Nursing in Critical Care最新文献

{"title":"Characteristics, Outcomes and Recovery of Patients 65 Years or Older Admitted to Swedish Intensive Care Units: A Protocol for a Longitudinal Observational Multicentre Study.","authors":"Fredrika Sundberg, Anna Kjellsdotter, Elisabeth Lindberg, Emma Backman, Åsa Israelsson-Skogsberg","doi":"10.1111/nicc.70109","DOIUrl":"10.1111/nicc.70109","url":null,"abstract":"<p><strong>Background: </strong>There are little data on the impact of frailty on critically ill older patients treated in intensive care units (ICUs) and on their characteristics and outcomes. More understanding of the longitudinal health and recovery process is needed and of the recovery traits of older patients after intensive care.</p><p><strong>Aim: </strong>This project aims to identify characteristics and outcomes in patients 65 years or older admitted to ICUs and to explore how health and recovery is experienced after discharge, with a special focus on frailty.</p><p><strong>Study design: </strong>This research project will conduct both retrospective and prospective data collection with a sample of approximately 3200 patients. This is a longitudinal, multicentre, prospective, observational research project with a nested cohort covering 12 months of admissions and comprising four studies. The first aims to map the characteristics of patients admitted to the ICUs, their treatments and their outcomes. The second will use questionnaires to assess their health and recovery process up to 18 months after discharge. The third and fourth studies aim to describe and understand their lived experiences using research interviews, with the fourth study including only frail patients.</p><p><strong>Relevance to clinical practice: </strong>The project comprises studies that seek to identify the characteristics of older people admitted to ICUs, to examine how frailty impacts them and to understand what they experience during and foremost after intensive care. The project also aims to understand the facilitators and barriers to promoting health and recovery after discharge from ICUs and to contribute to the growing body of evidence supporting health and recovery initiatives. The results need to be spread and the knowledge sprung from this project may be implemented and used by intensive care unit clinicians.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70109"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610272","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":"Dream Experiences During Intensive Care Unit Stay: Occurrence, Content, Vividness and Associated Factors.","authors":"Adrienne E van der Hoeven, Rolf Fronczek, Denise Bijlenga, Sarah Hadra, Caro Ridder, Marlies Henneman, Jessica A Maas, Suzanna A Goedemans-de Graaf, Gert Jan Lammers, David J van Westerloo, Mink S Schinkelshoek","doi":"10.1111/nicc.70106","DOIUrl":"10.1111/nicc.70106","url":null,"abstract":"<p><strong>Background: </strong>Vivid dream experiences in the intensive care unit (ICU) are common, but poorly understood.</p><p><strong>Aim: </strong>We investigated the occurrence, vividness, content, emotional impact and associated factors of dream experiences in the ICU.</p><p><strong>Study design: </strong>Retrospective mixed methods study with subjects ≥ 18 years, previously admitted to the ICU for ≥ 4 days and/or due to COVID-19, who were not sedated for ≥ 24 h during their stay (n = 80). Participants answered a retrospective questionnaire by telephone. Clinical data were collected from electronic health records.</p><p><strong>Results: </strong>The questionnaires were taken a median of 9 months post-discharge. Dream experiences were reported by 79%. Of participants who recollected dream experiences, 73% reported \"life-like\" dreams, 49% associated their dreams with negative emotions and 54% said their dreams impacted them even after awaking. Some participants (28.6%) continued to have similar dreams at home. After being asked if they had additional comments, some participants suggest receiving information during their hospital stay about the potential for vivid dream experiences could be beneficial. The dream content was often related to the ICU admission. Younger age and longer length of stay were related to vivid dream experiences. Of participants with dream experiences 62.5% had experienced delirium during their ICU stay. Perceptual disturbances were also frequently reported by participants (50%) and only 45% could clearly distinguish them from dream experiences. There was an overlap between participants reporting perceptual disturbances and confirmed delirium (70%).</p><p><strong>Conclusions: </strong>Vivid dream experiences are common in ICU patients and often have a negative emotional impact. Future studies should dive deeper into effective ways to distinguish dreams, delirium and perceptual disturbances and how to reduce their impact.</p><p><strong>Relevance to clinical practice: </strong>ICU nurses should be aware of the occurrence and psychological burden of vivid negative dreams in ICU patients. Providing anticipatory support may help patients process these experiences during recovery.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70106"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555600","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":"Frailty and fear of death among geriatric patients in critical care units: A mixed methods study.","authors":"Eman Arafa Hassan, Shimmaa Mohamed Elsayed, Heba Hashem Monged, Basma Taher Abdelwahab","doi":"10.1111/nicc.13219","DOIUrl":"10.1111/nicc.13219","url":null,"abstract":"<p><strong>Background: </strong>Frailty, a geriatric syndrome characterized by decreased resilience, is a known risk factor for mortality in critical care settings and can significantly impact a patient's perception of their own health and prognosis.</p><p><strong>Aim: </strong>To explore the relationship between frailty and fear of death in geriatric patients admitted to critical care units.</p><p><strong>Study design: </strong>A convergent parallel mixed methods design was applied.</p><p><strong>Methods: </strong>Data were collected from 247 geriatric patients in critical care units from March 2023 to February 2024. Quantitative data included clinical frailty score and death anxiety questionnaire. Qualitative data were gathered through semi-structured interviews with a subset of 34 participants. Quantitative analysis involved descriptive statistics, correlation analysis and multiple linear regression. Qualitative data were analysed thematically using Braun and Clarke's approach.</p><p><strong>Results: </strong>Quantitative analysis revealed a positive significant correlation between frailty and death anxiety (r = 0.19, p = 0.003). Additionally, regression analysis identified age (B = 0.69, 95% CI [0.22, 1.15], p = 0.004), lack of social support (B = 2.88, 95% CI [0.28, 5.47], p = 0.030), lower income (B = -5.33, 95% CI [-9.03, -1.63], p = 0.005) and higher frailty scores (B = 0.83, 95% CI [0.10, 1.56], p = 0.025) as significant predictors of increased death anxiety. Qualitative findings yielded four key themes: the impact of frailty on perception of mortality, the psychological and emotional dimensions of fear of death, the role of the critical care unit environment on fear of death and coping mechanisms and support.</p><p><strong>Conclusion: </strong>Frailty in geriatric critically ill patients heightened death anxiety due to physical decline, existential worries and the overwhelming critical care environment.</p><p><strong>Relevance to clinical practice: </strong>This study can help nurses provide more personalized care to geriatric patients by addressing both their physical frailty and psychological needs related to fear of death. This, in turn, can improve the quality of care and enhance patient satisfaction.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13219"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820077","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 Risk Factors of Oral Endotracheal Tube-Related Mucous Membrane Pressure Injury in Intensive Care Units.","authors":"Chen Yi, Lu Yan, Yang Xiao-Hui, Jin Xiao-Liang, Wu Lin-Zhu, Zhang Li-Juan, Zhao Jing, Lu Jian-Ying","doi":"10.1111/nicc.70090","DOIUrl":"10.1111/nicc.70090","url":null,"abstract":"<p><strong>Background: </strong>Device-related pressure injuries in critically ill patients have gained significant attention, yet limited research has specifically focused on oral endotracheal tube-related mucous membrane pressure injury (OETMMPI) in intensive care unit (ICU) settings. Comprehensive assessment of intra- and extra-oral factors is crucial for accurately characterizing OETMMPIs and identifying broader risk factors may enhance prevention strategies.</p><p><strong>Aim: </strong>To investigate the characteristics and factors associated with OETMMPI in ICUs.</p><p><strong>Study design: </strong>A retrospective observational study.</p><p><strong>Results: </strong>OETMMPIs in ICU patients can occur inside and outside the oral cavity, most frequently on the lower lip (35.3%, n = 41), palate (19.8%, n = 23), lingual surface (19.0%, n = 22) and mouth corners (17.2%, n = 20). The highest proportion of injuries occurred on Day 2 post-intubation (43%), with a mean onset time of 4.74 ± 1.82 days. Logistic regression identified primary diagnosis, disease outcome, intubation time and length of stay as statistically significant (p < 0.05). Cardiovascular disease (OR = 12.183, p = 0.037), death (OR = 14.281, p = 0.001), intubation time (OR = 1.191, p = 0.003) and length of stay (OR = 1.049, p = 0.007) emerged as statistically significant factors of OETMMPIs in this study.</p><p><strong>Conclusions: </strong>OETMMPIs are more likely to occur after 4 days of intubation and are linked to cardiovascular disease, poor outcomes and prolonged ICU stays. Their occurrence may indicate disease progression, underscoring the need for early, site-specific oral assessments and preventive care in critically ill patients.</p><p><strong>Relevance to clinical practice: </strong>Close monitoring of the lower lip, palate, tongue surface and mouth corners is essential for early detection of OETMMPIs in intubated ICU patients. Critical care nurses should closely monitor patients with cardiovascular disease, prolonged intubation or extended ICU stays and adopt comprehensive approaches to identify and prevent OETMMPIs, thereby reducing injury and improving outcomes.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70090"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287068","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 Family-Centred Paediatric Delirium Bundle: A Feasibility Study.","authors":"Rikke Louise Stenkjaer, Ingrid Egerod, Mala Moszkowicz, Gorm Greisen, Janne Weis, Erwin Ista, Jakob Gjedsted, Marianne Steen Jensen, Kirsten Krone Reichl, Suzanne Forsyth Herling","doi":"10.1111/nicc.70103","DOIUrl":"10.1111/nicc.70103","url":null,"abstract":"<p><strong>Background: </strong>Paediatric delirium (PD) is a common disorder in critically ill children. PD management, however, needs improvement. To this end, we developed a family-centred non-pharmacological delirium management bundle based on consensus from paediatric intensive care unit experts and parents. The bundle included interventions such as developing a day structure and encouraging parent presence.</p><p><strong>Aim: </strong>We aimed to test the feasibility of our PD bundle by investigating acceptability, implementation and practicality for parents, nurses and physicians.</p><p><strong>Study design: </strong>A multiple-method process evaluation study with quantitative and qualitative data, using questionnaires and focus group interviews. To determine the feasibility of the PD bundle, we set provisional goals for the acceptability, implementation and practicality prior to conducting our study. The study took place in two paediatric cardiac units from March to May 2024.</p><p><strong>Results: </strong>Two focus group interviews were held with 15 nurses and four physicians. Parents, nurses and physicians found the PD bundle acceptable because all the interventions were intuitively relevant and familiar, meeting our target goals to proceed with an RCT study. We surveyed 31 parents to estimate the degree of implementation of the 11 interventions in the PD bundle. Six of the interventions in the bundle were delivered in more than 80% reported by the parents, while five fell short of our target goals. Nurses and physicians suggested that the PD bundle could be implemented if the interventions were consolidated into fewer elements. We trained 90% of the invited nurses and physicians to deliver the PD bundle, which met our target goal of 80%. Hospital organisation, environment and differences in hygienic policy interpretations challenged the practical application of the PD bundle according to the nurses and physicians.</p><p><strong>Conclusions: </strong>The PD bundle appears promising for acceptance, implementation and practical application in clinical practice. However, as the delivery of the PD bundle fell short of our target goals, a revised PD bundle should be tested before performing an RCT.</p><p><strong>Relevance to clinical practice: </strong>A non-pharmacological paediatric delirium bundle is now available to critical care nurses to prevent and manage delirium in critically ill children.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70103"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531004","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":"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":"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>Aim: </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":" ","pages":"e13203"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","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":"Development and validation of a nomogram for circuit lifespan of regional citrate anticoagulation-continuous renal replacement therapy in intensive care patients with acute kidney injury.","authors":"Zhongbin Chen, Lingai Pan, Jia Zhang, Yanyu Chen, Yi Liu, Ping Jia, Shiya Liu, Bo Wang, Ping Zheng, Feng Chen, Bin Zeng, Wenting Zhang, Qin Yang, Xiaobo Huang, Caixia Xie","doi":"10.1111/nicc.13196","DOIUrl":"10.1111/nicc.13196","url":null,"abstract":"<p><strong>Background: </strong>Regional citrate anticoagulation-continuous renal replacement therapy (RCA-CRRT) has a wide range of applications in clinical practice, but unplanned downtime due to RCA-CRRT circuit coagulation is as high as 15.75%-66.70%.</p><p><strong>Aim: </strong>To build a nomogram model for predicting the lifespan circuits of RCA-CRRT.</p><p><strong>Study design: </strong>A prospective observational cohort study was conducted in Sichuan, China. The collected clinical data from 404 RCA-CRRT sessions involving 135 patients were utilized. The patients' basic information, laboratory indicators and RCA-CRRT parameters were used as independent variables, and the survival status and survival time of RCA-CRRT circuits were used as dependent variables. A Cox multivariate analysis was performed to build the nomogram model for predicting the lifespan of RCA-CRRT circuits. The model was validated internally and externally.</p><p><strong>Results: </strong>The median lifespan of RCA-CRRT circuits was 28.0 (12.0-46.5) h, and the unplanned downtime rate was 23.76%. In the Cox multivariate analysis, venous pressure, haemoglobin, Sequential Organ Failure Assessment (SOFA), lactate, and blood transfusion were identified as statistically significant predictive factors for the lifespan of RCA-CRRT circuits (p < .05). Subsequently, a nomogram model for predicting the lifespan of RCA-CRRT circuits was developed. The AUC values for internal and external validation within the 12-72-h timeframe ranged from 0.648 to 0.816 and 0.613 to 0.956, respectively. Both the calibration curve and clinical decision curve demonstrated the model's good performance.</p><p><strong>Conclusion: </strong>The nomogram model developed in this study demonstrates its efficacy in accurately predicting the lifespan circuits of RCA-CRRT.</p><p><strong>Relevance to clinical practice: </strong>Clinical nurses can use the prediction model to assess the lifespan of RCA-CRRT circuits, so as to formulate a personalized RCA-CRRT treatment plan for patients, thus reducing the unplanned downtime of RCA-CRRT.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13196"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607349","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":"The Modern Role of Neonatal PICCs Subspecialty.","authors":"Matheus Van Rens, Matthew Ostroff, Mohammad A A Bayoumi","doi":"10.1111/nicc.70111","DOIUrl":"10.1111/nicc.70111","url":null,"abstract":"<p><p>This perspective review examines the evolving role of neonatal peripherally inserted central catheters (n-PICCs) as a distinct subspecialty within neonatal vascular access. n-PICCs are indispensable for delivering long-term intravenous therapies in critically ill neonates. The review explores ethical considerations, equitable access to vascular access technologies and prioritisation of patient safety in procedural training. The implementation of specialised vascular access teams, rather than an all-staff model, is advocated to enhance procedural success, reduce device-related complications and promote a culture of accountability. Future directions include the development of smart catheter technologies, pseudo-tunnelling techniques and simulation-based education to advance and maintain clinical competency.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70111"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561858","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":"Family Intensive Care Unit Syndrome: Investigating the Mediating Role of Healthcare Communication in Psychological Well-Being Among Family Members.","authors":"Haitham Mokhtar Mohamed Abdallah, Shaimaa Mohamed Amin, Eman Yasser Hammouda, Mohamed Hussein Ramadan Atta, Ahmed Hashem El-Monshed, Nagwa Ibrahim Mohamed Hamad","doi":"10.1111/nicc.70119","DOIUrl":"10.1111/nicc.70119","url":null,"abstract":"<p><strong>Background: </strong>Family members of patients in intensive care units (ICUs) often encounter profound emotional and psychological difficulties, a condition known as family intensive care unit syndrome (FICUS). These experiences can severely affect their mental health and psychological well-being. While effective communication within healthcare environments is likely essential for mitigating these challenges, it has not been thoroughly researched as a mediating factor in FICUS.</p><p><strong>Aim: </strong>This study explores how healthcare communication influences the connection between FICUS and the psychological well-being of family members.</p><p><strong>Study design: </strong>A cross-sectional descriptive design was adopted across 10 hospitals in Mansoura City, Egypt. Utilising convenience sampling, the study included 244 adult family members (aged 18 and older) of ICU patients who were actively involved in decision-making and maintained regular communication with healthcare staff. Exclusion criteria included family members receiving palliative care or those with pre-existing psychological conditions. Validated tools used in the study included the Family Intensive Care Unit Syndrome Inventory, Ryff's Psychological Well-being Scale and the Healthcare Communication Questionnaire.</p><p><strong>Results: </strong>Structural equation modelling revealed that healthcare communication fully mediates the relationship between FICUS and psychological well-being. A significant indirect effect was observed (Estimate = -0.063, p < 0.001), while the direct effect was not statistically significant. Model fit indices were excellent (Comparative Fit Index [CFI] = 1.000, Tucker-Lewis Index [TLI] = 1.000, Root Mean Square Error of Approximation (RMSEA) =0.000 and Standardised Root Mean Square Residual [SRMR] ≈0.000), supporting the robustness of the mediation model. Additionally, age negatively influenced both psychological well-being and healthcare communication, identifying older adults as particularly vulnerable.</p><p><strong>Conclusions: </strong>The findings emphasise the detrimental impact of FICUS on family members' psychological well-being and the pivotal role of healthcare communication in alleviating these effects. Tailored communication strategies and support services are particularly crucial for older family members.</p><p><strong>Relevance to clinical practice: </strong>The study highlights the critical need to improve healthcare communication practices in ICU settings. Training clinicians in structured and empathetic communication, particularly for families of elderly patients, may help buffer the emotional burden associated with FICUS. Establishing communication protocols and offering psychosocial support services are essential for protecting the well-being of ICU family members.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70119"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735175","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":"Single-use versus multiple-use endotracheal suction catheters flushed with chlorhexidine in mechanically ventilated ICU patients: A study protocol of a feasibility randomized controlled trial with an embedded qualitative study.","authors":"Mohamed H Eid, Kevin Hambridge, Pat Schofield, Jos M Latour","doi":"10.1111/nicc.13227","DOIUrl":"10.1111/nicc.13227","url":null,"abstract":"<p><strong>Background: </strong>Endotracheal suction catheters are often used multiple times during endotracheal suctioning procedures in resource-limited intensive care units (ICU). The impact of this practice on mechanically ventilated patients' outcomes remains unclear.</p><p><strong>Aim: </strong>The aim of this feasibility randomized controlled trial (fRCT) is to assess the feasibility and acceptability of single-use versus multiple-use endotracheal suction catheters flushed with chlorhexidine in mechanically ventilated ICU patients.</p><p><strong>Study design: </strong>This study is a three-armed fRCT with an embedded qualitative study.</p><p><strong>Results: </strong>The trial involves three groups. One group includes endotracheal suctioning using a single-use catheter; the second group includes a multiple-use endotracheal suction catheter flushed with chlorhexidine and the control group includes a multiple-use endotracheal suction catheter flushed with normal saline. Sixty adult ICU patients (20 in each group) will be recruited, along with 12-16 ICU nurses delivering the interventions, and 12-16 patients' next-of-kin for semi-structured interviews. The study protocol has been approved by two ethics committees. Study recruitment will be conducted over an 8-month period with an expected start date of 12 April 2024.</p><p><strong>Conclusion: </strong>The feasibility outcome measures will be recruitment, retention, and follow-up measures as well as the identification of clinical outcomes such as Ventilator-Associated Pneumonia (VAP) using the modified clinical pulmonary infection score, and ICU length-of-stay.</p><p><strong>Relevance to clinical practice: </strong>This study will help ICU nurses to understand how different methods of endotracheal suctioning affects patients in ICUs with limited resources. The findings could influence clinical practice and improve patient outcomes.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13227"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923959","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}