Agreement in Fall Risk Perception Among Oncohematology Patients, Caregivers, and Nurses October/December 2026: 41(4):E54-E61 Background: Falls are preventable adverse events in hospitalized oncology populations. Purpose: To determine agreement in perceived fall risk among oncohematologic patients, caregivers, and nurses within 72 hours of admission. Methods: A prospective cross-sectional study was conducted in 2 university hospitals involving patient-caregiver-nurse triads. The primary outcome was perceived fall risk assessed with the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients. Results: A total of 126 triads (378 assessments) were analyzed. Overall agreement was moderate (72.2%; k = 0.573). “History of falls” showed almost perfect agreement (93.7%; k = 0.824). “Patient agitation” showed fair agreement (k = 0.280), whereas “visual impairment” and “frequent toileting/toilet assistance” showed no significant agreement. Pairwise concordance ranged from 79.4%–83.3% (k = 0.536–0.607), with the highest agreement between caregiver and nurse. Conclusions: Overall agreement was moderate, with the highest agreement for history of falls. Standardizing interpretation and incorporating multidimensional assessments may improve fall risk identification. Agreement in Fall Risk Perception Among Oncohematology Patients, Caregivers, and Nurses Falls are preventable adverse events in hospitalized oncology populations. To determine agreement in perceived fall risk among oncohematologic patients, caregivers, and nurses within 72 hours of admission. A prospective cross-sectional study was conducted in 2 university hospitals involving patient-caregiver-nurse triads. The primary outcome was perceived fall risk assessed with the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients. A total of 126 triads (378 assessments) were analyzed. Overall agreement was moderate (72.2%; k = 0.573). “History of falls” showed almost perfect agreement (93.7%; k = 0.824). “Patient agitation” showed fair agreement (k = 0.280), whereas “visual impairment” and “frequent toileting/toilet assistance” showed no significant agreement. Pairwise concordance ranged from 79.4%–83.3% (k = 0.536–0.607), with the highest agreement between caregiver and nurse. Overall agreement was moderate, with the highest agreement for history of falls. Standardizing interpretation and incorporating multidimensional assessments may improve fall risk identification. The Impact of Nurse-to-Patient Ratios on Nurses’ Burnout, Job Dissatisfaction, and Intention-to-Leave October/December 2026: 41(4):379-387 Background: Adequate nurse staffing is essential for ensuring workforce well-being and patient safety. Imbalanced nurse-to-patient ratios contribute to burnout, job dissatisfaction, and turnover, which compromise care quality. Objective: This systematic review and meta-analysis evaluated the impact of nurse-to-patient ratios on nurse burnout, job dissatisfaction, intention-to-leave, and patient outcomes. Methods: A systematic search of PubMed, Scopus, and Web of Science identified cross-sectional studies examining nurse-to-patient ratios and related outcomes. Results: Eighteen studies involving 183 876 nurses from 4085 hospitals were included. Higher nurse-to-patient ratios increased the odds of burnout (OR: 1.08), job dissatisfaction (OR: 1.10), and intention-to-leave (OR: 1.09). Each additional patient per nurse increased mortality and readmission risks by 7% to 8%, with decreased perceived care quality. Conclusion: Higher nurse-to-patient ratios adversely affect nurses and patients. Ensuring adequate staffing is critical to prevent burnout and maintain safe, high-quality care. The Impact of Nurse-to-Patient Ratios on Nurses’ Burnout, Job Dissatisfaction, and Intention-to-Leave Adequate nurse staffing is essential for ensuring workforce well-being and patient safety. Imbalanced nurse-to-patient ratios contribute to burnout, job dissatisfaction, and turnover, which compromise care quality. This systematic review and meta-analysis evaluated the impact of nurse-to-patient ratios on nurse burnout, job dissatisfaction, intention-to-leave, and patient outcomes. A systematic search of PubMed, Scopus, and Web of Science identified cross-sectional studies examining nurse-to-patient ratios and related outcomes. Eighteen studies involving 183 876 nurses from 4085 hospitals were included. Higher nurse-to-patient ratios increased the odds of burnout (OR: 1.08), job dissatisfaction (OR: 1.10), and intention-to-leave (OR: 1.09). Each additional patient per nurse increased mortality and readmission risks by 7% to 8%, with decreased perceived care quality. Higher nurse-to-patient ratios adversely affect nurses and patients. Ensuring adequate staffing is critical to prevent burnout and maintain safe, high-quality care. Predictive Relationships Among Nurses’ Perceptions of Shared Governance, Psychological Empowerment, and Turnover Intentions October/December 2026: 41(4):370-378 Background: A significant shortage of experienced nurses poses a major challenge in health care. Although evidence indicates that shared governance, a hallmark of Magnet organizations, supports nurse retention, gaps remain in understanding how psychological empowerment influences this relationship. Objective: The purpose of this study was to investigate predictive pathways among nurses’ perceptions of shared governance, psychological empowerment, and turnover intention, with psychological empowerment examined as a mediating mechanism. Methods: A total of 313 nurses from an integrated care system participated in a cross-sectional survey study. Data were analyzed using descriptive and inferential statistics. Results: Nurses’ perceptions of shared governance predicted turnover intention, with psychological empowerment partially mediating this relationship. The combined effects accounted for 24% of the variance in nurses’ turnover intention. Conclusions: Nurse leaders should invest in shared governance principles that foster psychological empowerment as an intentional leadership strategy to effectively reduce turnover intention. Predictive Relationships Among Nurses’ Perceptions of Shared Governance, Psychological Empowerment, and Turnover Intentions A significant shortage of experienced nurses poses a major challenge in health care. Although evidence indicates that shared governance, a hallmark of Magnet organizations, supports nurse retention, gaps remain in understanding how psychological empowerment influences this relationship. The purpose of this study was to investigate predictive pathways among nurses’ perceptions of shared governance, psychological empowerment, and turnover intention, with psychological empowerment examined as a mediating mechanism. A total of 313 nurses from an integrated care system participated in a cross-sectional survey study. Data were analyzed using descriptive and inferential statistics. Nurses’ perceptions of shared governance predicted turnover intention, with psychological empowerment partially mediating this relationship. The combined effects accounted for 24% of the variance in nurses’ turnover intention. Nurse leaders should invest in shared governance principles that foster psychological empowerment as an intentional leadership strategy to effectively reduce turnover intention. Code Wellness Debriefing to Enhance Nurse Wellness and Peer Support October/December 2026: 41(4):363-369 Background: Repeated exposure to high-stress clinical events negatively impacts nurse wellness in medical–surgical units. Problem: Nurses experience significant emotional strain following Code Blue, Code Green (disruptive behavior), and rapid response events, contributing to burnout and reduced team resilience. Approach: A peer-led, evidence-based Code Wellness Debriefing model was implemented on a 48-bed medical–surgical unit. After a code event, structured debriefs were conducted. To assess impact, post-intervention surveys were completed by staff. Outcomes: Routine wellness debriefing increased perceived peer support and feeling cared for, and reduced emotional stress. Qualitative findings reflected emotional relief, strengthened team cohesion, and continued requests for support. Conclusion: Structured wellness debriefing supports nurse well-being following high-stress events and demonstrates a feasible, nurse-driven approach to improving unit culture. Code Wellness Debriefing to Enhance Nurse Wellness and Peer Support Repeated exposure to high-stress clinical events negatively impacts nurse wellness in medical–surgical units. Nurses experience significant emotional strain following Code Blue, Code Green (disruptive behavior), and rapid response events, contributing to burnout and reduced team resilience. A peer-led, evidence-based Code Wellness Debriefing model was implemented on a 48-bed medical–surgical unit. After a code event, structured debriefs were conducted. To assess impact, post-intervention surveys were completed by staff.

Routine wellness debriefing increased perceived peer support and feeling cared for, and reduced emotional stress. Qualitative findings reflected emotional relief, strengthened team cohesion, and continued requests for support. Structured wellness debriefing supports nurse well-being following high-stress events and demonstrates a feasible, nurse-driven approach to improving unit culture. Evaluation of Physical and Mental Workload and Transfusion Time in Trauma Resuscitation October/December 2026: 41(4):355-362 Background: Trauma resuscitation is time sensitive and complex. Whole blood (WB) and blood components are standard treatments for trauma related hemorrhage, yet their nursing workload and transfusion time have not been well evaluated. Purpose: To assess feasibility of a simulation-based crossover trial and obtain preliminary estimates comparing nursing workload and transfusion completion time between WB and blood component administration. Methods: A randomized crossover pilot study using in situ simulation was conducted with experienced trauma nurses. Time-motion analysis measured transfusion completion time, and the National Aeronautical and Space Administration Task Load Index assessed workload domains. Results: Strong feasibility was demonstrated across recruitment, retention, adherence, and completion. WB was associated with significantly shorter transfusion time, lower overall workload and mental demand, less effort, and better perceived performance. Conclusions: These findings support the feasibility and justify a fully powered trial. WB may improve resuscitation efficiency and reduce cognitive burden, with potential implications for patient outcomes and nursing workflow. Evaluation of Physical and Mental Workload and Transfusion Time in Trauma Resuscitation Trauma resuscitation is time sensitive and complex. Whole blood (WB) and blood components are standard treatments for trauma related hemorrhage, yet their nursing workload and transfusion time have not been well evaluated. To assess feasibility of a simulation-based crossover trial and obtain preliminary estimates comparing nursing workload and transfusion completion time between WB and blood component administration. A randomized crossover pilot study using in situ simulation was conducted with experienced trauma nurses. Time-motion analysis measured transfusion completion time, and the National Aeronautical and Space Administration Task Load Index assessed workload domains. Strong feasibility was demonstrated across recruitment, retention, adherence, and completion. WB was associated with significantly shorter transfusion time, lower overall workload and mental demand, less effort, and better perceived performance. These findings support the feasibility and justify a fully powered trial. WB may improve resuscitation efficiency and reduce cognitive burden, with potential implications for patient outcomes and nursing workflow. Home Health Initiative to Minimize Transportation Barriers and Improve Show Rates to Primary Care Provider Follow-Up Appointments Journal of Nursing Care Quality . September 22, 2026 Background: Transportation barriers to medical appointments lead to poor health outcomes. Purpose: The purpose of this study was to evaluate the impact of a transportation resource guide on access to transportation for postdischarge primary care follow-up appointments. Methods: A quasi-experimental research design was employed. Patients in the 4 zip-code target area who screened positive for transportation barriers received the transportation resource guide, which offered patients meaningful information and options in planning transportation to medical appointments. Results: Attendance at follow-up primary care appointments within 7 days of hospital discharge increased from 10.2% (n = 37) to 10.8% (n = 50), P = .856. Conclusions: While not statistically significant, the intervention was clinically impactful in influencing patients’ ability to access transportation for follow-up appointments. Results support sustaining ongoing provision of this transportation resource with routine surveillance. PAP Home Health Initiative to Minimize Transportation Barriers and Improve Show Rates to Primary Care Provider Follow-Up Appointments Transportation barriers to medical appointments lead to poor health outcomes. The purpose of this study was to evaluate the impact of a transportation resource guide on access to transportation for postdischarge primary care follow-up appointments. A quasi-experimental research design was employed. Patients in the 4 zip-code target area who screened positive for transportation barriers received the transportation resource guide, which offered patients meaningful information and options in planning transportation to medical appointments. Attendance at follow-up primary care appointments within 7 days of hospital discharge increased from 10.2% (n = 37) to 10.8% (n = 50), P = .856. While not statistically significant, the intervention was clinically impactful in influencing patients’ ability to access transportation for follow-up appointments. Results support sustaining ongoing provision of this transportation resource with routine surveillance. Improving Heart Failure Outcomes Through Hemodynamic Monitoring A Retrospective Program Evaluation Journal of Nursing Care Quality . September 22, 2026 PAP Improving Heart Failure Outcomes Through Hemodynamic Monitoring Adverse Events in Long-Term Care A Mixed-Methods Systematic Review Journal of Nursing Care Quality . September 22, 2026 Introduction: Adverse events are a major patient safety concern in long-term care, where older people with complex health needs are particularly vulnerable. Purpose: The purpose of this mixed-methods systematic review was to systematically synthesize quantitative and qualitative evidence regarding the occurrence, outcomes, and associated risk factors of adverse events in long-term care settings. Methods: A mixed-methods systematic review using a convergent integrated approach was conducted. Results: One hundred studies were included. Falls were the most frequently reported adverse event, followed by medication errors, adverse drug events, and pressure injuries. Outcomes ranged from mild harm to death, with moderate harm most commonly reported. Risk factors were multifactorial, spanning patient, care process, team, and organizational domains, with mostly moderate consistency of evidence. Conclusions: Adverse events in long-term care are common and complex. Improving safety requires system-level, multicomponent interventions and more consistent reporting practices. PAP SDC Open Adverse Events in Long-Term Care Adverse events are a major patient safety concern in long-term care, where older people with complex health needs are particularly vulnerable. The purpose of this mixed-methods systematic review was to systematically synthesize quantitative and qualitative evidence regarding the occurrence, outcomes, and associated risk factors of adverse events in long-term care settings. A mixed-methods systematic review using a convergent integrated approach was conducted. One hundred studies were included. Falls were the most frequently reported adverse event, followed by medication errors, adverse drug events, and pressure injuries. Outcomes ranged from mild harm to death, with moderate harm most commonly reported. Risk factors were multifactorial, spanning patient, care process, team, and organizational domains, with mostly moderate consistency of evidence. Adverse events in long-term care are common and complex. Improving safety requires system-level, multicomponent interventions and more consistent reporting practices.