Nursing Practice Today

Evaluating informatics competency of hemodialysis nurses: A longitudinal study

2025-12-14T14:16:05+0330

Background & Aim: The complexity of chronic kidney disease care necessitates multidisciplinary coordination, making it susceptible to care fragmentation. Electronic Health Records are strategic tools for integrating this care, but their effectiveness depends on the informatics competency of their users, mainly nurses. This study aimed to determine and compare the level of nurses' self-reported informatics competency before and after the deployment of specialized dialysis software in centers affiliated with Tehran University of Medical Sciences.
Materials & Methods: This longitudinal study was conducted in 2024 using a census sample of 51 nurses across seven hemodialysis centers. The standard Persian version of the Nursing Informatics Competency Assessment Tool was administered before and at least one month after software implementation. Data were analyzed using descriptive statistics, the McNemar Test, and the Paired Samples t-test.
Results: A statistically significant positive shift in nurses' categorical competency status (Sufficient vs. Insufficient) was confirmed by the McNemar test (p=.039). Specifically, 8 nurses shifted from Insufficient to Sufficient status post-implementation. Paired Samples t-tests on the subscales revealed a significant improvement in Information Literacy (mean difference: 5.02; p=.001) and Information Management Skills (mean difference: 3.10; p=.003). However, the change in Computer Literacy scores was not statistically significant (mean difference: 1.67; p=.117).
Conclusion: Direct, sustained, hands-on experience with electronic health records systems improves nurses' informatics competency, particularly in information literacy and information management, even without formal curricular education. This study highlights practice-based learning as an effective and viable strategy for cultivating essential informatics skills in technology-driven clinical environments.

Evaluation of digital health technology acceptance for breastfeeding support among perinatal women in rural areas: A scoping review

2025-12-10T12:00:29+0330

Background & Aim: Breastfeeding is fundamental to maternal and infant health, yet rural populations face barriers to support due to limited infrastructure and geographic constraints. Although digital health technologies are increasingly used to promote maternal and child health, evidence on their acceptance and effectiveness in supporting breastfeeding among perinatal women in rural settings remains limited. This scoping review aims to examine digital interventions supporting breastfeeding areas and to identify their outcomes, challenges, and enabling factors.
Materials & Methods: Following the Joanna Briggs Institute methodology, systematic searches were conducted in Scopus, PubMed, Wiley Online Library, ScienceDirect, DOAJ, and Web of Science. Studies published in English between January 2015 and May 2025 were included. Two reviewers independently screened studies, with disagreements resolved by a third reviewer. Data were synthesized thematically, and methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT).
Results: A total of 22 studies (n=22) were included, identifying four categories of interventions: mobile health (mHealth) applications, messaging services (SMS/IVR), telelactation, and social media platforms. These interventions improved exclusive breastfeeding rates, maternal knowledge, confidence, and satisfaction with care. Key facilitators included culturally tailored content, hybrid human–digital models, and interactive features. Barriers were low digital literacy, poor connectivity, weak integration with health systems, and socio-cultural resistance.
Conclusion: Digital health technologies demonstrate significant potential to strengthen breastfeeding support in rural areas. Their effectiveness depends on accessibility, cultural relevance, and integration into existing health and community structures. The findings underscore the need for policies that promote digital equity, community-based design, and sustainable integration of technology into rural maternal care programs. Future research should also assess cost-effectiveness and long-term user engagement.

Effectiveness of a self-regulation program using iPad-assisted communication in intubated patients with respiratory failure: A randomized controlled trial

2025-12-09T13:50:54+0330

Background & Aim: Communication limitations in intubated patients with respiratory failure increase anxiety, compromise care quality, and may delay ventilator weaning. This study evaluated the effects of a self-regulation program using iPad-assisted communication on anxiety, perceived fulfillment of care needs, and weaning outcomes.
Methods & Materials: A randomized controlled trial was conducted from April to December 2024 and enrolled 60 mechanically ventilated patients with respiratory failure. Participants were randomly assigned to an experimental group (n= 30) and a control group (n = 30). Data were collected on demographics, health status, anxiety levels, perceived fulfillment of care needs, and ventilator weaning outcomes. Statistical analyses included descriptive statistics, chi-square or Fisher’s exact tests, t-tests, and ANCOVA.
Results: Two hours after the intervention, the experimental group reported significantly lower anxiety levels and higher perceived fulfillment of care needs compared with baseline and the control group (p< 0.001). The experimental group also demonstrated a higher weaning success rate (83.33%) than the control group (66.67%) (χ²= 6.76, p= 0.009). Re-intubation within 48 hours was significantly lower in the experimental group (16.67%) than in the control group (33.33%) (χ² = 4.85, p = 0.028). The tracheostomy rate was lower in the experimental group (6.67% vs. 13.33%), but this difference was not statistically significant (χ² = 1.09, p = 0.296).
Conclusion: The self-regulation program with iPad-assisted communication reduced anxiety, enhanced perceived care needs, and improved weaning outcomes. These results support its applicability as a patient-centered intervention to optimize respiratory care in intensive care settings.

Psychometric properties of the smartphone use and distraction questionnaire in Spanish and Portuguese nursing students

2025-12-07T13:52:03+0330

Background & Aim: Smartphone use in nursing education offers both learning benefits and risks of distraction, influenced by cultural and institutional norms. The Nursing Students’ Smartphone Use and Distraction Questionnaire, originally developed in Spanish but never psychometrically validated, was formally validated among Spanish nursing students and simultaneously translated, culturally adapted, and validated for Portuguese nursing students.
Methods & Materials: A psychometric study was conducted among 543 Portuguese and 480 Spanish nursing students enrolled in their second year or higher. The questionnaire was translated and culturally adapted into Portuguese following International Society for Pharmacoeconomics and Outcomes Research guidelines. Psychometric evaluation included exploratory factor analysis with varimax rotation, Kaiser-Meyer-Olkin measure, Bartlett’s test of sphericity, and internal consistency analysis using Cronbach’s alpha, conducted with IBM SPSS Statistics version 29.
Results: The analysis extracted 26 items across six factors: Clinical Practice Use, Regulatory Policy, Unprofessional Personal Use, Observed Unprofessional Use, Student’s Distraction, and Ethics, explaining 57.8% of the variance in Portugal and 61.8% in Spain. Kaiser-Meyer-Olkin values were 0.747 and 0.818, with Bartlett’s test significant in both samples (p < 0.001). Cronbach’s alpha coefficients for the total scale were 0.717 (Portugal) and 0.740 (Spain), with subscale values ranging from moderate to good reliability.
Conclusion: The Smartphone Use and Distraction Questionnaire showed valid structural properties and acceptable reliability in two distinct cultural settings. Its adaptability supports use across health professions and diverse countries and cultures, informing evidence-based policies that promote professional smartphone use and reduce distraction in clinical education.

Mapping the use of artificial intelligence for skin injury assessment and care in hospitalized patients: A scoping review

2025-12-06T10:14:56+0330

Background & Aim: Skin injuries are frequent hospital complications, and the role of artificial intelligence in management remains unclear. This review aimed to identify, map, and analyze the evidence on the use of artificial intelligence in the assessment, monitoring, and management of skin injuries in hospitalized patients worldwide.
Methods & Materials: A scoping review was conducted following the Joanna Briggs Institute guidance and the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Searches were carried out in Embase, PubMed, Scopus, CINAHL, Cochrane Library, Web of Science, SciELO, BVS, LILACS, and the CAPES thesis and dissertation catalog. Eligible sources included primary studies, technical notes, dissertations, and theses. All references were organized in EndNote Web and transferred to Rayyan to support duplicate removal and facilitate screening by reviewers.
Results: The search resulted in the identification of 1,240 studies, of which eight were included and published in English. Most studies are technological development studies with samples ranging from 10 to 5,729 images or participants. Studies have shown that artificial intelligence techniques applied to pressure injuries, including Convolutional Neural Networks, Random Forest, Support Vector Machine, and Extreme Gradient Boosting, improve detection, measurement, classification, risk prediction, and clinical decision support, potentially reducing workload and enhancing care safety.
Conclusion: The application of artificial intelligence in the domain of skin injuries revealed a variety of uses. However, it was predominantly focused on the specific context of pressure injuries in hospitalized individuals. Consequently, a noticeable gap in the literature was identified regarding alternative categories of injuries affecting this population segment.