and Reproductive Health (SRH). Some of the main challenges were strong influence from parents and sexual partners, limited knowledge on SRH, low confidence to decide and implement decisions, being dependent financially on parents and sexual partners, and lack of basic needs. On the other hand, being in school and having supportive people such as family members around the girls helped them to feel more in control and able to decide on SRH matters. To help these girls have more say over their SRH, the findings emphasise efforts at different levels of society and from different people with whom they regularly interact. Such efforts could include helping families improve their incomes to financially support the girls, supporting parents on how to communicate with the girls, and making sure all girls can get education.
In multilingual nursing education, English-medium practices often dominate teaching, assessment and documentation, positioning students' home languages as informal or inappropriate for legitimate academic participation. This qualitative, descriptive, exploratory and contextual study investigates how nurse educators conceptualise the role of students' home languages in teaching and assessment, and what these conceptualisations disclose about language ideologies, recognition and the politics of voice in professional formation. Across five focus groups with 44 nurse educators, participants framed home language as a pathway to epistemic access, enabling comprehension, conceptual clarity and participation when English constrained expression. They also described multilingual responsiveness as a practice of dignity and cultural recognition, in which respectful communication and non-humiliating feedback enact humanising pedagogy. At the same time, educators highlighted structural tensions in which English operates as a gatekeeping regime in assessment and professional communication, producing moments where students 'know' content yet struggle to demonstrate competence in sanctioned discourse. Communication was further expanded beyond linguistic proficiency to include cultural nuance, nonverbal meaning and relational conduct, linking language to clinical readiness and patient care. The article argues for structured multilingual pedagogies and language-aware assessment that maintain standards while widening voice, belonging and equitable participation.
The COVID-19 pandemic highlighted the need for alternative healthcare delivery models, leading to the development of Continuous Remote Patient Monitoring (CRPM). CRPM allows for real-time monitoring of high-risk patients, reducing the burden on hospital resources. The integration of virtual nursing into CRPM has enhanced remote care capabilities, though it has also introduced new challenges related to patient safety and staffing, that is, nurse-to-patient ratios. This scoping review aims to explore the current evidence on virtual nursing using CRPM and identify challenges or barriers that help further future research and healthcare practices. This scoping review followed the PRISMA-ScR guidelines. Eligible studies focused on virtual nursing with physiological monitoring in either remote hospital or home-based care settings, with explicit examination of nursing care and its impact on patient and nursing outcomes. Peer-reviewed articles published in the past 10 years in English were included. Four databases (Ovid, PubMed, CINAHL, and Medline) were searched with support from a medical librarian. After screening 207 records using Covidence, 17 studies met the inclusion criteria. Two reviewers independently screened all records, with a third resolving discrepancies. Data was charted using a standardized extraction template. Seventeen studies were included in this review. CRPM was associated with reported benefits in managing chronic conditions, extending acute care into home settings, and enhancing healthcare system adaptability, particularly during the COVID-19 pandemic. Clinical benefits included early detection of health deterioration, reduced hospital readmissions, and improved patient satisfaction. Nurses played a pivotal role in physiologic data interpretation and intervention, highlighting the importance of continuous oversight in achieving favorable outcomes. However, implementation challenges, such as alert fatigue, data overload, user interface complexity, and financial sustainability were consistently reported. These findings underscore the need for improved data management systems, targeted nurse training, and sustainable funding models to support broader CRPM adoption. Virtual nursing within CRPM demonstrates strong potential to improve patient outcomes and reduce hospitalizations by extending inpatient-level physiologic surveillance into home-based and hospital-at-home settings through continuous, nurse-led monitoring. Successful integration of this model into routine practice will require addressing challenges related to data management, clinician workload associated with 24/7 surveillance, and sustainable funding mechanisms to support continuous virtual nursing coverage.
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