The aim of this study was to assess student nurses' knowledge of and attitudes towards pressure injury prevention evidence-based guidelines. Pressure injuries are a substantial problem in many healthcare settings causing major harm to patients, and generating major economic costs for health service providers. Nurses have a crucial role in the prevention of pressure injuries across all health care settings. A multi-centered, cross-sectional study was conducted using a paper-based questionnaire with undergraduate nursing students enrolled in seven universities with campuses across five Australian states (Queensland, New South Wales, Western Australia, Victoria and Tasmania). Data were collected from nursing students using two validated instruments (Pressure Ulcer Knowledge Assessment Instrument and Attitude Toward Pressure Ulcer Prevention Instrument), to measure students' pressure injury prevention knowledge and attitudes. Students reported relatively low pressure injury prevention knowledge scores (51%), and high attitude scores (78%). Critical issues in this study were nursing students' lack of knowledge about preventative strategies to reduce the amount and duration of pressure/shear, and lower confidence in their capability to prevent pressure injury. Level of education and exposure to working in a greater number of different clinical units were significantly related to pressure injury prevention knowledge and attitude scores. The study findings highlight the need to implement a comprehensive approach to increasing Australian nursing students' pressure injury prevention and management knowledge, as well as ensuring that these students have adequate experiences in clinical units, with a high focus on pressure injury prevention to raise their personal capability.

Background: The emergence of COVID-19 and public health measures implemented to reduce SARS-CoV-2 infections have both affected acute lower respiratory tract disease (aLRTD) epidemiology and incidence trends. The severity of COVID-19 and non-SARS-CoV-2 aLRTD during this period have not been compared in detail. Methods: We conducted a prospective cohort study of adults age ≥18 years admitted to either of two acute care hospitals in Bristol, UK, from August 2020–November 2021. Patients were included if they presented with signs or symptoms of aLRTD (e.g., cough, pleurisy), or a clinical or radiological aLRTD diagnosis. Findings: 12557 adult aLRTD hospitalisations occurred: 10087 were associated with infection (pneumonia or NP-LRTI), 2161 with no infective cause, with 306 providing a minimal surveillance dataset. Confirmed SARS-CoV-2 infection accounted for 32% of respiratory infections. Annual incidences of overall, COVID-19, and non- SARS-CoV-2 pneumonia were 714, 264, and 450, and NP-LRTI were 346, 44, and 302 per 100,000 adults, respectively. Weekly incidence trends in COVID-19 aLRTD showed large surges (range: 0—221), while other infective aLRTD events were more stable (range: 71—152) as were non-infective aLRTD events (range: 18—66). Interpretation: While COVID-19 disease was a large component of total aLRTD during this pandemic period, non- SARS-CoV-2 infection still caused the majority of respiratory infection hospitalisations.COVID-19 disease showed significant temporal fluctuations in frequency, which were less apparent in non-SARS-CoV-2 infection. Despite public health interventions to reduce respiratory infection, disease incidence remains high. Funding: AvonCAP is an investigator-led project funded under a collaborative agreement by Pfizer. Declaration of Interest: CH is Principal Investigator of the Avon CAP study which is an investigator-led University of Bristol study funded by Pfizer and has previously received support from the NIHR in an Academic Clinical Fellowship. JO is a Co-Investigator on the Avon CAP Study. LD is further supported by UKRI through the JUNIPER consortium (grant number MR/V038613/1), MRC (grant number MC/PC/19067), EPSRC (EP/V051555/1 and The Alan Turing Institute, grant EP/N510129/1). AF is a member of the Joint Committee on Vaccination and Immunization (JCVI) and chair of the World Health Organization European Technical Advisory Group of Experts on Immunization (ETAGE) committee. In addition to receiving funding from Pfizer as Chief Investigator of this study, he leads another project investigating transmission of respiratory bacteria in families jointly funded by Pfizer and the Gates Foundation and is an investigator in trials of COVID19 vaccines including ChAdOx1nCOV-19, Janssen and Valneva vaccines. EB, JS, JC, SG, RH, SV, GE, and BG are employees of Pfizer and own Pfizer stock. The other authors have no relevant conflicts of interest to declare Ethical Approval: This is a prospective observational cohort study of adults admitted to two large university hospitals in Bristol, UK. The study was approved by the Health Research Authority Research Ethics Committee East of England, Essex, reference 20/EE/0157, ISRCTN: 17354061.

Background: Healthcare is a dynamic environment for nurses, with early career nurses (ECNs) needing to adapt and learn while also meeting care demands. Effective support systems, mentorship, and continuous professional development are vital in facilitating their transition while navigating competing demands. The aim of this study is to interpret and understand the meaning of ECNs’ professional experiences four years after completing their bachelor’s degree in Australia. Method: A qualitative descriptive design using a hermeneutic phenomenological approach was used as part of a longitudinal study. Follow-up semi-structured interviews were conducted among twenty-five ECNs between 2022 and 2024 using purposive sampling to recruit ECNs who had graduated four years ago. Thematic analysis was used to analyse data while adhering to the consolidated criteria for reporting qualitative research (COREQ) guidelines. Results: Four themes emerged among participants, which encompassed professional growth and unwavering commitment, ongoing professional adaptability, feeling stuck with limited choices, and continual learning amid career challenges and personal life demands. Conclusions: Change is needed to ensure professional learning becomes a shared responsibility among policy makers and healthcare leaders and to ensure that professional learning leads to more nurses taking up further study, thus increasing the safety and quality of care delivered in the healthcare environment.

To explore the lived experience of Early Career Nurses four years post-graduation and identify factors influencing their decision to stay in or leave the profession. The retention of Early Career Nurses is a critical issue globally, with many leaving the profession within the first few years. Various interventions have been implemented to support Early Career Nurses, but the complexities of retention require a more nuanced understanding, particularly for those in the latter stages of their transition. A qualitative descriptive study. Early Career Nurses who participated in a longitudinal study as undergraduate nursing students were interviewed 48 months after graduation. The study used phenomenological approach to explore key experiences and phenomena. Data were analysed using Thematic Analysis, adhering to COREQ guidelines. Among the 25 participants, key themes identified included being 'Overworked and undervalued' and being 'Anchored by care.' Early Career Nurses experienced significant pressures, including incivility, poor management and staffing shortages, leading to a desire to leave the profession. However, a strong commitment to patient care and support from peers and family helped some Early Career Nurses remain in the profession. The study highlights the need for systemic changes to support Early Career Nurses, including empathetic leadership, adequate training and supportive work environments. Addressing these issues is essential for the wellbeing of Early Career Nurses and maintaining high standards of patient care. Understanding the unique challenges faced by Early Career Nurses can inform strategies to improve retention and support their professional development.