Critical Care Nursing Quarterly最新文献

{"title":"Effect of Reflexology Intervention on Stress Levels, Sleep Duration, Sucking Frequency, and Crying Episodes in Newborn Infants.","authors":"Abdullah Sarman, Suat Tuncay, Ali Ay","doi":"10.1097/CNQ.0000000000000567","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000567","url":null,"abstract":"<p><p>Reflexology is an alternative treatment method that has been increasingly used in recent years. This study aimed to determine the effect of reflexology intervention on stress levels, sleep duration, sucking frequency, and crying episodes in newborn infants. This study was designed as a randomized controlled trial. Using the block randomization method, 72 infants were included in the study (control = 36, experimental = 36). A demographic characteristics form, the Neonatal Stress Scale, and neonatal sleep duration, sucking frequency, and crying episodes form were used. Reflexology was applied to the left and right feet twice on the second day of the study, once in the morning and once in the evening. Within-group comparisons showed that the stress scale scores of infants in the experimental group decreased statistically significantly compared to the control group. One day before the intervention, sleep duration, sucking frequency, and crying episodes of the control and experimental group infants were similar. On the second and third days, when the intervention was applied twice, the sleep duration and sucking frequency increased, and the crying episodes decreased. Reflexology was found to decrease stress, crying episodes and increase sleep duration and sucking frequency in newborn infants.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"429-440"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191039","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":"Using a Checklist to Decrease Central Line Infections in the Intensive Care Unit.","authors":"Charles S Reynolds, Jill L Cunningham, Yeow Chye Ng, Candy L Dean","doi":"10.1097/CNQ.0000000000000568","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000568","url":null,"abstract":"<p><p>Central line-associated bloodstream infections (CLABSIs) are common types of hospital acquired infections (HAIs) that can place heavy financial and medical burdens on healthcare practices and facilities. In the medical intensive care unit (ICU) of a medical center, the CLABSI rate rose to 6.60.</p><p><strong>Purpose: </strong>The purpose of this project was to develop and implement an evidence-based central line clinical protocol (paper checklist) to prevent CLABSIs in the ICU.</p><p><strong>Methods: </strong>A quality improvement project was implemented in a 16-bed medical ICU. The project focused on the use of a nine-question checklist and education on the use of the checklist to decrease the occurrence of CLABSIs in ICU patients.</p><p><strong>Results: </strong>During the eight weeks of the pre-intervention period, the CLABSI rates were 6.13 and 5.68. During the eight weeks of the post-intervention period, the CLABSI rates were 4.41 and 0.0.</p><p><strong>Conclusions: </strong>Implementation of this intervention showed a decrease in CLABSI rates.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"337-344"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191375","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":"To Nap or Not to Nap? Medical Managers' Views on Night Shift Fatigue Management.","authors":"Roqia Saleem Maabreh, Ghada Shalaby Khalaf Mahran, Nahed Khamies Mohamed, Amany Gamal Abd-Elhamed","doi":"10.1097/CNQ.0000000000000574","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000574","url":null,"abstract":"<p><p>Night shift work is a critical component of healthcare delivery, yet it poses significant challenges to the well-being and performance of healthcare professionals. This qualitative study explores the perceptions of medical managers regarding night shift napping, a potential strategy to mitigate fatigue and enhance patient safety. Using semi-structured interviews with 20 medical managers from various intensive care units at Assiut University Hospital in Egypt, we examined views on the benefits, challenges, and institutional support for sanctioned napping during night shifts. Thematic analysis revealed 3 key themes: (1) perceived benefits of napping; (2) barriers to implementation-such as concerns about professional image, staffing inadequacies, and operational disruptions; and (3) institutional support and policy gaps-highlighting a lack of formal guidelines, inconsistent leadership attitudes, and logistical challenges in creating designated nap areas. While many managers acknowledged the potential benefits of night shift napping, concerns about its practical implementation and impact on workflow persist. The findings suggest that developing clear policies, fostering a culture of safety, and addressing logistical constraints could enhance support for strategic napping as a fatigue management tool in healthcare settings. This study underscores the need for further research and policy development to balance staff well-being with continuous, high-quality patient care.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"373-380"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191337","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":"The Effect of Different Levels of PEEP on the Occurrence of Atelectasis After CABG: A Retrospective Study From Palestine.","authors":"Ahmad Bassam Abdallatif, Basma Salameh, Bahaaeddin Hammad, Sameer A Alkubati, Mohammed ALBashtawy, Abdullah Alkhawaldeh","doi":"10.1097/CNQ.0000000000000577","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000577","url":null,"abstract":"<p><p>Respiratory complications are among the most common issues post coronary artery bypass grafting (CABG), with atelectasis being one of the most serious respiratory consequences. This study aims to evaluate the association between positive end-expiratory pressure (PEEP) levels and post-CABG atelectasis, investigate demographic risk factors associated with atelectasis, and determine the timing pattern of atelectasis development. A retrospective analysis was conducted on data from 268 CABG patients. Three PEEP levels-5, 8, and 10 cm H2O were considered. Demographic information and postoperative outcomes were collected using a self-developed data collection tool. The study took place at a tertiary care hospital in Nablus, West Bank. Higher PEEP levels, especially at 10 cm H2O, were associated with a reduction in pulmonary atelectasis. Smoking emerged as a significant factor influencing atelectasis, while interventions such as spirometry and early thoracic drainage showed positive effects in reducing the incidence of atelectasis. Furthermore, higher PEEP levels were associated with a shorter hospital stay after CABG. This study has highlighted the importance of optimal PEEP adjustment in improving respiratory outcomes and reducing recovery time post-CABG.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"389-400"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191377","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":"Predictors of Nurses' Practice Regarding Care of Patients With Stroke: A Cross-Sectional Study.","authors":"Raghad N Khallaf, Moath Abu Ejheisheh, Ahmad Ayed, Ibrahim Aqtam, Ahmad Batran, Bahaaeddin M Hammad, Mohammed F Hayek","doi":"10.1097/CNQ.0000000000000576","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000576","url":null,"abstract":"<p><p>Stroke is a leading global health concern and a primary cause of death and disability. Nurses play an essential role in stroke care, significantly influencing patient outcomes. This study aimed to assess the predictors of nurses' practice in caring for patients with stroke. A cross-sectional study was conducted among 167 nurses working in medical departments between January 1, 2023 and March 15, 2024. Data were collected using a structured questionnaire evaluating nurses' knowledge, attitudes, and practices. The study revealed that 138 (82.6%) nurses had moderate knowledge, 77 (46.1%) displayed positive attitudes, and 91 (54.4%) demonstrated good practice levels regarding stroke care. Multivariable regression analysis showed that education level (bachelor's degree), stroke care training, and knowledge were significant predictors of effective nursing practice (P < .01). This study highlights that while nurses generally have moderate knowledge and positive attitudes, only half exhibit good practices in stroke care. Tailored educational and training programs focusing on evidence-based stroke care can significantly enhance nursing practices, ultimately improving patient outcomes. Prioritizing ongoing professional development and structured stroke care protocols in resource-constrained settings like Palestine is essential to address these gaps effectively.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"381-388"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191091","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":"An Operating Room to Intensive Care Unit Handoff That Is More Than a Handshake: A Quality Improvement Project.","authors":"Shannon Kirk, Aisling Coffey, MeganLynn Duffy, Ryan Dos Reis, Kathleen Evanovich Zavotsky, Thomas Jan","doi":"10.1097/CNQ.0000000000000579","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000579","url":null,"abstract":"<p><p>Interdisciplinary collaboration is a vital part of patient care. One of the most important aspects of care in the intensive care unit is the handoff process. Guided by the principles of High-Reliability Organizations, this process allows intra-professional and inter-professional sharing of critical patient information that can influence patient outcomes. The purpose of this project was to develop, implement, and evaluate the impact of a structured handoff process in the immediate postoperative recovery phase in the adult cardiothoracic intensive care unit (CTICU) in an academic medical center (AMC). The project focused on patients being transferred directly from the operating room (OR) to the CTICU with the goal of promoting efficiency, effectiveness, and optimizing the work environment. This was a nurse-led quality improvement project that took place over a 5-month period in a CTICU in an AMC. The project utilized the development of a comprehensive handoff process that included a staff position map and a handoff tool. Pre-post implementation unit-specific data were analyzed that includes staff workflow satisfaction surveys and financial savings to evaluate the outcomes of the handoff process. The CTICU handoff process helped reduce perceived OR patient turnover times and improved handoff efficiency, effectiveness, and readiness of providers at the point of care. The department will save a projected $25.5 K/annually by not interrupting the patient's arterial pressure monitoring system that was utilized in the OR. This CTICU handoff process has been shown to provide a seamless transition for the adult immediate postoperative patient. By providing standardized guidelines on communication, clarity of individual roles, and elimination of waste there is greater team member confidence in safety, completeness, and adaptability during handoff. Maintaining these improvements has required ongoing re-evaluation of the process including ongoing multidisciplinary education during the onboarding process. Overall, the implementation of this nurse-driven handoff process has proven to help efficiency, effectiveness and optimize the work environment and patient outcomes in a CTICU.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"441-450"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191399","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":"Erratum: \"Starting on the Right Foot\": An Algorithmic Approach to Facilitate an Improved ICU Admission Process.","authors":"","doi":"10.1097/CNQ.0000000000000588","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000588","url":null,"abstract":"","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"459"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191007","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":"Exploring Barriers to Use of Train of Four Peripheral Nerve Monitoring in the ICU.","authors":"Khrizna Belardo Chong, Jennifer Harris, Angela Klinkhamer, Heather Fojas, Maren Attanasio, Tran Chau, Kwanghwi Park, Priscila S Kovacs, Judy E Davidson","doi":"10.1097/CNQ.0000000000000569","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000569","url":null,"abstract":"<p><p>Peripheral nerve stimulation (PNS) Train of Four (TOF) monitoring is indicated for use in patients receiving neuromuscular blockade (NMBA). Nurses are responsible for TOF monitoring, yet little is known about barriers to use. NMBA guidelines recommend quantitative electromyography (Q-EMG) monitoring not yet used in ICUs. The aim of this study was to explore ICU nurses' experiences with TOF and perceived barriers to use. This qualitative study explored ICU nurses' perspectives and perceived barriers to use of TOF. Semi-structured interviews were analyzed using thematic analysis. Thirty nurses from 6 ICUs participated. Two main themes emerged: (1) lack of confidence in visually monitoring TOF and (2) inconsistent procedures. Lack of confidence was related to device concerns, difficulty visualizing twitches, absence of baseline data, TOF not aligned with clinical presentation, and provider preference for ventilator synchrony vs. TOF. Barriers to skin access were reported. Objective measurement of Q-EMG twitch ratio may improve confidence. Nerve stimulation reported as minor discomfort (mean = 2, scale 0-10). Current barriers have led to misuse or disuse. Use of Q-EMG TOF may increase confidence in TOF monitoring and overcome current barriers. Further research is indicated to test Q-EMG in the ICU setting.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"345-363"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191127","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":"Exploring Nurses' Understanding of Sternal Wound Infections.","authors":"Danielle Ramsey, Jennifer Withall, Kasey Jackman","doi":"10.1097/CNQ.0000000000000583","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000583","url":null,"abstract":"<p><p>Sternal wound infections (SWIs) are a serious risk following medial sternotomy, occurring in 3-8% of cases. Despite stringent infection control measures, these infections can lead to extended hospital stays and frequent readmissions. Early SWI detection is essential, underscoring the need for nurses to understand SWI risk factors and management. To evaluate knowledge of SWIs, including associated risk factors and evidence-based management practices, among nurses with varying levels of experience in a cardiothoracic step-down unit (CTSDU). An anonymous survey, including case-based questions and open-ended responses, was distributed to CTSDU nurses from April to May 2023. Nurses were grouped based on experience (≤3 years or ≥4 years), and data were analyzed using descriptive and inferential statistics. Out of 61 nurses, 33 completed the survey. Correct SWI risk identification rates were 77%, 21%, and 46%, while correct identification of individual risk factors was 63%, 54%, and 62% across 3 case studies. Cohen's d values were 0.809, 0.296, and 0.07. No significant confidence difference was found between experience levels (P = 0.065). Variability in SWI knowledge across experience levels highlights the need for standardized training to enhance SWI detection and patient outcomes.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"419-428"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191150","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":"Intensive Care Nurses' Opinions on Bariatric Surgery Patients: A Qualitative Descriptive Study.","authors":"Sevgi Deniz Doğan, Pınar Kaya","doi":"10.1097/CNQ.0000000000000572","DOIUrl":"https://doi.org/10.1097/CNQ.0000000000000572","url":null,"abstract":"<p><p>This study was conducted with a descriptive qualitative design to reveal the opinions and experiences of intensive care nurses who care for bariatric surgery patients. The study was conducted with 11 nurses working in hospitals' general surgery intensive care units caring for bariatric surgery patients. The data were collected using the interview method, which is one of the qualitative data collection methods. In the study, intensive care nurses expressed both positive and negative perspectives on bariatric surgery. They also reported challenges in patient care, particularly related to high-weight patients, in-pain patients, and fearful patients. Additionally, hospital-related difficulties, such as lack of staff and lack of equipment, were highlighted as key barriers to providing care. However, nurses identified facilitating factors, including patient characteristics and procedural aspects which contributed to more manageable care experiences. The findings of this study illuminate the diverse views and experiences of intensive care nurses caring for bariatric surgery patients.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 4","pages":"364-372"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191119","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}