Purpose To undertake a systematic review of the literature to investigate the HRQOL among adults living with DFUs. Methods A systematic search of the medical and nursing/health content databases including MEDLINE, CINAHL, and PsycINFO was conducted up to November 2018. The methodological quality of each study was assessed independently by all authors using the Joanna Briggs Institute checklist. Data analysis was conducted using the Comprehensive Meta-analysis software. All analyses were performed using random-effects models and heterogeneity was quantified. Results A total of 12 studies were included in the review. Overall, the HRQOL of participants in the studies was poor on four of eight subscales in the SF-36: physical functioning (mean = 42.75, SE 1.5); role physical (mean = 20.61, SE 3.4); general health (mean = 39.52, SE 1.7); and vitality (mean = 45.73, SE 2.8). In addition, presence of pain, high levels of C-reactive protein (> 10 mg/L), ulcer size > 5 cm 2 , Ankle Brachial Index < 0.9, high glycosylated haemoglobin and body mass index > 25 kg/m 2 were associated with poorer HRQOL in people with DFUs. Conclusions This review has provided evidence indicating that people with DFUs have a significantly lower HRQOL. Evidence-based interventions to improve the HRQOL in this group of people is needed.

Aims and objectives: To explore how nurses influence the perceptions and experience of safety among consumers who have been admitted to an acute mental health unit. Background: Safety is a priority in acute mental health inpatient units, yet consumers do not always experience acute units as safe. Despite being primary stakeholders, little is known about what safety means for consumers in acute mental health units. Design: A qualitative descriptive study informed by naturalistic enquiry was conducted and is reported using the COREQ checklist. Methods: Fifteen consumers with experience of mental illness participated in semistructured individual interviews. These interviews explored what safety meant for them during their acute mental health unit admissions. Thematic analysis was used to analyse the data. Findings: The theme Influence of Nurses reflected that the way nurses engaged in acute mental health units had a profound impact on participants' sense of safety. Three sub-themes emerged as follows: (a) Availability: "It's about nurses spending time with you"; (b) Being responsive: "They would listen if you had a concern"; and (c) Caring: "Little acts of kindness." Conclusions: These findings challenge the dominant discourse around safety in mental health organisations, in which nursing practice is often oriented towards the management of risk, rather than the promotion of safety. The findings demonstrate that, through their clinical practice, nurses can enhance consumers' feelings of safety in the acute mental health unit. Relevance to clinical practice: Nurses play a key role in providing care within acute mental health units. It is vital that the behaviours and actions nurses can enact in order to promote feelings of safety among consumers in this setting are enabled at individual, unit and organisational levels.

Aims and objective: To develop nursing-sensitive patient indicators to measure the outcomes of nursing practice.Background: Nurses play an important role in the healthcare system, yet there is

Hospitals are an integral part of Australian rural communities. Not only are they often the largest employer in the area, but also they are usually the sole provider of health care to rural communities (Twigg, Cramer, & Pugh, 2016). Health care in rural hospitals is provided largely by nurses who need to have a broad skill set and the ability to work autonomously with limited medical and allied health support (Baernholdt & Mark, 2009). Studies have shown that rural hospitals operate with fewer resources than their urban counterparts (Smith, 2007) and that rural hospitals also experience ongoing issues with recruitment

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Aim: To describe the development, testing, and implementation of a data registry of nursing-sensitive indicators for measuring the quality and safety of nursing practice.Background: Recent research has established causal links between nurse staffing and patient outcomes. Unit level data is necessary for implementation of evidencebased strategies on nurse staffing and nursing care processes.Design: Multi-site, cross-sectional design.Methods: Retrospective data were collected from administrative data sets on nurse staffing, patient flow, and adverse events in three hospitals in 2016. Periodic observational surveys on pressure injury prevalence, hand hygiene practices, and documentation of processes of care were also conducted. Prospective data were collected from patients at time of discharge using the Caring Assessment Tool.Nurses' perceptions of their practice environment were assessed using the Nursing Work Index -Revised: Australian. Data from annual Press Ganey ® surveys on patient satisfaction/experience were obtained.

Aims The aim of this review was to synthesize the best available evidence on the impact of nurses' safety attitudes on patient outcomes in acute‐care hospitals. Design Systematic review with a narrative synthesis of the available data. Data sources Data sources included MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Scopus and Web of Science Core Collection. Studies published up to March 2021 were included. Review Methods This review was conducted using guidance from the Joanna Briggs Institute for Systematic Reviews and reported as per the Preferred Reporting Items for Systematic Review and Meta‐Analyses guidelines. Results A total of 3,452 studies were identified, and nine studies met the inclusion criteria. Nurses with positive safety attitudes reported fewer patient falls, medication errors, pressure injuries, healthcare‐associated infections, mortality, physical restraints, vascular access device reactions and higher patient satisfaction. Effective teamwork led to a reduction in adverse patient outcomes. Most included studies (N = 6) used variants of the Hospital Survey on Patient Safety Culture to assess nurses' safety attitudes. Patient outcomes data were collected from four sources: coded medical records data, incident management systems, nurse perceptions of adverse events and patient perceptions of safety. Conclusion A positive safety culture in nursing units and across hospitals resulted in fewer reported adverse patient outcomes. Nurse managers can improve nurses' safety attitudes by promoting a non‐punitive response to error reporting and promoting effective teamwork and good communication.

Aims and objectives To critically analyse the literature describing nurses' knowledge, attitudes and practices regarding influenza vaccination. Background Influenza is a serious illness that has significant impacts on productivity, health outcomes and healthcare costs. Despite the recommendations for nurses to be vaccinated annually against influenza, the vaccination rates remain suboptimal. Design Integrative literature review. Methods An integrative review was conducted as described by Whittemore and Knafl (2005). A search of CINAHL, Cochrane Library, ProQuest Central, ClinicalKey, ScienceDirect, Wiley Online Library, and Informit was undertaken to identify relevant papers. Given the heterogeneity of included studies, a narrative approach was used to analyse the data. Results There was limited research available on this topic area, with only 10 papers identified as meeting the inclusion criteria. Five themes were identified: the relationship between knowledge and influenza vaccination, perception of risk, motivators for influenza vaccination, barriers to influenza vaccination and impact of demographics on vaccination. Conclusions Despite the evidence for the protective effects of influenza vaccination, rates of vaccination among nurses remain suboptimal. Nurses' influenza vaccination practices likely relate to their level of knowledge and perception of risk; the greater nurses' knowledge regarding influenza and influenza vaccination the higher their perception of risk and the more likely they are to be vaccinated. This also translates to the advice that they give patients with vaccinated nurses more inclined to recommend vaccination than those unvaccinated. Relevance to clinical practice The practices of nurses related to influenza vaccination may translate to the advice that they give their patients. Understanding the knowledge levels, practices and attitudes of nurses can assist in developing strategies to enhance education of nurses. Disciplines Medicine and Health Sciences | Social and Behavioral Sciences Publication DetailsSmith, S., Sim, J. & Halcomb, E. (2016). Nurses' knowledge, attitudes and practices regarding influenza vaccination: an integrative review. Journal of Clinical Nursing, Background: Influenza is a serious illness that has significant impacts on productivity,