Nursing in Critical Care最新文献

{"title":"Non-pharmacological interventions to support the cognitive rehabilitation of patients admitted to the intensive care unit: An umbrella review.","authors":"Anna Holm, Linette Thorn, Anette Bjerregaard Alrø, Helene Korvenius Nedergaard, Hanne Irene Jensen, Pia Dreyer","doi":"10.1111/nicc.13190","DOIUrl":"https://doi.org/10.1111/nicc.13190","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients experience cognitive impairment throughout their intensive care unit trajectory, in the acute phase and the long-term alike. Cognitive impairment may negatively impact patients' quality of life and rehabilitation outcomes.</p><p><strong>Aim: </strong>To provide an overall examination of literature concerning non-pharmacological interventions that can enhance cognitive functioning in critically ill patients or facilitate their rehabilitation pathway during and after their intensive care unit stay.</p><p><strong>Study design: </strong>This study was conducted as an umbrella review. A systematic search was conducted in CINAHL, Embase, PubMed and PsychINFO, including all types of peer-reviewed research syntheses published between 2008 and 2023. Eligible studies had to describe interventions capable of improving adult patients' cognitive functioning or supporting their cognitive rehabilitation process throughout the intensive care unit trajectory. All eligible research syntheses were screened systematically; those included were critically appraised.</p><p><strong>Result: </strong>Based on 13 research syntheses, this review summarizes rehabilitative interventions that may be delivered during different phases of critical illness and recovery, in relation to content, delivery and timing. Interventions were: (1) cognitive activities and training, (2) mobilization and physical exercises, (3) emotional, psychological and social support and (4) information.</p><p><strong>Conclusion: </strong>Due to limited evidence, no definitive conclusion can be drawn about which type of intervention is most supportive or effective. Additionally, no recommendations can be made about the optimal timing for intervention delivery.</p><p><strong>Relevance to clinical practice: </strong>Clinicians involved in developing and implementing cognitive rehabilitation measures should consider designing individualized, multicomponent interventions with a focus on content, delivery and timing.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583650","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":"Safe and effective pressure of endotracheal tube suctioning based on sputum viscosity grades during artificial airway open suctioning procedures: A double-blind randomized controlled trial.","authors":"Weiquan Liu, Chunling Gu, Miqi Li, Jie Xiong","doi":"10.1111/nicc.13203","DOIUrl":"https://doi.org/10.1111/nicc.13203","url":null,"abstract":"<p><strong>Background: </strong>Endotracheal tube suctioning is an effective measure to ensure airway patency during mechanical ventilation; however, inappropriate suction pressure often leads to many adverse effects.</p><p><strong>Aims: </strong>This study aimed to investigate safe and effective suction pressures and intracatheter pressure ranges during artificial airway open suctioning procedures.</p><p><strong>Study design: </strong>In this double-blind randomized controlled trial, 438 patients receiving mechanical ventilation in China were divided into nine groups according to their sputum viscosity grades and suction pressure. A random sampling method was used to select one of the three pressure groups (low-, medium- and high-pressure groups). Registered intensive care unit (ICU) nurses performed open suction manoeuvres of the artificial airway based on the pressures set by the researchers. Two teaching supervisors observed and recorded the sputum viscosity, suction pressure, minimum intracatheter pressure, maximum intracatheter pressure, heart rate, mean arterial pressure, pulse oxygen saturation, airway mucosal bleeding and sputum sound improvement score.</p><p><strong>Results: </strong>This study finally included 438 patients. The results showed that the safe and effective suction pressures were 80-120 mmHg for grade I sputum viscosity, 150 mmHg for grade II sputum viscosity and 200 mmHg for grade III sputum viscosity in open suction procedures for ICU patients. These pressure values were associated with the lowest changes in heart rate, mean arterial pressure and pulse oxygen saturation; the lowest incidence of airway mucosal bleeding; and the highest sputum sound improvement score.</p><p><strong>Conclusions: </strong>In an open suction procedure, accurate setting of safe and effective suction pressure for sputum of different viscosity grades can not only achieve the suction effect but also have minimal impact on the vital signs and airway mucosal bleeding of patients.</p><p><strong>Relevance to clinical practice: </strong>The findings can guide critical care nurses to accurately select safe and effective initial suction pressure values rather than use general ranges when performing artificial airway open suctioning procedures.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583748","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 accuracy of radial artery applanation tonometry and intra-arterial blood pressure monitoring in critically ill patients: An evidence-based review.","authors":"Amber Leigh Borg, Josef Trapani","doi":"10.1111/nicc.13006","DOIUrl":"10.1111/nicc.13006","url":null,"abstract":"<p><p>The invasive intra-arterial approach is the gold standard for measuring blood pressure in intensive care units where accuracy is crucial. However, invasive procedures increase the risk of infections and mortality. This evidence-based review aimed to determine whether continuous non-invasive blood pressure (CNIBP) monitoring, using Radial Artery Applanation Tonometry (RAAT) devices, is as accurate as invasive methods. Six papers were included: three prospective cohort studies and three comparative studies. Most studies showed that mean arterial pressure is accurately recorded through RAAT monitoring; however, more research is needed to assess the accuracy of non-invasive readings of systolic and diastolic blood pressures, as data are not always concordant.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500146","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":"Effect of abdominal massage in preventing ventilator-associated pneumonia in patients connected to mechanical ventilators: A systematic review.","authors":"Hatice Şimşek, Birgül Vural Doğru, Emine Kaplan Serin","doi":"10.1111/nicc.13083","DOIUrl":"10.1111/nicc.13083","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) is one of the common complications in patients in the intensive care unit. Abdominal massage may prevent the development of VAP by reducing residual gastric volume in enterally fed patients.</p><p><strong>Aim: </strong>The purpose of this study is to review the literature on randomized controlled and quasi-experimental studies evaluating the effectiveness of abdominal massage in preventing VAP.</p><p><strong>Methods: </strong>The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) criteria were taken as the basis for creating the protocol of the systematic review and writing the article. The systematic review was performed using the Google Scholar, PubMed, Web of Science, Scopus, CINAHL and Cochrane Library databases from December 2023 to January 2024. Studies were selected by determining inclusion and exclusion criteria according to the PICOS method. The studies were evaluated using the Joanna Briggs Institute (JBI) tool for quality assessment.</p><p><strong>Results: </strong>Three randomized controlled and one quasi-experimental study with a total of 225 participants met the inclusion criteria. The four studies conducted on patients in the intensive care unit showed that abdominal massage reduced VAP. The studies reported no adverse effects of abdominal massage.</p><p><strong>Conclusion: </strong>Promising evidence was found for the effect of abdominal massage in preventing VAP. However, scientific studies with larger samples, of higher quality, and using randomized controls and blinding methods are needed to evaluate the unknown dimensions of abdominal massage and determine its beneficial effects on patients.</p><p><strong>Relevance to clinical practice: </strong>Several non-pharmacological methods may decrease VAP incidence and mortality. Abdominal massage may decrease VAP incidence and mortality.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873317","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":"Investigation of burnout and quality of work life of cardiac surgery nurses: A cross-sectional study.","authors":"Nihal Celikturk Doruker, Fatma Demir Korkmaz","doi":"10.1111/nicc.13124","DOIUrl":"10.1111/nicc.13124","url":null,"abstract":"<p><strong>Background: </strong>The care processes of cardiac surgery patients are difficult, complex and stressful. Nurses, who have an important role in the care of these patients, may experience burnout or poor quality of work life may be affected because of difficult care processes, and professional difficulties.</p><p><strong>Aim: </strong>This study analysed burnout and quality of work life in cardiac surgery nurses.</p><p><strong>Study design: </strong>This cross-sectional study was conducted with 68 nurses in the clinic and intensive care unit of a university hospital's cardiovascular surgery department. Clinical nurses care for inpatients in this department, while intensive care nurses care for patients in the intensive care unit. The 'Sociodemographic and Descriptive Characteristics of Nurses Form', 'Maslach Burnout Inventory' and 'Nursing Work Quality of Life Scale' were used to collect the data.</p><p><strong>Results: </strong>The mean score of emotional exhaustion sub-dimension of Maslach Burnout Inventory was 15.25 ± 5.08 (min: 7, max: 27), the mean score of the personal accomplishment sub-dimension was 17.48 ± 4.90 (min: 8, max: 27), and the mean score of depersonalization sub-dimension was 5.60 ± 2.70 (min: 0, max: 13). The mean scores of the emotional exhaustion sub-dimension (t: -2.380, p: .020, risk ratio [RR]: 1.67, confidence interval [CI]: [14.21, 18.82]) and the personal accomplishment sub-dimension (t: -2.604, p: .011, RR: 1.00, CI: [16.08, 19.92]) were higher in intensive care nurses. The mean total score of the nursing quality of work life scale was 107.20 ± 14.60 (min: 72, max: 149). A negative statistically significant relationship was found between the mean scores of emotional exhaustion (r: -0.243, p: .045) and depersonalization sub-dimension (r: -0.325, p: .007) of the Maslach Burnout Scale and the mean total score of the nursing quality of work life scale.</p><p><strong>Conclusion: </strong>In this study, it can be said that cardiac surgery nurses had moderate levels of emotional burnout, personal accomplishment and quality of work life, and low levels of depersonalization. At the same time, it can be seen that intensive care nurses have higher levels of emotional burnout. The increased emotional burnout and depersonalization in nurses decreased the quality of work life.</p><p><strong>Relevance to clinical practice: </strong>This study provided an understanding of burnout and quality of work life of cardiac surgery nurses. Strategies can be developed to reduce burnout and improve the quality of the work life of cardiac surgery nurses. Particular attention should be paid to intensive care nurses who experience more burnout on several sub-dimensions. This may be a good approach to improving the quality of patient care.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617611","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":"Relationship between moral resilience and secondary traumatic stress among ICU nurses: A cross-sectional study.","authors":"Mengyi Hu, Hongli Zhang, Chao Wu, Lu Li, Xinhui Liang, Yu Zhang, Hongjuan Lang","doi":"10.1111/nicc.13120","DOIUrl":"10.1111/nicc.13120","url":null,"abstract":"<p><strong>Background: </strong>Since the outbreak of COVID-19, researchers worldwide have focused more on the issue of secondary traumatic stress (STS) experienced by nurses. This stress has an adverse effect on the health of nurses and the quality of nursing care, potentially undermining the stability of the nursing team and hindering the ability to meet the growing demand for nursing services. The impact of the COVID-19 pandemic, and the rise in global demand for ICU nursing, has placed a significant strain on ICU nurses, severely damaging their mental and physical health. Notably, ICU nurses also face high levels of moral distress, and moral resilience can effectively alleviate this distress and improve the quality of care.</p><p><strong>Aim: </strong>This study aimed to examine the levels of moral resilience and STS among ICU nurses, to explore their relationship and identify the factors influencing STS.</p><p><strong>Study design: </strong>This cross-sectional study involved 229 ICU nurses from two tertiary hospitals in Xi'an, China, who participated between November and December 2023. The data were collected through email using anonymous electronic questionnaires, encompassing a self-designed demographic- and work-life-related characteristic questionnaire; the Rushton Moral Resilience Scale; and the Secondary Traumatic Stress Scale. Descriptive statistics, t-tests, analysis of variance and hierarchical regression analysis were performed to analyse the data.</p><p><strong>Results: </strong>The findings of the study indicated that ICU nurses' moral resilience and STS scores were at an intermediate level. Hierarchical regression analysis indicated that STS was negatively correlated with the subscales of the Rushton Moral Resilience Scale, specifically moral adversity coping (β, -0.156; 95% CI, -1.241 to -0.039) and relational integrity (β, -0.245; 95% CI, -1.453 to -0.388), which are significant predictors of STS. Additionally, good sleep quality (β, -.396; 95% CI, -14.948 to -7.117) and seeking psychological counselling because of work difficulties (β, .107; 95% CI, 0.237-9.624) emerged as significant predictors of STS among ICU nurses, with the model's explanation of the variance in STS increasing to 45.5%, △R² = .167, F = 16.482 (p < .001).</p><p><strong>Conclusion: </strong>This study found that ICU nurses have moderate levels of moral resilience and STS, which are negatively correlated. This suggests that improving the moral resilience of ICU nurses may help reduce their STS levels.</p><p><strong>Relevance to clinical practice: </strong>The study revealed that ICU nurses' moral resilience and secondary traumatic stress levels were at a moderate level, indicative of the need to take measures to enhance their moral resilience and reduce their secondary traumatic stress, as their presence not only affects the health of ICU nurses but also diminishes the quality of care and increases turnover rates.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789800","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":"Delirium care burden of intensive care nurses caring for patients undergoing open-heart surgery: A mixed-method research.","authors":"Meltem Ulus, Aylin Durmaz Edeer","doi":"10.1111/nicc.13137","DOIUrl":"10.1111/nicc.13137","url":null,"abstract":"<p><strong>Background: </strong>Delirium is an acute confusional state characterized by inattention, cognitive dysfunction and an altered level of consciousness. Delirium causes negative outcomes in patients, and patients with delirium increase the workload of nurses. Therefore, it is important to recognize the challenges and burdens experienced by nurses caring for patients with delirium.</p><p><strong>Aim: </strong>To determine the subjective burden experienced by intensive care nurses caring for patients who have undergone open-heart surgery.</p><p><strong>Study design: </strong>A mixed-method sequential explanatory design. A non-probability purposive sampling method was used for the quantitative stage. Using OpenEpi, we employed the method of sample calculation with an unknown universe. The sample size of the quantitive study comprised 130 nurses. Quantitative data were collected with Google survey. For gathering qualitative data, online video interviews were conducted with 10 nurses, an interpretive phenomenological approach was used and content analysis was performed.</p><p><strong>Results: </strong>In the quantitative phase, we found that the subjective burden was high. In the qualitative phase, five main themes emerged: difficulty in recognizing delirium, physical burden, emotional burden, burden in care management of patients with delirium and the effect of patients with delirium on other patients. The nurses experienced physical and emotional burden in delirium management and felt lonely while caring for patients with delirium.</p><p><strong>Conclusions: </strong>Because nurses play a key role in the care of patients with delirium, reducing the burden nurses experience when caring for patients with delirium should be considered important in ensuring that this patient population receives adequate care.</p><p><strong>Relevance to clinical practice: </strong>Delirium patients create a care burden for intensive care nurses. To reduce this burden of care, in-service training in patient management and bedside teaching support should be provided to nurses. Furthermore, the use of a valid scale to diagnose delirium should be integrated into health policies. Nurses should not be left alone in the management of delirium. Managing delirium patients with a team including physicians, nurses and professionals from other health disciplines will ensure that patients receive high-quality care, thereby reducing the care burden of nurses.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908257","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":"How emotional contagion shapes spiritual care competence: Insights from a cross-sectional study on intensive care nurses.","authors":"Sevgi Koroglu, Emine Öksüz","doi":"10.1111/nicc.13160","DOIUrl":"10.1111/nicc.13160","url":null,"abstract":"<p><strong>Background: </strong>Intensive care units (ICUs) are environments where nurses are open to emotional interactions because of complex structures and dynamic relationships. Nurses' susceptibility to emotional contagion and their spiritual care competence may affect the quality of care by influencing their ability to manage and respond to the emotional dynamics present in these environments.</p><p><strong>Aim: </strong>This study aimed to determine the level of emotional contagion and spiritual care competence in intensive care nurses.</p><p><strong>Study design: </strong>This study is a descriptive cross-sectional study conducted with 199 nurses working in the ICUs of a training and research hospital in Turkey. The data were collected between December 2021 and June 2022 using the Emotional Contagion Scale (ECS) and the Spiritual Care Competence Scale (SCCS).</p><p><strong>Results: </strong>The mean score of the nurses was 50.29 ± 15.36 on the ECS and 90.29 ± 29.53 on the SCCS. A statistically significant difference was found between the ECS and SCCS and gender, marital status, weekly working hours and some approaches about spiritual care (p < .05). It was determined that there was a statistically significant positive correlation between the total scales and sub-dimensions of the ECS and SCCS (p < .05). In this study, it was found that intensive care nurses' susceptibility to emotional contagion was high, and that their spiritual care competence was at a moderate level. The results show that gender, marital status, weekly working hours, type of ICU and some approaches about spiritual care are crucial factors in nurses' emotional contagion and spiritual care competence. In addition, as the intensive care nurses' susceptibility to emotional contagion increased, their spiritual care competence also increased.</p><p><strong>Conclusions: </strong>The results of this study will guide the planning of interventions to protect intensive care nurses from the negative effects of emotional contagion and increase their spiritual care competence.</p><p><strong>Relevance to clinical practice: </strong>It is necessary to protect intensive care nurses from the negative effects of emotional contagion and to increase their competences in spiritual care.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331991","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":"Turning knowledge into action: The vital role of science in nursing.","authors":"Ruy de Almeida Barcellos","doi":"10.1111/nicc.13140","DOIUrl":"10.1111/nicc.13140","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082446","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":"NICC news: Vol 29, Issue 6.","authors":"Louise Stayt","doi":"10.1111/nicc.13175","DOIUrl":"10.1111/nicc.13175","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523646","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}