Australian Critical Care最新文献

{"title":"A systematic review of the comparative effects of sound and music interventions for intensive care unit patients' outcomes.","authors":"Elizabeth Papathanassoglou, Usha Pant, Shaista Meghani, Neelam Saleem Punjani, Yuluan Wang, Tiffany Brulotte, Krooti Vyas, Liz Dennett, Lucinda Johnston, Demetrios James Kutsogiannis, Stephanie Plamondon, Michael Frishkopf","doi":"10.1016/j.aucc.2024.101148","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.101148","url":null,"abstract":"<p><strong>Background: </strong>Despite syntheses of evidence showing efficacy of music intervention for improving psychological and physiological outcomes in critically ill patients, interventions that include nonmusic sounds have not been addressed in reviews of evidence. It is unclear if nonmusic sounds in the intensive care unit (ICU) can confer benefits similar to those of music.</p><p><strong>Objective: </strong>The aim of this study was to summarise and contrast available evidence on the effect of music and nonmusic sound interventions for the physiological and psychological outcomes of ICU patients based on the results of randomised controlled trials.</p><p><strong>Methods: </strong>This systematic review was directed by a protocol based on the Methodological Expectations of Cochrane Intervention Reviews. Quality of studies was assessed with the Cochrane risk of bias assessment tool. Searches were performed in the following databases: MEDLINE, Embase, APA PsycInfo, CINAHL Plus with Full Text, Academic Search Complete, RILM Abstracts of Music Literature, Web of Science, and Scopus.</p><p><strong>Results: </strong>We identified 59 articles meeting the inclusion criteria, 37 involving music and 22 involving nonmusic sound interventions, with one study comparing music and sound. The identified studies were representative of a general ICU population, regardless of patients' ability to communicate. Our review demonstrated that both slow-tempo music and sound interventions can significantly (i) decrease pain; (ii) improve sleep; (iii) regulate cortisol levels; (iv) reduce sedative and analgesic need; and (v) reduce stress/anxiety and improve relaxation when compared with standard care and noise reduction. Moreover, compared to nonmusic sound interventions, there is more evidence that music interventions have an effect on stress biomarkers, vital signs, and haemodynamic measures.</p><p><strong>Conclusion: </strong>These results raise the possibility that different auditory interventions may have varying degrees of effectiveness for specific patient outcomes in the ICU. More investigation is needed to clarify if nonmusic sound interventions may be equivalent or not to music interventions for the management of discrete symptoms in ICU patients.</p><p><strong>Registration of reviews: </strong>The protocol was registered on Open Science Framework in November 6 2023 (https://doi.org/10.17605/OSF.IO/45F6E).</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101148"},"PeriodicalIF":2.6,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An interprofessional multicomponent intervention to improve end-of-life care in intensive care: A before-and-after study.","authors":"Tania Lovell, Marion Mitchell, Madeleine Powell, Petra Strube, Angela Tonge, Kylie O'Neill, Elspeth Dunstan, Amity Bonnin-Trickett, Elizabeth Miller, Adam Suliman, Tamara Ownsworth, Kristen Ranse","doi":"10.1016/j.aucc.2024.101147","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.101147","url":null,"abstract":"<p><strong>Background: </strong>The provision of end-of-life care (EOLC) is an ongoing component of practice in intensive care units (ICUs). Interdisciplinary, multicomponent interventions may enhance the quality of EOLC for patients and the experience of family members and ICU clinicians during this period.</p><p><strong>Objectives: </strong>This study aimed to assess the impact of a multicomponent intervention on EOLC practices in the ICU and family members' and clinicians' perceptions of EOLC.</p><p><strong>Methods: </strong>A before-and-after interventional study design was used. Interventions comprising of EOLC guidelines, environmental and memory-making resources, EOLC education day for nurses, web-based resources, and changes to EOLC documentation processes were implemented in a 30-bed adult tertiary ICU from September 2020 onwards. Data collection included electronic health record audits of care provided post initiation of EOLC and family and clinician surveys. Open-ended survey questions were analysed using content analysis. Data from before and after the intervention were compared using the Chi-squared test for categorical variables, unpaired two-sample t-tests for normally distributed continuous measurements, and Mann-Whitney U tests for non-normally distributed data.</p><p><strong>Findings: </strong>A reduction in documented observations and medications and an increased removal of invasive devices unrelated to EOLC were observed post the intervention. The mean overall satisfaction of family members improved from 4.5 to 5 (out of 5); however, this was not statistically significant. Statistically significant improvements in clinicians' perception of overall quality of EOLC (mean difference = 0.28, 95% confidence interval: 0.18, 0.37; t₂₈₂ = 5.8, P < 0.01) were found. Although statistically significant improvements were evident in all subscales measured, clinicians' work stress related to EOLC and support for staff, patients, and their families were identified as needing further improvement.</p><p><strong>Conclusions: </strong>The development and implementation of a multicomponent interdisciplinary intervention successfully improved EOLC quality, as measured by chart audit and family and clinician perceptions. Continuing interdisciplinary collaboration is needed to drive further change to continue to support high-quality EOLC for patients, families, and clinicians in the ICU.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101147"},"PeriodicalIF":2.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical utility of shock index in hospitalised patients requiring activation of the rapid response team.","authors":"Hasan M Al-Dorzi, Yasser A AlRumih, Mohammed Alqahtani, Mutaz H Althobaiti, Thamer T Alanazi, Kenana Owaidah, Saud N Alotaibi, Monirah Alnasser, Abdulaziz M Abdulaal, Turki Z Al Harbi, Ahmad O AlBalbisi, Saad Al-Qahtani, Yaseen M Arabi","doi":"10.1016/j.aucc.2024.101150","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.101150","url":null,"abstract":"<p><strong>Background: </strong>The systolic shock index (SSI) is used to direct management and predict outcomes, but its utility in patients requiring rapid response team (RRT) activation is unclear.</p><p><strong>Objectives: </strong>We explored whether SSI can predict the outcomes of ward patients experiencing clinical deterioration and compared its performance with other parameters.</p><p><strong>Methods: </strong>This retrospective study included adult patients in medical/surgical wards who required RRT activation. We calculated SSI (heart rate/systolic blood pressure [BP]), diastolic shock index (DSI, heart rate/diastolic BP), modified shock index (heart rate/mean BP), and quick Sequential Organ Failure Assessment (qSOFA) score at activation. We categorised patients into two groups (SSI: ≥1.0 and <1.0). We performed univariate and multivariable logistic regression analyses to evaluate the association of SSI with intensive care unit (ICU) admission, vasopressor therapy, and in-hospital mortality. The covariates included demographics, comorbidities, and reasons for RRT activation.</p><p><strong>Results: </strong>Among the 837 study patients, 297 (35.5%) had an SSI ≥1.0. On univariate analysis, SSI was associated with vasopressor therapy (odds ratio [OR]: 2.04, 95% confidence interval [CI]: 1.40-2.99) but not ICU admission or in-hospital mortality. On multivariable logistic regression analysis, an SSI ≥1.0 was associated with ICU admission (adjusted OR: 1.55, 95% CI: 1.05-2.28), vasopressor therapy (adjusted OR: 3.05, 95% CI: 1.86-5.00), and in-hospital mortality (adjusted OR: 2.18, 95% CI: 1.42-3.33). A systolic BP <90 mmHg, mean BP < 65 mmHg, and qSOFA score ≥2 were associated with these outcomes in univariate and multivariable regression analyses (adjusted ORs close to those of SSI). Separate receiver operating characteristic curve analysis found that SSI, diastolic shock index, and modified shock index poorly discriminated between survivors and nonsurvivors (area under the curve: <0.60 for all).</p><p><strong>Conclusions: </strong>In ward patients experiencing clinical deterioration, an SSI ≥1.0 was associated with adverse outcomes but did not perform better than systolic and mean BP and qSOFA. This limits its standalone clinical utility in these patients.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101150"},"PeriodicalIF":2.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial draft Volume 38, Issue 1, 2025.","authors":"Samantha Keogh, Andrea P Marshall","doi":"10.1016/j.aucc.2024.101160","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.101160","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101160"},"PeriodicalIF":2.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the feasibility of handheld scanning technologies in neonatal intensive care: Trueness, acceptability, and suitability for personalised medical devices.","authors":"Deanne August, Isabel Byram, David Forrestal, Mathilde Desselle, Nathan Stevenson, Kartik Iyer, Mark W Davies, Katherine White, Linda Cobbald, Lynette Chapple, Kellie McGrory, Margaret McLean, Stephanie Hall, Brittany Schoenmaker, Jackie Clement, Melissa M Lai","doi":"10.1016/j.aucc.2024.09.012","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.09.012","url":null,"abstract":"<p><strong>Background: </strong>Nasal continuous positive airway pressure (CPAP) injuries are common for premature infants. Clinical use of three-dimensional (3D) scanning is established in adult medicine, but the possibilities in neonatal care are still emerging. Custom printed CPAP devices have the potential to reduce injuries and disfigurement in this vulnerable population.</p><p><strong>Aim: </strong>We sought to identify the most feasible portable 3D scanner for use in the neonatal intensive care environment towards the development of custom-fitting CPAP devices for premature infants.</p><p><strong>Methods: </strong>Four handheld 3D scanners were assessed and compared, Artec Leo, Revopoint POP 2, iPad Pro/Metascan, and iPhone/Scandy Pro. Trained neonatal clinicians (medical and nursing) undertook mock scans in a simulated neonatal intensive care environment.</p><p><strong>Results: </strong>Sixty scans were performed by 13 neonatal clinicians (four medical/nurse practitioners and nine nurses). The median mean absolute error was 0.21 mm (interquartile range [IQR]: 0.19-0.26), 0.17 mm (IQR: 0.15-0.21), and 1.08 mm (IQR: 1.0-1.63) for Artec Leo, Revopoint POP 2, and Scandy Pro, respectively. Scan times were the quickest for Artec Leo at 22.9 sec (IQR: 18.5-27), followed by Revopoint POP 2 at 25.2 sec (IQR: 22-34.4). Artec Leo was rated most expensive, but Revopoint POP 2 was rated more ergonomic. Both app-based 3D scanners (Metascan and Scandy Pro) presented data security issues.</p><p><strong>Conclusions: </strong>Artec Leo and Revopoint POP 2 were identified as most feasible for use to perform 3D scans on premature infants in the neonatal intensive care environment.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101127"},"PeriodicalIF":2.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in early mobilisation research in critically ill children: A scoping review.","authors":"Barbara M Geven, Erwin Ista, Job B M van Woensel, Sascha C A T Verbruggen, Faridi S van Etten-Jamaludin, Jolanda M Maaskant","doi":"10.1016/j.aucc.2024.101139","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.101139","url":null,"abstract":"<p><strong>Objective: </strong>Early mobilisation in critically ill children is safe and feasible. However, the effectiveness of early mobilisation on short- and long-term outcomes is understudied. The aim of this scoping review was to generate an overview of outcomes used in previous research regarding early mobilisation in critically ill children.</p><p><strong>Data sources: </strong>A systematic search was performed in Medline, Embase, Cochrane library, and CINAHL, without restricting on design, on April 3rd, 2023.</p><p><strong>Study selection: </strong>Two independent reviewers assessed titles, abstracts, and full texts. Studies were included if they described any outcomes related to early mobilisation in critically ill children.</p><p><strong>Data charting process: </strong>One reviewer performed data extraction, which was subsequently verified by another reviewer. Seven domains were used to categorise the outcomes: mortality, physiological, life impact, resource use, adverse events, process indicators, and perception of early mobilisation.</p><p><strong>Data synthesis: </strong>Out of 3380 screened titles, 25 studies were included. Data extraction yielded 148 unique outcomes, which were clustered into 40 outcomes. Outcomes spanned in all seven domains, with \"length of paediatric intensive care unit stay\" (resource use) and \"adverse events involving unintentional removal of catheters, tubes, and/or lines\" (adverse events) being the most frequently reported. Process indicators such as mobilisation activities were well documented. Mortality and functionality outcomes were chosen the least.</p><p><strong>Conclusions: </strong>This scoping review provides a categorised overview of outcomes that have been used to assess the effectiveness of early mobilisation in critically ill children. The findings show a great heterogeneity in used outcomes and are input for paediatric intensive care unit experts and parents to prioritise outcomes developing a Core Outcome Set.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101139"},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prediction of intensive care unit admission in emergency department patients using machine learning.","authors":"Dinesh Pandey, Hossein Jahanabadi, Jack D'Arcy, Suzanne Doherty, Hung Vo, Daryl Jones, Rinaldo Bellomo","doi":"10.1016/j.aucc.2024.101143","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.101143","url":null,"abstract":"<p><strong>Background: </strong>The timely identification and transfer of critically ill patients from the emergency department (ED) to the intensive care unit (ICU) is important for patient care and ED workflow practices.</p><p><strong>Objective: </strong>We aimed to develop a predictive model for ICU admission early in the course of an ED presentation.</p><p><strong>Methods: </strong>We extracted retrospective data from the electronic medical record and applied natural language processing and machine learning to information available early in the course of an ED presentation to develop a predictive model for ICU admission.</p><p><strong>Results: </strong>We studied 484 094 adult (≥18 years old) ED presentations, amongst which direct admission to the ICU occurred in 3955 (0.82%) instances. We trained machine learning in 323 678 ED presentations and performed testing/validation in 160 416 (70 546 for testing and 89 870 for validation). Although the area under the receiver operating characteristics curve was 0.92, the F1 score (0.177) and Matthews correlation coefficient (0.257) suggested substantial imbalance in the dataset. The strongest weighted variables in the predictive model at the 30-min timepoint were ED triage category, arrival via ambulance, quick Sequential Organ Failure Assessment score, baseline heart rate, and the number of inpatient presentations in the prior 12 months. Using a likelihood of ICU admission of more than 75%, for activation of automated ICU referral, we estimated the model would generate 2.7 triggers per day.</p><p><strong>Conclusions: </strong>The infrequency of ICU admissions as a proportion of ED presentations makes accurate early prediction of admissions challenging. Such triggers are likely to generate a moderate number of false positives.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101143"},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and outcomes of adults with acute brain injuries admitted to intensive care units in Australia and New Zealand from 2013 to 2022.","authors":"David Golding, Anis Chaba, Anthony Delaney, Valery L Feigin, Edward Litton, Champ Mendis, Alex Poole, Andrew Udy, Paul J Young","doi":"10.1016/j.aucc.2024.101145","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.101145","url":null,"abstract":"<p><strong>Background: </strong>The characteristics and outcomes of patients with acute brain injuries admitted to the intensive care unit (ICU) in Australia and New Zealand (ANZ) are insufficiently described.</p><p><strong>Objective: </strong>This study aimed to describe the epidemiology of acute brain injury in ICU patients in ANZ.</p><p><strong>Methods: </strong>A binational retrospective cohort study was conducted using the ANZ Intensive Care Society Adult Patient Database. Adult unplanned admissions from 2013 to 2022 were eligible unless the presence of acute brain injury could not be determined or the admission was for end-of-life care. In cases where a patient had multiple admissions, only the first was included. The population was divided into two cohorts: acute brain injury diagnoses and other diagnoses. The primary outcome was in-hospital mortality. Secondary outcomes included 90- and 180-day mortality, ICU and hospital lengths of stay, duration of invasive ventilation, and the proportion discharged home.</p><p><strong>Results: </strong>Acute brain injuries accounted for 92 948 of 684 981 unplanned ICU admissions (14%). Hypoxic ischaemic encephalopathy, traumatic brain injury, and seizures were the most common diagnoses. A total of 24 568 of 92 948 (26%) and 62 603 of 592 033 (10%) patients with acute brain injuries and other diagnoses, respectively, died in hospital. Among the patients with brain injury the highest hospital mortality was in hypoxic ischaemic encephalopathy (53%), intracerebral haemorrhage (36%), subarachnoid haemorrhage (22%), and ischaemic stroke (22%); the lowest mortality was in traumatic brain injury (14%), central nervous system infection (10%), and seizures (4%). Acute brain injury patients were more likely to receive invasive mechanical ventilation, had longer ICU and hospital lengths of stay, had higher 90- and 180-day mortality, and were more likely to be discharged to chronic care than other patients.</p><p><strong>Conclusions: </strong>Acute brain injuries accounted for a disproportionally high number of in-hospital deaths occurring in our cohort of adults who received unplanned ICU care; however, the mortality rates varied, and patients with central nervous system infections and seizures had similar or lower mortality compared to patients without brain injury.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101145"},"PeriodicalIF":2.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"You need to be supported\": An integrative review of nurses' experiences after death in neonatal and paediatric intensive care.","authors":"Melissa J Bloomer, Laura A Brooks, Alysia Coventry, Kristen Ranse, Jessie Rowe, Shontelle Thomas","doi":"10.1016/j.aucc.2024.101149","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.101149","url":null,"abstract":"<p><strong>Background: </strong>The death of a child can have a profound impact on critical care nurses, shaping their professional practice and personal lives in diverse, enduring ways. Whilst end-of-life care is recognised as a core component of critical care nursing practice and a research priority, evidence about nurses' experiences after death in neonatal and paediatric intensive care is poorly understood.</p><p><strong>Research question: </strong>What is the experience of the nurse after death of a patient in neonatal and/or paediatric intensive care?</p><p><strong>Method: </strong>Following registration with Open Science Framework, an integrative review of the empirical literature was undertaken. A combination of keywords, synonyms, and Medical Subject Headings was used across the Cumulative Index Nursing and Allied Health Literature (CINAHL) Complete, Medline, APA PsycInfo, Scopus, and Embase databases. Records were independently assessed against inclusion and exclusion criteria. All included papers were assessed for quality. Narrative synthesis was used to analyse and present the findings.</p><p><strong>Findings: </strong>From 13,018 records screened, 32 papers reporting primary research, representing more than 1850 nurses from 15 countries, were included. Three themes were identified: (i) postmortem care; (ii) caring for bereaved families; and (iii) nurses' emotional response, which includes support for nurses. Nurses simultaneously cared for the deceased child and family, honouring the child and child-family relationship. Nurses were expected to provide immediate grief and bereavement support to families. In response to their own emotions and grief, nurses described a range of strategies and supports to aid coping.</p><p><strong>Conclusion: </strong>Recognising neonatal and paediatric critical care nurses' experience after death is key to comprehensively understanding the professional and personal impacts, including the shared grief of a young life lost. Enabling nurses to acknowledge and reflect upon their experiences of death and seek their preferred supports is critically important. Thus, ensuring organisational and system processes similarly align with nurses' preferences is key.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101149"},"PeriodicalIF":2.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-person, virtual visiting and telephone calls in Australia and New Zealand intensive care units: A point prevalence multicentre study mapping daytime and nighttime interactions.","authors":"Alexis Tabah, Mahesh Ramanan, Kevin B Laupland, Kimberley Haines, Naomi Hammond, Serena Knowles, Kylie Jacobs, Stuart Baker, Edward Litton","doi":"10.1016/j.aucc.2024.101144","DOIUrl":"https://doi.org/10.1016/j.aucc.2024.101144","url":null,"abstract":"<p><strong>Background: </strong>Family presence, in-person and via virtual visiting (video calls) and the telephone, is an integral part of patient- and family-centred critical care. Previous studies focussed on visiting policies and their effects. Data mapping the frequency and timing of these interactions are not available.</p><p><strong>Objectives: </strong>The aims of this study were to describe the prevalence of in-person visiting and the use of telephone or video conferencing in Australia and New Zealand intensive care units (ICUs).</p><p><strong>Design: </strong>A point prevalence survey was conducted to map visiting policies, hourly family presence at the bedside, telephone or video calls, and reasons for each interaction.</p><p><strong>Setting: </strong>The research was conducted in a 24-h study period in October 2020, corresponding to the end of the 2nd COVID-19 pandemic wave in 40 Australia and New Zealand ICUs.</p><p><strong>Measurements and main results: </strong>At the time of survey, 77% of ICUs had restrictions to visiting, median (interquartile range [IQR]) time of 9 (2; 24) hours with permitted visiting per day, a mean of 8 hours less than before the COVID-19 pandemic. There were 532 patients, a median (IQR) of 13 (6; 25) patients per ICU. Two patients had COVID-19. Over 24 h, 65% of patients had at least one in-person visit, median (IQR) of 1 (0; 3) hours with visitors. Telephone calls were received for 52% patients, median (IQR) of 1 (0; 2) calls. Video calls were received for 6% of the patients. In-person visits peaked between 10:00 and 12:00, with a second smaller peak between 16:00 and 17:00. Visiting continued through the evening, and 2% of the patients had visitors overnight. Telephone calls peaked at 10:00, continued through the day and evening, with few calls received overnight. In-person visits were predominantly motivated by family interactions (81%) and telephone calls by clinical updates (51%) and family interactions (47%).</p><p><strong>Conclusions: </strong>In a low COVID-19 prevalence period, Australia and New Zealand ICUs had partially reopened to visitors. Most visits happened during the day and evening but persisted overnight. ICU resourcing and visiting policies should take these data into account to facilitate family presence at the bedside, virtual visiting, and obtaining clinical updates via telephone.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101144"},"PeriodicalIF":2.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}