To establish research priorities for Australian Nurse Practitioners and develop a robust research agenda. A descriptive, exploratory approach was used and conducted in two stages. Data were collected over two stages. Data for Stage 1 were collected from 14 December 2023 to 16 February 2024. For the Delphi rounds (Stage 2), data were collected from 11 March to 24 March 2024 for Delphi Round 1 and from 12 June to 26 June 2024 for Delphi Round 2. An exploratory survey was used in Stage 1 to identify clinical challenges and research themes perceived as important for Australian Nurse Practitioners. In Stage 2, a two-phased modified Delphi survey was conducted to prioritise the research themes identified in Stage 1. A total of 315 participants responded to the exploratory survey, with a majority being female (77%), aged between 30 and 75 years. Participants were primarily employed in the public healthcare sector (60%), the private sector (23%), while 17% practised across both sectors. A total of 1335 challenges facing Australian Nurse Practitioners were identified. Sixty-nine participants completed the first Delphi round, and 33 the second, giving response rates of 21% (69/315) and 48% (33/69), respectively. The first Delphi round yielded 11 research themes. Seven of these yielded Content Validity Indices of < 0.90. Four research priority areas remained and were ranked in order of importance. The identified Australian Nurse Practitioner research priorities will play a pivotal role in shaping policies, fostering the efficient integration of Nurse Practitioners into the healthcare system and advancing research capacity. Nurse Practitioners are established providers of high-quality care internationally; however, they face persistent integration challenges in Australia. This study delivers a nationally relevant, consensus-based research agenda that identifies key priorities across clinical, educational and leadership domains. No patient or public contribution.

Although the majority of doctorally prepared nurses work in academia, a percentage choose clinical work. Knowledge about the contribution of doctorally prepared clinical nurses (DPCNs) is growing, but further exploration is required. This research explored the value that DPCNs provide to nursing practice and healthcare. Using an interpretive descriptive approach, individual interviews were conducted with 18 DPCNs. Data was collected between 2021 and 2022. Reflexive thematic analysis informed the data analysis. Five key mechanisms drive DPCNs' value: being a knowledge expert; an enhanced approach to practice; increased credibility/prestige of the doctorate; valuable conversations; and new opportunities and collaborations. Challenges to value contribution were also highlighted, including identity issues; negative external perceptions; fragmented mentorship; no post-doctoral pathway; and little recognition from nursing leaders. Doctorally prepared clinical nurses bring significant value to nursing and healthcare through distinct mechanisms that should be nurtured and strengthened. Doctorally prepared clinical nurses add important value to healthcare. However, these nurses are under-utilised and require support to enhance their value contribution. Identifying the mechanisms driving value provides a unique opportunity to acknowledge, support and enhance the value provided by DPCNs. The research will be impactful for nurses considering doctoral study, nursing leaders and healthcare managers. This research is reported following SRQR guidelines. This study did not include patient or public involvement in its design, conduct or reporting.

Healthcare systems face a growing challenge: as technology advances, patients increasingly feel like data points in systems that prioritise efficiency over empathy. This paper addresses the global healthcare crisis of disconnection, arguing that fundamental change requires putting human experience at the centre through Caring Science principles in nursing. COVID-19 clearly revealed this disconnect. While showcasing scientific advances, it exposed gaps in compassionate care and fair access globally. Nurses struggled to maintain human connection while dealing with resource shortages and isolation protocols, proving that advanced medical treatments alone cannot address the physical, emotional, spiritual, and social factors that influence health. This work draws on peer-reviewed studies, contemporary research, and theories of human caring to demonstrate the global responsibility and urgent need for integrating caring practices into healthcare systems. Collectively, this evidence underscores both the necessity of intervention and the effectiveness of Caring Science as a strategy for transforming organisational practices while highlighting a pressing truth: healthcare systems worldwide must move beyond efficiency alone and intentionally weave caring practices into their structures. This analysis examines Caring Science through three key areas: Relational, Organisational, and Global. Using Watson's Theory of Human Caring and current research, the paper shows how caring relationships can improve through thoughtful use of innovation. Recent healthcare improvements demonstrate promising results when technology integration enhances both nurse empowerment and patient outcomes within frameworks that prioritise human connection. Future directions position Caring Science as a mature, evidence-informed framework for addressing healthcare's complex challenges. The paper calls for 'sacred activism'-a commitment to protecting caring's essential dimensions while embracing beneficial innovation, positioning nursing to lead healthcare transformation through both the art and science of nursing that honours human dignity.

To provide an in-depth description of an innovative Doctor of Nursing programme which prepares nurses for senior roles in healthcare and related organisations. This programme provides nurse leaders with the knowledge and skills to advance systems through healthcare innovation design, implementation, and evaluation. A comparison of doctoral nursing programmes, highlighting the unique aspects of the University of Calgary Doctor of Nursing programme. The University of Calgary Doctor of Nursing programme addresses key gaps that currently exist within nursing education. Few existing programmes directly support the development of nurses as healthcare leaders and innovators. This programme enables nurse leaders to leverage their front-line experience into senior system-level leadership roles. Each core course includes a building block assignment that develops key doctoral skills: framing research questions, appraising literature, selecting methods and data, planning ethically sound projects, and translating evidence into persuasive arguments for policy or system change. Nurses play a vital role in healthcare around the world. The University of Calgary Doctor of Nursing programme recognises the value of investing in nursing leaders and emboldening them to leverage their frontline leadership experience to advance data-driven change, innovation, and policy development in the complex healthcare systems in which they work and lead. Currently, there is a dearth of programmes available to prepare nurses for senior leadership roles in healthcare or related organisations, despite significant demand from prospective students and employers alike. The University of Calgary Doctor of Nursing programme meets the workforce demand for a programme focused on nursing leadership, to advance health systems through skill development in systems innovation, appraisal of evidence and implementation science, as well as quality assurance/quality improvement and programme evaluation. This programme focus also better equips students to examine and evaluate systemic inequities and challenges currently facing healthcare systems, practitioners and users.

To examine participation in workplace and non-workplace emotional well-being programs among nurses. Cross-sectional survey. Survey was administered to nurses who participated in the Virtual Schwartz Rounds peer support program retrospectively (sessions November 19, 2020-March 31, 2024; survey administered April 23, 2024-June 22, 2024) or immediately following a session (April 1-December 12, 2024). Of 290 respondents, 55 were excluded due to missing data, yielding an analytic sample of 235 nurses. Nurses who participated in workplace emotional well-being programs reported greater use of external resources than those who did not. These nurses were more likely to spend time with animals for emotional support, use mindful or physical self-care strategies, and participate in community support, social media, online nursing forums and counselling. Nurses adopt a multipronged approach to well-being, combining self-care, group and individual supports. Findings underscore maintaining well-being resources, with non-workplace programs complementing workplace initiatives to support the emotional needs of the nursing workforce. Findings highlight the need for leaders to invest in organizational well-being programs and increase awareness of resources outside the workplace that may support nurses' emotional well-being. These insights can inform development of well-being programs that increase engagement and support patient care. Nurses experience emotional strain, yet little is known about the resources they use outside workplace programs. This study found that nurses who participate in workplace well-being programs are more likely to engage with additional supports, including self-care practices, peer or community groups and counselling. These findings can inform healthcare organizations and nursing leaders designing well-being initiatives that better support nurses. The study adheres to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. This study did not include patient or public involvement in its design, conduct or reporting.

To compare attitudes and perceptions towards opioid use disorder among people with opioid use disorder and emergency providers, describe interactions between the two groups, and identify barriers to providing and receiving care. Mixed methods observational study. Participants were recruited from an academic, tertiary care hospital and a community-based harm reduction agency in New England. Emergency healthcare providers (nurses, physicians, and paramedics) and adult people with opioid use disorder were enrolled. Electronic surveys were administered to providers, and semi-structured interviews were conducted with people with opioid use disorder and a subset of providers. Descriptive statistics were calculated for surveys, and directed content analysis was used to analyse semi-structured interviews. Sixty-eight providers completed the survey, 11 of whom also completed a semi-structured interview. Twenty-two people with opioid use disorder completed the semi-structured interview. Both providers and people with opioid use disorder agreed that addiction is a disease; however, opinions differed on the extent to which personal choice played a role in the onset of opioid use disorder. Participants described how factors such as experiencing homelessness, alongside other personal or familial challenges, contributed to ongoing substance use and presented barriers to accessing healthcare. There was discordance in priorities between providers and people with opioid use disorder, which often drove conflict and perceived stigma. Both groups described physical and emotional trauma from prior interactions, which shaped expectations of future interactions and biases towards each other. Educational initiatives should arm providers not only with clinical knowledge about opioid use disorder but with skills to recognize implicit biases, navigate unique barriers related to social determinants of health, and effectively deploy shared decision-making techniques. Healthcare organizations should provide support for trauma that emergency care providers are exposed to in caring for people with opioid use disorder. Consolidated criteria for reporting qualitative studies (COREQ)-32 item checklist. This study did not include patient or public involvement in its design, conduct, or reporting.

Healthcare systems are undergoing major transformation driven by technological progress, growing patient involvement, workforce shortages, complex care needs, and rising costs. Against this backdrop, value-based healthcare has gained traction, yet the notion of 'value' remains ambiguously defined. To clarify the concept of 'value' in value-based healthcare. We conducted a concept analysis using Walker & Avant's eight-step method: (1) Select a concept; (2) Determine the aims; (3) Identify uses; (4) Define the concept's attributes; (5) Identify the model case(s); (6) Identify additional cases; (7) Identify antecedents and consequences; and (8) Define empirical referents. Scoping review methods following the Joanna Briggs Institute (JBI) recommendations were used to introduce rigour in locating, screening, and extracting data. We used a deductive thematic analysis for data analysis. We selected the concept of value in value-based healthcare because it lacked conceptual clarity to support healthcare systems transformations. We propose that value arises when outcomes-to-costs ratios (empirical referents) are considered in processes (uses) addressing healthcare systems transformations, characterised by more informed and engaged patients and rising costs (antecedents). Model case included consideration for all components (health, non-health outcomes, and direct, indirect, social costs) of the ratio, whereas additional cases showed that consideration for most, not all, or none of these components led to partial or no value creation. Value is used from individual to collective dimensions and at clinical, organisational and system levels (attributes) to improve patient experience, care team well-being, health equity, and population health, and to reduce costs (consequences). A shared understanding of 'value' can guide its design, measurement, and implementation to support successful transformations toward value-based healthcare. Our conceptual proposition of 'value' within value-based healthcare establishes a framework for a common understanding of 'value' that enables the successful transformation of health systems toward value-based healthcare.

To explore the current status and associated factors of advance care planning intentions among people living with dementia in China. An explanatory sequential mixed-methods design was adopted. The research is guided by the knowledge-attitude-practice model and the theory of planned behaviour. Quantitative surveys were used to assess advance care planning intentions and associated factors in people living with dementia, followed by qualitative semi-structured interviews to delve into participants' perceptions and feelings about advance care planning. Quantitative data were analysed using multiple linear regression, while qualitative data were analysed using thematic analysis. The overall advance care planning behavioural intention was at a moderately high level. The quantitative results revealed that higher education level, certain religious beliefs, greater advance care planning knowledge, positive behavioural attitudes and stronger subjective norms were significantly positively associated with advance care planning intentions. Qualitative analysis identified three themes: positive attitude but limited ACP awareness, supportive relationships enable early ACP consideration and cultural norms shape willingness to engage in ACP. Advance care planning intentions among people living with dementia are shaped by a combination of social, familial and individual factors. Increasing public awareness, addressing cultural challenges and establishing professional teams are crucial to promoting advance care planning practices. Future research should focus on larger, multicenter studies to enhance intervention strategies. Although the attitude toward advance care planning is more positive, various factors need to be carefully considered in the process of constructing relative intervention strategies. This study did not include patient or public involvement in its design, conduct or reporting.