Nursing in Critical Care最新文献

{"title":"Nurse-involved early mobilization in the intensive care unit: A systematic review and meta-analysis.","authors":"Jungmin Lee, Yeonju Kim, Hyun Joo Lee","doi":"10.1111/nicc.13278","DOIUrl":"10.1111/nicc.13278","url":null,"abstract":"<p><strong>Background: </strong>Early mobilization is one proposed strategy for reducing complications and optimizing patient outcomes. Nurses play an essential role in patient monitoring and co-ordination.</p><p><strong>Aims: </strong>To assess the effects of a nurse-involved early mobilization programme on muscle strength and intensive care unit (ICU) length of stay and identify the components of an early mobilization programme.</p><p><strong>Study design: </strong>A systematic review and meta-analysis were conducted. MEDLINE (PubMed), Embase, Cochrane and CINAHL databases were searched. Eligible studies included randomized controlled trials (RCTs) and non-randomized studies of adult ICU patients undergoing early mobilization. The studies were appraised using RoB 2.0 and ROBINS-I tools, and a meta-analysis was performed using Rstudio 2023.06.2.</p><p><strong>Results: </strong>Nine studies were selected from 943 studies. Four studies involved only ICU nurses, while five involved multidisciplinary teams. Concerns about bias were raised in four RCTs, and two non-randomized studies had moderate bias risk. Interventions involved progressive exercise steps, but none detailed the specific role of nurses. Early mobilization significantly decreased ICU length of stay (95% CI: -3.22, -0.11; p = .04), although it did not improve muscle strength (95% CI: -0.86, 0.99; p = .80).</p><p><strong>Conclusions: </strong>Nurse-involved early mobilization was associated with a reduction in ICU stay, although it did not impact muscle strength. The nurses' roles were not specifically defined.</p><p><strong>Relevance to clinical practice: </strong>An analysis of relevant tasks is necessary to clarify the role of nurses in early mobilization and to provide optimal care. Including these roles is crucial in the development of standardized early mobilization.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13278"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484689","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":"Advanced clinical practitioners in paediatric critical care transport services.","authors":"Sasha Herring, Shelley Riphagen, Fiona E Bickell","doi":"10.1111/nicc.13224","DOIUrl":"10.1111/nicc.13224","url":null,"abstract":"<p><p>Advanced clinical practitioners (ACPs) specializing in the transfer of critically ill children began training at the South Thames Retrieval Service in London in 2003. Over 20 years, this model has been emulated across the United Kingdom. The aim of this study was to explore the national contribution of ACPs in paediatric critical care transport services in the United Kingdom. This national survey found that nine of the 12 regional services employed ACPs. The proportion of transfers led by ACPs ranged from 10% to 64%, suggesting that they make a valuable contribution to the transport of critically ill children between district general hospitals and paediatric intensive care units. The ACPs have expanded their scope practice and now fulfill the role of lead practitioner in the transport of critically ill children. There is scope to increase their contribution across retrieval services in the United Kingdom.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13224"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484679","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":"Risk factors for oral mucosal pressure injury associated with endotracheal tubes in intensive care unit patients: A single-centre longitudinal study with brief follow-up.","authors":"Ecem Ozdemir, Oznur Kavakli","doi":"10.1111/nicc.70009","DOIUrl":"10.1111/nicc.70009","url":null,"abstract":"<p><strong>Background: </strong>In intensive care units (ICUs), endotracheal tubes (ETTs) cause injury to the oral mucosa through friction and pressure. The incidence and risk factors of oral mucosal pressure injuries (PIs) have gained increasing attention in recent years.</p><p><strong>Aim: </strong>The study aimed to identify risk factors for oral mucosal PIs associated with ETTs.</p><p><strong>Study design: </strong>This was a single-centre brief follow-up longitudinal study conducted from January to May 2022. It recruited 250 patients without oral mucosal PIs who received mechanical ventilation support via ETT and were hospitalized in the ICU of a teaching and research hospital in Turkey. Receiver operating characteristic (ROC) analysis was performed to estimate the onset time of oral mucosal PI using the ETT repositioning time as an independent variable.</p><p><strong>Results: </strong>Oral mucosal PIs associated with ETT developed in 41.6% of patients. Of the 250 endotracheally intubated patients, the mean Acute Physiology and Chronic Health Evaluation (APACHE-II) score was 27.5 (min/max: 18/42), the mean length of stay (LOS) in the ICU was 24 days (min/max: 13/80). The median body mass index (BMI) of patients with oral mucosal PIs was (24.59 [IQR = 3.81] kg/m²), significantly lower than the median BMI of patients without oral mucosal PIs (26.62 [IQR = 5.93] kg/m²) (Z = 4.200; p < .001). The earliest onset of oral mucosal PIs was noted at 16 h after the start of follow-up, and the latest was 208 h after the start of follow-up, with a median of 160 (IQR = 48) h (approximately 6.7 days). Patients whose ETT was repositioned after 10.5 h had a higher risk of developing oral mucosal PIs (OR = 3.77; 95% CI: 2.65-5.37; p < .001). The decision tree (CHAID) method was applied to determine the time required to reposition the ETT to prevent oral mucosal PIs. The decision tree correctly classified the occurrence of oral mucosal PIs by 60.6% and the non-occurrence of oral mucosal PIs by 97.9%. Patients with parenteral nutrition and a low frequency of ETT repositioning time had a higher risk of oral mucosal PIs (p < .001).</p><p><strong>Conclusions: </strong>Parenteral nutrition support and ETT repositioning timing were the primary risk factors for developing oral mucosal PIs. Close monitoring of endotracheally intubated patients receiving parenteral nutrition is essential, with particular attention to forming oral mucosal PIs. Additionally, repositioning the ETT at intervals of no more than 8 h may help reduce the risk of oral mucosal PI development.</p><p><strong>Relevance to clinical practice: </strong>As ICU patients are particularly vulnerable to mucosal membrane PIs, recognizing the associated risk factors is crucial for early detection and prevention. This study highlights the specific risk factors for oral mucosal PIs, equipping nurses with the knowledge to develop targeted interventions to prevent these injuries.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e70009"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606414","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":"Causes and impacts of interrupted enteral nutrition in critically ill patients: A secondary analysis of a cluster-randomized controlled trial.","authors":"Hengyu Zheng, Lina Cai, Pingrong Wang, Lijiang Zheng, Jiajia Lin, Ting Sun, Jiaqi Li, Juntao Zuo, Yuxiu Liu, Xianghong Ye","doi":"10.1111/nicc.70006","DOIUrl":"10.1111/nicc.70006","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition due to interruption of enteral nutrition remains a prevalent issue in the intensive care unit (ICU).</p><p><strong>Aim: </strong>This study aimed to determine the frequency and causes of enteral nutrition interruption (ENI)and its impact on implementing enteral nutrition.</p><p><strong>Study design: </strong>This is a secondary analysis of a multicentre, cluster-randomized controlled trial (N = 2772). This secondary analysis included patients in the ICU for at least 72 h and receiving total enteral nutrition. The causes of ENI were defined as (1) feeding intolerance, (2) diagnostic and therapeutic procedures and (3) others. Multiple linear regression analyses investigated the association between ENI and nutrition intake.</p><p><strong>Results: </strong>A total of 1331 patients were included for analysis. Approximately 18.63% of the patients experienced at least one episode of ENI. The main cause of ENI was diagnostic and therapeutic procedures. Energy intake was 17.54 ± 6.85 versus 16.64 ± 7.06 (p = .065) among patients with and without ENI, and the protein intake was 0.69 ± 0.27 versus 0.64 ± 0.27 (p = .016). Multiple linear regression analysis revealed that ENI was significantly associated with diminishing energy and protein intake (B = -1.012, 95% CI -1.857 to -0.167, p = .019; B = -0.050, 95% CI -0.083 to -0.017, p = .003, respectively).</p><p><strong>Conclusions: </strong>Based on this multicentre study about ENI, the incidence of interruptions in enteral nutrition was 18.6%, with diagnostic and therapeutic procedures being the leading causes. The occurrence of interruptions in the delivery of enteral nutrition leads to a reduction in the nutritional intake of critically ill patients.</p><p><strong>Relevance to clinical practice: </strong>Critical care nurses should establish comprehensive nutrition support protocols and strengthen the training of department nurses, equipping them with the skills to effectively prevent and manage ENI. This is essential for actively achieving feeding goals and improving the outcomes of ICU patients.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e70006"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606057","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":"To survive and thrive-Patients, staff and countries need healthy critical care units.","authors":"Janice Rattray, Lisa Salisbury, Alastair Hull, Louise McCallum","doi":"10.1111/nicc.70030","DOIUrl":"https://doi.org/10.1111/nicc.70030","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e70030"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702187","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":"Exploring the experiences of newly graduated nurses transiting into critical care settings: A descriptive qualitative study.","authors":"Xing Kang, Chia En Lau, En Ting Athena Chan, Norasyikin Hassan","doi":"10.1111/nicc.13262","DOIUrl":"10.1111/nicc.13262","url":null,"abstract":"<p><strong>Background: </strong>The transition of newly graduated nurses (NGNs) into the intensive care unit (ICU) differs from general nursing because of the complexities of critical care management, which includes managing life-threatening conditions. The ICU transition experiences for NGNs can contribute to higher occupational stress and lead to greater turnover intentions. This turnover may exacerbate staffing shortages, increase workloads and potentially compromise care quality. Understanding the new nurses' transition experiences is crucial for providing strategies to support their adaptation and retention in the nursing workforce.</p><p><strong>Aim: </strong>To explore the transition experiences and describe the unique challenges that NGNs face in the ICU.</p><p><strong>Study design: </strong>A descriptive qualitative study design was utilized to explore the NGNs' transition experiences into the ICU in Singapore. A purposive sampling of 15 participants was used, and semi-structured interviews were conducted from November 2023 to February 2024. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was used for data analysis.</p><p><strong>Results: </strong>Three major themes and eight sub-themes emerged from the participants' interviews. The three major themes are: 'Navigating the Unfamiliar Realm of the ICU', 'Traversing Personal Growth Amid Concerns for Independence' and 'Becoming Proficient and Taking More Responsibilities'. Themes were explored through a phased approach that captured the evolving challenges and experiences NGNs face during the transition into ICU.</p><p><strong>Conclusions: </strong>Understanding each phase of NGNs' experiences in the ICU is necessary for raising awareness within organizations or academic institutions. Future research can take a phased approach to address the issues identified, as each phase may present different challenges.</p><p><strong>Relevance to clinical practice: </strong>Identifying and addressing NGNs' transition period and how they learn new critical care skills are essential for safe critical care practice.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13262"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531845","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 effect of a 10-week field-oriented transition programme for new graduate registered nurses in critical care.","authors":"Hana Kim, Eunhye Kim, Jamin Noh, Eunkyung Bang, Sunghee H Tak","doi":"10.1111/nicc.13298","DOIUrl":"10.1111/nicc.13298","url":null,"abstract":"<p><strong>Background: </strong>The turnover rate of new graduate registered nurses in critical care is high as they have trouble adapting to the field. Various transition programmes are being applied, but the effectiveness thereof remains controversial.</p><p><strong>Aim: </strong>This study examined the effects of a 10-week field-oriented training programme for new graduate registered nurses in critical care setting using the Kirkpatrick model.</p><p><strong>Study design: </strong>This study used a one-group, repeated-measures design. A total of 71 new graduate registered nurses at a tertiary hospital in South Korea completed a 10-week field-oriented transition programme between March 2020 and June 2021. The programme consisted of a two-week ward-based modular orientation grounded in the concept of distributed practice model and eight-week individualized preceptorship. Using the Kirkpatrick model, the measures included the Job Satisfaction Scale, Clinical Knowledge Evaluation, Clinical Competencies, Professionalism Inventory, Organizational Commitment Questionnaire and short-term turnover rate, and data were collected four times: pre-education, after each education and at 3-month follow-up.</p><p><strong>Results: </strong>The ward-based modular orientation significantly improved clinical competencies (p < .001) and professionalism (p = .02). When preceptorship was applied, clinical knowledge (p < .001) and competencies (p < .001) significantly improved; in contrast, job satisfaction (p = .009) and organizational commitment (p < .001) were significantly reduced. Three months after the end of education, clinical knowledge (p < .001) and competencies (p < .001) increased compared with immediately after the programme, but organizational commitment (p = .013) decreased significantly. The turnover rate at 6 months after employment was estimated to be 15.5%.</p><p><strong>Conclusions: </strong>The findings indicate that a field-oriented transition programme with sufficient practice opportunities in clinical sites and customized field training results in improved clinical knowledge and competencies in new graduate nurses.</p><p><strong>Relevance to clinical practice: </strong>A transitional programme for new graduate nurses needs to include additional components such as socialization within organization in order to improve job satisfaction and organizational commitment.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13298"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460573","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":"Guiding novice nurses through resuscitations in the intensive care units: A qualitative descriptive study.","authors":"Yongxing Patrick Lin, Le Yi Cynthia Chan, Ee-Yuee Chan","doi":"10.1111/nicc.13301","DOIUrl":"10.1111/nicc.13301","url":null,"abstract":"<p><strong>Background: </strong>Resuscitation in the ICU represents a critical juncture where both junior and experienced nurses are expected to respond effectively. As junior nurses may lack the clinical expertise to contribute optimally in a resuscitation, senior nurses may then be required to guide them while managing the intricacies of a resuscitation. Understanding such clinical teaching experiences is essential to strengthening the intra-professional nursing response to resuscitations.</p><p><strong>Aim: </strong>The aim of this study was to explore junior and senior nurses' experience of guiding and being guided during resuscitations in the ICUs.</p><p><strong>Study design: </strong>A qualitative descriptive study was conducted in four ICUs of a tertiary hospital. Ten ICU nurses who have experience with guiding junior nurses or being guided during resuscitations were recruited and interviewed using semi-structured interviews. Interviews were transcribed verbatim and thematically analysed.</p><p><strong>Results: </strong>Three main themes emerged from the data. First, \"Under siege from all sides\" highlights the limitations and challenges faced by junior nurses, as observed by senior nurses. Particularly, competency gaps in executing resuscitative procedures resulted in them being under-performing team members during resuscitations. Second, \"Acts of guiding\" depicted how senior nurses guided junior nurses through passive observation or active participation, with either approach facilitating the junior nurse into the functional roles of a resuscitation. Lastly, \"Shouldering guiding responsibilities\" espoused the moral quagmire that senior nurses experience when they must manage the complexity of a resuscitation while simultaneously guiding the junior nurse.</p><p><strong>Conclusions: </strong>This study provides insights on the intra-professional experiences of nurses guiding and being guided during ICU resuscitations. Findings illuminate the need for leadership and clinical teaching capability building among senior nurses to create opportunistic learning during resuscitations for junior nurses.</p><p><strong>Relevance to clinical practice: </strong>More support is required for junior and senior nurses as they mount an attempt to revive the patient during resuscitations.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13301"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588066","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 workplace violence and occupational health in emergency nurses: The mediating role of dyssomnia.","authors":"Hao Zhang, Jing Zhou, Luying Zhong, Ling Zhu, Xiaoli Chen","doi":"10.1111/nicc.70008","DOIUrl":"10.1111/nicc.70008","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Violence in the workplace is a common concern within the health care field, particularly in the high-intensity, high-risk and high-stress environment of the emergency and critical care department. Workplace violence poses significant risks to their physical, psychological and sleep quality. Therefore, it is essential to explore the mechanisms through which workplace violence impacts the occupational health of emergency and critical care nurses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To explore how dyssomnia affects the relationship between workplace violence and emergency and critical care nurses' health, as well as to determine the degree of interaction between workplace violence, dyssomnia and somatic symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;This cross-sectional survey study included 1540 emergency and critical care nurses from 30 tertiary hospitals across 20 provinces and autonomous regions in mainland China, conducted between 26 December 2023 and 18 January 2024. Spearman correlation analysis was employed to evaluate the relationship among workplace violence, sleep disorders and somatic symptoms. A mediated structural equation model analysis was performed utilizing the Latent Moderated Structural Equations (LMS) method. In this manuscript, we adhered to the STROBE checklist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 85.0% (1309) of emergency and critical care nurses had experienced workplace violence in the preceding year, and 59.3% (913) had developed dyssomnia. Significant path coefficients were found for workplace violence on sleep (β = 0.333, 95% confidence interval = [0.276, 0.388], p &lt; .01), sleep on somatization symptoms (β = 0.572, p &lt; .01) and workplace violence on symptoms (β = 0.307, 95% confidence interval = [0.254, 0.359], p &lt; .01). The mediating effect of dyssomnia between workplace violence and somatization symptoms in emergency and critical care nurses accounted for 38% of the total effect, indicating a significant mediating effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Sleep disorders were found to mediate the link between workplace violence and somatic symptoms, suggesting that measures other than sleep-specific interventions are required to reduce the risk of somatization symptoms developing in emergency and critical care nurses. In addition, the conjunction effect of workplace violence and sleep highlighted the benefits of simultaneous and integrated interventions to mitigate health risks for nurses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Relevance to clinical practice: &lt;/strong&gt;The study's findings stress the importance of physical and mental health and sleep quality interventions for emergency and critical care nurses, given the strong connection between sleep disorders and workplace violence. Nursing administrators are encouraged to explore interventions such as individual counselling, a reasonable shift system and adequate time off for emergency and critical care nurses to alleviate sleep disorders, ultimately enhancing","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e70008"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617752","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":"Incidence, characteristics and influencing factors of medical adhesive-related skin injury in the indwelling urinary catheter attachment region in critically ill patients: A longitudinal study.","authors":"Oleci P Frota, Fabiana M Paula, Danielle N Ferreira, Marcos A Ferreira-Júnior, Elaine A R Domingues, Juliana Silva Ruiz, Fernanda Carvalho do Nascimento Gonçalves","doi":"10.1111/nicc.13253","DOIUrl":"10.1111/nicc.13253","url":null,"abstract":"<p><strong>Background: </strong>Medical adhesives are potentially harmful to the skin, depending on the patient's condition, the adhesive agent and the adhesive application and removal technique.</p><p><strong>Aim: </strong>The objective of the study was to determine the incidence, characteristics and influencing factors of medical adhesive-related skin injury from the indwelling urinary catheter attachment in critically ill patients.</p><p><strong>Study design: </strong>This is a longitudinal study. Data were collected in an adult intensive care unit of a university hospital, a sample size of 132. The socio-demographic and clinical data were obtained from the medical records. Skin exposed to indwelling urinary catheter adhesive tapes was examined daily by trained field researchers. The association between independent variables and medical adhesive-related skin injury was investigated by bivariate statistical analysis and multiple logistic regression.</p><p><strong>Results: </strong>The medical adhesive-related skin injury incidence was 28%. The association between independent variables and medical adhesive-related skin injury was mechanical (91.8%): skin peeling (56.7%), skin breakdown (18.9%) and tension injury or blister (16.2%); followed by irritant contact dermatitis (21.6%), with no statistical difference between the groups. More than one type of medical adhesive-related skin injury was concomitantly located in 16% of patients, with skin peeling present in all of these cases. The length of stay in the intensive care unit was an independent risk factor for medical adhesive-related skin injury (odds ratio [OR]: 1.072; 95% confidence interval [2.1-12.5]) and the Braden Scale score was a predictive factor (OR: 0.711; 95% CI: 0.3-49.3), with higher scores indicating lower risk.</p><p><strong>Conclusions: </strong>Medical adhesive-related skin injury at the indwelling urinary catheter fixation site is a relevant problem, its mechanical aetiology is predominant and most of the risk factors are modifiable.</p><p><strong>Relevance to clinical practice: </strong>This evidence contributes to the epidemiological and clinical knowledge of medical adhesive-related skin injury at the indwelling urinary catheter attachment site, as well as to recognizing the problem as relevant and implementing preventive care.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13253"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606406","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}