Nursing in Critical Care最新文献

{"title":"The Mediating Role of Spiritual Well-Being in the Relationship Between Spiritual Care Needs and Death Anxiety Among Coronary Intensive Care Patients.","authors":"Ebubekir Kaplan, Cemile Hürrem Ayhan, Çağlar Şimşek, Mehmet Cihad Aktaş, Türkan İstek","doi":"10.1111/nicc.70659","DOIUrl":"10.1111/nicc.70659","url":null,"abstract":"<p><strong>Background: </strong>Patients hospitalised in coronary intensive care units often experience heightened existential distress, including increased spiritual care needs and death anxiety. Spiritual well-being has been suggested as a key protective factor that may alleviate death-related anxiety in critically ill populations; however, the mechanisms underlying these relationships remain insufficiently explored.</p><p><strong>Aims: </strong>This study examined the relationships among spiritual care needs, spiritual well-being and death anxiety in patients hospitalised in a coronary intensive care unit and tested whether spiritual well-being mediates the relationship between spiritual care needs and death anxiety.</p><p><strong>Design: </strong>A cross-sectional design was employed.</p><p><strong>Methods: </strong>The study included a convenience sample of patients hospitalised in a coronary intensive care unit in Eastern Turkey, between September and December 2024. Data were collected using a Sociodemographic and Clinical Variables Form, the Patients' Spiritual Needs Assessment Scale, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale and the Templer Death Anxiety Scale. Data analysis involved descriptive statistics, Pearson correlation analysis and mediation analysis using Hayes's PROCESS macro (Model 4), with age and gender included as control variables.</p><p><strong>Results: </strong>Patients reported moderate levels of spiritual care needs (3.04 ± 0.47), spiritual well-being (30.53 ± 6.87) and death anxiety (8.04 ± 3.00). Spiritual care needs were positively associated with spiritual well-being (r = 0.56, p < 0.001) and its subdimensions (meaning, peace and faith). Death anxiety was negatively correlated with spiritual well-being (r = -0.32, p < 0.001), with the strongest association observed for the peace subdimension (r = -0.39, p < 0.001). Mediation analysis demonstrated a significant indirect effect of spiritual care needs on death anxiety through spiritual well-being (b = -1.46, 95% CI [-2.28, -0.67]). Although higher spiritual care needs were directly associated with greater death anxiety, they were also associated with higher spiritual well-being, which in turn was related to lower death anxiety, suggesting that spiritual well-being may buffer the association between spiritual care needs and death anxiety.</p><p><strong>Conclusions: </strong>Higher spiritual care needs among coronary intensive care patients are associated with greater spiritual well-being, which in turn relates to lower levels of death anxiety. The significant indirect effect suggests that spiritual well-being plays a buffering role in the relationship between spiritual care needs and death anxiety. Given the cross-sectional design, these findings should be interpreted as associative rather than causal.</p><p><strong>Relevance to clinical practice: </strong>Assessing spiritual care needs and supporting spiritual well-being in corona","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70659"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882518","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}

{"title":"Reducing Night-Time Sound Levels Through Bed-Level Quiet ICU Bundle: A Randomised Counterbalanced Crossover Study in Adult Intensive Care.","authors":"Wei Jun Dan Ong, Adrian Ujin Yap, Woon Hean Keenan Chong, Lawrence Ace Azul, Patricia Leong, Faheem Ahmed Khan","doi":"10.1111/nicc.70633","DOIUrl":"10.1111/nicc.70633","url":null,"abstract":"<p><strong>Background: </strong>Elevated night-time noise in intensive care units (ICUs) may reduce alarm salience, increase cognitive workload and contribute to alarm desensitisation during bedside surveillance. Most evaluations of Quiet ICU interventions have used uncontrolled or quasi-experimental designs, limiting causal inference.</p><p><strong>Aim: </strong>To evaluate whether a structured bed-level Quiet ICU bundle reduced nocturnal acoustic burden in an adult ICU while preserving alarm visibility for clinical surveillance.</p><p><strong>Study design: </strong>This prospective, randomised counterbalanced crossover study was conducted in an adult intensive care unit in Singapore. Eligible bed-episodes were assigned to one of two 4-night sequences: AABB or BBAA, where A represented usual care and B represented Quiet ICU. The Quiet ICU bundle included muting bedside ventilator and monitor alarm audio while maintaining central alarm visibility, alongside alarm-hygiene measures and quieter communication. Acoustic monitoring was performed overnight from 10:00 PM to 6:00 AM. The primary outcome was equivalent continuous sound level (LAeq); secondary outcomes were maximum sound level (Lmax) and time above 80 dBA. Repeated bed-night observations were analysed using linear mixed-effects models.</p><p><strong>Results: </strong>Sixty-nine monitored bed-episodes contributed 220 analysed nights. Compared with usual care, Quiet ICU reduced LAeq (adjusted mean difference -4.56 dBA, 95% CI -5.69 to -3.43; p < 0.001), Lmax (-7.77 dBA, 95% CI -9.47 to -6.06; p < 0.001) and time above 80 dBA (-2.43 min, 95% CI -3.63 to -1.23; p < 0.001). The LAeq reduction was likely noticeable in practice. Bedside alarm audio was reactivated on 2 of 113 Quiet ICU nights (1.8%). No safety incidents were identified.</p><p><strong>Conclusions: </strong>A structured bed-level Quiet ICU bundle reduced night-time acoustic burden while preserving central alarm visibility. Effects on alarm response, staff workload and patient outcomes remain uncertain.</p><p><strong>Relevance to clinical practice: </strong>In ICUs with reliable central monitoring and clear alarm-governance processes, a Quiet ICU bundle may offer a feasible, low-resource strategy to reduce bedside noise.</p><p><strong>Study registration: </strong>OSF Registries; DOI: 10.17605/OSF.IO/AM59F.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70633"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13467657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723773","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":"Research Confidence of Critical Care Nurses: A Mixed Methods Preliminary Study.","authors":"Mary Grace Anne P Batalla, Jeffrey R Salazar","doi":"10.1111/nicc.70651","DOIUrl":"10.1111/nicc.70651","url":null,"abstract":"<p><p>Gaining competencies in the research process is difficult and labour-intensive, especially if the nurse has no prior experience in research engagement. The aim of this paper was to examine the research confidence of critical care nurses. This preliminary study utilised a mixed methods design. Critical care nurses working in the United Kingdom participated in the study. A survey questionnaire and focus group discussions (FGD) were used to collect data. Findings showed that nurses had moderate levels of confidence in research skills. Thematic analyses of FGD responses highlighted the organisational barriers to and the role of the research link nurse in increasing nurses' confidence in research activities. As such, healthcare organisations should take steps to boost confidence in research. Nurses who feel confident in engaging and participating in research activities are ideally positioned to maximise the benefits of research in clinical practice.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70651"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841901","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 Role of Machine Learning and Artificial Intelligence in Enhancing Critical Care Nursing Practice: A Scoping Review.","authors":"Omar Alqaisi, Suhair Al-Ghabeesh, Mohammed Dibas, Lorent Sijarina, Patricia Tai","doi":"10.1111/nicc.70629","DOIUrl":"10.1111/nicc.70629","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) and machine learning (ML) are emerging as transformative tools in healthcare, with significant potential to enhance nursing practice, particularly in intensive care units (ICUs). ICUs pose complex challenges, including high patient acuity, ICU delirium, and nurse workload. These factors demand innovative technological solutions.</p><p><strong>Aim: </strong>This scoping review comprehensively explores the current picture of AI and ML applications in critical care nursing, focusing on decision support systems, predictive analytics, workflow automation, and patient engagement tools.</p><p><strong>Methods: </strong>A search of Four databases (Scopus, PubMed/MEDLINE, Science Direct, and CINAHL) was conducted for original peer-reviewed studies published between January 2019 and September 2025. The 2019 start date was selected to capture the contemporary wave of AI applications in critical care nursing, coinciding with the documented exponential growth in AI-related ICU publications following widespread EHR adoption and the maturation of deep learning architectures.</p><p><strong>Results: </strong>Five key themes were identified: predictive analytics and early warning systems, clinical decision-support tools, automation and workflow enhancements, monitoring combined with human-AI collaboration, and implementation challenges. Findings reveal that AI can reduce administrative burden and improve care quality. However, significant gaps persist, especially in evaluating long-term outcomes, nurse involvement, and ethical implementation.</p><p><strong>Conclusion: </strong>This scoping review provides a contemporary, integrated thematic synthesis of machine learning and AI applications in critical care nursing. While not claiming absolute novelty, this review addresses a distinct and timely gap by simultaneously mapping predictive analytics, clinical decision support, workflow automation, and implementation challenges within a single evidence synthesis.</p><p><strong>Relevance to clinical practice: </strong>AI and machine learning may support critical care nurses by facilitating earlier recognition of patient deterioration, strengthening clinical decision-making, and reducing repetitive workload. Successful implementation requires nurse involvement in system design, appropriate training, transparent algorithms, and integration with existing clinical workflows.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70629"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814179","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":"Wearable Sleep and Circadian Monitoring in Intensive Care Nursing: A Scoping Review.","authors":"Walaa Badawy, Mostafa Shaban","doi":"10.1111/nicc.70671","DOIUrl":"10.1111/nicc.70671","url":null,"abstract":"<p><strong>Background: </strong>Sleep and circadian disruption are common in critical illness, yet bedside assessment remains difficult. Wearables are unobtrusive and extend observation across 24 h, but their measurement performance in critical illness requires appraisal.</p><p><strong>Aims: </strong>To map wearable sleep and circadian monitoring during intensive care, its measurement performance, clinical applications and nursing implications.</p><p><strong>Study design: </strong>A scoping review followed JBI and PRISMA-ScR guidance. PubMed, Europe PMC and OpenAlex were searched from inception to 22 July 2026, with citation searching. Eligible primary reports used a body-worn sensor during intensive care to estimate sleep or circadian/rest-activity outcomes at any age. Conventional polysomnography/electroencephalography without an eligible wearable, non-contact systems, staff studies and post-ICU-only monitoring were excluded. No risk-of-bias appraisal was undertaken.</p><p><strong>Results: </strong>Sixty-one reports (43 adult; 18 paediatric/neonatal; 1996-2026) were included. Actigraphy dominated; commercial trackers, smartwatches and one respiratory-belt/heart-rate-variability system were less common. Monitoring was feasible, but performance varied by device, patient state and age group: wake specificity was often poor in ventilated, sedated or immobile patients and agreement with patient or nurse reports was weak to modest. Records showed fragmented and daytime sleep, weak day-night consolidation and attenuated circadian rhythmicity. Nursing bundles, massage, positioning, light and chronotype-informed care changed selected outcomes, but effects were heterogeneous.</p><p><strong>Conclusions: </strong>Wearables usefully describe rest-activity patterns and support nursing assessment, but agreement with physiological sleep varied by device, patient state and age; movement-derived estimates need clinical context and are not a stand-alone sleep measure.</p><p><strong>Relevance to clinical practice: </strong>Nurses should combine wearable trends with patient report, sedation and mobility, delirium screening and care-interaction records; escalation thresholds require prospective validation.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70671"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889329","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":"Analysis of Factors Influencing Downtime During Continuous Renal Replacement Therapy in Critically Ill Patients and Construction of a Prediction Model.","authors":"Bingbing Pang, Jie Zhang, Yanshuo Wu, Qiaoju Kang, Kaihua Dong, Suzhi Guo, Yanling Yin","doi":"10.1111/nicc.70664","DOIUrl":"10.1111/nicc.70664","url":null,"abstract":"<p><strong>Background: </strong>Prolonged CRRT downtime compromises treatment efficacy and worsens outcomes. Daily downtime > 20% exacerbates acidosis and is associated with 28-day mortality.</p><p><strong>Aims: </strong>This study aimed to develop and validate a bedside-accessible nomogram for early identification of treatment days at risk of suboptimal CRRT downtime control in critically ill patients.</p><p><strong>Study design: </strong>This retrospective cohort study was conducted in one Chinese ICU (January 2019-December 2023). The binary outcome was cumulative downtime > 2.4 h per standardised treatment day. Variables included demographics, laboratory parameters, CRRT circuit and other treatment factors. GEE identified predictors; the model was displayed as a nomogram and assessed by AUC, calibration and decision curve analysis.</p><p><strong>Results: </strong>A total of 145 patients contributing 595 CRRT treatment days were included. Total treatment time was 14 280 h and cumulative downtime was 1725.07 h. Mean daily downtime was 2.90 ± 2.72 h (12.08% ± 11.35% of treatment time). Suboptimal CRRT downtime control occurred on 232 treatment days (39.0%). Multivariable GEE analysis identified five independent risk factors for suboptimal downtime control: daily number of filter replacements (OR = 2.629, 95% CI 1.822-3.794, p < 0.001), agitation (OR = 2.331, 95% CI 1.041-5.218, p = 0.040), plasma exchange (OR = 4.654, 95% CI 1.042-20.782, p = 0.044), catheter dysfunction (OR = 10.528, 95% CI 2.939-37.710, p < 0.001) and out-of-unit transport for procedures (OR = 7.563, 95% CI 2.663-21.484, p < 0.001). The nomogram yielded AUCs of 0.789 (95% CI 0.726-0.841), 0.813 (95% CI 0.725-0.897) and 0.835 (95% CI 0.768-0.896) in the training, internal validation and external validation sets, respectively.</p><p><strong>Conclusions: </strong>Daily number of filter replacements, agitation, plasma exchange, catheter dysfunction and out-of-unit transport are independent risk factors for suboptimal CRRT downtime control. This nomogram showed satisfactory discrimination, calibration and net clinical benefit in internal and external validation, offering ICU nurses a rapid bedside risk assessment tool.</p><p><strong>Relevance to clinical practice: </strong>ICU nurses can use this nomogram at CRRT initiation to identify high-risk patients and prioritise bedside procedures, sedation, catheter care and filter longevity to reduce downtime.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70664"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841951","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 Digital Psychoeducation and ICU Delirium Care Bundle Programmes on Nurses' Competency, Confidence and Care-Related Strain: A Systematic Review and Narrative Synthesis.","authors":"Baraa I Aldayyat, Ekhlas Al Gamal, Jafar A Alshraideh, Rabia H Haddad","doi":"10.1111/nicc.70645","DOIUrl":"10.1111/nicc.70645","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Delirium is a common and serious complication among critically ill patients, affecting approximately 20%-80% of ICU populations and contributing to increased mortality, prolonged mechanical ventilation, extended hospital stays, cognitive impairment and higher healthcare costs. Nurses play a central role in delirium prevention, assessment and management; however, deficiencies in delirium-related knowledge, confidence and assessment practices remain widespread. Digital psychoeducation and delirium care bundle interventions have been increasingly implemented to address these gaps.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To systematically review and narratively synthesize evidence regarding the effects of digital psychoeducation and ICU delirium care bundle programmes on nurses' competency, confidence and care-related strain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A systematic review with narrative synthesis was conducted in accordance with PRISMA 2020 and SWiM guidance. Six electronic databases (PubMed, CINAHL, Scopus, Web of Science, Embase and ProQuest) were searched. Eligible studies included quasi-experimental, pre-post and quality-improvement studies evaluating delirium-focused educational or care bundle interventions among ICU nurses. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eight studies involving approximately 472 nurses from five countries met the inclusion criteria. Competency outcomes improved in 87.5% of studies, with delirium knowledge increasing by 100%-150%, CAM-ICU assessment accuracy reaching 95.5%, documentation completeness exceeding 91% and bundle compliance reaching 97.5%. Confidence improved across all studies evaluating this outcome, with increases ranging from 35.3 to 60.1 percentage points, including one study reporting a very large effect size (Cohen's d = 2.31). The only study assessing care-related strain demonstrated a 48.8% reduction in delirium-related nursing stress. Overall, educational interventions were associated with improved clinical practice indicators, although implementation varied across healthcare settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Digital psychoeducation and ICU delirium care bundle programmes consistently improve nurses' delirium-related competency and confidence and may reduce care-related strain. However, evidence regarding strain remains limited, and variability in clinical implementation highlights the need for more rigorous controlled studies and long-term evaluations to strengthen the evidence base.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Relevance to clinical practice: &lt;/strong&gt;Integrating digital delirium education programmes and structured care bundles into ICU nursing practice can improve nurses' competency, confidence and adherence to evidence-based delirium assessment, supporting earlier recognition and higher quality patient care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/stro","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70645"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814996","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":"Severity and Associated Factors of Alarm Fatigue Among Intensive Care Unit Nurses: A Systematic Review and Meta-Analysis.","authors":"Ling Zhu, Siying Wei, Yawen An, Wenjun Hu, Xiaofeng Xie","doi":"10.1111/nicc.70666","DOIUrl":"10.1111/nicc.70666","url":null,"abstract":"<p><strong>Background: </strong>Alarm fatigue is a critical concern in intensive care units (ICUs), affecting nurse well-being and patient safety. It may reflect interacting conditions within the clinical work system, yet evidence on its severity and associated factors among ICU nurses remains fragmented.</p><p><strong>Aim: </strong>To synthesise evidence on alarm fatigue severity and associated factors among ICU nurses.</p><p><strong>Study design: </strong>Eleven databases were searched from inception to July 2025. Observational studies assessing alarm fatigue among ICU nurses using measurement tools with reported reliability were included. A random-effects meta-analysis was performed for alarm fatigue severity, stratified by instrument; associated factors and adverse outcomes were synthesised narratively using direction-of-association plots.</p><p><strong>Results: </strong>A total of 28 studies involving 6908 ICU nurses were included, of which 27 reported alarm fatigue scores. For the Iranian Alarm Fatigue Questionnaire, the most common instrument, the pooled mean was 26.12 (95% CI: 23.94-28.30). Heterogeneity was extremely high (I² ≈98%) and was not meaningfully explained by subgroup analyses or meta-regression. Directional evidence suggested that higher alarm fatigue was associated with a greater tendency towards medical errors and higher levels of burnout. Evidence on associated factors was mostly inconsistent or non-significant, with studies focusing mainly on person- and organisation-level factors. Poorer health, secondary traumatic stress, false alarms and lower trust in alarms tended to show adverse directional signals, whereas job satisfaction, resilience, alarm management support and a better nursing work environment showed potentially protective signals.</p><p><strong>Conclusions: </strong>Alarm fatigue among ICU nurses appeared to show a moderate tendency overall, although findings should be interpreted cautiously because of substantial heterogeneity. Evidence on associated factors remains scattered, with task-, technology- and environment-related factors comparatively underexplored.</p><p><strong>Relevance to clinical practice: </strong>Alarm fatigue may be usefully considered from a clinical work-system perspective. Greater attention to task, technology and environmental factors may inform future practice improvement. REVIEW REGISTRATION: Prospero registration number: CRD42024565806.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70666"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882453","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":"Eating Habits of Surgical Intensive Care Nurses During Shifts: A Mixed-Methods Investigation of Food Craving, Acceptance and Eating Behaviours.","authors":"Esra Özkan, Belgin Şen Atasayar","doi":"10.1111/nicc.70643","DOIUrl":"10.1111/nicc.70643","url":null,"abstract":"<p><strong>Background: </strong>Shift-based work is a fundamental component of surgical intensive care nursing and has significant effects on health-related behaviours, particularly nutrition. Irregular working hours, high workload and limited access to healthy food options may contribute to unhealthy eating patterns among nurses.</p><p><strong>Aim: </strong>This study aimed to explore food craving, food acceptance and eating behaviours among surgical intensive care nurses during shift work using a mixed-methods approach in two hospitals located in northern Türkiye.</p><p><strong>Study design: </strong>The study employed a concurrent sequential nested quantitative-qualitative mixed-methods design. Quantitative data were collected using a Personal Information Form, the Food Craving Questionnaire, the Acceptance of Food Craving Scale and the Eating Behaviour Scale and were analysed using descriptive and inferential statistics. Subsequently, semi-structured interviews were conducted with a purposively selected group of nurses. The qualitative data were analysed using thematic analysis, and the findings were integrated with the quantitative results through triangulation to provide a more comprehensive understanding of nurses' eating habits during shift work.</p><p><strong>Results: </strong>Quantitative findings from 159 surgical intensive care nurses indicated moderate levels of food acceptance and willingness towards available food options, alongside difficulties in maintaining regular and balanced nutrition during shifts. These patterns were further explained by qualitative findings from 16 nurses, which revealed that irregular meal patterns were commonly experienced due to shift schedules, high workload and fatigue. Limited access to nutritious and affordable food options was also identified as an additional barrier, providing contextual understanding for the quantitative results and explaining the observed eating behaviour patterns.</p><p><strong>Conclusions: </strong>Shift work is associated with changes in eating behaviours among surgical intensive care nurses. Both environmental and organisational factors play a critical role in shaping nurses' nutritional practices.</p><p><strong>Relevance to clinical practice: </strong>Improving access to healthy food options and ensuring structured meal opportunities may support nurses' well-being and contribute to sustainable workforce performance and quality of care.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"31 5","pages":"e70643"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889326","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}