{"title":"Robotic Hysterectomy for Benign Gynecology: Evidence and Insights.","authors":"Sana Mushtaq, Muhammad Arslan Ul Hassan, Yan Li","doi":"10.1097/CNQ.0000000000000608","DOIUrl":"10.1097/CNQ.0000000000000608","url":null,"abstract":"<p><p>Hysterectomy is the regimen of choice for benign gynecologic diseases, including uterine myoma, adenomyosis, endometriosis, and genital prolapse. Surgeons choose hysterectomy methods based on clinical situations or patients' preferences. Even though minimal invasive surgery (MIS) such as robotic hysterectomy (RH) and laparoscopic hysterectomy (LH) has been improved, the abdominal hysterectomy (AH) approach is still the most common. The advancement in robotic surgeries results in increased adoption of MIS. It allows the surgeon to perform a hysterectomy for complex cases where LH and vaginal hysterectomy are contraindicated and would otherwise require laparotomy. Since both LH and RH have low rates of complications, it is not clear what benefits RH offers over LH. So, RH's advantages over LH are being debated. Robotic gynecologic treatment may have benefits that are hard to quantify. In the literature, different factors such as quality of life, cost, uterine size, complex pathology, obesity, and surgeon's experience, are being used to know the feasibility of RH. Therefore, in this review, we evaluate the factors that can help conclude the benefits or drawbacks of RH and LH.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 2","pages":"196-204"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perioperative Blood Pressure and Anesthesia Management: Impact on Outcomes.","authors":"Xiang Xue, YuXin Wang, QianNan Fan, YuJie Li, Fang Yan, XiaoBao Zhang","doi":"10.1097/CNQ.0000000000000598","DOIUrl":"10.1097/CNQ.0000000000000598","url":null,"abstract":"<p><p>Blood pressure fluctuations during surgery are common and potentially significant. General anesthesia is a key factor influencing blood pressure throughout the perioperative period. Moreover, both intraoperative and postoperative blood pressure instability are associated with complications such as acute kidney injury, myocardial injury, and postoperative delirium. Blood pressure during and after surgery is affected by numerous factors. Despite frequent or even continuous intraoperative hemodynamic monitoring, inadequate blood pressure management may still occur, thereby increasing the risk of postoperative complications. Therefore, perioperative blood pressure management is an important and complex task for anesthesiologists. The purpose of this article is to summarize the current understanding of the relationship between different levels of perioperative blood pressure management and outcomes in patients undergoing surgery under general anesthesia, and to explore the association between anesthesia and blood pressure regulation.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 2","pages":"174-185"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yazan Awawdeh, Moath Abu Ejheisheh, Ahmad Ayed, Ibrahim Aqtam, Ahmad Batran
{"title":"Knowledge, Attitude, and Practice of Clinicians Regarding Continuous Renal Replacement Therapy for Critical Care Patients in Southern Palestine.","authors":"Yazan Awawdeh, Moath Abu Ejheisheh, Ahmad Ayed, Ibrahim Aqtam, Ahmad Batran","doi":"10.1097/CNQ.0000000000000596","DOIUrl":"10.1097/CNQ.0000000000000596","url":null,"abstract":"<p><p>Continuous renal replacement therapy (CRRT) is crucial for managing acute kidney injury in critical care settings, particularly when traditional dialysis is unsuitable. In resource-limited regions like Palestine, intensive care unit (ICU) clinicians' knowledge, attitudes, and practices (KAP) significantly impact patient outcomes. This study assessed the KAP of ICU clinicians in southern Palestine to identify gaps and propose improvements. A cross-sectional study in 6 hospitals across Hebron and Bethlehem involved 250 ICU clinicians. Data were collected using a structured questionnaire and analyzed using SPSS. All 250 questionnaires were completed (100% response rate). Participants' ages ranged from 23 to 59 years (mean = 31.56, standard deviation [SD] = 6.48); 64.4% were male, and 70% held bachelor's degrees. Knowledge was moderate (mean score = 0.50, SD = 0.14); 52.4% had adequate knowledge, while 30% showed gaps. Attitudes were positive overall, but 30% viewed peritoneal dialysis negatively. Practice scores averaged 3.26, with ICU nurses outperforming others. Age (B = 0.217, P = .004) and clinical role (B = -0.211, P < .001) significantly predicted practice. ICU clinicians exhibit moderate knowledge and positive attitudes toward CRRT, but gaps persist in practice. Targeted training is recommended to enhance patient outcomes in ICUs across Palestine.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 2","pages":"225-234"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Moseley, Stephanie Slayton, Susan Morello, Cynthia Sylvia
{"title":"Does Lateral Rotation Replace Manual Turns for Pressure Injury Prevention?: A Review.","authors":"Rachel Moseley, Stephanie Slayton, Susan Morello, Cynthia Sylvia","doi":"10.1097/CNQ.0000000000000597","DOIUrl":"10.1097/CNQ.0000000000000597","url":null,"abstract":"<p><p>Support surfaces can offer a variety of rotational therapies, including continuous lateral rotation therapy (CLRT). In both rotational therapy and manual turning, the patient is rotated along the longitudinal axis; however, with manual turning the patient's posterior surface comes off the support surface. This paper will review the literature and attempt to answer the clinical question, \"Does lateral rotation/rotational therapy replace manual turns for pressure injury (PI) prevention?\" A literature review was undertaken, commencing with the introduction of CLRT in 1967. English language articles that were published using the search terms CLRT, lateral rotation, rotational therapy, kinetic therapy, oscillating therapy, pressure injuries, pressure ulcers, pneumonia, manual turning, and PI prevention were reviewed. Literature results that contained information related to PI were narrowed down to 9 articles and divided into 3 categories for review. The result of the review highlights the scarcity of direct evidence supporting CLRT for PI prevention. Based on the current literature, the author's practice recommendation is that PI prevention interventions such as turning and repositioning should continue to be implemented and that CLRT does not replace manual turning for PI prevention.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 2","pages":"205-224"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asmaa Bakry Mohamed Gomaa, Samah Mohamed Abdallah, Alaa Mohamed Ahmed Attia, Mervat Anwar Abd ElAziz
{"title":"How Does the Use of a Clinical Pathway Affect Chest Trauma Patients, Improve Patient Outcomes, and Reduce Length of Stay and Overall Costs?: A Quasi-Experimental Study.","authors":"Asmaa Bakry Mohamed Gomaa, Samah Mohamed Abdallah, Alaa Mohamed Ahmed Attia, Mervat Anwar Abd ElAziz","doi":"10.1097/CNQ.0000000000000594","DOIUrl":"10.1097/CNQ.0000000000000594","url":null,"abstract":"<p><p>The purpose of this study is to evaluate the effectiveness of clinical pathways on patient outcomes associated with ICU stay for chest trauma patients. A quasi-experimental research design was utilized in this study. The sample consisted of 60 adult patients with chest trauma. The study was conducted at the trauma ICU in Assiut University Hospital. There were 60 patients included in this study related to the demographic characteristics of the patients assigned to the study and control groups. The difference in mean age between the 2 groups was not statistically significant. Across both groups, most participants were male and educated; the differences found in medical diagnoses between groups were statistically significant. The cost of medication represents the highest cost among the total costs for financial and cost of stay in ICU (7505 ± 1207) for the study group and (32 004 ± 8790) for the control group. There were high differences between the means of all costs with statistically significant differences at the level in relation to the financial and cost of stay in the ICU. A clinical pathway improves outcomes for patients with chest trauma. The findings highlight the importance of implementing clinical pathways to enhance patient care and optimize health care resources.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 2","pages":"137-150"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jenny Alderden, Jonas Prince, Susan M Kennerly, Tracey L Yap
{"title":"Diabetes and Pressure Injury in Critical Care Patients ≥65 Years: The Role of Hemoglobin in Patient Outcomes.","authors":"Jenny Alderden, Jonas Prince, Susan M Kennerly, Tracey L Yap","doi":"10.1097/CNQ.0000000000000603","DOIUrl":"10.1097/CNQ.0000000000000603","url":null,"abstract":"<p><strong>Background: </strong>Pressure injuries represent a significant healthcare challenge in ICUs, particularly among older adults with diabetes. This study examined the relationship between hemoglobin levels and hospital-acquired pressure injury (HAPrI) development.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed MIMIC-IV database data from 10,468 ICU patients aged ≥65 years with stays of 2-14 days. Primary outcome was HAPrI development during ICU stay. Clinical and laboratory factors were compared between diabetic and non-diabetic patients.</p><p><strong>Results: </strong>Among 10,468 patients (mean age 77.56±8.05 years), 366 (3.5%) developed HAPrIs. Diabetes patients (n=1,513, 14.5%) had significantly higher HAPrI rates than non-diabetic patients (6.3% vs 3.0%; P<0.001). Diabetic patients who developed HAPrIs had markedly lower minimum hemoglobin levels than those without HAPrIs (7.94±2.07 vs 10.00±1.73 g/dL; P<0.001). Among diabetic patients with HAPrIs, those developing multiple injuries had lower hemoglobin levels than those with single injuries (7.22±2.06 vs 8.30±2.00 g/dL; P=0.02).</p><p><strong>Conclusions: </strong>Low hemoglobin levels are strongly associated with HAPrI development in older ICU patients with diabetes, with anemia severity correlating with multiple injury occurrence. Hemoglobin optimization may represent an important targeted prevention strategy for high-risk ICU patients.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 2","pages":"186-195"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Review on Self-Care-Promoting Interventions in Hemodialysis Patients.","authors":"Azar Jafari-Koulaee, Tahereh Heidari, Hedayat Jafari","doi":"10.1097/CNQ.0000000000000599","DOIUrl":"10.1097/CNQ.0000000000000599","url":null,"abstract":"<p><p>Considering the importance of self-care in hemodialysis patients and the lack of comprehensive evaluation of the effects of interventions on self-care in patients undergoing hemodialysis, the present study provides evidence to review the interventions and strategies that promote self-care behaviors in hemodialysis patients. This narrative review study was conducted to identify interventions to promote self-care in hemodialysis patients. To find evidence related to the study objective, the databases such as PubMed, Embase, Scopus, Web of Science, SID, Magiran, and the Google Scholar search engine were searched without time limitation until 2025. The keywords that were used to search were \"Self-care, Dialysis, Hemodialysis, Renal Replacement Therapy.\" A checklist was used to extract data from the studies. After screening studies and removing duplicates, 14 studies remained. Of the studies, 6 were quasi-experimental, 7 were randomized clinical trials, and 1 was a mixed-method study. The total number of hemodialysis patients studied in these studies was 1020. Interventions focused on several educational approaches to improve self-care behaviors in hemodialysis patients. These approaches included the following: video-based training, structured intervention programs, educational pamphlets and booklets, Orem's self-care theory, self-efficacy theory, health and nursing belief models, 5A self-management program model, PRECEDE-based training, behavioral training sessions, interactive multimedia approach and mobile applications, and peer and nurse education. The results of the review of studies indicated that educational methods had significant effects on improving self-care behaviors of hemodialysis patients (P < .05). Educational interventions, especially those that use structured programs, multimedia tools, and theoretical frameworks, can improve self-care behaviors, knowledge, and self-efficacy in hemodialysis patients. Therefore, health care providers are suggested to use these strategies to increase self-care in hemodialysis patients.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 2","pages":"121-136"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Setareh Homami, Farshad Zinvand-Moghaddam, Maryam Rassouli, Ali Valinejadi, Abbasali Ebrahimian
{"title":"Assessment of Compliance with Nursing Care Documentation for Patients with Acute Coronary Syndrome Using the Clinical Care Classification System in the Emergency Department: A Descriptive and Directed Content Analysis Study.","authors":"Setareh Homami, Farshad Zinvand-Moghaddam, Maryam Rassouli, Ali Valinejadi, Abbasali Ebrahimian","doi":"10.1097/CNQ.0000000000000606","DOIUrl":"10.1097/CNQ.0000000000000606","url":null,"abstract":"<p><p>Nursing documentation based on the Clinical Care Classification (CCC) system has positive results and is an excellent model to follow. This study investigated the compliance of nursing care documentation of acute coronary syndrome (ACS) patients with the CCC system. In a directed content analysis study based on the CCC system, the degree of compliance with nursing care records in patients with ACS was assessed. In the first phase, the files of all patients (108 cases) with ACS admitted to the emergency ward for 18 months were included. In the study's second phase, by purposeful sampling, verbal reports of nursing care during shift handovers were analyzed. Several new meaning units emerged in the analysis of patients' records. The most widely used new meaning unit was the patient referral method, and the next item was the site of the IV line. The overall compatibility between our findings and CCC was 27.3% in the cardiac component. The compatibility in nursing diagnosis, nursing interventions, and evaluation of nursing interventions was 25%, 33.3%, and 25%, respectively. While our study revealed a low degree of compatibility of nursing diagnosis, interventions, and evaluation with the cardiac component of the CCC system, it also highlighted the potential for improvement.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 2","pages":"151-162"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Telenursing and Self-Efficacy in Heart Failure.","authors":"Farhanaz Narimisa, Shahrbanoo Karbakhsh, Shiva Pouradeli","doi":"10.1097/CNQ.0000000000000605","DOIUrl":"10.1097/CNQ.0000000000000605","url":null,"abstract":"<p><p>Chronic heart failure significantly impacts patients' quality of life and self-management. Enhancing self-efficacy is crucial for improving treatment adherence and health outcomes. This study aimed to evaluate the impact of telenursing-specifically through telephone training and follow-up-on the self-efficacy of patients with chronic heart failure. A quasi-experimental study was conducted with patients diagnosed with chronic heart failure at Shafa Hospital in Kerman, Iran in early 2024. The study involved the following: (1) patient education and consent, (2) weekly follow-up calls by trained nurses to provide self-care guidance and support, and (3) pre- and post-intervention assessments using the Sullivan Cardiac Self-Efficacy Scale. Fifty-five patients participated, with a mean age of 66.24 years. Post-intervention, the percentage of patients with low self-efficacy decreased from 21.8% to 1.8%, while those with high self-efficacy increased from 3.6% to 90.9% (P < .0001). Clinical symptoms, such as weakness (P = .016) and fatigue (P = .031), were also significantly reduced. Structured telephone follow-up and education effectively enhance self-efficacy and reduce symptoms in patients with chronic heart failure, indicating the potential of telenursing in chronic care management.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 2","pages":"163-173"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghada Shalaby Khalaf Mahran, Seham Mohamed Abd Elhamed Ahmed, Amira Adel Mohammed, Hanaa Mohamed Ahmed
{"title":"Nurses' Perception and Practice of Night Shift Napping: Qualitative Research at Different Medical Settings.","authors":"Ghada Shalaby Khalaf Mahran, Seham Mohamed Abd Elhamed Ahmed, Amira Adel Mohammed, Hanaa Mohamed Ahmed","doi":"10.1097/CNQ.0000000000000580","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000580","url":null,"abstract":"<p><strong>Background: </strong>Nurses working night shifts face the risk of sleep deprivation, posing threats to patient and nurse safety. There has been limited nursing research on napping, which is recognized as an effective strategy to enhance performance, reduce fatigue, and increase alertness.</p><p><strong>Objectives: </strong>This study aims to investigate nurses' practices and perceptions regarding the benefits and drawbacks associated with napping during night shifts.</p><p><strong>Methods: </strong>Qualitative research methods were utilized with a targeted sample of critical care nurses working in intensive care units or emergency departments at Assiut University Hospitals in Egypt. Nurses participated in semi-structured interviews using a questionnaire. Analysis involved constant comparison of transcripts to identify categories and themes.</p><p><strong>Results: </strong>Most participants (65.6%) acknowledged the benefits of napping. Reported positive effects included clearer communication (98.09%), enhanced efficiency during shift changes (59.04%), wakefulness during charting (89.52%), increased energy levels (95.23%), and confidence in task completion (87.61%). Additionally, napping was found to improve nurses' psychological adjustment (100%) and enhance safety for both nurses and patients (100%). However, a minority of respondents (34.4%) cited drawbacks such as understaffing associated with napping and patients worry.</p><p><strong>Conclusion: </strong>This study provides evidence of the positive impact of napping on various aspects of nursing care and safety for patients and nurses.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"49 1","pages":"E1-E9"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}