Dimensions of Critical Care Nursing最新文献

{"title":"Call for Manuscripts.","authors":"","doi":"10.1097/DCC.0000000000000791","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000791","url":null,"abstract":"","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 5","pages":"241"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608606","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":"La Famiglia è Tutto: Why Families Must Be at the Bedside.","authors":"Chiara Squeglia, Tommaso Meini, Biren B Kamdar","doi":"10.1097/DCC.0000000000000781","DOIUrl":"10.1097/DCC.0000000000000781","url":null,"abstract":"<p><p>Open Intensive Care Units (ICUs) represent one of the most significant transformations in the humanization of health care by removing temporal, physical, and relational barriers. While limitations on visiting hours are often implemented to alleviate concerns about infection spread or issues with interference with care, numerous studies have demonstrated overwhelming benefits of family members at patients' bedside, including reduced incidence of delirium and shorter hospital stays. Family members are vital teammates in the patient recovery process and, with clear engagement methods, can help provide care to loved ones and alleviate burdens on busy ICU team. Our values and commitment to serve our vulnerable patients highlights a duty we have as ICU providers to identify and overcome barriers to visitation in order to foster the peaceful, empathetic, and patient- and family-centered environments that we would want for ourselves and our loved ones.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 5","pages":"295-297"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608707","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":"Nurse-driven Mobility Progression for the Liver Transplant Population in an Intensive Care Unit.","authors":"Chloe N Bridgeman, Melanie Donovan, Jennifer Do, Fady M Kaldas, Lianna Z Ansryan","doi":"10.1097/DCC.0000000000000765","DOIUrl":"10.1097/DCC.0000000000000765","url":null,"abstract":"<p><strong>Background: </strong>Patients with cirrhosis requiring liver transplant often suffer from frailty, sarcopenia, and malnutrition. As their disease progresses, their complex and acute pretransplant state usually leads to longer, more complicated recoveries in the posttransplant setting.</p><p><strong>Objective: </strong>Standard care for mobilizing high-acuity intensive care unit (ICU) patients before and after liver transplantation is mobilization at least twice daily. This quality improvement initiative sought to increase adherence to this standard.</p><p><strong>Methods: </strong>The mobility champion role was established to support early mobilization efforts. Mobility champions consist of a multidisciplinary team of registered nurses (RNs) and restorative care assistants (RCAs) who provide staff education and led the implementation of an early mobilization program. Team-based mobility initiatives have been shown to be effective in improving mobilization among high-acuity patient populations.</p><p><strong>Results: </strong>Following the implementation of the mobility champions, more than 88% of patients were mobilized at least twice per day; additional analysis correlated mobility frequency with improved disposition after hospitalization. Using mobility champions led to increased compliance with patient mobilization standards.</p><p><strong>Conclusion: </strong>Although this quality improvement initiative demonstrated promising early results, additional study is needed to assess the effectiveness and sustainability of mobility champions in the liver transplant population.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 4","pages":"181-189"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057488","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":"Intravenous Smart Pump Alarms in Everyday Hospital Use: A Real-world Descriptive Analysis.","authors":"Brenda Abena Nyarko, Cidalia J Vital, Karen K Giuliano","doi":"10.1097/DCC.0000000000000764","DOIUrl":"10.1097/DCC.0000000000000764","url":null,"abstract":"<p><strong>Background: </strong>Frequent intravenous smart-pump (IVSP) alarms can disrupt workflow, increase alarm fatigue, and threaten patient safety.</p><p><strong>Objectives: </strong>To describe the frequency, distribution, and care-area variation of IVSP alarms from the Baxter Sigma Spectrum IVSP over a 2-year period at a large academic medical center.</p><p><strong>Methods: </strong>A retrospective study of IVSP alarms was performed for all inpatient areas at a US academic medical center. Alarm events and infusion starts were extracted using the Care Everywhere analytics platform and aggregated by frequency of alarms, number of infusions, alarm type, and care area. Analyses were done using descriptive statistics.</p><p><strong>Results: </strong>A total of 5,129,505 alarms were linked to 1,102,303 infusion starts (mean = 4.65 alarms per infusion). Four alarm categories accounted for 86.5% of events: downstream occlusion (42.5%), air-in-line (15.5%), infusion complete (14.4%), and upstream occlusion (14.1%). Although they accounted for only 6% of total infusion starts, the NICU, pediatrics, and pediatric intensive care unit (PICU) had the highest alarm rates, averaging 28.6, 9.0, and 7.7 alarms per infusion, respectively. Downstream occlusion rates peaked in Pediatrics (696/100 starts) and PICU (536/100), while upstream occlusions were highest in the NICU (337/100). Air-in-line alarms were greatest in Oncology (103/100).</p><p><strong>Conclusion: </strong>Downstream occlusion, air-in-line, infusion-complete, and upstream occlusion alarms dominated the 2 years of alarm data, generating the majority of the 5 million IVSP alarms. Although adult medical-surgical (Med/Surg) and critical care generated the most alarms overall, pediatric and neonatal areas experienced the highest number of alarms per infusion, placing them at the greatest risk for alarm fatigue.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 4","pages":"197-203"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13218573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring RN Resignation Experiences.","authors":"Susan Rux, Patricia E Ferguson, Gay L Landstrom, Adam C Savine, Joyce Young","doi":"10.1097/DCC.0000000000000768","DOIUrl":"10.1097/DCC.0000000000000768","url":null,"abstract":"<p><p>The COVID‑19 pandemic has had a catastrophic and enduring impact on frontline nurses, contributing to burnout, stress, and widespread workforce disruption. This qualitative study used Thorne's interpretive description methodology to explore the lived experiences of nursing students, new graduate nurses, and nurses who resigned within their first year of practice during the pandemic. Semi‑structured interviews were conducted across multiple US regions to understand how pandemic‑era educational and clinical experiences shaped perceptions of nursing, career trajectories, and readiness for practice. Six themes emerged: (1) the pandemic did not dissuade students from becoming nurses; (2) career trajectories were altered; (3) institutional and peer support were insufficient; (4) practical readiness was diminished; (5) rifts within the nursing workforce intensified; and (6) media shaped perceptions of nursing. Findings highlight the need for robust transition‑to‑practice structures, intentional mentoring, and leadership strategies to support early‑career nurses and mitigate workforce attrition. Implications for nurse leaders and recommendations for future research are discussed.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 4","pages":"218-223"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057343","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 Trajectories of Platelet, Fibrinogen, and D-dimer in Severe Trauma Patients and Their Value in Predicting Venous Thromboembolism: A Retrospective Study.","authors":"Yi Gou, Cun Huang, Wu-Jun Du, Jun-Fei Zhang, Ke Feng","doi":"10.1097/DCC.0000000000000766","DOIUrl":"10.1097/DCC.0000000000000766","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a major contributor to morbidity and mortality in severe trauma (ST) patients. Platelet count (PLT), fibrinogen level (FIB), and D-dimer level are important coagulation indicators; however, few studies have described their trajectory in ST and assessed predictive value for VTE in clinical and nursing practice.</p><p><strong>Objective: </strong>To describe the trajectories of PLT, FIB, and D-dimer on days 1, 3, 5, and 7 after ST, and to evaluate their predictive value for post-traumatic VTE.</p><p><strong>Methods: </strong>Clinical data, including PLT, FIB, and D-dimer, were retrospectively collected from 184 ST patients. Univariate analysis and multivariate logistic regression analysis were used to identify independent risk factors for intramuscular venous thrombosis (IMVT), deep vein thrombosis (DVT), and pulmonary embolism (PE) in ST patients. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of these independent risk factors.</p><p><strong>Results: </strong>PLT showed a decreasing trend from day 1 to day 3 after trauma, followed by an increasing trend from day 3 to day 7. FIB dropped sharply to the lowest value on day 1 after trauma and then gradually increased. D-dimer surged sharply to the peak on day 1 after trauma, decreased gradually in the first 3 days, and then increased slowly from day 3 to day 7. Multivariate logistic regression analysis identified D-dimer level on day 5 as an independent risk factor for both IMVT (OR=1.133, 95% CI: 1.032-1.243; P=0.009; AUC=0.561) and PE (OR=1.085, 95% CI: 1.016-1.160; P=0.015; AUC=0.721). PLT and FIB were not identified as independent risk factors for IMVT, DVT, or PE.</p><p><strong>Conclusions: </strong>This study demonstrated that while the dynamic changes in PLT, FIB, and D-dimer can reflect the transition of coagulation status after ST, their value as independent VTE predictive tools is limited. In clinical and nursing practice, it is crucial to determine the timing of coagulation status transition after trauma and explore the optimal timing for pharmacological prophylaxis.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 4","pages":"190-196"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057430","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":"Nursing Perspectives on Glycemic Control for Critically Ill Adults in the Intensive Care Unit: A Narrative Review.","authors":"Irene Comisso, Federico Fonda, Simone Bressan, Federica Vuerich, Matteo Maserin, Barbara Narduzzi, Tiziana Bove","doi":"10.1097/DCC.0000000000000769","DOIUrl":"10.1097/DCC.0000000000000769","url":null,"abstract":"<p><strong>Background: </strong>Glycemic control involves methods for measuring, evaluating, and correcting blood glucose levels to maintain glucose homeostasis. It is essential to reduce hyperglycemia-related complications while minimizing the risk of hypoglycemia, and registered nurses (RNs) play a key role in blood glucose monitoring and insulin therapy management in the intensive care unit (ICU).​.</p><p><strong>Objectives: </strong>To provide a thorough synthesis of nursing perspectives on glycemic control practices for critically ill adult patients admitted to the ICU.</p><p><strong>Methods: </strong>We conducted a narrative review of the literature using PubMed, Scopus, CINAHL, and Google Scholar, complemented by manual searches of relevant scientific society websites, textbooks, and reference lists.</p><p><strong>Results: </strong>Available evidence suggests initiating glycemic control for persistent hyperglycemia at ≥180 mg/dL (10 mmol/L) and titrating therapy to an individualized target based on patient evaluation. Arterial blood samples should be prioritized for glucose measurement when available, followed by venous and capillary sampling, individualizing the monitoring frequency. Continuous intravenous insulin infusion is generally recommended, guided by a standardized protocol specifying treatment thresholds, target ranges, insulin infusion adjustments, and monitoring frequency.</p><p><strong>Conclusions: </strong>This narrative review summarizes nursing perspectives on glycemic control in critically ill adult ICU patients, including glucose measurement, individualized monitoring frequency, and protocol-based intravenous insulin infusion management. Evidence gaps remain regarding the optimal application of these approaches, and nursing research should focus on both patient-centered and organizational outcomes.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 4","pages":"209-217"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057494","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":"Identifying Early Predictive Factors of Unexpected Clinical Deterioration in Postoperative Pediatric Surgical Patients.","authors":"Jenilea K Thomas, Aarti C Bavare, Brandi Guyton, Caitlin Justus, Adam M Vogel, Danielle Guffey, Erin Kritz","doi":"10.1097/DCC.0000000000000774","DOIUrl":"10.1097/DCC.0000000000000774","url":null,"abstract":"<p><strong>Background: </strong>Postoperative patients are at a higher risk for unexpected clinical changes in the immediate postoperative period that may necessitate escalation of care.</p><p><strong>Objective: </strong>The study aimed to identify the characteristics, triggers, potential risk factors, and outcomes associated with clinical deterioration necessitating rapid response (RR) activation in post-surgical patients.</p><p><strong>Methods: </strong>A 5-year retrospective review was performed at a large tertiary academic hospital of clinical characteristics and outcomes of postoperative pediatric surgical patients admitted to the ward who had a RR within 30 days after surgery. The study utilized the National Surgical Quality Improvement Program (NSQUIP) calculator as a predictor tool to compare individual patients' risk to the average population risk.</p><p><strong>Results: </strong>Of the 435 surgical patients, the predominant reasons for RR activation were: multisystem 136 (34.1%) and respiratory 114 (28.6%). Two hundred thirty-eight (55.7%) were elective cases, and the most common surgical category was otolaryngology, 55 (12.8%). Patient comorbidities included: developmental delay (135, 31.5%) and cardiac anomalies (102, 23.8%). After RR, transfer to the PICU occurred in 248 events (57%); 63.7% (158) required intravenous fluid therapy, 19.8% (47) required mechanical ventilation within 24 hours, and 46 (12.3%) underwent reoperation. The median PICU length of stay (LOS) was 2 days (IQR: 0.0, 7.0), and mortality of 23 (5.9%). This patient cohort had a higher NSQUIP risk for any complications, pneumonia, surgical site infection, venous thrombosis, renal failure, and reintubation versus the average population risk.</p><p><strong>Conclusions: </strong>Postoperative RR activation with PICU transfer is associated with longer LOS, higher rate of reoperation, and higher mortality. The NSQUIP predictor tool should be explored further to guide postoperative clinical management and resource allocation for future surgical patients.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 4","pages":"176-180"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057348","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":"Section: Book and Media.","authors":"Kathleen Ahern Gould","doi":"10.1097/DCC.0000000000000770","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000770","url":null,"abstract":"","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 4","pages":"224"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057503","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":"Imagining the Future of Critical Care Nursing: An International Perspective.","authors":"Stefano Bambi, Pasquale Iozzo, Alberto Lucchini","doi":"10.1097/DCC.0000000000000767","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000767","url":null,"abstract":"","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"45 4","pages":"173-175"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057378","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}