Journal of Modern Multidisciplinary Research
Journal of Modern Multidisciplinary Research (JMMR) is a peer-reviewed, open-access journal publishing high-quality research across diverse disciplines, including science, engineering, health, social sciences, business, and humanities. The journal welcomes original research articles, review papers, and short communications that advance knowledge and practice through multidisciplinary perspectives. JMMR is committed to research integrity, editorial transparency, and timely publication.
The Determinants of Employee Engagement in Nursing: A Systematic Review
Employee engagement in nursing has become a strategic concern because engaged nurses are more likely to remain in post, sustain performance under pressure, and support safer care delivery. This systematic review synthesized the determinants of employee engagement in nursing and developed an integrated multilevel framework. Following PRISMA 2020 guidance, searches were conducted across major health and interdisciplinary databases and were supplemented with Google Scholar for English-language studies published between January 2015 and December 2025. After screening, eligibility assessment, and methodological appraisal using MMAT 2018, 53 studies were included in the final narrative synthesis. The evidence indicated that engagement in nursing is shaped by interacting individual, relational, work-design, and contextual determinants. Leadership, structural empowerment, favorable practice environments, psychological capital, emotional intelligence, core self-evaluation, self-efficacy, resilience, meaningful work, decent work, social support, and job crafting consistently strengthened engagement. By contrast, burnout, hindrance stress, compassion fatigue, perceived overqualification, organizational dehumanization, illegitimate tasks, and poor work-life fit weakened engagement or limited its sustainability. More recent evidence also suggests that digital literacy and nursing informatics capability function as emerging job resources rather than peripheral technical attributes. The literature remains dominated by cross-sectional self-report designs, limiting causal inference and weakening understanding of how engagement is built and sustained over time. This review contributes a clearer analytic structure by distinguishing foundational job resources, personal resources, and demand-related constraints. It also offers practical guidance for nursing leaders seeking to strengthen retention, well-being, and quality of care through deliberate engagement-building strategies.
The Determinants of Work-Life Balance in Nursing: A Systematic Review
Work-life balance is a persistent challenge in nursing because caregiving is delivered within chronically demanding, time-sensitive, and emotionally intensive environments. This systematic review aimed to identify, critically appraise, and synthesize empirical evidence on the determinants of work-life balance among nurses. The review was conducted and reported in line with PRISMA 2020 guidance. A structured search of PubMed/MEDLINE, CINAHL, Scopus, Web of Science, PsycINFO, and the Cochrane Library was undertaken for English-language studies published between January 2015 and December 2024. Quantitative, qualitative, and mixed-methods studies that examined work-life balance, work-family balance, work-family conflict, or closely related constructs among nurses were eligible. Twenty-four studies met the inclusion criteria and were synthesized narratively because of substantial heterogeneity in design, setting, and outcome measurement. Across the included studies, the most consistent determinants of poorer work-life balance were high workload, understaffing, rotating and night shifts, long working hours, schedule unpredictability, weak managerial support, unsupportive organizational climate, caregiving burden, stress, emotional exhaustion, sleep disruption, fatigue, and physical pain. Protective factors included family support, resilience, positive coping, schedule flexibility, and family-supportive leadership. Overall, the evidence indicates that nurses’ work-life balance is shaped less by personal preference alone than by the interaction between individual resources and organizational conditions. Improving work-life balance in nursing therefore requires multilevel action, particularly staffing reform, healthier scheduling systems, family-supportive leadership, and policy environments that protect recovery time and sustainable practice.
The midwifery profession plays a vital role in ensuring the health and well-being of mothers and newborns, yet midwives often face significant workload-related challenges that impact both their performance and the quality of care provided. This paper explores the concept of midwifery workload, analyzing its defining attributes, antecedents, consequences, and empirical referents. Through a comprehensive review of existing literature, the study identifies several key factors that contribute to high workloads in midwifery, including inadequate staffing, high patient acuity, and insufficient organizational support. These factors lead to increased stress, burnout, and job dissatisfaction among midwives, which in turn negatively affects patient care outcomes. The study also discusses the role of external elements such as socio-cultural expectations, resource availability, and institutional factors in shaping midwifery workload. This research highlights the complex nature of midwifery workload and underscores the need for targeted interventions to address the negative consequences of high workload. The findings suggest that improving staffing levels, providing organizational support, and fostering a positive work environment are essential strategies for reducing workload-related stress and enhancing job satisfaction among midwives. Furthermore, the study calls for the development of standardized workload measurement tools to better quantify and manage midwifery workload across healthcare settings. The paper concludes by emphasizing the importance of addressing midwifery workload to ensure the sustainability of the midwifery workforce and to improve the quality of care delivered to mothers and newborns. By implementing strategies that reduce workload-related stress and support midwives in their professional roles, healthcare systems can promote better outcomes for both healthcare providers and patients, ultimately contributing to a more effective and sustainable midwifery workforce.
The determinants of Maternal Satisfaction; A Systematic Review
Maternal satisfaction is widely recognized as a key indicator of the quality of maternity care and an important determinant of women’s future use of health services. It reflects women’s perceptions of interpersonal care, clinical practices, and health system responsiveness across antenatal, intrapartum, and postnatal services. Despite growing attention to respectful and woman-centered care, evidence on the prevalence, determinants, and outcomes of maternal satisfaction remains fragmented across regions and service types. This systematic review synthesized existing evidence on the prevalence of maternal satisfaction with maternity care and identified its key behavioral, organizational, and contextual determinants, as well as its outcomes for women and health systems. A systematic literature search was conducted across multiple academic databases in accordance with PRISMA 2020 guidelines. Peer-reviewed empirical studies and systematic reviews addressing maternal satisfaction with antenatal, intrapartum, postnatal, or vaccination services were included. Studies were screened using predefined eligibility criteria, and data were extracted on study design, setting, sample characteristics, measurement tools, prevalence estimates, determinants, and reported outcomes. Due to heterogeneity in study designs and measurement instruments, a narrative synthesis approach was applied. The review revealed substantial variation in reported levels of maternal satisfaction across countries and care settings, with generally higher satisfaction in well-resourced facilities and lower satisfaction in settings characterized by long waiting times, inadequate privacy, and limited respectful care. Key determinants of satisfaction included quality of communication, respectful treatment, shared decision-making, waiting time, facility cleanliness, availability of supplies, mode of delivery, labor duration, and women’s prior expectations and experiences. Maternal satisfaction was consistently associated with greater confidence in the maternal role, improved health-seeking behavior, and a higher likelihood of recommending services to others. Overall, maternal satisfaction is a multidimensional construct shaped by both interpersonal interactions and health system factors. Enhancing respectful maternity care, improving communication, and strengthening facility resources are critical strategies for improving women’s experiences and promoting positive maternal and child health outcomes. Future research should adopt standardized measurement tools and comparative designs to enable stronger cross-country evidence synthesis.
The Determinants of Nursing Team Effectiveness; A Systematic Review
Background Nursing team effectiveness is increasingly recognized as a critical determinant of high-quality patient care, workforce well-being, and organizational performance in healthcare settings. Effective teamwork among nurses influences communication, coordination, decision-making, and patient safety, while poor teamwork has been linked to missed nursing care, burnout, and adverse clinical outcomes. Despite growing interest in this topic, evidence on the determinants and outcomes of nursing team effectiveness remains fragmented across disciplines, making it necessary to systematically synthesize existing research. Objective This systematic review aims to identify and synthesize contemporary evidence on the determinants of nursing team effectiveness and examine its key outcomes for nurses, healthcare organizations, and patients. Methods A systematic review was conducted following the PRISMA 2020 framework, including the four stages of identification, screening, eligibility, and inclusion. Multiple electronic databases were searched using structured keywords related to nursing teamwork, leadership, communication, staffing, workload, digital tools, and patient safety. Peer-reviewed studies published between 2021 and 2025 were included if they focused on nursing teams in hospital or clinical settings. A standardized literature review matrix was used for data extraction, and findings were synthesized thematically across behavioral, organizational, and contextual domains. Results Thirty studies met the inclusion criteria. The review identified three major categories of determinants influencing nursing team effectiveness: behavioral factors (communication, psychological safety, trust, competence), organizational factors (leadership style, staffing adequacy, workload, work environment), and contextual factors (digital technologies, organizational culture, safety climate). Strong nursing teamwork was consistently associated with positive outcomes, including higher nurse-reported quality of care, reduced missed nursing care, lower occupational fatigue, improved job satisfaction, and enhanced patient-centered care. Conversely, weak teamwork was linked to increased workload strain, higher burnout risk, and compromised patient safety. Conclusions Nursing team effectiveness is a complex, multilevel phenomenon shaped by the interaction of individual, organizational, and contextual factors. Strengthening teamwork requires integrated strategies that address leadership development, staffing policies, communication practices, and digital system design simultaneously. Healthcare organizations should adopt comprehensive, system-wide approaches that foster collaborative cultures and empower nursing teams to deliver safer, higher-quality care.
Nursing Team Effectiveness A Concept Analysis
Background: Nursing team effectiveness is a vital construct in contemporary healthcare systems, influencing care quality, patient safety, and organizational performance. However, its definition remains ambiguous in the literature. Objectives: This study aims to refine the definition of nursing team effectiveness using Walker and Avant’s concept analysis methodology, addressing conceptual inconsistencies and identifying measurable attributes. Methods: A systematic review of empirical and theoretical literature published between 2020 and 2025 was conducted. The analysis followed Walker and Avant’s eight-step method to identify the defining attributes, antecedents, consequences, empirical referents, and conceptual boundaries of nursing team effectiveness. Results: Nursing team effectiveness is defined as the sustained capacity of a nursing team to deliver safe, high-quality, patient-centered care through coordinated practice, effective communication, shared decision-making, and adaptive problem-solving. Key attributes include interprofessional coordination, role clarity, mutual trust, and adaptability. Antecedents include adequate staffing, targeted training, transformational leadership, and a supportive work environment. Consequences involve improved patient outcomes, enhanced nurse well-being, and strengthened organizational performance. Empirical referents such as the Nursing Teamwork Survey and TeamSTEPPS Teamwork Perceptions Questionnaire are identified for measurement and benchmarking. The concept is distinguished from related terms like collaboration and team efficiency. Conclusion: The refined conceptualization of nursing team effectiveness clarifies a previously ambiguous construct in nursing management literature. By defining its core attributes and identifying measurable indicators, this study supports evidence-based interventions, workforce planning, and policy development to enhance team performance and patient care outcomes.
The Determinants of Telemedicine Adoption: A Systematic Review
Telemedicine has shifted from a peripheral service option to an important mode of healthcare delivery, yet adoption remains uneven across settings, professional groups, and patient populations. This systematic review synthesizes the determinants of telemedicine adoption and proposes an integrated multilevel framework. Guided by PRISMA 2020, the review searched PubMed, Scopus, Web of Science, and CINAHL for peer-reviewed English-language studies published between 2016 and 2025. Following screening, eligibility assessment, and quality appraisal, 40 studies were included in the final synthesis. The evidence indicates that adoption is shaped by interacting individual, technological, organizational, and environmental determinants. Perceived usefulness, usability, digital capability, and trust consistently influence acceptance; however, favorable perceptions do not translate into sustained use when connectivity is unreliable, privacy arrangements are ambiguous, workflows are poorly integrated, or reimbursement and regulatory conditions are unclear. Sustained adoption is more likely when organizations provide leadership support, training, technical assistance, interoperability, and implementation-ready workflows. The review also identifies persistent equity challenges, including age-related capability differences, rural connectivity constraints, and socioeconomic disparities in access. An integrative conceptual framework is proposed in which decision confidence and implementation fit mediate the transition from favorable perceptions to sustained adoption outcomes. The review contributes a clearer analytical structure for telemedicine adoption research and offers practical guidance for health systems seeking durable, scalable, and equitable telemedicine delivery.
Telemedicine Adoption; A Concept Analysis
Telemedicine adoption has emerged as a vital component of modern healthcare systems, yet its conceptual boundaries remain unclear and inconsistently applied across the literature. This study aims to clarify the concept of telemedicine adoption through a structured concept analysis using the Walker and Avant framework. A systematic examination of existing literature was undertaken to identify defining attributes, antecedents, consequences, empirical referents, and illustrative cases related to telemedicine adoption. The analysis demonstrates that telemedicine adoption is not limited to initial technology acceptance but represents a sustained, multidimensional process involving regular use, integration into clinical workflows, user competence, organizational support, and enabling policy environments. Key antecedents include technological infrastructure, digital literacy, leadership commitment, and regulatory readiness, while consequences encompass improved access to care, enhanced patient and provider satisfaction, continuity of services, and greater system efficiency. By offering a clear and comprehensive conceptualization, this study provides a theoretical foundation to support consistent measurement, guide implementation strategies, and inform future research and policy initiatives aimed at promoting sustainable and equitable telemedicine integration.
Transformational Leadership Training, Motivation and Work-Life Balance Toward Nurse Burnout: A Conceptual Framework
This paper proposes a conceptual framework examining the relationship between transformational leadership training, empowerment, motivation, and nurse burnout within healthcare settings. The framework integrates Transformational Leadership Theory, Empowerment Theory, and Self-Determination Theory (SDT) to explain how leadership development initiatives can enhance nurses’ psychological well-being and reduce burnout. Transformational leadership training is positioned as a critical organizational strategy that equips nurse leaders with the emotional intelligence, communication, and motivational skills necessary to inspire and empower their teams. Empowerment and motivation are identified as dual mediating mechanisms that translate leadership behaviors into improved engagement, job satisfaction, and emotional resilience. By fostering autonomy, competence, and professional purpose, leadership-driven empowerment and motivation are expected to significantly mitigate burnout symptoms such as emotional exhaustion and depersonalization. The model is especially relevant to the Saudi Vision 2030 healthcare transformation agenda, which prioritizes leadership capacity-building, workforce sustainability, and quality of care. This framework offers both theoretical and practical contributions, guiding future empirical studies and leadership interventions aimed at developing psychologically supportive work environments. Ultimately, it underscores the essential role of transformational leadership training in cultivating empowered and motivated nurses capable of delivering high-quality, patient-centered care while maintaining personal well-being and professional fulfillment.
Work-Life Balance in Nursing Field; A Concept Analysis
Work-life balance has become a critical issue within the nursing field due to escalating workloads, workforce shortages, and increasing professional demands. Nurses are required to manage complex clinical responsibilities while maintaining personal, family, and social roles, making work-life balance essential for individual well-being and the sustainability of healthcare systems. Despite extensive discussion in the literature, the concept of work-life balance in nursing remains inconsistently defined and frequently conflated with related constructs such as burnout, job satisfaction, and quality of work life. This study aims to clarify and refine the concept of work-life balance in the nursing field through a systematic concept analysis. Walker and Avant’s eight-step method was employed to analyze the concept. A comprehensive literature search was conducted across major academic databases, and relevant studies were selected and screened using a PRISMA-style process. The analysis involved identifying the various uses of the concept, defining attributes, model and alternative cases, antecedents, consequences, and empirical referents specific to nursing contexts. The findings reveal that work-life balance in nursing is a multidimensional construct characterized by perceived equilibrium between professional and personal roles, organizational and leadership support, flexibility in work arrangements, and holistic well-being. Antecedents of work-life balance include manageable workloads, supportive organizational cultures, effective leadership, flexible scheduling, and personal coping resources. Consequences of achieving work-life balance extend across individual, organizational, and care-delivery levels, including enhanced psychological well-being, increased job satisfaction, improved retention, and better quality of nursing care. This concept analysis provides conceptual clarity and a structured foundation for future research, policy development, and practical interventions aimed at promoting sustainable nursing practice and workforce resilience.
A Digital Health Immunization Technology Framework for Nursing Practice
Digital transformation in healthcare has significantly reshaped immunization services, yet the mechanisms through which digital technologies influence nursing practice remain insufficiently theorized and empirically integrated. This paper proposes a Digital Health Immunization Technology Framework for Nursing Practice that explains how digital immunization technologies affect nursing outcomes through both direct and indirect pathways. Grounded in a socio-technical perspective, the study conceptualizes Digital Health Immunization Technology as the independent variable, Nursing Practice as the dependent variable, and Digital Competence and Technology Adoption as parallel mediators. The framework synthesizes insights from digital health, nursing informatics, and technology adoption research to clarify how technological environments shape professional capabilities and behavioral engagement in immunization settings. The paper first reviews theoretical foundations related to socio-technical change, digital leadership, digital competence, and contemporary nursing practice in digital immunization. It then develops a series of hypotheses linking digital technology to competence, adoption, and practice, including two mediation pathways. A gap analysis highlights limitations in existing literature, particularly the fragmented treatment of technology, competence, and adoption as separate constructs. The proposed conceptual model integrates these elements into a coherent structure that explains how digital immunization systems can enhance documentation quality, decision-making, workflow efficiency, and continuity of care. The paper concludes by outlining practical implications for nursing leaders, policymakers, and educators, emphasizing the need for user-centered system design, continuous digital competence development, and supportive organizational environments to maximize the benefits of digital immunization technologies for nursing practice and public health outcomes.
The Determinants of Digital Health Immunization Technology; A Systematic Review
Digital health technologies have become central to modern immunization systems, replacing paper-based processes with electronic registries, mobile health applications, interoperable platforms, and digital decision-support tools. While these innovations promise improvements in vaccination coverage, data quality, and program efficiency, their adoption and effectiveness vary widely across health system contexts. Fragmented evidence, diverse technologies, and inconsistent outcomes have made it difficult to understand what truly enables or constrains successful digital immunization implementation. This study therefore aimed to systematically identify and synthesize the key determinants of digital health immunization technology across global settings. A systematic review was conducted following PRISMA 2020 guidelines, drawing on multiple academic databases and applying clear inclusion and exclusion criteria to select empirical studies relevant to digital immunization systems. Thirty peer-reviewed studies were analysed using thematic synthesis to categorize determinants into technological, behavioural, organizational, and contextual domains. The findings reveal that electronic immunization registries, community-based mHealth tools, system interoperability, workforce capacity, governance structures, and digital infrastructure are the most influential determinants of performance. Positive outcomes were most consistently observed in vaccination coverage, timeliness, data reliability, and workflow efficiency, particularly when digital tools were embedded within well-coordinated health systems. The review concludes that digital immunization technologies are most effective when technological innovation is accompanied by strong leadership, sustained investment, user-cantered design, and supportive policy environments, rather than being implemented as isolated technical solutions
The Determinants of Air Pollution Prevention; A Systematic Review
Air pollution remains a critical global environmental and public health challenge, contributing to respiratory, cardiovascular, and developmental diseases while imposing substantial social and economic costs. Although numerous studies have examined air pollution impacts and mitigation strategies, prevention efforts remain fragmented, and a comprehensive understanding of the determinants that enable effective air pollution prevention is still lacking. This systematic review aims to identify, classify, and synthesize the key determinants of air pollution prevention, with a focus on behavioral, organizational, policy, technological, and contextual factors influencing preventive actions and outcomes. A systematic review was conducted in accordance with PRISMA 2020 guidelines. Peer-reviewed studies addressing air pollution prevention or control determinants were identified through structured database searches. Eligible studies were screened and assessed for relevance, and the findings were synthesized using a narrative approach. Determinants were categorized into thematic domains to examine their prevalence, interrelationships, and influence on prevention outcomes. The findings indicate that air pollution prevention is shaped by multiple interconnected determinants operating across individual, organizational, and contextual levels. Behavioral factors such as knowledge, awareness, attitudes, and risk perception influence individual preventive actions. Organizational determinants, including governance structures, internal monitoring mechanisms, and sustainability-oriented cultures, affect the implementation of prevention strategies. Contextual determinants, such as regulatory quality, institutional effectiveness, urbanization patterns, and infrastructure development, create enabling or constraining environments for prevention. Health concerns consistently emerge as a central driver linking individual behavior with organizational and policy responses. Air pollution prevention is a multi-dimensional process that requires alignment between behavioral engagement, organizational capability, and supportive governance contexts. Integrated prevention frameworks that address determinants across individual, institutional, and systemic levels are essential for achieving sustained improvements in air quality and long-term public health outcomes.
Patient safety remains a central pillar of healthcare quality and nursing practice, representing an essential commitment to preventing harm and ensuring optimal outcomes for patients. Despite extensive policy and research attention, conceptual ambiguity persists regarding the defining attributes, antecedents, and consequences of patient safety, particularly within diverse healthcare settings. Addressing this gap requires a structured conceptual analysis to refine the theoretical boundaries of the concept and enhance its practical application in clinical, managerial, and educational contexts. This study aimed to clarify the concept of patient safety through a comprehensive analysis using Walker and Avant’s (2011) eight-step method. The objectives were to identify its defining attributes, antecedents, and consequences, construct illustrative model and borderline cases, and determine its empirical referents for measurement in contemporary healthcare practice. A concept analysis approach guided by Walker and Avant’s methodology was employed. A systematic search was conducted across major electronic databases, including PubMed, CINAHL, Scopus, MEDLINE, and the Cochrane Library, for articles published between 2000 and 2025. Studies focusing on patient safety concepts, culture, indicators, and outcomes in healthcare were included. The process followed a PRISMA-style flow of screening and selection, yielding 30 relevant studies that were synthesized to extract conceptual elements and thematic patterns. The analysis revealed that patient safety is characterized by five defining attributes: proactive error prevention, effective communication and teamwork, leadership-driven safety culture, professional competence, and continuous organizational learning. Antecedents included adequate staffing, supportive leadership, ethical awareness, and open reporting systems. Consequences of patient safety encompassed improved patient outcomes, enhanced professional satisfaction, and institutional trust. Empirical referents such as safety culture surveys and quality indicators provided measurable frameworks for evaluating patient safety performance. This concept analysis defines patient safety as a dynamic, multidimensional, and ethically grounded construct integral to high-quality healthcare. It emphasizes the need for collaboration, leadership engagement, and continuous learning to foster a sustainable safety culture. The clarified conceptual framework contributes to theoretical advancement and offers practical guidance for research, policy development, and clinical education aimed at achieving zero preventable harm in healthcare settings.
Determinants Affecting Homeownership for Middle-Income Earners in Libya; A Conceptual Framework
Homeownership represents an essential socio-economic milestone for middle-income earners, signifying both financial stability and social security. In transitional economies such as Libya, however, this aspiration is increasingly constrained by overlapping structural, institutional, and social barriers. This paper develops a conceptual framework to examine the determinants influencing homeownership for Libya’s middle-income households, a group often excluded from both state-subsidized housing programs and high-cost private markets. The framework identifies three major categories of determinants: socio-economic and demographic characteristics such as income, education, and employment; housing policy factors including subsidy design, accessibility, and regulatory frameworks; and social capital dimensions such as trust, social networks, and cultural expectations. In addition to these direct determinants, the framework integrates housing affordability and housing quality as critical mediating variables that shape the translation of resources and policies into ownership outcomes. Furthermore, broader social dynamics particularly institutional trust, cultural norms, and urban–rural disparities are considered as moderating influences that condition household decision-making and access pathways. Drawing on Social Capital Theory, Configuration Theory, and Cognitive Theory of Homeownership, the study advances a multidimensional perspective that captures the interplay between structural constraints, social networks, and individual perceptions. By situating middle-income earners at the center of the analysis, the proposed framework contributes to filling an important research gap in both Libyan and broader MENA housing studies. The findings are expected to provide insights for designing inclusive housing policies, strengthening affordability mechanisms, and promoting sustainable homeownership strategies in fragile, post-conflict urban environments.
The Technological and Workload Drivers of Nursing Care Efficiency: A Systematic Literature Review
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-weight: bold;">Nursing services face mounting pressures from rising patient acuity, administrative burden, and fragmented workflows, which collectively compromise the efficiency and reliability of frontline care delivery. While significant investments have been made in electronic records, artificial intelligence, mobile health, telehealth, and virtual nursing, these tools do not consistently yield efficiency gains when implemented without deliberate workflow redesign and structured workload governance. This systematic literature review examines how technological integration and workload management contribute to nursing care efficiency through the mediating role of workflow optimization. Following internationally recognized standards for systematic reviews, fifty-one studies were synthesized across diverse care environments, including intensive care units, emergency departments, general hospital wards, and community health settings. The evidence highlights that efficiency gains are not inherent to technology or staffing models alone but emerge when interoperable systems, acuity-based staffing, predictive scheduling, and digital dashboards are embedded into workflows that reduce duplication, standardize processes, and balance workloads. These findings carry particular significance for healthcare systems such as the Madinah Health Cluster, where digital transformation is a cornerstone of national reform. The review concludes that co-designed, interoperable, and acuity-aware systems that foreground workflow optimization can strengthen workforce resilience, improve patient safety, and advance the goals of healthcare transformation.
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Virtual Discharge Nursing in Pediatric Care: A Concept Analysis Using Walker and Avant’s Method
Virtual discharge nursing is an emerging innovation in pediatric healthcare that addresses the risks of complications, caregiver uncertainty, and preventable hospital readmissions following discharge. Despite its increasing adoption, the concept remains insufficiently defined and is often confused with general telehealth follow-up. This study aims to clarify the concept of virtual discharge nursing in pediatric care by identifying its defining attributes, antecedents, consequences, and empirical referents. Walker and Avant’s eight-step concept analysis method was applied. Guided by Donabedian’s structure–process–outcome model, a systematic review of twenty-four empirical studies published between 2020 and 2025 was conducted, focusing on nurse-led digital interventions, structured follow-up, and caregiver support. The analysis identified five defining attributes: nurse-led protocol-driven care, technology-enabled communication, structured discharge education, early symptom monitoring, and caregiver-centered engagement. Antecedents included the presence of skilled pediatric nurses, reliable digital infrastructure, and integration into discharge protocols. Consequences included reduced thirty-day readmissions, improved caregiver satisfaction, and earlier detection of complications. By distinguishing virtual discharge nursing from broader telehealth practices, this study establishes conceptual clarity and offers a structured framework for researchers, clinicians, and policymakers to strengthen pediatric transitional care.
Emotional Intelligence toward Nurse Managers Competency; A Systematic Review
Emotional intelligence is increasingly recognized as a vital competency in healthcare leadership, especially for nurse managers operating in emotionally complex clinical environments. These professionals must balance clinical duties, staff supervision, organizational demands, and patient-centered care tasks that require strong emotional regulation and interpersonal skills. Despite growing attention to emotional intelligence in nursing leadership, existing evidence on its determinants and influence on managerial competency remains fragmented. This systematic review aimed to synthesize empirical research on the prevalence, determinants, and outcomes of emotional intelligence among nurse managers, with a focus on its impact on leadership effectiveness, managerial competency, and organizational outcomes. Following PRISMA 2020 guidelines, peer-reviewed studies were identified across multiple databases. Eligible studies included various research designs that examined emotional intelligence in relation to leadership performance, job outcomes, organizational factors, or professional well-being. Due to methodological diversity, findings were synthesized narratively. Thirty studies met the inclusion criteria. Emotional intelligence levels among nurse managers were generally moderate to high and were shaped by individual, organizational, and contextual factors. A consistent positive association was found between emotional intelligence and leadership competency, communication, job performance, organizational commitment, and reduced burnout. Key determinants included leadership experience, organizational culture, and emotional intelligence training. Additionally, emotionally intelligent nurse managers demonstrated better decision-making, staff engagement, and care quality. The review concludes that emotional intelligence is a foundational element of effective nurse management. It enhances leadership capacity, promotes workforce stability, and improves organizational effectiveness. Integrating emotional intelligence into leadership development, performance evaluations, and policy frameworks is essential for advancing sustainable, high-quality healthcare delivery.
Conflicts Management Strategies; A Concept Analysis
Conflict is an inevitable feature of organizational life and plays a significant role in shaping employee relationships, leadership effectiveness, and organizational performance. This study aimed to clarify the concept of conflict management strategies through a systematic concept analysis based on Walker and Avant’s framework. A comprehensive review of the literature was conducted to identify the defining attributes, antecedents, consequences, and empirical referents associated with conflict management. The analysis revealed that conflict management is a multidimensional process characterized by intentional engagement, effective communication, emotional regulation, problem-solving orientation, and contextual adaptability. Antecedents of conflict management include workplace tensions, leadership behaviors, emotional competence, and organizational climate, while its consequences range from improved collaboration and job satisfaction to reduced burnout and enhanced organizational effectiveness. Empirical referents were identified through observable behaviors such as communication practices, leadership actions, and employee performance outcomes. The findings provide conceptual clarity and emphasize the importance of integrating conflict management into leadership development, organizational policy, and professional practice. This analysis contributes to a deeper understanding of conflict management strategies and offers a foundation for future research and evidence-based interventions aimed at fostering constructive conflict resolution in diverse organizational settings.
The Virtual Post Discharge Nursing Clinic and Hospital Readmission: Systematic Review
Hospital readmissions pose a persistent challenge to healthcare systems worldwide, signaling gaps in transitional care and contributing to increased costs and poor patient outcomes. In response, virtual post-discharge nursing clinics have emerged as an innovative telehealth-based intervention aimed at reducing preventable readmissions by providing remote follow-up, symptom monitoring, patient education, and early clinical intervention. This systematic literature review (SLR) synthesizes evidence from 2000 to 2024 to evaluate the effectiveness of virtual nursing clinics in minimizing hospital readmissions. The review draws from Scopus and Web of Science, using defined inclusion criteria targeting peer-reviewed, open-access studies focused on virtual nursing interventions in the post-discharge phase. The findings highlight both the potential benefits and limitations of such interventions, including variations in care models, technology integration, patient engagement, and outcomes across healthcare systems. While many studies report positive results particularly in managing chronic diseases and elderly populations gaps remain regarding standardization, scalability, cost-effectiveness, and equity in digital care access. This review contributes to the existing knowledge by identifying critical success factors, highlighting research gaps, and offering insights for healthcare policymakers and clinicians aiming to optimize transitional care through virtual nursing innovations.
Nursing Care Efficiency; A Concept Analysis
Nursing care efficiency has become a critical concern in contemporary healthcare due to increasing patient complexity, workforce shortages, digital transformation, and financial constraints. Despite its growing importance, the concept remains inconsistently defined across nursing, health informatics, and health systems research, leading to theoretical ambiguity and practical challenges in measurement and implementation. This paper presents a concept analysis of Nursing Care Efficiency using Walker and Avant’s framework to clarify its meaning, defining attributes, antecedents, consequences, and empirical referents. A structured literature review informed the analysis, drawing on studies addressing nursing workload, staffing models, digital health systems, workflow design, and hospital performance. The analysis identifies three core defining attributes of nursing care efficiency: optimal resource utilization, streamlined workflow, and quality-preserving care delivery. Key antecedents include adequate and resilient staffing, interoperable digital systems, standardized documentation, and supportive leadership. Major consequences include improved patient safety, enhanced patient experience, reduced length of stay, decreased documentation burden, and greater organizational sustainability. Empirical referents encompass measurable indicators such as documentation time, workload indices, nurse-to-patient ratios, adverse events, patient satisfaction, and hospital efficiency scores. The findings demonstrate that nursing care efficiency is a multidimensional, sociotechnical construct that integrates human, technological, and organizational factors. This concept analysis provides a clear theoretical foundation to guide future research, inform policy development, and support practical interventions aimed at optimizing nursing practice and health system performance.
The Role of Digital Technologies in Enhancing Sustainable Construction and Waste Management: A Systematic Review of Emerging Tools and Applications
The construction industry is a major contributor to global waste and carbon emissions, intensifying the need for sustainable and efficient waste management practices. This study aims to systematically review the role of digital technologies in promoting sustainability and minimizing construction and demolition (C&D) waste across the project lifecycle. Using the PRISMA framework, peer-reviewed articles published between 2015 and 2024 were sourced from databases such as Scopus, ScienceDirect, Web of Science, and Google Scholar. The review focused on technologies including Building Information Modeling (BIM), Artificial Intelligence (AI), Internet of Things (IoT), Geographic Information Systems (GIS), robotics, digital twins, and blockchain. Findings revealed that while BIM is the most extensively applied tool, newer technologies like AI and digital twins are emerging as powerful enablers of predictive waste management and circular resource use. Quantitative results from reviewed studies show waste reductions of up to 57% through BIM and prediction accuracies exceeding 90% using AI models. However, gaps remain in multi-technology integration, regional research representation, and long-term impact studies. This review concludes that digital transformation holds significant promise for driving sustainability in construction, but broader adoption, policy support, and inclusive innovation are essential for realizing its full potential.
Determinants of Public Attitudes and Support Toward Air Pollution Prevention: A Conceptual Framework
Air pollution prevention is a critical global priority due to its profound implications for public health, environmental sustainability, and policy effectiveness. While regulatory and technological measures are essential, the success of air pollution prevention increasingly depends on public engagement and societal dynamics. This paper develops a conceptual framework to explain how public perceptions, public attitudes, and public support interact to influence air pollution prevention. The framework posits that public perceptions shape air pollution prevention both directly and indirectly through public attitudes, while public support moderates the strength of these relationships by conditioning the translation of perceptions and attitudes into preventive outcomes. By integrating mediation and moderation mechanisms into a unified model, the study addresses fragmentation in existing research that often examines these constructs in isolation. The proposed framework advances theoretical understanding of air pollution prevention as a socially embedded process and provides a foundation for future empirical research and policy interventions aimed at strengthening public engagement and enhancing the effectiveness of air pollution prevention strategies
Air pollution prevention; Public perceptions; Public attitudes; Public support; Environmental policy