Background/Objectives: Nursing informatics competency is critical for nursing students entering clinical practice in the digital era. Current undergraduate nursing informatics courses prioritize theoretical instruction but lack sufficient integration with clinical applications, which restricts the depth of content delivery. This study aimed to design, implement, and conduct a preliminary evaluation of an undergraduate nursing informatics literacy course. Methods: This was a single-arm mixed-methods study. We implemented five sequential steps aligned with the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model: (1) needs assessment, (2) design of a systematic, progressive course spanning theoretical foundation, technical skills, and clinical application; (3) development of teaching materials and environment; (4) implementation through nine weekly 90 min sessions incorporating teach-practice-feedback; and (5) evaluation via a customized questionnaire and nursing informatics system project reports. Quantitative data were analyzed using the mean, standard deviation, and paired t tests; qualitative data were collected through post-course semi-structured interviews. Results: A total of 120 participants were enrolled from a provincial public medical school, of which 119 (99.2%) completed the course. Statistically significant pre-post improvements were observed in participants' nursing informatics competencies, informatics literacy self-efficacy, and innovative behavior after course completion (p < 0.001). Participants completed 12 group projects, which received two C grades, nine B grades, and one A grade. Overall course satisfaction averaged 89.03 ± 14.62. Qualitative interviews yielded three themes: (a) cognitive reconstruction and improvement in the ability to apply nursing informatics competencies, (b) dilemmas and breakthroughs in the integration of technology and knowledge in nursing informatics design, and (c) optimization direction of course content, design, and evaluation. Conclusions: An ADDIE-based nursing informatics literacy course may be associated with improvements in nursing informatics competencies, informatics literacy self-efficacy, and innovative behavior among nursing undergraduates. This study provides preliminary evidence supporting the feasibility and potential educational value of such a curriculum.
Background: Spirituality and religious diversity are increasingly recognized as essential components of holistic nursing care in global healthcare systems. However, their integration into undergraduate nursing education remains heterogeneous and often insufficiently structured, creating a gap between professional values and students' preparedness to address spiritual needs in culturally diverse clinical environments. This study aimed to explore nursing students' perceptions, attitudes, and perceived competencies regarding spirituality, religion, and spiritual care. Methods: A descriptive exploratory survey was conducted on a sample of 69 third-year nursing students (69.6% female; majority aged ≤24 years) enrolled in two universities in Rome, Italy. Data were collected between May and July 2025 using the Nursing Care and Religious Diversity Scale (NCRDS), consisting of 31 items. Statistical analyses included descriptive statistics, internal reliability analyses, group comparisons, and multivariate regression models. Results: Students showed moderate levels of attention to patients' spiritual needs (mean = 3.11, SD = 0.88) and integration of spirituality into care practice, while high importance was attributed to spiritual care skills. University education was perceived as only partially adequate. Multivariate analyses showed that students' personal spirituality is positively associated with the assessment of spiritual needs and the perception of competence, while exposure to contexts characterized by greater religious diversity is associated with a lower perception of preparedness. Conclusions: The results highlight a discrepancy between professional values and perceived operational skills, suggesting the need to systematically integrate spirituality and religious diversity into nursing curricula. These findings highlight the need for a structured integration of spirituality and religious diversity into nursing curricula through targeted educational strategies in order to strengthen students' competencies and promote truly holistic and person-centered care.
Background: Rapid technological progress has transformed healthcare systems through integrating electronic health (eHealth) into clinical practice. Consequently, nursing students, upcoming healthcare professionals, face new challenges arising from this digital transition. Adequate technological skills and eHealth literacy are essential to meet the requirements of contemporary healthcare environments. The aim of this study was to translate, culturally adapt, and validate a questionnaire measuring technophilia, Internet use, eHealth literacy, and nursing students' attitudes toward technology and eHealth. Methods: A cross-sectional validation study was conducted using a convenience sample of Albanian undergraduate nursing students. After forward and backward translation, the instrument's construct validity was examined using exploratory factor analysis (EFA). Cronbach's alpha assessed internal consistency, and the relationships among the four constructs were explored using structural equation modeling (SEM). Results: A total of 357 undergraduate nursing students participated in the survey. EFA identified a clear four-factor structure corresponding to Technophilia, Internet Use, eHealth Literacy, and Technology and Electronic Health in Nursing Education, with all items demonstrating satisfactory factor loadings. Internal consistency of the four scales ranged from 0.692 to 0.852, indicating generally satisfactory reliability. Although the SEM model fit was below the recommended thresholds, the results provide some evidence for relationships among the constructs. Conclusions: The findings provide preliminary evidence for the reliability and validity of the adapted instrument and set a baseline for assessing Albanian nursing students' knowledge, skills, and attitudes regarding technology and eHealth literacy. Several strategies can be developed based on this evidence to prepare nursing students for technologically advanced healthcare systems.
Introduction: Climate change is increasingly affecting the health of older people. This study aimed to determine the knowledge, skills, and attitudes of nurses and undergraduate nursing students regarding the effects of climate change on older people's health. Material and Methods: A descriptive cross-sectional study was conducted between January and April 2024 with 708 participants (210 nurses and 498 undergraduate nursing students). The Nursing Competencies Questionnaire on Environmental Health of Older People (NCQ-OPEH) was used to assess environmental competencies. Descriptive values were calculated and interrelationships between knowledge, attitudes, and skills were analysed. Results: A total of 115 nurses (54.75%) and 185 students (37.15%) demonstrated good-excellent knowledge. Similarly, a higher percentage of nurses (50.77%) reported better perceived skills than students (42.52%). However, the majority of both samples (98.97% and 87.85%, respectively) had good to excellent attitudes. These differences were significant for knowledge (p < 0.001) and attitudes (p = 0.013) but not for skills (p = 0.054). Furthermore, a significant relationship was found between prior education on climate change and health and greater knowledge (p = 0.019) and skills (p = 0.027) among nurses and better skills and attitudes (p < 0.001 in both) among nursing students. Conclusions: Nurses have better environmental competencies than undergraduate nursing students. Therefore, it is important to include education on climate change and older people's health to be included in the academic curriculum of university nursing degrees. Nurses also need to reinforce these competencies through specific educational programmes, ensuring that clinical practice effectively adopts an environmental health approach to the care of older people.
Background: Evidence-based practice (EBP) is a cornerstone of high-quality and safe nursing care. However, undergraduate nursing students often experience cognitive, methodological, and contextual barriers to learning and applying EBP. Active teaching strategies, such as the flipped classroom, may support the development of EBP competencies, yet qualitative evidence exploring students' learning experiences remains limited. Objectives: To explore nursing students' perceptions and experiences of learning evidence-based practice through a flipped classroom model. Methods: A qualitative descriptive study was conducted at the Faculty of Nursing of the University of Murcia (Spain). Purposeful maximum variation sampling was used to recruit undergraduate nursing students from the second and fourth academic years who had completed an EBP course delivered using a flipped classroom approach supported by an online learning platform. Twenty semi-structured interviews were conducted via videoconference. Data were transcribed verbatim and analyzed using reflexive thematic analysis with independent coding by two researchers and consensus procedures. Ethical approval and confidentiality were ensured. Results: Three main themes were identified: (1) transformation of the meaning of EBP learning and professional role, (2) cognitive and metacognitive processes in EBP learning, and (3) the learning experience as a catalyst for deep learning. Students described a shift from initial fear and perceived difficulty toward recognizing the practical value of EBP, accompanied by increased critical thinking, autonomous learning, and a growing evidence-informed professional identity. The flipped classroom model facilitated engagement and understanding, while the transfer of learning to clinical practice was influenced by contextual facilitators and barriers. Conclusions: Learning EBP through a flipped classroom was experienced as a transformative process that fostered critical thinking, self-regulated learning, and the construction of an evidence-oriented professional identity among nursing students. Strengthening information literacy skills and improving alignment between academic and clinical environments may enhance the sustainable application of EBP in clinical practice.
Background/Objectives: Artificial intelligence (AI) is increasingly used in healthcare to support clinical decision-making, patient monitoring, and administrative tasks. Nurses are expected to work with these technologies. However, the evidence suggests that their knowledge and preparedness remain limited. As future healthcare providers, nursing students must be prepared to integrate AI into their practice. This study aimed to assess nursing students' knowledge, attitudes, perceived benefits and risks, barriers, professional impact, and preparedness toward AI in healthcare. Methods: This cross-sectional descriptive study was conducted between April and July 2024 at the College of Nursing, University of Hail, Saudi Arabia. A convenience sample of 320 undergraduate nursing students completed an online structured questionnaire that assessed their demographics, knowledge, attitudes, perceived barriers, benefits, risks, professional impact, and preparedness. Data were analyzed using IBM SPSS version 27 with descriptive statistics. Inferential analyses, including independent t-tests and one-way ANOVA, were performed to examine differences between groups. Pearson's correlation was used to identify correlations between the study variables. Statistical significance was set at p < 0.05. Results: Most students (79.7%) had poor AI knowledge, whereas 52.5% reported positive attitudes. Older students (≥24 years) and internship students showed significantly more positive attitudes (p < 0.001). Knowledge was weakly correlated with attitudes (r = 0.147), benefits (r = 0.222), and risks (r = 0.152). Attitudes were weakly positively correlated with benefits (r = 0.243) and negatively correlated with barriers (r = -0.219). Conclusions: Despite their positive attitudes, nursing students showed limited knowledge and preparedness. Integrating AI education and practical training into nursing curricula is therefore essential. These findings should be interpreted cautiously given the cross-sectional design, single-institution sampling, and reliance on self-reported measures, which may limit generalizability.
Background: Nursing students are at high risk of exposure to blood and body fluids due to limited clinical experience. Ensuring adequate knowledge and proper post-exposure protocols is vital for improving safety and post-exposure management. Aim: This study aimed to evaluate the level of knowledge, previous exposure experience, and reporting practices regarding occupational exposure incidents among nursing students at the Faculty of Health Sciences, University of Split, Croatia. Methods: A cross-sectional study was conducted among 274 nursing students using a structured self-administered questionnaire. Descriptive statistical methods were applied, along with univariate and multivariate linear regression analyses. Results: Exposure incidents were experienced by 36.3% of students, with needlestick injuries being the most common (80.1%). In terms of reporting practices, fewer than half (40.8%) of those affected officially reported the incident. While students demonstrated adequate overall performance on the knowledge assessment (median score 12, IQR: 11-14), significant gaps were identified in hepatitis B and C protocols and immediate wound care. Multivariate analysis identified full-time student status (β = 1.24; p = 0.010) and first-year students (β = 0.82; p = 0.036) as factors significantly associated with higher knowledge scores. Conclusions: Although nursing students possess solid fundamental knowledge of exposure-related risks, a significant gap remains in their practical application and incident reporting. The high incidence of needlestick injuries (80.1%) underscores the importance of moving beyond theory toward enhanced clinical supervision. To address these gaps, nursing education should prioritize targeted practical training and cultivate a robust safety culture that encourages incident reporting.
Background: Examining the relationship between burnout and absenteeism is important for understanding how chronic occupational stress translates into economic costs, reduced productivity, and deterioration in the health of nursing staff. The aim of this study was to evaluate absenteeism among nursing staff and its association with burnout from a gender perspective. Methods: A total of 154 nursing professionals with permanent contracts were included. An interview was conducted, which included the collection of sociodemographic data, characteristics related to their employment status, and the Maslach Burnout Inventory questionnaire in its Spanish-validated healthcare personnel version. The absenteeism rate was calculated using information from the hospital's human resources department. The Mantel-Haenszel test was used to identify the association between burnout and absenteeism from a gender perspective. A p-value < 0.05 was considered statistically significant. Results: The prevalence of burnout was 70.1%; 52.6% reported absenteeism in 2024. The general nursing category was significantly associated with burnout (p = 0.039). Although no association was found between burnout and overall absenteeism, holding multiple jobs was identified as a determinant of partial absenteeism (p < 0.05). The hospital absenteeism rate was 4.8%. No statistically significant difference was found between burnout, gender, and absenteeism, with an adjusted odds ratio of 1.386 (95% CI: 0.75-2.65) after controlling for the effect of gender (χ2MH = 0.672, df = 1, p = 0.412). Conclusions: Nursing staff present a critical level of burnout. No statistically significant difference was found between burnout, gender, and absenteeism, which could indicate that gender roles in the workforce may be changing in our population.
Background/Objectives: The rapid expansion of telemedicine has reshaped healthcare delivery, positioning telenursing as essential for continuity of care and patient management. This scoping review maps current evidence on telecare nursing practices, examining organizational models, professional roles, and key clinical and organizational outcomes. Methods: The review was conducted across five international databases, following the methodological framework proposed by Arksey and O'Malley, the interpretive extension by Levac et al., and the Joanna Briggs Institute guidelines, with reporting aligned to PRISMA-ScR recommendations. The search identified 1760 records, of which 1219 remained after duplicate removal. After title and abstract screening and full-text evaluation, 25 studies met the inclusion criteria. Results: Telenursing was implemented across diverse clinical contexts, particularly in chronic disease management, oncology, postoperative care, and emergency settings. Evidence indicates improvements in symptom management, therapeutic adherence, quality of life, and complication reduction, suggesting positive clinical and organizational impacts. The literature highlights the need for advanced digital, communication, and relational competencies, emphasizing the importance of targeted professional training. Cross-cutting trends include enhanced continuity of care, greater patient autonomy, improved integration between hospital and community services, and reduced healthcare costs. Conclusions: This review provides an updated overview of telenursing applications, highlighting their adaptability across clinical settings and the expanding strategic role of nurses in digital care. The findings indicate a rapidly evolving field and emphasize the need for further research to strengthen organizational frameworks, define advanced competencies, and support the sustainable integration of telenursing into healthcare systems.
Background/Objectives: Therapeutic communication is a core competency in mental health nursing, yet clinical placements often offer limited opportunities for undergraduate students to practise relational skills in a safe and structured way. Simulation, particularly when aligned with the Healthcare Simulation Standards of Best Practice™ (INACSL), may provide a useful context for fostering empathy, emotional presence, and professional communication. This study aimed to evaluate undergraduate nursing students' satisfaction and self-confidence following participation in a standardised-patient simulation designed to address therapeutic relationship competencies. Methods: A descriptive cross-sectional study was conducted with 142 third-year nursing students at a public university. Participants completed two INACSL-aligned simulation encounters involving psychiatric scenarios that required therapeutic engagement. After the sessions, students completed a questionnaire based on the Student Satisfaction and Self-Confidence in Learning Scale, adapted to the context of the simulation. Data were analysed using descriptive statistics. Results: Students reported high levels of satisfaction and self-confidence following the simulation experience. Between 88.0% and 92.9% of participants agreed or strongly agreed with items related to realism, relevance, and motivation. High levels of agreement were also observed for items related to therapeutic communication, critical thinking (98.6%), clinical competence (95.8%), and teamwork (93.6%). Lower levels of agreement were found for the usefulness of video-based debriefing (61.9%) and the adequacy of material resources (57.1%), suggesting areas for improvement in future implementation. Conclusions: Standardised-patient simulation was positively evaluated by nursing students and was associated with high levels of satisfaction and self-confidence in learning. The findings suggest that this type of educational strategy may support students' perceived development of therapeutic communication and relational skills in mental health nursing education. However, these results are based on self-reported data collected using an adapted measurement approach and should be interpreted with caution. Further research using validated instruments and performance-based measures is needed to assess competence development more directly.
Introduction/Objective: Patient satisfaction with nursing care quality is an important patient-reported indicator of hospitalization experience. Previous studies have mainly examined sociodemographic, clinical, and organizational factors, while personality traits have rarely been included in explanatory models. This study examined the association of sociodemographic characteristics, hospitalization-related variables, and personality traits with patient satisfaction. Methods: A single-center cross-sectional study was conducted among hospitalized patients in a general hospital in Croatia. Data were collected at discharge using a demographic and hospitalization questionnaire, the NEO Five-Factor Inventory, and the Croatian version of the Patient Satisfaction with Nursing Care Quality Questionnaire. Group differences were analyzed using non-parametric tests, and hierarchical regression analysis was performed. Results: Younger age, employment, male gender, and better self-rated health were associated with higher satisfaction. Patients admitted on a scheduled basis and those staying alone or with one other person in the room were more satisfied. Sociodemographic variables explained 21.5% of the variance in satisfaction (R2 = 0.215; adjusted R2 = 0.168). After hospitalization-related variables were added, the explained variance increased to 30.1% (R2 = 0.301; adjusted R2 = 0.232). The addition of personality traits further increased the explained variance to 45.6% (R2 = 0.456; adjusted R2 = 0.385). In the final model, staying with two or more persons was negatively associated with satisfaction, whereas agreeableness and conscientiousness were positively associated with satisfaction. Conclusions: Patient satisfaction with nursing care quality was associated with patient characteristics, hospitalization conditions, and personality traits. Accommodation conditions and individual psychological differences should be considered when interpreting satisfaction as an indicator of nursing care quality.
Background: Nursing student experiences in the clinical learning environment have been described in many countries but less is known about student nurses in rural settings. Aim: To explore undergraduate nursing students' experience of clinical placement in a rural setting and identify factors that influence their experience. Methods: A cross-sectional observational study was conducted with a convenience sample of 170 undergraduate nursing students in regional Victoria, Australia, who completed professional experience placements between January and June 2020. Following their placements, participants completed the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) scale. Data were analysed using logistic regression models. Results: Completing clinical placements in medium to small rural towns or remote and very remote communities were associated with increased odds of high scores in the learning environment [odds ratio (OR) 2.90, 95% CI, 1.32 to 6.37; P = 0.01] and the supervisory relationship domains (OR 3.16, 95% CI, 1.40 to 7.14; P = 0.01). Female gender (OR 3.38, 95% CI, 1.12 to 10.19; P = 0.03), supervision by staff other than an educator (OR 2.71, 95% CI, 1.16 to 6.33; P = 0.02) and increased frequency of ad hoc (extra) supervision with a buddy nurse without the nurse educator (OR 2.55, 95% CI, 1.07 to 4.75; P = 0.03) were associated with increased odds of high scores in the role of nurse educator domain. Conclusions: In this study, nursing students reported valuing their exposure to smaller and more remote communities, the learning environments within rural and remote healthcare facilities, and the relationships they developed with supervising nurses. The findings also suggest that some students perceived greater value in supervision provided by clinical staff who were not in formal nurse educator or nurse facilitator roles. Given the limitations of the study, these observations should be interpreted cautiously and may warrant further investigation in broader contexts.
Background: Specialized palliative care requires nursing professionals to address the complex physical, psychological, social and spiritual needs of patients with advanced incurable illness. This study aimed to assess the perceived adequacy of formal educational preparation among nurses working in specialized palliative care services in the Republic of Croatia and examine its association with self-assessed knowledge and the perceived need for additional education. Methods: A nationwide cross-sectional survey was conducted among nursing professionals employed in specialized palliative care services across Croatia. Data were collected using a structured questionnaire assessing sociodemographic characteristics, perceived adequacy of formal education, self-assessed knowledge, as well as the need for additional education in physical, psychological, social and spiritual care domains. An Educational Sufficiency Discrepancy Index (ESDI) was calculated to quantify the difference between perceived educational sufficiency and continuing education needs. For inferential statistics significance was set at p < 0.05 (two-tailed). Results: Among the 194 nursing professionals who participated in the study, perceived educational sufficiency was highest in the physical domain (87.5%), where it exceeded the reported need for additional education (31.6%). Negative discrepancies were observed in social (-12.9) and spiritual care (-17.6), indicating perceived educational deficits. Representation of physical care content in formal education was significantly associated with higher self-assessed knowledge across several domains (physical p < 0.001; psychological p = 0.008; social p < 0.001; spiritual p = 0.008). No significant associations were found between self-assessed knowledge and age, work experience or level of education. Conclusions: Formal nursing education alone may not fully meet the multidimensional competency requirements of specialized palliative care practice. Strengthening structured continuing professional development, particularly in psychosocial and spiritual care, may support holistic palliative care delivery and sustained professional competence.
Background: Emergency obstetric situations require rapid clinical decision-making, technical competence, and emotional preparedness to ensure safe and compassionate care for both mother and newborn. However, nursing students often have limited opportunities to experience such high-risk, low-frequency events during clinical placements. Simulation-based education has emerged as an effective strategy to prepare future nurses for caring in emergency contexts, allowing them to develop both technical and non-technical skills in a safe learning environment. This study aimed to evaluate the effects of a high-fidelity obstetric emergency simulation program on nursing students' knowledge, perceived safety, and learning experience. Methods: A mixed-methods design was employed, combining a quasi-experimental pretest-posttest assessment without a control group and qualitative analysis of open-ended reflections. Eighty-two third-year nursing students participated in two simulation sessions addressing obstetric emergencies such as breech birth, shoulder dystocia, out-of-hospital delivery, eclampsia, postpartum hemorrhage, and maternal cardiac arrest. Data were collected using validated instruments measuring knowledge, perceived safety, and satisfaction and self-confidence in learning, and were analyzed using Wilcoxon signed-rank tests and thematic analysis. Results: Significant improvements were observed in specific knowledge areas related to complex obstetric maneuvers and in their perceived safety when managing emergency situations (p < 0.001, r > 0.40). Participants reported high levels of satisfaction and confidence in learning. Qualitative findings highlighted increased emotional preparedness, improved clinical reasoning, and recognition of the importance of teamwork and reflective debriefing in emergency care contexts. Conclusions: High-fidelity simulation appears to be an effective educational strategy for preparing nursing students to provide safe and confident care in obstetric emergencies. Integrating simulation into nursing curricula can strengthen both technical competence and the emotional readiness required for caring in urgent and high-pressure clinical situations.
Simulation is increasingly recognised as a strategic approach in nursing education for developing clinical competencies within safe learning environments. However, there is limited understanding of how virtual patient simulation supports the early development of clinical reasoning from the perspective of nursing students. Aim: To explore the perceptions of first-year undergraduate nursing students regarding the development of clinical reasoning and collaborative decision-making through virtual patient simulation. Methods: A qualitative, descriptive, and exploratory design was adopted. Semi-structured focus groups were conducted with 73 first-year undergraduate nursing students. Data were analysed using thematic content analysis following Bardin's approach. Results: Students perceived virtual patient simulation as a meaningful and high-impact learning strategy. Realism, interactivity, and group collaboration emerged as key strengths. Engagement with dynamic clinical scenarios supported the integration of theoretical knowledge into practice, enhanced prioritisation skills, and promoted structured clinical reasoning. Collaborative learning facilitated shared reflection and collective problem-solving, while immediate feedback enabled learning through error within a psychologically safe environment. Participants also reported increased confidence and autonomy in decision-making. At the same time, students identified limitations related to software constraints and the alignment between automated assessment and their reasoning processes. Conclusions: Group-based virtual simulation appears to support the early structuring of clinical reasoning, extending beyond technical skill acquisition to foster reflective and collaborative practice. Its educational value, however, depends on intentional curricular integration and strong pedagogical alignment including structured facilitation, alignment between assessment and learning objectives, and opportunities for guided reflection. These findings contribute to a process-oriented understanding of how novice learners make sense of clinical reasoning in simulated contexts.
Background: Safe medication administration is a fundamental aspect of nursing practice and a core component of patient safety. However, systemic failures, workload pressures, and educational gaps continue to contribute to medication errors, posing persistent challenges for healthcare systems. In this context, innovative educational technologies, particularly Artificial Intelligence (AI), have emerged as promising strategies to support the development of competencies related to safe medication administration. Methods: This scoping review aimed to map evidence on AI-based tools used to teach safe medication administration in nursing. The review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the PRISMA-ScR guidelines. Searches were performed in PubMed, Scopus, Web of Science, LILACS, and Google Scholar, covering studies published between 2010 and October 2025 in English, Portuguese, and Spanish. Study selection was conducted in two stages, followed by standardized data extraction. Results: A total of 545 records were identified, of which only two studies met the eligibility criteria. The included studies, conducted in Israel and South Korea, evaluated a microlearning chatbot and Large Language Model (LLM)-based tools designed to support teaching safe medication administration. Both studies demonstrated improvements in knowledge and performance in tasks and simulations related to the medication process, as well as positive acceptability among participants. However, neither study assessed direct clinical outcomes, such as reductions in medication errors or preventable adverse events. Conclusions: Although AI-based educational tools show potential to enhance competencies related to medication safety in nursing, the available evidence remains limited. Further robust, multicenter, and comparative studies are needed to evaluate their impact on clinical outcomes and to support their integration into nursing education and practice.
Background: Artificial intelligence (AI) is increasingly integrated into healthcare systems, with important implications for nursing practice and clinical workflows. However, evidence regarding nurses' digital skills, perceptions, and readiness to adopt AI-enabled technologies remains limited, particularly in national healthcare contexts such as Greece. Objectives: This study examined nurses' digital skills, perceptions of AI, and readiness for AI adoption in clinical practice, and explored demographic and professional factors associated with these outcomes. Methods: A cross-sectional survey was conducted among 166 nurses working in two public hospitals in Greece. Results: Nurses reported moderate digital skills, with 59.1% indicating competence in email/video communication and 27.2% reporting adequate use of digital security tools, while exposure to AI remained limited (18.0% reported using AI products/services in daily life). Perceived professional impact of AI was moderate, whereas readiness for AI adoption was comparatively lower, with only 7.8% considering health professionals adequately prepared and 7.2% reporting adequate AI training. Statistical analyses indicated that educational level and computer literacy certification were positively associated with digital skills, whereas longer professional experience was negatively associated with readiness for AI adoption. Conclusions: These findings highlight a gap between general digital competence and preparedness for AI-driven healthcare applications and underline the need for targeted education and implementation strategies to support effective and ethical integration of AI in nursing practice. From a nursing workforce perspective, the results underscore the importance of integrating AI literacy into continuing professional education and aligning digital health implementation strategies with clinical nursing practice.
Background: Population ageing has increased the number of older adults living in nursing homes, where loneliness and sleep disturbances are prevalent and negatively affect well-being. Evidence suggests a bidirectional relationship between loneliness and sleep quality, although research in institutionalised populations remains limited. Objectives: This study aimed to characterise the sociodemographic and health profile of nursing home residents in Northern Portugal and examine associations between sleep quality, loneliness, sociodemographic and health variables. Methods: A cross-sectional study was conducted with 157 older adults (≥65 years) across 13 nursing homes. Data were collected using a sociodemographic questionnaire and the Portuguese version of UCLA Loneliness Scale, Pittsburgh Sleep Quality Index and Montreal Cognitive Assessment. Pearson correlations and hierarchical multiple regression analyses were performed. Results: Participants were predominantly female (72.6%), widowed (55.4%), and aged ≥80 years. Most reported chronic conditions (98.7%) and limitations in activities of daily living (75.2%). Age showed modest positive correlations with loneliness. Loneliness dimensions were strongly associated with poorer sleep quality and greater daytime dysfunction. Hierarchical regression revealed that sociodemographic variables explained only a small proportion of variance in sleep quality. The addition of loneliness variables increased explained variance to 38.1%, highlighting loneliness as a key psychosocial predictor. Conclusions: Loneliness significantly influences sleep quality among older adults living in nursing homes. Interventions should integrate strategies to enhance social engagement alongside sleep hygiene measures. Longitudinal studies are recommended to clarify causal pathways.
Background: Violence in healthcare settings affects nursing students during clinical training and may compromise their mental well-being, learning experiences, and professional development. Despite evidence from high-income countries, limited data exist on how contextual and organizational factors in Latin American settings shape these experiences. This study aimed to assess the frequency and types of violence experienced by nursing students during clinical practice and the academic and emotional consequences. Methods: Cross-sectional study conducted among undergraduate and graduate nursing students in Mexico City who had completed at least one hospital-based clinical placement in the previous 12 months. Data were collected between January 2024 and September 2025 using a validated questionnaire assessing types of violence, perpetrators, academic and emotional consequences. Violence was defined as experiencing events "occasionally," "sometimes," or "frequently." Descriptive statistics were calculated. Associations were examined using Pearson's chi-square test, and logistic regression models adjusted for age, sex, and year of study. Results: Seventy-three students participated (86.3% female). Non-physical violence was the most frequent type (90.4%), followed by sexual harassment (49.3%), mainly perpetrated by nurses (62%) and physicians (46.5%). Considering leaving the profession (41.4%) and feelings of inadequacy (66.2%) were the most common academic and emotional consequences. Although some associations were observed in bivariate analyses, these were not significant after adjustment. Conclusions: Violence during clinical training is highly prevalent and may represent a significant threat to nursing students' mental well-being and professional development. Strengthening institutional policies, reporting mechanisms, and supportive learning environments is essential to mitigate its impact and promote safer clinical training.
Background: Hospital-acquired infections (HAIs) pose significant safety risks, making nursing students' behavioural intention during clinical rotations vital for prevention. Objective: To analyze the influence of Perceived Behavioural Control (PBC) and knowledge on students' intention to maintain a safe clinical environment. Methods: A cross-sectional design was conducted with 242 nursing students at a Type A referral hospital in Pekanbaru, Indonesia. Participants were selected via simple random sampling. Data were collected using validated questionnaires measuring PBC (six indicators), knowledge (three subscales), and behavioural intention. Statistical analysis involved Chi-square tests for unadjusted Odds Ratios (OR) and binary logistic regression to calculate adjusted Odds Ratios (AOR) by entering all variables into the model simultaneously. Results: The majority of participants demonstrated high intention (66.5%) and high PBC (83.9%). In the univariate analysis, all six PBC indicators and general nosocomial knowledge were significantly associated with high intention (p < 0.05), with staff direction (OR = 5.96) and specific training (OR = 4.94) showing the strongest independent effects. However, when all environmental and cognitive variables were entered into the regression model simultaneously, only knowledge of personal protective equipment (PPE) use remained a significant independent factor (AOR = 2.66; 95% CI: 1.40-5.06, p = 0.003). The unadjusted OR emphasized the isolated influence of each factor, whereas the adjusted OR showed that technical knowledge was the only variable to retain significance after controlling for other factors. Conclusions: Technical knowledge regarding PPE use is the primary independent driver of nursing students' intention to maintain a safe clinical environment. While environmental support and general knowledge are important foundational elements, clinical education should prioritize practical, technical training in protective measures to translate knowledge into behavioural intention effectively.