Higher nurse-to-patient ratios are associated with poor patient care and adverse nurse outcomes, including emotional exhaustion and intention to leave. We examined the effect of nurses' intention to leave and nurse-patient workload on in-hospital patient mortality in Italy. A multicentered descriptive and regression study using clinical data of patients aged 50 years or older with a hospital stay of at least two days admitted to surgical wards linked with nurse variables including workload and education levels, work environment, job satisfaction, intention to leave, nurses' perception of quality and safety of care, and emotional exhaustion. The final dataset included 15 hospitals, 1046 nurses, and 37,494 patients. A 10 % increase in intention to leave and an increase of one unit in nurse-patient workload increased likelihood of inpatient hospital mortality by 14 % (odds ratio 1.14; 1.02-1.27 95 % CI) and 3.4 % (odds ratio 1.03; 1.00-1.06 95 % CI), respectively. No other studies have reported a significant association between intention to leave and patient mortality. To improve patient outcomes, the healthcare system in Italy needs to implement policies on safe human resources policy stewardship, leadership, and governance to ensure nurse wellbeing, higher levels of safety, and quality nursing care.

Aim: To report an analysis of the concept of fundamental care in the literature.Design: An evolutionary concept analysis.Data sources: PubMed and CINAHL Complete databases were consulted using the key terms: fundamental care, fundamentals of care, essential care, basic nursing care and basic care revised. Articles published from 2008 to 2022, in English and Italian, in scholarly/peer‐reviewed nursing journals were included.Methods: Rodgers's Evolutionary Method of concept analysis was used. Our thematic analysis yielded common themes related to the concept, antecedents, attributes and consequences of fundamental care.Results: A total of 50 articles were analysed. Thirty‐eight attributes were identified, such as integration of care, patient and family centred care and trusting relationship; eight antecedents including nursing care, nursing practice and care context; and 17 consequences including the safety, quality and consistency of care.Conclusion: This review of literature reveals that there is no consistent definition of the concept of ‘fundamental care’. Findings from this exploration of the literature emphasized the importance of communication, the contextual environment, leadership influence and nurse–patient relationship in providing effective and high‐quality fundamental care. Our definition of this concept may help nurse leaders in practice, research, education, management and policy to promote and enhance the application of fundamental care.Impact: What problem did the study address? While numerous studies examine fundamental nursing care, various terms are used with no consensus on definitions emerging. Given the relevance of this topic, reaching a clear and agreed definition of fundamental care is essential. What were the main findings? Fundamental care encompasses the importance of communication, the contextual environment, leadership influence and nurse‐patient relationship in providing effective and high‐quality care. Where and on whom will the research have an impact? This definition of fundamental care will assist nurse leaders and researchers to promote and enhance the examination and application of fundamental care in clinical practice to ensure better care outcomes across all healthcare settings.

Aim: To identify factors protecting and hindering the well‐being of critical care nurses during the COVID‐19 pandemic.Background: The unique work challenges of critical care nurses can undermine their professional and mental well‐being; as evidenced by the prevailing literature on burnout, compassion fatigue, and moral distress. The COVID‐19 pandemic has seen these professionals on the front lines and has raised many questions about professional well‐being. Identifying the factors that protect and hinder the well‐being of critical care nurses would help to develop the strategies necessary to reduce worrying phenomena associated with professional malaise.Evaluation: A systematic review was conducted using electronic databases including PubMed, CINAHL, Scopus, Cochrane, PsycINFO, and Web on Science.Key issues: After full text analysis, 25 papers were included in the current systematic review. Factors influencing the well‐being of critical care nurses have been grouped into “Protective” and “Hindering.”Conclusions: This review shows that critical care nurses’ well‐being is influenced by factors like personal resilience and supportive work environments, which enhance their experience. Challenges include sociodemographic issues and the COVID‐19 pandemic's impact. Addressing these factors is crucial for their well‐being and the effectiveness of healthcare systems.Implications for clinical practice: The well‐being of nurses is intricately linked to the quality and security of patient care, ultimately influencing clinical outcomes. This review delves deeply into the multifaceted factors that affect the professional well‐being of critical care nurses during the COVID‐19 pandemic. Recognizing these elements is critical for directing health policy toward the development of initiatives that bolster healthcare workers’ welfare. Prioritizing the professional well‐being of nurses is imperative, as it is fundamental in mitigating the increasing inclination towards job turnover, a challenge that is profoundly impacting the healthcare sector.

Background: Pre‐hospital emergency nurses, frequently exposed to high‐stress situations, are at risk for burnout and stress‐related issues, affecting their overall well‐being. The Professional Quality of Life (ProQoL) scale, widely used among hospital nurses, remains untested in pre‐hospital emergency settings.Aim: To adapt and validate the ProQoL scale for pre‐hospital emergency contexts and explore the protective role of emotional intelligence in professional well‐being.Methods: A mixed‐method study was conducted. The qualitative approach involved semi‐structured interviews to inform the modification of items for adapting the ProQoL to the pre‐hospital emergency setting. A quantitative method was applied to assess the relationship between emotional intelligence and professional well‐being through content and face validity measures.Results: Qualitative interviews suggested refining the ProQoL for pre‐hospital emergency settings, emphasising factors such as job satisfaction and professional conduct. The revised 21‐item Pre‐Hospital Emergency‐Professional Quality of Life (PHE‐ProQoL) scale demonstrated strong content validity (I‐CVI: 0.86‐1, S‐CVI: 0.9) and face validity. Significant correlations were observed between emotional intelligence and professional well‐being, with negative correlations between emotional intelligence and both burnout (Pearson's r = −0.859) and post‐traumatic stress (Pearson's r = −0.792), and a positive correlation with compassion satisfaction (Pearson's r = +0.917). Pre‐hospital nurses displayed moderate levels of compassion satisfaction (27.3 ± 9.81), high emotional intelligence (28.0 ± 9.58), especially in empathy, and substantial levels of burnout (22.5 ± 6.09) and stress (21.2 ± 4.3).Discussion: The study found that pre‐hospital emergency nurses exhibit moderate compassion satisfaction and above‐average emotional intelligence, particularly in perceiving and managing others' emotions. However, they also experience significant levels of burnout and post‐traumatic stress.Conclusions: Burnout and post‐traumatic stress significantly affect pre‐hospital emergency nurses. Enhancing emotional intelligence is crucial for their well‐being. Nursing managers now have access to a validated and reliable tool to assess this.

Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers’ attitudes toward older people’s nutrition using the validated Italian version of the Staff Attitudes to Nutritional Nursing Geriatric care scale (SANN-G), focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software (R-4.4.2 for Windows). Results: Most healthcare workers were female (68.59%) and aged 41–50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most exhibiting neutral or negative attitudes. Healthcare workers who attended a malnutrition course were more likely to exhibit positive attitudes toward nutrition, particularly in the dimension of norms, assessment, intervention, and individualization. Younger healthcare workers, with the role of nurses and who attended a course on malnutrition, were more likely to have positive attitudes, while older healthcare workers and with the role of physicians tended to show neutral or negative attitudes. Conclusions: Education on malnutrition improves healthcare workers’ attitudes toward older adults’ nutrition, especially among younger nurses. The low percentage of positive attitudes (23.48%) underscores the need for broader education programs to enhance nutritional care quality.