Aim:The aim of this study was to identify current practices and perceptions of intensive care nurses regarding delirium assessment and to examine the factors that affect these practices and perceptions. Background: As delirium in intensive care unit (ICU) patients is a serious problem that can result in increased mortality and morbidity, routine delirium assessment of all ICU patients is recommended. The severity, duration and outcome of the syndrome are directly related to nurses' continuous assessment of patients for signs and symptoms of delirium. However, studies indicate that very few nurses monitor for delirium as a part of their daily practices. Design: A descriptive, correlational study design was used. Methods: Data were collected from five Turkish public hospitals using a structured survey questionnaire. The study sample comprised 301 nurses who agreed to participate. Data were analysed using descriptive statistics. Results: More than half of the nurses performed delirium assessments. However, the proportion of nurses who use delirium assessment tools was quite low. Almost all of the nurses perceived delirium as a problem and serious problem for ICU patients. The patient group least monitored for delirium was that of unconscious patients. Statistically significant differences were found in the proportion of nurses who assessed delirium symptoms and whose care delivery system was patient-centred and perceived delirium as a serious problem. Conclusion: While a majority of ICU nurses perceived delirium as a problem and serious problem, the proportion of those who perform routine delirium assessments was less. It was found that delirium assessment practices of nurses were affected from their perceptions of delirium and the implementation of patient-centred care delivery. Relevance to clinical practice: It is essential to develop strategies to encourage ICU nurses to perform delirium assessments through the use of delirium assessment tools.

Objective: This study was conducted to evaluate the levels of psychological resilience, academic stress and social support available to nursing students and the relationship between these factors. Methods: The population of the study, which had a descriptive and correlational research design, was made up of 1202 students, while the sample consisted of 322 students selected using the sample size formula for a known population. Data were collected using a Structured Questionnaire, the Psychological Resilience Scale for Adults, the Nursing Education Stress Scale and the Multidimensional Scale of Perceived Social Support. Results: 76.7% of students were female and 23.3% were male. A statistically significant correlation was found between scores for psychological resilience and perceived social support (p<0.05). It was found that the individual characteristics of students affected their psychological resilience. Levels of psychological resilience, academic stress, and social support among nursing students are at a moderate level. Conclusion: The significance of resilience is clear, a better understanding is needed of what factors affect a student's level of resilience and how this resilience can best be improved.

Aim To investigate the association of unfinished nursing care on nurse outcomes. Design Systematic review in line with National Institute for Health and Care Excellence guideline. Data sources CINAHL, the Cochrane Library, Embase, Medline, ProQuest and Scopus databases were searched up until April 2020. Review Methods Two independent reviewers conducted each stage of the review process: screening eligibility, quality appraisal using Mixed Methods Appraisal Tool; and data extraction. Narrative synthesis compared measurements and outcomes. Results Nine hospital studies were included, and all but one were cross‐sectional multicentre studies with a variety of sampling sizes (136–4169 nurses). Studies had low internal validity implying a high risk of bias. There was also a high potential for bias due to non‐response. Only one study explicitly sought to examine nurse outcomes as a primary dependent variable, as most included nurse outcomes as mediating variables. Of the available data, unfinished nursing care was associated with: reduced job satisfaction (5/7 studies); burnout (1/3); and intention‐to‐leave (2/2). No association was found with turnover (2/2). Conclusion Unfinished nursing care remains a plausible mediator of negative nurse outcomes, but research is limited to single‐country studies and self‐reported outcome measures. Given challenges in the sector for nurse satisfaction, recruitment and retention, future research needs to focus on nurse outcomes as a specific aim of inquiry in relation to unfinished nursing care. Impact Unfinished nursing care has previously been demonstrated to be associated with staffing, education and work environments, with negative associations with patient outcomes (patient satisfaction, medication errors, infections, incidents and readmissions). This study offers new evidence that the impact of unfinished nursing care on nurses is under investigated. Policymakers can prioritize the funding of robust observational studies and quasi‐experimental studies with a primary aim to understand the impact of unfinished nursing care on nurse outcomes to better inform health workforce sustainability.

Aims To investigate how nursing experts and experts from other health professions understand the concept of rationing/missed/unfinished nursing care and how this is compared at a cross‐cultural level. Design The mixed methods descriptive study. Methods The semi‐structured questionnaires were sent to the sample of 45 scholars and practitioners from 26 countries. Data were collected from November 2017–February 2018. Results Assigning average cultural values to participants from each country revealed three cultural groups: high individualism‐high masculinity, high individualism‐low masculinity and low individualism‐medium masculinity. Content analysis of the findings revealed three main themes, which were identified across cultural clusters: (a) projecting blame for the phenomenon: Blaming the nurse versus blaming the system; (b) intentionality versus unintentionality; and (c) focus on nurses in comparison to focus on patients. Conclusion Consistent differences in the understanding of missed nursing care can be understood in line with the nation's standing on two main cultural values: individualism and masculinity. Impact The findings call for scholars' caution in interpreting missed nursing care from different cultures, or in comparing levels and types of missed nursing tasks across nations. The findings further indicated that mimicking interventions to limit missed nursing care from one cultural context to the other might be ineffective. Interventions to mitigate the phenomenon should be implemented thoughtfully, considering the cultural aspects.