Nursing in Critical Care最新文献

{"title":"Caregiving experiences of Turkish intensive care unit nurses who survived in the most destructive double earthquake of the century: A qualitative study.","authors":"Onur Çetinkaya, Selva Ezgi Aşkar, Özlem Ovayolu","doi":"10.1111/nicc.13223","DOIUrl":"10.1111/nicc.13223","url":null,"abstract":"<p><strong>Background: </strong>Turkey has been exposed to many devastating earthquakes in recent years. Considering that nurses are on the front lines of responding to disasters, they need to be prepared at all times. In the literature review, it was seen that despite the roles of intensive care nurses in disasters, their experiences in caring for earthquake victims have not been adequately researched.</p><p><strong>Aim: </strong>This study aims to investigate the experiences of intensive care nurses during the double earthquake in Turkey in 2023.</p><p><strong>Study design: </strong>This descriptive qualitative research was conducted with 11 intensive care nurses working in the double earthquake in Turkey in 2023. Snowball sampling was used to select participants. Data were collected through face-to-face semi-structured interviews. Interviews were continued until data saturation was reached.</p><p><strong>Results: </strong>As part of the analysis of the interviews, the nurses' experiences were grouped under four main themes covering 10 sub-themes-'Continuing care despite difficulties', 'Staying in a dilemma', 'Two faces of the earthquake' and 'The need for perfect planning kneaded with experience.'</p><p><strong>Conclusion: </strong>The main source of the difficulties and dilemmas experienced is the obligation of nurses who experienced the earthquake to continue their profession. Still, continuity of care was maintained and nurses drew positive conclusions from the negativity.</p><p><strong>Relevance to clinical practice: </strong>Considering the positive and negative effects of the earthquake, intensive care nurses should be both professionally and psychologically empowered, organizational planning should be conducted as soon as possible and their functionality should be tested through drills.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13223"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985386","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":"Decision-Making Support for an Adult Patient With Severe Congenital Heart Disease: A Case Study.","authors":"Yu Yamaguchi, Shingo Ueki","doi":"10.1111/nicc.70101","DOIUrl":"10.1111/nicc.70101","url":null,"abstract":"<p><p>In critical care, owing to the severity of the illness, it is often difficult to confirm the patient's treatment preferences because of issues with their level of consciousness. Supporting patient decision-making should prioritize confirming patients' wishes. This case study examines an instance in which the focus shifts from family- to patient-centred decision-making. During a multidisciplinary conference in which the medical and nursing team considered delegating treatment decisions to the family, an intervention advocating the necessity of patient-centred decision-making prompted a reconsideration of the principles of decision-making support. In the present case, a patient with congenital heart disease was admitted to the intensive care unit after cardiopulmonary resuscitation. The process involved assessing the patient's recovery from impaired consciousness, engaging with the family as well as the medical and nursing team and supporting autonomous decision-making. By maintaining the existing relationships among the patient, family and medical and nursing team, and supporting the patient's independent decision-making, the patient's wishes and sentiments towards the family were reflected, resulting in a desirable outcome. Without this intervention, the treatment plan may not have reflected patients' wishes. Timely and swift coordination among patients, families and the medical and nursing team is crucial. Accurately assessing a patient's decision-making ability and enhancing the remaining quality of life of the patient and family raises the challenge of educating the medical and nursing team to generalize such interventions. This case illustrates the importance of accurately assessing a patient's level of consciousness and promoting autonomous decision-making in intensive care settings, even when communication is impaired. By advocating for the incorporation of the patient's preferences into treatment planning, nurses can contribute to the realization of truly patient-centred care. This approach is particularly relevant for adult patients with complex chronic conditions from childhood, as it enables care that is tailored to the individual's values, experiences and developmental background.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70101"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259316","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 nursing workload and staff size with the occurrence of adverse events and deaths of patients with COVID-19: A retrospective cohort study.","authors":"Carolina Cassiano, Lilia de Souza Nogueira, Ana Carolina Unger Araújo, Fernanda Rodrigues Lima, Nasrin Hanifi","doi":"10.1111/nicc.13221","DOIUrl":"10.1111/nicc.13221","url":null,"abstract":"<p><strong>Background: </strong>The safety of patients in the intensive care unit (ICU) is significantly impacted by inadequate staffing of nursing professionals to meet the demand for care of critically ill patients. COVID-19 patients increased nurses' workload, particularly in high-intensity care settings like the ICU.</p><p><strong>Aim: </strong>To evaluate the association of workload and number of patients per nursing professional with the occurrence of adverse events and death in critically ill patients with COVID-19 in the ICU.</p><p><strong>Study design: </strong>This is a retrospective cohort study. This study analysed patients with COVID-19, aged 12 years or older, admitted between 1 April 2020 and 31 May 2021 in the ICU of a hospital in Brazil. Nursing workload was measured by the Nursing Activities Score (NAS). The independent variables were the ratio of the NAS score per nursing professional (NNR) and the ratio of the number of patients per nursing professional (PNR). Dependent variables included adverse events (pressure injuries and health care-associated infections-HAIs) and death in the ICU.</p><p><strong>Results: </strong>Of the 386 included patients, 59.59% were male and the median age was 60.5 years. The median NAS, NNR and PNR values were 72.81%, 128% and 1.64, respectively. The frequency of pressure injuries (31.09%) exceeded that of HAIs (16.06%), and 218 patients (56.48%) died. The NNR was associated with HAIs (OR 1.006; CI95% 1.001-1.012; p = .012), pressure injury (OR 1.005; CI95% 1.000-1.010; p = .033) and death (OR 1.010; CI95% 1.005-1.015; p < .001) in the ICU. There was no association between PNR values and the study's dependent variables.</p><p><strong>Conclusion: </strong>A high workload per nursing professional was associated with the occurrence of adverse events and deaths of patients with COVID-19 in the ICU, while the nursing staff sizing was not.</p><p><strong>Relevance to clinical practice: </strong>The results reinforce the importance of evaluating the workload of nursing professionals to establish safety measures for the care of patients with infectious diseases.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13221"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of swimmer position during prone ventilation on the onset of brachial plexus injury in the intensive care unit: A multiprofessional clinical study protocol.","authors":"Filippo Binda, Simone Gambazza, Federica Marelli, Veronica Rossi, Alessandro Galazzi, Cesare Del Monaco, Maurizio Vergari, Benedetta Ticozzelli, Mauro Panigada, Giacomo Grasselli, Maura Lusignani, Dario Laquintana","doi":"10.1111/nicc.13208","DOIUrl":"10.1111/nicc.13208","url":null,"abstract":"<p><strong>Background: </strong>Prone positioning improves oxygenation in adults with acute respiratory distress syndrome (ARDS) and has been extensively applied in intensive care units (ICU) during the COVID-19 pandemic. Although some complications due to the manoeuvre are well known, brachial plexus injury after prone positioning is reported as a rare complication and the phenomenon could be either very rare or underestimated.</p><p><strong>Aim: </strong>This study aimed to evaluate the effect of swimmer position during prone ventilation on the onset of brachial plexus injury in patients admitted to ICU for ARDS. The study will also evaluate the safety of prolonged prone positioning collecting data on any adverse events occurred.</p><p><strong>Study design: </strong>A prospective, observational cohort study will be conducted in a tertiary level ICU in the metropolitan area of Milano (Italy) specialized in advanced treatment of patients with ARDS. This observational study will report clinical data on the electromyography (EMG) and the muscle strength assessment, including comorbidities and cardio-respiratory status. A baseline EMG will be performed within 2 h from the first pronation manoeuvre and immediately at the end of each pronation cycle. The functional assessment of patients will be also performed at the end of ICU stay and at hospital discharge.</p><p><strong>Results: </strong>The primary outcome is to estimate the prevalence of brachial plexus injury in patients with ARDS placed in the swimmer position during prone ventilation. Secondary outcomes will also include the safety of the manoeuvre by evaluation of all adverse events classified as skin or ocular damage, loss of tube and vascular access and new pressure ulcers.</p><p><strong>Relevance to clinical practice: </strong>The findings of this study will contribute to understand the possible benefits/harms of prone ventilation performed using swimmer position. Eventually, this will call for the development of specific and tailored rehabilitation programs for patients with upper limb injuries during ICU stay, including also timely follow-up upon ICU-discharge.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13208"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711797","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":"Response Commentary: Enhancing ICU Care With Nurse-Written Diaries.","authors":"Vincenzo Bosco, Caterina Mercuri, Vincenza Giordano, Anna Maria Froio, Daniele Commisso, Rita Nocerino, Assunta Guillari, Teresa Rea, Helenia Mastrangelo, Izabella Uchmanowicz, Silvio Simeone","doi":"10.1111/nicc.70092","DOIUrl":"https://doi.org/10.1111/nicc.70092","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70092"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592831","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 study protocol to develop virtual reality software in the care management of patients in intensive care.","authors":"Banu Terzi, Duygu Sönmez Düzkaya, Gülzade Uysal, Nazik Yalnız","doi":"10.1111/nicc.13231","DOIUrl":"10.1111/nicc.13231","url":null,"abstract":"<p><strong>Background: </strong>The use of virtual reality is increasing in nursing to ensure patient safety and to improve the quality of care in the education of nurses.</p><p><strong>Aim: </strong>To develop a virtual reality software for intensive care patient care management and to investigate the effect of this software on novice intensive care nurses.</p><p><strong>Study design: </strong>This study protocol contains a randomized controlled experimental design research. The nurses will be divided into control (n = 34) and study groups (n = 34) by randomization. The research will be conducted in four steps: (1) according to Kolcaba's Comfort Theory, the protocol for care management of an intensive care patient will be prepared and transferred to the virtual reality software, (2) the nurses in both groups will be given theoretical training, (3) a routine orientation training programme will be applied to the nurses in the control group, and those in the study group will be given virtual reality goggles. (4) Tools such as a 'Clinical Practice Skills Observation Form and Knowledge Level Questionnaire' and 'Problem-Solving Inventory', 'Clinical Decision-Making Scale in Nursing', 'State Anxiety Inventory' and 'Satisfaction Level Questionnaire' will be applied to both groups before commencing the theoretical training, 1 week after the application and in the first month of the application.</p><p><strong>Results: </strong>This protocol describes an experimental study aiming to test the impact of virtual reality software on novice intensive care nurses in the care management of an intensive care patient.</p><p><strong>Conclusions: </strong>The results and recommendations will be shared after the study is completed.</p><p><strong>Relevance to clinical practice: </strong>Within the scope of the research, the virtual reality software to be developed for the care management of an intensive care patient will provide important contributions to the development of nurses' problem-solving and clinical decision-making skills and reduce state anxiety levels in orientation to the intensive care unit (ICU).</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13231"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985384","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}

{"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}