Nursing in Critical Care最新文献

{"title":"Variability in Intravenous Insulin Infusion Management in Italian Intensive Care Units: A National Cross-Sectional Survey of Reported Nursing Practice.","authors":"Carmelo Pujia, Giuseppe Neri, Helenia Mastrangelo, Giuseppe Mazza, Eugenio Biamonte, Caterina Mercuri, Vincenzo Bosco, Tiziana Montalcini, Eugenio Garofalo","doi":"10.1111/nicc.70656","DOIUrl":"10.1111/nicc.70656","url":null,"abstract":"<p><strong>Background: </strong>Hyperglycaemia is common in critically ill patients and is associated with increased morbidity and mortality. Continuous intravenous insulin infusion is widely used for glycaemic control in intensive care units; however, its implementation is complex and requires frequent monitoring and substantial nursing involvement.</p><p><strong>Aims: </strong>To describe reported practices in continuous intravenous insulin infusion management across Italian intensive care units and to explore variability in glycaemic targets, insulin initiation thresholds, glucose measurement methods and monitoring frequency according to healthcare setting.</p><p><strong>Study design: </strong>A national cross-sectional survey. A structured questionnaire was distributed to intensive care unit nurses and nurse coordinators in Italy between September and November 2025. Data were collected on institutional characteristics, insulin infusion protocols, glycaemic targets, initiation thresholds, glucose measurement methods and monitoring practices. Exploratory comparisons by healthcare setting used cross-tabulations and exact tests, as appropriate.</p><p><strong>Results: </strong>A total of 128 valid responses were analysed. Standardised insulin infusion protocols were reported by 119 respondents (93.0%), but considerable variability was observed in reported practice. The most commonly reported insulin initiation threshold was 180 mg/dL (50.0%). Exploratory comparisons suggested differences across healthcare settings in initiation thresholds, glucose measurement methods and monitoring frequency before glycaemic stabilisation. The median reported monitoring interval before stabilisation was 120 min (interquartile range 60-240), exceeding the recommended hourly frequency during glycaemic instability.</p><p><strong>Conclusions: </strong>Despite widespread reported protocol availability, substantial variability remained in reported continuous intravenous insulin infusion management, particularly in initiation thresholds, glucose measurement methods and monitoring before glycaemic stabilisation. Because workload, staffing and protocol adherence were not directly measured, they should be considered possible explanations rather than study findings.</p><p><strong>Relevance to clinical practice: </strong>The findings support review of local insulin infusion protocols, explicit monitoring intervals during glycaemic instability, staff education, audit and feedback and escalation processes when glucose checks are delayed.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70656"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver Perceptions of the Transition From Paediatric Intensive to Acute Care.","authors":"Maia D Regan, Briana P Keller, Emily Boulos, Kristina Betters, Jessika C Boles","doi":"10.1111/nicc.70662","DOIUrl":"10.1111/nicc.70662","url":null,"abstract":"<p><strong>Background: </strong>Transfer from the intensive care unit to an acute care unit is reportedly a stressful time for adult patients and their families. However, little has been done to understand these transition experiences and needs in paediatric patients and their parents/caregivers.</p><p><strong>Aim: </strong>To describe parent/caregiver perceptions of their child's transition from the paediatric general or cardiac intensive care unit to an acute care unit.</p><p><strong>Study design: </strong>Using a descriptive electronic survey-based design, parents/caregivers reported their perceptions of the quality of their child's transition from a paediatric intensive care unit to an acute care unit in a United States hospital, as well as their perceptions about the care received in each location. Responses were analysed using sign tests, Spearman's rank correlations and other non-parametric tests.</p><p><strong>Results: </strong>A total of 87 parents/caregivers participated. Participants reported significantly more positive perceptions of the quality of intensive care their child received compared to acute care experiences across all response domains (z = -0.3921, p < 0.001); this effect held significance even for those with prior paediatric intensive care admissions (z = -2.1971, p = 0.028). Those who reported receiving adequate preparation and information regarding transfer across units were more likely to report more positive perceptions of overall care quality (r(82) = 0.817, p < 0.001).</p><p><strong>Conclusions: </strong>Transferring from the paediatric intensive care unit is a challenging event for paediatric patients and families. With intentional, effective communication and preparation, healthcare providers can empower caregivers as their child's condition improves.</p><p><strong>Relevance to clinical practice: </strong>Families who feel more prepared for transition to acute care are more satisfied with their overall care experience and report that their needs are better met. Intensive care and acute care providers should collaborate on transfer planning initiatives that ensure families are informed, prepared for and supported during transfer between units.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70662"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct Health-Related Quality of Life Recovery Trajectories Among ICU Survivors: A Multicentre Prospective Cohort Study Using the EQ-5D-5L.","authors":"Jiyeon Kang, Yujin Jeong","doi":"10.1111/nicc.70673","DOIUrl":"https://doi.org/10.1111/nicc.70673","url":null,"abstract":"<p><strong>Background: </strong>ICU survivors frequently experience reduced health-related quality of life (HRQoL); however, recovery trajectories vary considerably, underscoring the need to identify distinct subgroups for targeted follow-up.</p><p><strong>Aims: </strong>To identify distinct HRQoL trajectory groups among ICU survivors, compare EQ-5D-5L profiles across groups and explore associated factors.</p><p><strong>Study design: </strong>This multicentre prospective study included 19 ICUs in four South Korean university hospitals. Adult survivors with admissions ≥ 24 h were assessed using the EQ-5D-5L over 24 months post-discharge. Trajectory groups were identified via latent-class mixed modelling, and associated factors via multinomial logistic regression.</p><p><strong>Results: </strong>Among 609 survivors, three groups emerged: normative stable (58.3%), suboptimal (31.7%) and persistently low (10.0%). The normative stable group maintained HRQoL near the Korean population norm. The suboptimal group showed persistently reduced HRQoL, with moderate-to-extreme problems in mobility and pain/discomfort at 24 months. The persistently low group exhibited profound, sustained impairment, particularly in mobility, usual activities and pain/discomfort. Older age (aOR 1.72, 95% CI 1.07-2.75), lower educational attainment (aOR 2.11, 95% CI 1.34-3.32) and ICU delirium (aOR 2.14, 95% CI 1.10-4.15) were associated with suboptimal membership, whereas surgical admission showed lower odds (aOR 0.49, 95% CI 0.26-0.94). Multimorbidity (aOR 3.36, 95% CI 1.69-6.69) and discharge to an extended care facility (aOR 4.97, 95% CI 2.40-10.27) were associated with persistently low membership.</p><p><strong>Conclusions: </strong>Three distinct HRQoL recovery trajectories emerged over 24 months post-discharge. Although most survivors maintained near-normal HRQoL, unfavourable groups experienced sustained impairment in mobility and pain/discomfort. These findings support trajectory-based approaches for identifying high-risk phenotypes and guiding individualised post-ICU care.</p><p><strong>Relevance to clinical practice: </strong>The persistent mobility and pain/discomfort problems highlight the importance of repeated assessment during post-ICU follow-up. Critical care nurses may consider them alongside ICU delirium history, multimorbidity and discharge destination; however, prospective validation is required before these trajectories or factors can identify high-risk survivors.</p><p><strong>Trial registration: </strong>This study was prospectively registered with the Korean Clinical Research Information Service (KCT0004045). Registered 11 June 2019. First recruitment 11 June 2019.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70673"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889193","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":"Efficacy of a Nursing Checklist During Mechanical Ventilation in Patients With Severe Pneumonia.","authors":"Miao Guo, Li Qiao, Xiaohui Xing, Jing Zhao, Zheng Wang","doi":"10.1111/nicc.70592","DOIUrl":"10.1111/nicc.70592","url":null,"abstract":"<p><strong>Background: </strong>Severe pneumonia is a respiratory disease associated with high morbidity and mortality, often necessitating mechanical ventilation. However, prolonged mechanical ventilation is associated with an increased risk of complications and higher use of healthcare resources. The efficacy of a nursing checklist on airway management during mechanical ventilation in patients with severe pneumonia has not been extensively investigated.</p><p><strong>Aim: </strong>This study aimed to evaluate the effectiveness of a nursing checklist in improving airway management during mechanical ventilation for patients with severe pneumonia.</p><p><strong>Study design: </strong>A prospective, assessor-blind, single-centre, randomized controlled trial was conducted, and 100 patients diagnosed with severe pneumonia who required mechanical ventilation were enrolled in the study. Participants were randomly assigned to either the Nursing Checklist group (NC group) or the Routine Management group (RM group). The primary outcome measures included the duration of mechanical ventilation, length of stay in the intensive care unit, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, tidal volume (TV), respiratory rate (f) and the oxygenation index (the ratio of arterial oxygen partial pressure [PaO₂] to fractional inspired oxygen [FiO₂] or PaO₂/FiO₂).</p><p><strong>Results: </strong>The duration of mechanical ventilation was significantly shorter among patients in the NC group compared to those in the RM group (p < 0.001), but the difference in length of stay in the intensive care unit (ICU) between the two groups was not statistically significant (p > 0.05). By Day 14, the APACHE II score in the NC group was significantly lower than that in the RM group (p < 0.001), and improvements in TV, f and PaO₂/FiO₂ in the NC group were also statistically significant compared to the RM group (p < 0.001).</p><p><strong>Conclusions: </strong>In this study, it was observed that the implementation of a nursing checklist was associated with significant improvements in the quality of airway care and patient outcomes during mechanical ventilation in patients with severe pneumonia, leading to a significant reduction in the duration of mechanical ventilation and improved oxygenation status and prognosis of patients.</p><p><strong>Relevance to clinical practice: </strong>These findings provide valuable insights for future research and clinical practice, and it is recommended that the use of a nursing checklist be integrated into clinical practice to improve the quality and safety of airway management for patients with severe pneumonia on mechanical ventilation.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70592"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Mechanical Insufflation-Exsufflation in Invasively Ventilated Critically Ill Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Zhiqun Liu, Guiling Liao, Hui Wen, Xiaotong Han, Maiying Fan, Shuzhen Mao, Xiaohua Liu, Huan Wan","doi":"10.1111/nicc.70598","DOIUrl":"10.1111/nicc.70598","url":null,"abstract":"<p><strong>Background: </strong>Mechanical insufflation-exsufflation (MI-E) is increasingly used in invasively ventilated adults in the intensive care unit (ICU), yet its therapeutic efficacy and safety remain uncertain due to inconsistent evidence.</p><p><strong>Aim: </strong>To synthesize evidence on the clinical efficacy and safety of MI-E in this population and to examine methodological and clinical heterogeneity underlying reported outcomes.</p><p><strong>Study design: </strong>A systematic review and meta-analysis of randomized studies (including RCTs and randomized crossover trials), conducted following PRISMA guidelines, with risk of bias assessed using the Cochrane risk-of-bias tool.</p><p><strong>Results: </strong>Five randomized controlled trials involving 310 patients were included. Meta-analysis showed that mechanical insufflation-exsufflation (MI-E) significantly increased sputum clearance (SMD = 0.63, 95% CI, 0.32-0.93; p < 0.00011; I² = 38%) without affecting oxygenation (MD = 0.28, 95% CI, -0.53 to 1.09; p = 0.50; I² = 9%). Data on respiratory mechanics, ventilation duration and ICU stay could not be pooled. No serious adverse events were reported.</p><p><strong>Conclusions: </strong>MI-E significantly improves sputum clearance in invasively ventilated critically ill adults, with no severe adverse events reported in the included studies. Its effects on other outcomes remain inconclusive due to limited data and heterogeneity. Standardized protocols and larger trials are needed.</p><p><strong>Relevance to clinical practice: </strong>Clinicians may consider MI-E as an adjunct for respiratory secretion management. Application should be guided by structured patient assessment and individualized parameter adjustment. Future research should standardize interventions and target well-defined patient subgroups to inform clear practice guidelines.</p><p><strong>Trial registration: </strong>The review protocol was registered in the International Prospective Register of Systematic Reviews, with registration number CRD42023403299.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70598"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Team Situation Awareness Within the Medical Field Context: A Scoping Review.","authors":"Tianjiao Shi, Huijuan Ma, Xi Yao, Suofei Zhang, Yu Luo","doi":"10.1111/nicc.70650","DOIUrl":"10.1111/nicc.70650","url":null,"abstract":"<p><strong>Background: </strong>In the medical field, the lack of team situation awareness is a substantial cause of communication failures, decision-making delays and treatment errors, particularly in emergency scenarios such as resuscitation and trauma management. Although this concept has been extensively studied in aviation and military fields, its application and efficacy in complex medical environments remain in a phase of rapid development and faces challenges.</p><p><strong>Aims: </strong>To conduct a scoping review of team situation awareness research in the medical field.</p><p><strong>Study design: </strong>This scoping review followed Arksey and O'Malley's methodology framework and the PRISMA-ScR guidelines. We searched nine electronic databases (PubMed, Web of Science, Embase, CINAHL, Cochrane Library, Wanfang Data, CNKI, VIP and CBM) from the database inception to 5 February 2026. The data from the literature were extracted, summarised and analysed by two independent researchers.</p><p><strong>Results: </strong>Sixteen English-language studies were included, one randomised controlled trial, three non-randomised intervention or quality-improvement studies, 10 quantitative observational or instrument-development studies and two qualitative studies. Among the 14 quantitative studies, simulation-based acute-care environments were most common (n = 8), followed by real-world clinical settings (n = 6). Eight studies used the Situation Awareness Global Assessment Technique (SAGAT) or a team variant, six used observational rating instruments and six used study-specific questionnaires, similarity indices or process measures; categories overlapped because several studies used more than one approach. Interventions were categorised as technology-assisted (n = 1), process-management (n = 2) and educational strategies (n = 1).</p><p><strong>Conclusion: </strong>Evidence on team situation awareness in healthcare is moving from conceptual exploration towards tool development and implementing interventions. However, standardised measurement, real-world validation and long-term evaluation remain insufficient.</p><p><strong>Relevance to clinical practice: </strong>Team situation awareness should be embedded in interprofessional healthcare education and clinical practice as a core non-technical safety competency. This requires clinicians and nurse leaders to: (1) implement structured briefings, huddles, closed-loop communication and shared high-risk patient labelling to create a common understanding of patient status and care priorities; (2) incorporate team situation awareness assessment into emergency resuscitation simulations and real-world debriefings using feasible observational or simulation-based tools; and (3) develop interprofessional training and technology-supported workflows that enable physicians, nurses and allied health professionals anticipate deterioration, coordinate roles and respond rapidly.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70650"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Available Evidence on Weaning and Extubation in Mechanically Ventilated Neurocritical Care Patients: An Evidence Summary.","authors":"Yuezhen Hong, Meixin Wang, Chenxing Zhang, Rachel H A Arbing, Wei-Ti Chen, Xuanye Han, Feifei Huang","doi":"10.1111/nicc.70670","DOIUrl":"https://doi.org/10.1111/nicc.70670","url":null,"abstract":"<p><strong>Background: </strong>Weaning and extubation in neurocritical care are high - risk decisions complicated by impaired consciousness and airway - protection challenges and practice guidance remains fragmented.</p><p><strong>Aims: </strong>To map, evaluate and synthesize the available evidence on weaning and extubation management for neurocritical care patients receiving mechanical ventilation.</p><p><strong>Study design: </strong>This study was designed as an evidence summary and conducted according to the methodological standards for evidence summaries established by the Fudan University Evidence - Based Nursing Center. Twenty - seven information sources were searched from inception to 7 June 2025, including clinical decision support systems, guideline repositories, professional association websites, evidence-based practice platforms and speciality databases. Eligible evidence included guidelines/manuals, evidence summaries, expert consensus, systematic reviews and randomized controlled trials. The evidence summary was registered with the Fudan University Evidence - Based Nursing Center and guided by the 6S evidence pyramid. Quality appraisal, evidence extraction, synthesis and grading were conducted using evidence type-specific tools and a pre-established evidence grading system.</p><p><strong>Results: </strong>Seventeen studies met the inclusion criteria and quality requirements. Thirty - two pieces of evidence were synthesized into six domains: functional rehabilitation and training interventions; airway protection and secretion management; swallowing and phonation training; weaning/extubation decision - making and peri - extubation management; sedation management and consciousness support; and risk factors and predictors of extubation failure.</p><p><strong>Conclusions: </strong>This study consolidated 32 pieces of evidence on weaning and extubation in neurocritical care, providing a structured synthesis while highlighting uneven evidence quality and uncertain feasibility in resource - limited settings.</p><p><strong>Relevance to clinical practice: </strong>Clinicians should prioritize positioning, early rehabilitation, artificial airway management and secretion clearance, while combining evidence with expert consensus and tailoring implementation to patient status and local resources.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70670"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889270","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":"Efficiency Meets Safety: Transforming Operating Theatre-To-Paediatric Intensive Care Unit Transfers in a Paediatric Hospital.","authors":"Adel Sharadgah, Shabaan Osman, Rajnish Kumar, Iman Darwish, Victoria Shaward, Hisham Obeidat, Jihad Zahra, Reda Elsahy, Hisham Abdulla","doi":"10.1111/nicc.70667","DOIUrl":"10.1111/nicc.70667","url":null,"abstract":"<p><strong>Background: </strong>Transfers from the Operating Theatre (OT) to the Paediatric Intensive Care Unit (PICU) represent a high-risk transition for critically ill children. At a Tertiary Paediatric Hospital, the absence of a standardised handover protocol resulted in prolonged recovery waits of up to 120 min, medication errors, haemodynamic instability, and reduced family and staff satisfaction.</p><p><strong>Aim: </strong>To enhance patient safety, reduce handover time, and improve family and staff satisfaction through a structured Operating Theatre-to-PICU handover process.</p><p><strong>Study design: </strong>Single-centre, pre-post quality improvement project in a 23-bed tertiary PICU. A multidisciplinary, co-designed intervention comprising a two-phase telephone checklist, a standardised shared drug library, preloaded infusion pumps delivered to OT, a dedicated receiving nurse and structured pre-arrival family orientation. Training was delivered by link nurses, using Kotter's change model.</p><p><strong>Results: </strong>Handover duration decreased by approximately 50% (15-20 to 8-10 min) following implementation. No transfer-related medication errors occurred across the 77 protocol cases, versus six across 96 baseline transfers and haemodynamic instability attributable to infusion changes was virtually eliminated. Family satisfaction scores were higher in post-implementation cohorts (87% at 3 months; 90% at 6 months) than pre-intervention (72%), as were staff satisfaction scores (80% and 95% vs. 58%). Mean PICU length of stay decreased from 5.2 to 4.6 days.</p><p><strong>Conclusions: </strong>A structured, multi-component handover process improved patient safety, handover efficiency, and family and staff experience during OT-to-PICU transfers, sustained at 6 months.</p><p><strong>Relevance to clinical practice: </strong>The intervention demonstrates that a multidisciplinary handover protocol can reduce transfer‑related risks and enhance family and staff experience during high‑risk transitions from the Operating Theatre-to-PICU.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70667"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management by Walking Around and Nurses' Voice Behaviour: A Structural Equation Modelling Approach to the Mediating Role of Trust in Intensive Care Units.","authors":"Sara Abd-Elmongy Mostafa Mohamed, Sally Abd-Elmongy Mostafa Mohamed, Mona Gamal Mohamed","doi":"10.1111/nicc.70655","DOIUrl":"10.1111/nicc.70655","url":null,"abstract":"<p><strong>Background: </strong>Management by walking around (MBWA) is a leadership practice in which head nurses maintain a visible presence in clinical settings, interact directly with nurses, promote open communication, observe workflow and foster a supportive work environment. These practices may contribute to building nurses' trust and encouraging them to speak up.</p><p><strong>Aim: </strong>To examine the direct and indirect effects of head nurses' MBWA on nurses' voice behaviour with trust as a single mediating variable.</p><p><strong>Study design: </strong>A cross-sectional correlational design was employed using a convenience sample of nurses working in intensive care units at a tertiary university hospital in Tanta, Egypt. Data were collected using Head Nurses' Management by Walking Around Questionnaire, Nurses' Trust Questionnaire, and Nurses' Voice Behaviour Scale. Structural equation modelling with bootstrapping (5, 000 resamples) was used to test a single-mediator model in which trust mediated the relationship between MBWA and nurses' voice behaviour.</p><p><strong>Results: </strong>MBWA was positively associated with trust (β = 0.620, p < 0.001) and nurses' voice behaviour (β = 0.468, p < 0.001). Trust significantly predicted voice behaviour (β = 0.471, p < 0.001). The indirect effect of MBWA on voice behaviour through trust was statistically significant (β = 0.292, 95% CI [0.115, 0.547]). Approximately 38.4% of the total effect of MBWA on voice behaviour was transmitted through trust, indicating partial mediation.</p><p><strong>Conclusion: </strong>MBWA was directly associated with nurses' voice behaviour and indirectly associated with voice behaviour through trust. These findings suggest that head nurses' visible leadership practices may strengthen trust and open communication, particularly in high-risk environments such as ICUs.</p><p><strong>Relevance to clinical practice: </strong>The findings of this study highlight the importance of a positive workplace ecology in enhancing nurses' job satisfaction and their intention to leave. Enhancing leadership practices, particularly those that promote effective communication, staff involvement in decision-making and adequate staffing and resources, can directly influence nurses' work experiences and retention. For clinical practice, fostering a positive work environment may improve teamwork, reduce turnover and ultimately contribute to better patient care outcomes. These findings underscore the need for nurse leaders and healthcare administrators to prioritize workplace improvements as part of organizational safety, quality and workforce sustainability initiatives.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70655"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an Online Meditation Programme on Stress and Fatigue in Critical Care Nurses: A Randomised Controlled Trial.","authors":"Songül Güngör, Derya Atik","doi":"10.1111/nicc.70613","DOIUrl":"10.1111/nicc.70613","url":null,"abstract":"<p><strong>Background: </strong>Critical care nurses are frequently exposed to high levels of occupational stress and fatigue because of demanding workloads, emotional burden and the need for sustained vigilance in complex clinical environments.</p><p><strong>Aim: </strong>To evaluate the effects of an online meditation programme on perceived stress and fatigue among intensive care nurses.</p><p><strong>Study design: </strong>This single-centre, two-arm, pre-test/post-test randomised controlled trial was conducted in a hospital in Türkiye between December 2021 and January 2022 using a convenience sample of eligible intensive care nurses. Nurses were randomly assigned to the intervention and control groups. The intervention group participated in a six-week online meditation programme delivered via WhatsApp, consisting of 20-min sessions three times per week.</p><p><strong>Results: </strong>Forty nurses completed the study and were included in the final analysis (20 in the intervention group and 20 in the control group). Baseline perceived stress and fatigue scores were similar between groups. At post-test, the intervention group had significantly lower perceived stress scores than the control group (25.50 ± 4.22 vs. 30.90 ± 7.50, p = 0.008) and significantly lower fatigue severity scores (3.06 ± 0.65 vs. 3.99 ± 0.77, p < 0.001).</p><p><strong>Conclusions: </strong>A brief online meditation programme may be a feasible supportive intervention for reducing stress and fatigue among intensive care nurses; however, larger multi-centre trials are needed to confirm these findings.</p><p><strong>Relevance to clinical practice: </strong>Remotely delivered meditation may offer an accessible and low-cost adjunct to staff well-being initiatives in intensive care settings, particularly for nurses working rotating shifts, but it should complement rather than replace organisational approaches to workforce well-being.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70613"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}