Nursing in Critical Care最新文献

{"title":"Improving Intensive Care Unit Nurses' Delirium Assessment Performance Through a Multimodal Educational Intervention.","authors":"Rui-Ling Chang, Shu-Fen Siao, Shih-Chi Ku, Yu-Chang Yeh, Yu-Chun Chang, Cheryl Chia-Hui Chen","doi":"10.1111/nicc.70168","DOIUrl":"10.1111/nicc.70168","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a prevalent and serious ICU complication, particularly in elderly or ventilated patients. Accurate assessment is crucial but often inconsistent. Intensive care unit (ICU) nurses' use of the Intensive Care Delirium Screening Checklist (ICDSC) may be limited without structured training.</p><p><strong>Aim: </strong>To evaluate the delirium assessment performance of ICU nurses using ICDSC and assess the effectiveness of a multimodal educational intervention for performance enhancement.</p><p><strong>Study design: </strong>This pre- and post-intervention study was conducted in three medical ICUs in Northern Taiwan. The delirium assessment performance of ICU nurses using ICDSC was evaluated, followed by a three-month multimodal educational intervention aimed at improving assessment performance. Each nurse's ICDSC assessment was paired with an independent assessment by a trained expert nurse. To ensure representation that reflects the true performance level, accounting for variations in nurses' working shifts, weekday and weekend staff ratios and sampling fairness across the three MICU units, the pairings were made using a three-step randomization process, managed by an independent third party. A 3-month multimodal educational intervention, including didactic lectures, difficult scenario reviews and one-to-one bedside mentoring, was implemented afterward. Inter-rater agreement before and after the intervention was assessed using Cohen's kappa and Gwet's AC1 statistics.</p><p><strong>Results: </strong>The baseline agreement between ICU nurses and the expert nurse was suboptimal (kappa = 0.63, 95% CI: 0.57-0.70). The multimodal educational intervention was well-received by the units, particularly among new nurses. Following the intervention, kappa significantly improved to 0.74 (95% CI: 0.69-0.80). Notable improvements were observed in key items of ICDSC, including the assessment of altered level of consciousness, inattention, disorientation, psychomotor agitation or retardation, and sleep-wake cycle disturbances. However, agreement remained poor for certain patient populations, especially those aged over 85 years and those subjected to physical restraint.</p><p><strong>Conclusions: </strong>A structured, multimodal educational intervention significantly improved the delirium assessment performance of ICU nurses using the ICDSC. One-to-one coaching and scenario-based learning were particularly effective in enhancing clinical assessment skills. However, additional strategies may be required to address persistent challenges in assessing very elderly patients and those subjected to physical restraint.</p><p><strong>Relevance to clinical practice: </strong>A structured, multimodal educational intervention can substantially enhance the performance of ICU nurses in delirium screening using the ICDSC. Tailored training strategies may help bridge the knowledge-practice gap, leading to more reliable clinical assessments ","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70168"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016641","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":"Dose-response analysis of music intervention for improving delirium in intensive care unit patients: A systematic review and meta-analysis.","authors":"Rong-Sian Dai, Tsuei-Hung Wang, Shao-Yun Chien, Ya-Ling Tzeng","doi":"10.1111/nicc.13230","DOIUrl":"10.1111/nicc.13230","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a common and severe condition among adult intensive care unit (ICU) patients. Music intervention, as a non-pharmacological approach, has the potential to reduce delirium, but the optimal dosage and type of intervention remain unclear.</p><p><strong>Aim: </strong>To explore the effects of music intervention at different doses and types on reducing delirium in ICU patients.</p><p><strong>Study design: </strong>This study was conducted as a systematic review and meta-analysis. Databases including Cochrane Library, EBSCO, Embase, PubMed, Web of Science, Airiti Library, China National Knowledge Infrastructure and Wanfang Data were searched until 29 February 2024. Study quality was assessed using the Cochrane Risk of Bias 2.0 criteria. Data were analysed using RevMan 5.4.1 and Comprehensive Meta-Analysis 3.0.</p><p><strong>Results: </strong>Fourteen studies involving 1434 ICU patients were included. Four studies were of good quality (low risk of bias), seven were of moderate quality (unclear risk) and three were of low quality (high risk). Pooled analysis showed that music interventions significantly reduced the risk of delirium (12 studies, RR = .49, 95% confidence interval [CI] [.40, .61]). Slow-tempo music had the strongest effect (11 studies, RR = .46, 95% CI [.37, .57]). The optimal intervention dosage involves conducting music interventions twice daily (12 studies, RR = .46, 95% CI [.34, .63]), with each session lasting 30 min (12 studies, RR = .41, 95% CI [.30, .55]). Additionally, a pooled analysis showed that a 7-day music intervention (6 studies, RR = .43, 95% CI [.26, .71]) was the most effective in reducing the risk of delirium.</p><p><strong>Conclusions: </strong>Music intervention reduces delirium in ICU patients, especially with two 30-min sessions daily for 7 days. However, the certainty of evidence is low, highlighting the need for further high-quality research.</p><p><strong>Relevance to clinical practice: </strong>Music intervention is a simple, non-invasive method that may help reduce delirium in ICU patients. However, given the low certainty of the current evidence, it should be used cautiously, and further research is needed to validate its effectiveness before routine implementation.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13230"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034720","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":"Prevalence of and risk factors analysis for post-intensive care syndrome among survivors of critical care during 3-month longitudinal follow-up.","authors":"Shuang Gao, Xifeng Liang, Yaning Lyu, Xiuping Zhang, Liwen Zhang","doi":"10.1111/nicc.13242","DOIUrl":"10.1111/nicc.13242","url":null,"abstract":"<p><strong>Background: </strong>Patients discharged from the intensive care unit (ICU) can experience post-intensive care syndrome (PICS), which is comprised of cognitive, physical and psychological impairments.</p><p><strong>Aim: </strong>The objective of this study was to identify the prevalence of and risk factors associated with all three domains of PICS at the first and third month after ICU discharge.</p><p><strong>Design: </strong>A prospective descriptive-analytic study was conducted in two ICUs of a Chinese university hospital. We used the Healthy Aging Brain Care Monitor Self-Report Chinese version, a scale from 1 to 57, with 57 indicating the worst outcome, to comprehensively assess PICS at the first and third month follow-ups after patients left the ICU. We performed an analysis of stepwise multiple linear regression to explore the relationship between risk factors and PICS.</p><p><strong>Results: </strong>We enrolled 654 and 584 participants at the first- and third-month follow-ups, respectively. More than 60% of patients experienced different degrees of PICS, with the most severe impairment being in the physical domain. We classified risk factors associated with PICS, categorized as patient-related, disease-related, and ICU-related factors. Among these risk factors, only being the main income provider for the family, the diagnosis of digestive system disease, trauma and the number of invasive catheters at ICU discharge significantly predicted PICS at both follow-ups. ICU-related risk factors should be given greater attention, given their potential for modification.</p><p><strong>Conclusions: </strong>The prevalence and severity of PICS were high in this population after their ICU stay. ICU nurses and medical staff members should collaborate to pay more attention to the comprehensive risk factors and implement targeted preventive measures.</p><p><strong>Relevance to clinical practice: </strong>ICU staff must have a holistic view of PICS and a comprehensive understanding of its risk factors to proactively evaluate patients at high risk of PICS upon admission to the hospital.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13242"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985415","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":"Effectiveness of non-pharmacological interventions to prevent enteral nutrition intolerance in ICU patients: A network meta-analysis.","authors":"Ni Yang, Yuan Xu, Xinyi Zhou, Shuli Guo, Haibo Deng, Jianhua Sun, Ying Liu, Manna Shao, Yufen Ma","doi":"10.1111/nicc.13226","DOIUrl":"10.1111/nicc.13226","url":null,"abstract":"<p><strong>Background: </strong>Enteral nutrition is beneficial for improving the clinical outcomes of intensive care unit patients. However, enteral nutrition intolerance is a common complication in intensive care unit patients undergoing enteral nutrition.</p><p><strong>Aim: </strong>We aimed to assess the effectiveness of non-pharmacological interventions in preventing enteral nutrition intolerance in intensive care unit patients and to identify the optimal non-pharmacological interventions.</p><p><strong>Study design: </strong>Seven databases were searched to obtain randomized controlled trials involving non-pharmacological interventions to prevent enteral nutrition intolerance in intensive care unit patients. Network meta-analysis was performed using Stata18.0 software, and the integrated data were investigated with odds ratio (OR) and 95% confidence interval (95% CI).</p><p><strong>Results: </strong>A total of 16 randomized controlled trials involving 10 non-pharmacological interventions and 1765 intensive care unit patients were included. Compared with routine enteral nutrition care, network meta-analysis showed that bundled care [OR = 0.93, 95% CI (0.32-1.53)] (p = .003), intra-abdominal pressure monitoring [OR = 1.68, 95%CI (1.19-2.16)] (p < .001), acupuncture [OR = 2.69, 95%CI (1.64-3.73)] (p < .001), pectin-added intermittent enteral nutrition [OR = 1.13, 95%CI (0.48-1.77)] (p = .001), multidisciplinary nutritional treatment model [OR = 1.98, 95%CI (0.87-3.10)] (p < .001), abdominal massage [OR = 2.42, 95%CI (1.50-3.34)] (p < .001) and intermittent feeding with semisolid nutrients [OR = 2.08, 95%CI (0.19-3.97)] (p = .031) were effective in preventing enteral nutrition intolerance in intensive care unit patients. The ranking probabilities of the interventions indicated that acupuncture (89.4%) was the optimal non-pharmacological intervention for preventing enteral nutrition intolerance in intensive care unit patients, followed by abdominal massage (83.4%).</p><p><strong>Conclusions: </strong>Acupuncture and abdominal massage are recommended to prevent enteral nutrition intolerance in intensive care unit patients. Moreover, more high-quality trials are needed to investigate the reliability of evidence levels for different non-pharmacological interventions.</p><p><strong>Relevance to clinical practice: </strong>This study provided evidence for intensive care nurses that acupuncture is the optimal intervention to improve enteral nutrition intolerance in intensive care unit patients among the 10 interventions. However, unique clinical circumstances should be considered. Therefore, we recommend that intensive care nurses also use abdominal massage when acupuncture is not available.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13226"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015600","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":"40 Years of the BACCN-Reflections From a Longstanding National Board Member.","authors":"Catherine Plowright","doi":"10.1111/nicc.70198","DOIUrl":"https://doi.org/10.1111/nicc.70198","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70198"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193719","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":"Association Between Glasgow Coma Scale Trajectory and In-Hospital Mortality in Traumatic Brain Injury in the ICU: A Retrospective Cohort Study.","authors":"Yangchun Zhang, Feng Chen, Na Ma, Cairong Liu, Xufeng Chen, Xueli Ji","doi":"10.1111/nicc.70139","DOIUrl":"10.1111/nicc.70139","url":null,"abstract":"<p><strong>Background: </strong>Glasgow Coma Scale (GCS) is fundamental for neurological assessment in traumatic brain injury (TBI) patients. Traditional single-point GCS measurements fail to capture the dynamic nature of brain injury progression, limiting nurses' ability to identify at-risk patients and implement timely interventions.</p><p><strong>Aims: </strong>To investigate the dynamic trajectories of the GCS during the first 24 h in ICU and their association with in-hospital mortality in adult TBI patients, providing evidence for nursing neurological assessment and care planning.</p><p><strong>Results: </strong>Five distinct GCS trajectory groups were identified: stable low level (G1, 3-8 points), stable intermediate level (G2, 9-12 points), stable medium-high level (G3, around 13 points), stable high level (G4, close to 15 points) and increasing (G5, from medium to medium-high level). Compared to G1, in-hospital mortality was significantly reduced in all other groups (G2-G5). Significant interactions were found between GCS trajectories and both age and heart failure status (all interaction p < 0.05), indicating these factors modified the relationship between GCS patterns and mortality.</p><p><strong>Conclusion: </strong>Dynamic GCS trajectory analysis provides superior prognostic information compared to static assessments. Age and heart failure significantly modify the relationship between GCS patterns and mortality outcomes, requiring careful consideration in nursing assessment of TBI patients.</p><p><strong>Relevance to clinical practice: </strong>These findings enable nurses to recognise neurological evolution patterns rather than relying on isolated measurements. Trajectory analysis helps identify high-risk patients requiring vigilant monitoring and those showing improvement patterns suitable for rehabilitation consideration. Particularly in elderly and heart failure patients, GCS trajectories should be interpreted with caution, as similar patterns may have different prognostic implications. Incorporating trajectory pattern recognition enhances care planning, resource allocation and team communication across shifts.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70139"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856942","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":"Turkish Reliability and Validity of the Intensive Care Unit Specific Pressure Injury Risk Assessment Scale (RAPS-ICU): A Tool Validation.","authors":"Sabahat Göncü, Emine Kir Bicer","doi":"10.1111/nicc.70176","DOIUrl":"10.1111/nicc.70176","url":null,"abstract":"<p><strong>Background: </strong>Pressure injuries are a major concern in intensive care units (ICUs), as critically ill patients are at high risk due to immobility and compromised health conditions. Accurate and reliable risk assessment tools, such as the Risk Assessment Pressure Injury Scale for the Intensive Care Unit (RAPS-ICU), are essential for early detection and prevention of pressure injuries in clinical practice.</p><p><strong>Aim: </strong>This study aimed to determine the Turkish validity and reliability of the RAPS-ICU.</p><p><strong>Study design: </strong>This was a tool validation study conducted with 62 patients hospitalised in the ICU of a Training and Research Hospital in Turkey. The RAPS-ICU was translated into Turkish, and its construct validity was evaluated using the content validity ratio (CVR) and content validity index (CVI). Further validation involved exploratory and confirmatory factor analyses (EFA, CFA). Reliability was assessed through internal consistency, inter-rater reliability, item-total correlation, and test-retest reliability.</p><p><strong>Results: </strong>The Kaiser-Meyer-Olkin (KMO) value for the scale was 0.804, indicating sample adequacy. All item discrimination values were above 0.20, with factor loadings between 0.35 and 0.90. Cronbach's alpha coefficient was 0.825. Standard factor loadings ranged from 0.23 to 0.93, with root mean square error of approximation (RMSEA) = 0.086, comparative fit index (CFI) = 0.98, normed fit index (NFI) = 0.94, goodness-of-fit index (GFI) = 0.93, and standardised root mean square residual (SRMR) = 0.061. The CVI was 0.88, and the CVR exceeded the criterion value. The test-retest reliability coefficient was 0.933, and inter-rater reliability ranged from 0.78 to 0.87.</p><p><strong>Conclusions: </strong>The Turkish version of the RAPS-ICU demonstrated established validity and reliability.</p><p><strong>Relevance to clinical practice: </strong>The validated Turkish version of the RAPS-ICU provides a reliable and accurate tool for assessing pressure injury risk in intensive care settings. Its high reliability and validity support its use in clinical practice to enhance early detection and prevention strategies, ultimately improving patient outcomes. By integrating the RAPS-ICU into routine assessments, intensive care nurses can make more informed decisions regarding pressure injury prevention, optimising nursing care planning and patient safety in Turkish ICUs.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70176"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056091","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":"What Emergency Severity Index Can Do and Scoring Systems Cannot Do?: Commentary for \"Early prediction of sepsis in emergency department patients using various methods and scoring systems\" by Song et al.","authors":"Amir Mirhaghi","doi":"10.1111/nicc.70137","DOIUrl":"https://doi.org/10.1111/nicc.70137","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70137"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066227","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":"Patient Handover From the Cardiac Surgery Operating Room to the Critical Care Unit: A Prospective Observational Study.","authors":"Nihal Celikturk Doruker, Fatma Demir Korkmaz, Asli Sarp","doi":"10.1111/nicc.70154","DOIUrl":"10.1111/nicc.70154","url":null,"abstract":"<p><strong>Background: </strong>Incomplete and inaccurate information transfer during the patient handover process has many risks, such as disruption of postoperative care and complications. Therefore, effective patient handover is essential.</p><p><strong>Aim: </strong>This study aimed to evaluate the handover of patients from the cardiac surgery operating room to the critical care unit by examining the type of information transferred, healthcare workers' roles during handover, handover time and frequency of interruptions.</p><p><strong>Study design: </strong>This is a prospective observational study. The sample of this study consisted of the handover process of 85 cardiac surgery patients at a university hospital, Izmir, Turkey, between January and June 2023.</p><p><strong>Results: </strong>In this study, it was found that the cardiac surgery team gave more information about systolic/mean arterial blood pressure goals/limits (95.3%), cross-clamp time (95.3%) and surgical procedure (94.1%). The anaesthesia team provided more information about arterial blood gas results (96.5%), and recently administered antibiotics (95.3%). While the surgical residents performed 100% of the patient handovers of the cardiac surgery team, 80% of the patients were only received by the critical care physician. In the anaesthesia team, 97.6% of the patient handovers were performed by the anaesthesia residents, while 81.2% of the patients were received by the critical care physician alone.</p><p><strong>Conclusions: </strong>This study found that the cardiac surgery team provided more information about the surgical and intraoperative procedures. The anaesthesia team provided more information about the monitoring of the patient's condition and the drugs administered. The most striking finding of the study was that few nurses were involved in most patient handovers. In line with the results of this study, it is recommended to conduct intervention studies to increase nurse participation in patient handover processes and to comparatively examine the effectiveness of handover models involving different disciplines.</p><p><strong>Relevance to clinical practice: </strong>This study provided a comprehensive evaluation of the handover process of cardiac surgery patients. The findings emphasise the need to establish protocols to overcome knowledge deficiencies in the patient handover process and to ensure the active participation of nurses in this process.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70154"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977910","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":"Prediction Models for Postoperative Delirium in Patients With Stanford Type A Aortic Dissection: A Systematic Review and Meta-Analysis.","authors":"Chenyang Zhu, Shuming Qi, Yixiang Wang, Yuxia Yang, Rongxiang Zhang, Feng Tian, Shiqi Chen, Yuan Chen","doi":"10.1111/nicc.70172","DOIUrl":"10.1111/nicc.70172","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a prevalent neurological complication following Stanford type A aortic dissection (STAAD), significantly impacting patient prognosis and cognitive function. While the number of models predicting POD risk in STAAD patients has been steadily rising, their quality and clinical applicability, as well as their potential utility in future research, remain uncertain.</p><p><strong>Aim: </strong>To systematically assess the performance and predictors of existing POD risk prediction models in STAAD patients.</p><p><strong>Study design: </strong>A comprehensive systematic search was conducted across PubMed, Embase, Web of Science, Ovid, CINAHL, CNKI, Wanfang, VIP, and SinoMed databases up to February 2025. Two independent reviewers screened the articles and assessed study quality using the PROBAST tool. Data extraction was performed independently by two reviewers using standardised forms, followed by a meta-analysis of predictive model performance using STATA 18.0 software.</p><p><strong>Results: </strong>A total of 605 studies were identified, of which 14 prediction models from 9 studies met the inclusion criteria. Seven studies were assessed as having a high risk of bias, and five showed high concerns regarding applicability. Meta-analysis yielded the pooled area under the curve of 0.87 (95% CI: 0.81-0.93), indicating moderate discriminatory ability. After analysing the sources of high heterogeneity (90.21%) and conducting sensitivity analyses, no significant changes were observed in the meta-analysis results, indicating high stability. Additionally, Egger's test and Begg's test revealed no evidence of small-sample bias. Existing POD prediction models have identified multiple high-frequency common predictors, including blood markers, acute kidney injury and male.</p><p><strong>Conclusions: </strong>Although the included model demonstrated good discriminatory power, further refinements are necessary to enhance its applicability and reduce the risk of bias. Future research can utilise the common predictors identified in this study to develop predictive models and proactively investigate high-risk factors associated with POD. Furthermore, research should prioritise the development of innovative models utilising multicentre data sources and validate their effectiveness in reducing the incidence of POD in STAAD patients through clinical trials.</p><p><strong>Relevance to clinical practice: </strong>A systematic review and meta-analysis of risk prediction models for POD in STAAD patients were conducted to assess the predictive performance of existing models and identify common high-risk factors. These findings will serve as a reference for precise clinical screening of high-risk patients and the development of targeted prevention strategies.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70172"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034661","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}