Objective: All Nurses experience work stress that can take their focus away from patient care. Healthcare organizations strive to identify successful, cost-effective stress reduction programs. Mindfulness Based Stress Reduction (MBSR) training is a validated approach to stress reduction, usually in a class format. However, financial and time constraints make it inaccessible to most practicing nurses. Alternatively, mobile mindfulness apps offer an approach to mindfulness that can reach large populations, are available 24/7, anonymous, and cost effective.
Methods: This prospective, study evaluated the efficacy of a mindfulness mobile app for stress reduction in nurses utilizing Whil, a Mobile App that offers mindfulness training specifically geared towards health professionals. Eight hundred and fifty-two nurses were recruited from twelve sites (71 per site) within a large Health Care System in the Northeast United States.
Results: Two scales were used to test results. Nurses Stress Scale (NSS) results indicated that nurses experienced a reduction in stress level with use and time spent in the app. Nurses in the 31-40 age range and nurses on 12-hour shifts experienced greater stress levels.
Conclusions: Significant differences were seen in the Subscales Conflict with Physicians, Conflict with other Nurses, and Lack of Support. There was no change in the Mindfulness Attention Awareness Scale (MAAS) over time. Spearman’s correlation showed a significant and negative correlation between NSS and MAAS scores. The Whil Mobile App is effective for stress reduction in practicing nurses on all shifts and is cost effective.

Objective: This study examined the relationship between well-being, psychological resilience, and burnout among nursing interns in China.
Methods: A cross-sectional study was carried out at 2 tertiary hospitals in Guangdong Province, China. Data were collected from 360 nursing interns using a structured questionnaire, and structural equation modeling was used to analyze the correlation between well-being, resilience, and burnout.
Results: Participants’ burnout score was in the upper range (mean [M]=12.748, standard deviation [SD] = 6.654). Burnout was negatively correlated with resilience (r = -0.477, p ＜.01) and well-being (r = -0.573, p ＜.01). Well-being mediated the relationship between resilience and burnout.
Conclusions: Resilience and well-being are inversely correlated with burnout, and well-being mediates the relationship between resilience and burnout. Improving well-being can reduce burnout risk and improve resilience among nursing interns. To prevent burnout among nursing interns, nursing managers should aim to improve their well-being by optimizing the work environment, promoting the cohesion of the nursing team, actively guiding and providing necessary help, and supporting the development of each intern’s nursing career.

Diabetes mellitus often leads to foot ulcers, which can result in amputations and significantly affect quality of life. Monitoring plantar foot temperature has emerged as a promising intervention for preventing these ulcers. This study aims to examine the potential benefits of plantar foot temperature monitoring in preventing ulcers in individuals with diabetes mellitus. The umbrella review protocol will follow the guidelines set forth by the Joanna Briggs Institute. Participants aged 18 years and older with a diagnosis of type 1 or type 2 diabetes mellitus, and without any active ulcers at the commencement of the study, will be included. We will consider studies that monitor plantar foot temperature using thermometry and thermography. Two independent reviewers will carry out the study location selection and data extraction, employing a modified and validated JBI extraction tool. The methodological quality of the studies included will be evaluated using both the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses, as well as the AMSTAR-2 tool. This systematic review is registered under PROSPERO number CRD42024509838. Data on the effectiveness of interventions for monitoring plantar foot temperature to prevent ulcers in individuals with diabetes will be collected and summarized. A citation matrix will analyze the overlap of primary studies, and meta-analysis will be performed if feasible. The certainty of evidence will be assessed using the GRADE system. This protocol ensures rigorous execution by researchers and may aid in implementing evidence-based nursing interventions for ulcer prevention in diabetes.

Objective: To explore students’ perspectives on clinical reasoning development and their experiences of learning through virtual simulation.
Methods: An exploratory, descriptive qualitative study design was used. Twenty-eight nursing students studying in a bachelor’s program received a 2-hour virtual simulation training with a debriefing session. Six semi-structured focus group interviews were conducted after the training. Thematic analysis was used to explore and analyze the students’ perspectives on clinical reasoning development and their experiences of learning through simulation training.
Results: Three main themes emerged: engagement in and satisfaction with learning, enhancement of clinical reasoning skills, and preparedness for clinical practice.
Conclusions: Virtual simulation training with debriefing sessions increased students’ engagement in and satisfaction with learning, developed their clinical reasoning skills, and enabled them to reflect on their own preparation for clinical practice. Our findings suggest that virtual simulation could be adopted in current nursing curricula to enhance the competencies of future nurses.

Lack of handoff between the emergency department and inpatient units may result in increased errors and decreased patient/family satisfaction due to a lack of nursing knowledge of the patient upon admission. To address this concern, a quality improvement study was implemented by utilizing the organization’s established text messaging system to promote communication between these two units regarding pertinent patient information and expected time of arrival to the inpatient unit. Despite efforts, nursing engagement was minimal due to the ongoing COVID-19 pandemic. Future successful implementation of this handoff process requires continued administrative support and nursing engagement.

Introduction: Type 2 Diabetes Mellitus (T2DM) is a chronic health condition with the potential for poor health outcomes that can be limited by good patient education and self-management approaches. Nurse-led diabetes self-management education (DSME) can reduce hospitalizations, support optimal blood glucose levels, and lower hemoglobin A1C. The goal of this study was to establish and maintain expertise for long term care (LTC) facility nurses in DSME. The project's purpose was to determine whether DSME increases LTC nurse knowledge about T2DM management, and whether it increases self-efficacy of LTC nurses to deliver DSME discharge training.
Methods: This project utilized a quasi-experimental prospective comparative pre and posttest design to examine the effect of DSME training for licensed practical and registered nurses practicing in Chicagoland LTC facilities. Knowledge was measured utilizing a pre-and-posttest survey before and after the educational intervention and analyzed with the Wilcoxen signed-rank test. The online survey included a questionnaire to assess nurses' knowledge about T2DM and DSME and self-efficacy for delivering DSME. Descriptive statistics analyzed demographic data and questionnaire responses. Data analysis was performed IBM's Statistical Package for the Social Sciences.
Results: Ten participants completed the survey. Post-test scores increased following the education session with a p-value (.03689) for the variable “knowledge in treating low blood sugar,” suggesting the DSME educational training increased LTC nurse knowledge. The average-pre-post-confidence level scores were significant (p =.01198), indicating that education on T2DM and DSME increases nurse knowledge about T2DM management and increases their self-efficacy for delivering T2DM education.
Conclusions: This study demonstrated a link between T2DM management knowledge and DSME education programs for LTC nurses. The study's findings emphasize the need for ongoing education to increase nurse knowledge, self-efficacy and confidence for providing T2DMcare to improve patient outcomes.

Background/Objective: Nurses in leadership and managerial roles require ongoing opportunities to develop their leadership knowledge and skills. Effective nursing leadership contributes to team functioning and healthy work environments, as well as improved outcomes for staff and patients. This paper reports on the development, implementation and evaluation of a Leadership and Management for Nurses Program (LMNP) in Ontario, Canada. The program was designed for novice nurse leader-managers to enhance knowledge and skills necessary to promote competence, confidence, and effectiveness in these roles.
Methods: A program evaluation framework was developed to evaluate the LMNP including the degree to which the program supported participants in achieving their leadership goals and the impact of the program on participant leadership and confidence. Upon completion of the program all participants were invited to respond to an electronic evaluation survey exploring both program processes and outcomes. Descriptive statistics were used to analyze survey data.
Results: Fifty-four participants responded to the survey. Results suggest that the program length and content were appropriate, contributing to the achievement of leadership learning goals and the development of leadership and managerial skills and knowledge, increased confidence and overall preparedness to lead.
Conclusions: Novice nurse leader-managers require support to develop and maintain leadership and managerial competencies, underscoring the importance of providing leadership development opportunities through programs such as the LMNP. Healthcare organizations should consider how best to support ongoing nurse leader-manager development through leadership training and mentorship programs.

Background and objective: Pregnant persons are less likely to be screened and treated for depression and anxiety during pregnancy compared to the pre- and post-natal periods, despite adverse effects associated with untreated mental health concerns during pregnancy. Patients have reported that maternal and mental health providers seem unable or unwilling to discuss treatment with psychopharmacological options during pregnancy. Literature concerning this pattern has not included the perspective of psychiatric mental health nurse practitioners (PMHNP). The objective of this study was to identify the barriers and needs of PMHNPs regarding the treatment of mental health concerns during pregnancy.
Methods: In this constructivist grounded theory study, data were collected between February 2023 and February 2024 through in-depth interview. Eligible participants were PMHNPs, or PMHNP students, working with patients who might become pregnant in an outpatient setting.
Results: Seventeen PMHNPs or students participated in this study. Many believed they were unprepared to treat pregnant patients and described barriers and needs that impede their comfort and willingness to treat people who are pregnant. These included inadequate training, limited research, and concerns about legal liability. PMHNPs requested more information about perinatal mental health and its treatment to be incorporated into training programs and clinical experience.
Conclusions: Many PMHNPs were unaware or underinformed of available resources and best practices for treatment during pregnancy. In addition to best practices for the treatment of people who are pregnant, PMHNP programs should consider including preparation for the emotional consequences of practice as well as clear and accurate information about malpractice and liability risks.

Objective: Simulation-based training equips students to meet the increasing demands of healthcare. While these trainings positively impact learning, the emotions experienced during simulations can influence these in learning outcomes. Achievement emotions, which are closely linked to academic performance, are considered to affect learning but have been underexplored in the context of simulation-based nursing education. Therefore, this study investigated the achievement emotions nursing students experience during simulation training and analyzed how they describe these emotions.
Methods: A concurrent mixed-methods design was used. The Achievement Emotions Questionnaire was administered to a sample of nursing students (n = 101) assessing their emotions during simulation training. Additionally, 31 problem-centered interviews were conducted to delve deeper into the students' emotional experiences. Quantitative data were analyzed using IBM SPSS Statistics Version 28, while qualitative data were analyzed using content analysis following Kuckartz methodology, utilizing MAXQDA (Version 24.2.0) for coding and analysis.
Results: Nursing students reported a range of achievement emotions, with positive emotions like enjoyment, pride, and hope scoring higher than negative emotions, such as boredom, hopelessness, and shame. Notably, anxiety levels were comparable to those of the positive emotions. Significant emotional shifts were observed during the simulation training. However, while quantitative data indicated a decrease in shame, interviews revealed students still felt shame after simulation, especially when knowledge gaps were exposed. Qualitative findings suggest that students' experience with simulation, the debriefing process, the training design, and their role in the simulation influence the achievement emotions experienced.
Conclusions: The dynamic nature of achievement emotions during simulation training calls for further research to better understand their complexity. The discrepancy regarding shame between quantitative and qualitative findings also requires more investigation. Nursing educators should consider achievement emotions in simulation design, as factors like training structure influence students' emotional experiences.