Australian Critical Care最新文献

{"title":"Intensive care unit nurses' understanding and experience of clinical debriefing: A focus group.","authors":"Annabel Levido, Fiona Coyer, Samantha Keogh, Liz Crowe","doi":"10.1016/j.aucc.2025.101439","DOIUrl":"https://doi.org/10.1016/j.aucc.2025.101439","url":null,"abstract":"<p><strong>Background: </strong>Intensive care nurses frequently request clinical debriefing with a goal to learn, develop, and process the sometimes confronting and distressing work environment. The literature and application of clinical debriefing can be confusing and difficult to navigate with a paucity of evidence in the intensive care environment. This creates uncertainty for how and what events should be debriefed and what would be beneficial for nurses working in the intensive care unit (ICU).</p><p><strong>Aims: </strong>The aim of this study was to explore the perceptions, attitudes, and experiences of clinical debriefing for nurses working in an ICU.</p><p><strong>Study design: </strong>This study utilised an interpretative qualitative design involving semistructured focus groups. Nurses employed within the ICU of a large metropolitan hospital in Australia were invited to participate. The focus groups were audio-recorded, transcribed verbatim, and analysed using an inductive thematic approach.</p><p><strong>Results: </strong>A total of 31 ICU nurses participated in five semistructured focus groups. Four themes were identified: (i) uncertainty of definition and logistics; (ii) clinical debriefing requires psychological safety; (iii) the value of clinical debriefing; and (iv) clinical debriefing as a form of organisational acknowledgement.</p><p><strong>Conclusion: </strong>This study identified four themes that outlined the potential importance and meaning of clinical debriefing for ICU nurses. Despite several perceived barriers to implementing regular clinical debriefing, ICU nurses advocated for the opportunity participate in regular clinical debriefing for learning and support.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"101439"},"PeriodicalIF":2.7,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233832","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":"Author’s response to the letter “Predicting Delirium in ICU Patients Every 8 Hours with Machine Learning: Model Development and Evaluation”","authors":"Kei Imai RN, MSN,&nbsp;Takeshi Unoki RN, PhD,&nbsp;Naoto Takahashi PhD,&nbsp;Megumi Horikawa RN","doi":"10.1016/j.aucc.2025.101445","DOIUrl":"10.1016/j.aucc.2025.101445","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101445"},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219647","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":"Identifying barriers and facilitators to therapeutic cuddling in the paediatric intensive care unit: A survey guided by the theoretical domains framework","authors":"Laurie A. Lee NP, PhD ,&nbsp;Karla D. Krewulak PhD ,&nbsp;Elaine Gilfoyle MD, MMEd, FRCPC ,&nbsp;Karen Choong MB, MSc, FRCPC ,&nbsp;Katie O'Hearn MSc ,&nbsp;Mark Todd HBSc, RRT ,&nbsp;Jennifer R. Foster MD, FRCPC ,&nbsp;Kathryn A. Birnie RPsych, PhD ,&nbsp;Christopher James Doig MD, MSc, MA ,&nbsp;Nicole Letourneau RN, PhD ,&nbsp;Kirsten M. Fiest PhD ,&nbsp;the Canadian Critical Care Trials Group","doi":"10.1016/j.aucc.2025.101440","DOIUrl":"10.1016/j.aucc.2025.101440","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to describe barriers and facilitators to paediatric intensive care unit (PICU) therapeutic cuddling (TC) perceived by healthcare professionals (HCPs).</div></div><div><h3>Background</h3><div>TC is a potential intervention to prevent/manage pain, agitation, delirium, and analgosedation exposure in PICUs. However, it is not widely practiced. Given the complexity of TC in critically ill children, PICU HCPs’ perspectives of barriers and facilitators are essential to inform implementation and evaluation.</div></div><div><h3>Methods</h3><div>A cross-sectional survey, guided by the Theoretical Domains Framework, was administered to PICU HCPs between December 2023 and July 2024. Items were asked based on age groups of patients (&lt;1, 1–2, 3–4, 5–8, 9–12, and &gt;12 years) and severity of illness. Nominal data were summarised using frequencies (percentage) based on the number of responses received per item. Subgroup analyses were conducted for professions with five or more respondents for items related to professional role and TC. Free-text responses were analysed utilising inductive and deductive content analysis.</div></div><div><h3>Results</h3><div>Respondents (n = 228) were predominantly women (88.6%), nurses (60.1%), physicians (17.1%), or respiratory therapists (11.8%). Most respondents (67.9%–86.4% depending on patient age group) agreed it was possible to provide TC to all PICU patients. However, respondents reported rarely (4.3%–52.6%) or never (0.5%–35.6%) observing/participating in TC, depending on child age group, with a larger proportion reporting rarely or never as age group increased. Potential determinants affecting the implementation of TC in PICUs were identified for all 14 domains of the Theoretical Domains Framework. Concerns about patient safety, staffing, and lack of supportive unit culture were identified as key barriers. Family engagement and partnership and beliefs about positive consequences were key facilitators.</div></div><div><h3>Conclusions</h3><div>Most PICU HCPs believe that TC can be implemented for all critically ill children. Important barriers include concerns about safety, staffing, and lack of a cuddling-supportive culture. Leveraging patient and family engagement is a key facilitator to support implementation of this intervention.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101440"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214408","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":"Multidrug-resistant Klebsiella pneumoniae in critically ill neonates: evidence from a Brazilian cohort","authors":"Isadora Caixeta da Silveira Ferreira PhD ,&nbsp;Ralciane de Paula Menezes PhD ,&nbsp;Mallu Santos Mendonça Lopes ,&nbsp;Lúcio Borges de Araújo PhD ,&nbsp;Daniela Marques de Lima Mota Ferreira PhD ,&nbsp;Denise Von Dolinger de Brito Röder PhD","doi":"10.1016/j.aucc.2025.101444","DOIUrl":"10.1016/j.aucc.2025.101444","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial resistance is a global health crisis, with multidrug-resistant (MDR) <em>Klebsiella pneumoniae</em> infections causing significant mortality, particularly in low- and middle-income countries.</div></div><div><h3>Objective</h3><div>Evaluate the incidence, risk factors, antimicrobial resistance patterns, and clinical outcomes of <em>K. pneumoniae</em> infections in a neonatal intensive care unit (NICU) in Brazil.</div></div><div><h3>Methods</h3><div>This retrospective cohort study evaluated 1627 neonates in a Brazilian NICU from 2015 to 2022.</div></div><div><h3>Results</h3><div>Invasive <em>K. pneumoniae</em> infections in 3.2% of cases, with a peak incidence of 7% in 2016. Among 62 infection episodes, 54.8% were bloodstream infections and 45.2% urinary tract infections, diagnosed at a median age of 28 days. Most isolates (98.4%) were nonsusceptible, including 41.9% MDR, 6.5% extensively drug-resistant, and 43.5% extended-spectrum beta-lactamase producers, with one carbapenem-resistant isolate. Infection extended hospital stays from 11 to 50 days and had a case fatality rate of 19.2%, with a median time to death of 5 days.</div></div><div><h3>Conclusions</h3><div>The findings underscore the critical burden of MDR <em>K. pneumoniae</em> in NICUs, emphasising the urgent need for targeted antimicrobial stewardship and effective infection control strategies to mitigate neonatal morbidity and mortality.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101444"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157968","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":"Response to letter to the editor regarding: Handgrip and inspiratory muscle strength as surrogates for intensive care unit–acquired weakness: A prospective cohort study in Taiwan","authors":"Meng-Shan Wu NP, RN,&nbsp;Cheryl Chia-Hui Chen RN, DNSc","doi":"10.1016/j.aucc.2025.101438","DOIUrl":"10.1016/j.aucc.2025.101438","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101438"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157966","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":"Optimising nonpharmacological strategies for upper-extremity venous thrombosis prevention: Standard care and intermittent pneumatic compression in traumatic brain injury patients with peripherally inserted central catheters—Letter on Liang et al.","authors":"Liu Luo MBBS Candidate,&nbsp;Ziye Zhuang MBBS Candidate,&nbsp;Gang Huang MBBS Candidate,&nbsp;Chengxuan Lu MBBS Candidate,&nbsp;Xiang Shen Dr","doi":"10.1016/j.aucc.2025.101437","DOIUrl":"10.1016/j.aucc.2025.101437","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101437"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157967","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":"Intensive care virtual visiting practices in Australia and New Zealand following the COVID-19 pandemic: A binational survey","authors":"Rachael Parke RN, PhD ,&nbsp;Louise Rose RN, PhD ,&nbsp;Thomas Buckley RN, PhD ,&nbsp;Alexis Tabah MD ,&nbsp;Jeffrey Presneill MBBS, PhD ,&nbsp;Kathleen Mason BHSc ,&nbsp;Kyly Mills PhD ,&nbsp;Andrea P. Marshall RN, PhD","doi":"10.1016/j.aucc.2025.101436","DOIUrl":"10.1016/j.aucc.2025.101436","url":null,"abstract":"<div><h3>Background</h3><div>Family members of patients admitted to an intensive care unit (ICU) may experience adverse physical, psychological, and social impacts. Although flexible in-person visiting aims to reduce these adverse family experiences, some families encounter challenges due to geographical distances and their own frailty and work/caregiving commitments. Virtual visiting (VV), as an adjunct or alternative to in-person visiting, is a strategy that could address inequities of access.</div></div><div><h3>Objectives</h3><div>To inform future research, our objectives were to document current (post-COVID-19 pandemic) ICU visiting practices and policies specific to VV in ICUs across Australia and New Zealand (ANZ).</div></div><div><h3>Methods</h3><div>We conducted a multicentre, cross-sectional, self-administered electronic survey sent to the lead medical director or nurse unit manager of adult/mixed ICUs in public and private hospitals across ANZ. Survey development was informed by the evidence base, our experience, and surveys conducted during the pandemic. Descriptive statistics were used to report survey results.</div></div><div><h3>Results</h3><div>In total, survey responses were received from 51 ICUs, comprising 26 of 31 (84%) of requested New Zealand sites and 25 of 162 (15%) of Australian sites (overall 26% ANZ response rate). While unrestricted visiting (no restriction on time or duration of visit) occurred in 53% of ICUs, only six (12%) offered 24 h/day family access. Thirty ICUs (59%) reported some use of VV although 15 of 30 (50%) reported this occurred only rarely. Ten ICUs that used VV during the pandemic now no longer provide this option. Challenges to VV included limited availability of hardware, organisational restrictions on software, and limited access to training on how to conduct a VV.</div></div><div><h3>Conclusions</h3><div>Currently, in Australian and New Zealand ICUs, in-person visiting is often restricted by duration of visiting hours. The use of VV to support patients and their families in adult/mixed ICUs appears limited and may be declining. The impact of reduced access and whether use of VV improves patient- and family-centred outcomes, addresses access inequities, and should be part of future pandemic preparedness should be explored in future research.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101436"},"PeriodicalIF":2.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105163","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":"A nurse practitioner service in an adult tertiary intensive care unit: A prospective observational evaluation","authors":"Kelly Harbour NP, BN, MN NP ,&nbsp;Sarah Webb NP, BN, MN NP ,&nbsp;Jessica Butler NP, BSc, MN Pre-registration, MN NP ,&nbsp;Katie Kelleway NP, BN, MN NP ,&nbsp;Frances Bass RN, BN, MN ,&nbsp;Naomi Hammond RN, BN, MN Critical Care MPH, PhD ,&nbsp;Anthony Delaney MBBS, PhD, FICM ,&nbsp;Rosalind Elliott RN, PhD","doi":"10.1016/j.aucc.2025.101414","DOIUrl":"10.1016/j.aucc.2025.101414","url":null,"abstract":"<div><h3>Background</h3><div>The intensive care nurse practitioner (NP) role in Australia is not well described, and intensive care NP models of care and activities have not been well reported.</div><div>An intensive care NP service at an Australian tertiary referral hospital was implemented. This service included six core practice areas: case management, vascular access, procedural sedation, tracheostomy management, intrahospital transport of critically ill patients who required mechanical ventilation, and external ventricular drain removal.</div></div><div><h3>Objective</h3><div>The objective of this study was to describe the activities of an Australian intensive care NP service at an adult tertiary intensive care unit over a 1-year period.</div></div><div><h3>Methods</h3><div>Observational and activity data were prospectively collected for all patients who received treatment or care from an intensive care NP. Data were stored in a specific database and summarised using descriptive statistics.</div></div><div><h3>Results</h3><div>During the 12-month period, 606 patients received care from the service with 1738 episodes of care. In addition, 20 patients were case managed (equating to 300 h of NP time planning and managing ventilator and tracheostomy weaning), 306 intravascular devices were inserted (complications: 1, 0.3% [95% confidence interval {CI}: 0.08–1.8%]), seven episodes of procedural sedation were administered (complications: 0), 62 episodes of tracheostomy care were provided, 33 external ventricular drains were removed (complications: 1, 3.0% [95% CI: 0.7–16%]), 324 intrahospital transfers were completed (avoidable complications: 0, 0% [95% CI: 0–1.1%]), and 72 episodes of supervision were provided by the NP for other clinicians.</div></div><div><h3>Conclusions</h3><div>The intensive care NP provided high volumes of advanced practice with low complication rates over a 1-year period. Implementation of an intensive care unit NP service has the potential to have positive impacts on workforce, capacity to train, and patient outcomes.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101414"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092645","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":"What is the effect of measurable respiratory muscle training on respiratory muscle strength in mechanically ventilated adults in intensive care units? A systematic review and meta-analysis","authors":"Eimear McCormack PT, BSc, PG Dip ,&nbsp;Suzanne McDonough PT, PhD ,&nbsp;Yvelynne P. Kelly MD, PhD ,&nbsp;Maria Baily-Scanlan PT, MSc ,&nbsp;Nina Holden PT, BSc ,&nbsp;Laura Hammond PT, BSc ,&nbsp;Orla Brady PT, BSc, MISCP, MCPRC ,&nbsp;Bernie Bissett PT, PhD, GCTE, SFHEA ,&nbsp;Orlagh O'Shea PT, PhD","doi":"10.1016/j.aucc.2025.101418","DOIUrl":"10.1016/j.aucc.2025.101418","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory muscle weakness, associated with mechanical ventilation during critical illness, is well established. Respiratory muscle strength training (RMST) including inspiratory muscle training (IMT) and expiratory muscle strength training (EMST) aims to address this weakness. The aim of this systematic review and meta-analysis was to assess the effectiveness of RMST, delivered using measurable load devices, to increase respiratory muscle strength in mechanically ventilated adults in the intensive care unit.</div></div><div><h3>Methods</h3><div>Conducted per Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, the review included randomised controlled trials of intensive care unit patients aged ≥16 years, ventilated ≥24 h, receiving RMST (IMT or EMST) via measurable load devices before extubation, published from January 2000 to January 2024. Preoperative/postoperative training and cohorts with other causes of respiratory weakness were excluded. Searches covered electronic databases, clinical registers, reference lists, and SCOPUS. Meta-analyses and sensitivity and subgroup analyses were performed using Cochrane Review Manager (RevMan). Risk of bias (RoB2) and Grading of Recommendations, Assessment, Development, and Evaluation tools were applied to assess respiratory muscle strength.</div></div><div><h3>Results</h3><div>Fourteen studies (n = 844) met inclusion criteria (seven with low and seven with a high risk of bias). No trial employed EMST. Thirteen randomised controlled trials (n = 747) reported maximal inspiratory pressure (MIP) in response to IMT. Findings showed low-certainty evidence that IMT increases MIP by 6.9 cmH₂O ([95% confidence interval {CI}: 4.9 to 9], i² = 83%), improving to high-certainty evidence after sensitivity analysis (6.3 cmH₂O [95% CI: 3.8 to 8.8], I² = 34 %, n = 397). IMT was also associated with reduced weaning time (−1.9 days [95% CI: −3 to −0.8], I² = 76 %, n = 482) and shorter ventilation duration (−1.7 days [95% CI: −3.8 to 0.3], I² = 32 %).</div><div>Reductions in rapid shallow breathing index (−6.4 breaths/min/L [95% CI: −16 to 3.2], I² = 78%) were also observed.</div></div><div><h3>Conclusion</h3><div>This systematic review supports the use of IMT delivered using measurable load devices, initiated during mechanical ventilation, in critical care patients, to increase MIP measures. Other potentially positive effects found in this review such as reduced weaning and mechanical ventilation durations in response to IMT need further confirmation.</div></div><div><h3>Registration</h3><div>This protocol was registered with the International Prospective Register of Systematic Reviews (CRD42023431244).</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101418"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092833","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":"Optimising the frequency of routine arterial blood gas testing in the intensive care unit: An observational study","authors":"James W. Cuskelly MD ,&nbsp;Craig A. McDonald MBChB, FCICM","doi":"10.1016/j.aucc.2025.101317","DOIUrl":"10.1016/j.aucc.2025.101317","url":null,"abstract":"<div><h3>Background</h3><div>Arterial blood gas (ABG) testing is a broadly utilised tool in intensive care units (ICUs), though there is an acceptance that an excessive number are performed routinely. Reducing collection frequency has previously demonstrated no impact on benchmarked outcomes. This observational study assessed the impact of reducing routine ABG testing frequency on critical value detection, routine bedside interventions, and patient outcomes.</div></div><div><h3>Objective</h3><div>The objective of this study was to evaluate the safety and clinical utility of routine ABG collection by reviewing test frequency, critical value detection, bedside interventions (including respiratory support and electrolyte supplementation), and patient outcomes.</div></div><div><h3>Methods</h3><div>This observational study compared three time periods (preintervention, postintervention, and 1-year follow-up) between 2019 and 2021, following implementation of an ABG testing protocol in February 2020. ABG testing frequency and associated critical values were recorded alongside routine bedside interventions (system support changes).</div></div><div><h3>Setting</h3><div>The study was conducted in Cairns Hospital ICU, a regional mixed ICU in Australia with approximately 1200 annual admissions.</div></div><div><h3>Participants</h3><div>Adult patients admitted for over 24 h without an established need for high-frequency ABG collection participated in the study.</div></div><div><h3>Results</h3><div>ABG use decreased significantly from 4.93 to 3.06 tests per patient per day (p &lt; 0.001), sustained at 1-year follow-up. The proportion of patients with at least one critical value detected did not differ significantly (57% vs. 49%, p = 0.06), though the number of critical values per patient per day declined (3.89 vs. 2.99, p &lt; 0.001). Rates of respiratory support changes—including adjustments in fraction of inspired oxygen, type of respiratory support, and amount of positive end-expiratory pressure—were not significantly reduced. Potassium supplementation remained similar (27.10 mEq/day vs. 26.20 mEq/day, p = 0.288). Mortality was unchanged (6.5% vs. 11.5%, p = 0.074).</div></div><div><h3>Conclusion</h3><div>Routine ABG analysis is associated with overtesting. A routine ABG collection protocol supported by staff education significantly reduces their collection frequency without compromising day-to-day care or overall patient outcomes.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101317"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092847","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}