Nursing in Critical Care最新文献

{"title":"Prediction models for post-traumatic stress disorder in family members of ICU patients: A systematic review.","authors":"Xinyu Zhang, Xiao Sun, Qianqian Cao, Qihong Li, Rongqing Li, Zikai Zhang, Jinxia Jiang, Li Zeng","doi":"10.1111/nicc.13248","DOIUrl":"10.1111/nicc.13248","url":null,"abstract":"<p><strong>Background: </strong>Several predictive models have been developed for post-traumatic stress disorder (PTSD) in intensive care unit (ICU) family members. However, significant differences persist across related studies in terms of literature quality, model performance, predictor variables and scope of applicability.</p><p><strong>Aim: </strong>This study aimed to systematically review risk prediction models for PTSD in family members of ICU patients, to make recommendations for health care professionals in selecting appropriate predictive models.</p><p><strong>Study design: </strong>China National Knowledge Infrastructure, VIP database, Wanfang database, SinoMed, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Embase and OVID were searched from inception to 1 May 2024. Two independent researchers conducted literature screening, data extraction and applied a risk of bias assessment tool for predictive models to evaluate included studies. The systematic review was registered on PROSPERO (registration number: CRD42024560815).</p><p><strong>Results: </strong>Seventeen studies were included, with sample sizes ranging from 32 to 2734. Incidence rates of outcomes ranged from 1.6% to 63.6%. The most frequently used predictors were relative's female sex, longer duration of ICU stay, patient's death in the ICU and type of relationship with the patient. Two models reported area under the receiver operating characteristic curve (AUC) values ranging from 0.73 to 0.74; only three models reported calibration, and one study conducted internal validation. Overall, the 17 studies showed good applicability but exhibited a high risk of bias, particularly in data analysis.</p><p><strong>Conclusions: </strong>Research on predictive models for PTSD risk in family members of ICU patients is in the developmental stage. Future studies should validate existing models or develop high-performance localized predictive models.</p><p><strong>Relevance to clinical practice: </strong>PTSD can have a significant impact on the families of ICU patients, making early identification of high-risk populations essential for health care professionals to implement timely interventions.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13248"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015765","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":"Investigation of Fluorescent Concretisation Intervention on Intensive Care Nurses' Hand Hygiene Training According to the Kirkpatrick Model: A Cluster Randomised Controlled Study.","authors":"Hülya Yılmaz, Dilan Ayhan, Dilek Yılmaz, Yılmaz Özen","doi":"10.1111/nicc.70141","DOIUrl":"10.1111/nicc.70141","url":null,"abstract":"<p><strong>Background: </strong>The predominant fomite responsible for the transmission of healthcare-associated infections via the hands of healthcare professionals is ineffective handwashing within critical care.</p><p><strong>Aim: </strong>The fundamental aim was to evaluate the impact of fluorescent concretisation intervention on handwashing efficiency, skill performance, duration scores and educational programmes on hand hygiene (HH). A secondary aim was to determine the level of HH knowledge in intensive care nurses.</p><p><strong>Study design: </strong>A cluster-randomised controlled pre-test-post-test and follow-up research design. This study was conducted with 76 nurses in Turkey. The participants in the intervention group (n = 39) had their hand washing efficiency evaluated using ultraviolet A light. The dirty spots were shown to the participants, and the reasons were discussed. The participants in the control group (n = 37) received handwashing training without fluorescent concretisation and ultraviolet light intervention. The evaluation followed Kirkpatrick's four levels: reaction, learning, behaviour and results.</p><p><strong>Results: </strong>From the first follow-up to the last follow-up, the highest increase in handwashing coverage was observed between the fingers, as determined by fluorescent assessment: from 15.4% to 82.1% for the right hand and from 20.5% to 76.9% for the left hand. When compared with the second and third follow-ups, the handwashing skill checklist total score percentage changes in the intervention group increased from 11 to 17, while the increase was from 5 to 9 in the control group.</p><p><strong>Conclusions: </strong>A training programme can be effective in improving HH compliance among ICU nurses, although further studies are needed to determine the added value of specific reinforcement strategies.</p><p><strong>Relevance to clinical practice: </strong>Findings from this study provide evidence that a structured training programme based on Kirkpatrick's learning model can significantly improve hand hygiene compliance among ICU nurses. Utilising technology tools that offer visual feedback in the structured hand hygiene training programmes may reduce healthcare-acquired/associated infections.</p><p><strong>Trial registration: </strong>Trial methods were retrospectively registered on the ClinicalTrials.gov Protocol Registration and Results System (PRS) (ClinicalTrials.gov ID: NCT06572176). https://register.</p><p><strong>Clinicaltrials: </strong>gov/prs/app/action/SelectProtocol?sid=S000EUO9&selectaction=Edit&uid=U0006UI0&ts=2&cx=3ldzyg.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70141"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856943","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":"Marking 40 Years of the BACCN Conference: A Tradition of Excellence.","authors":"Karin Gerber","doi":"10.1111/nicc.70202","DOIUrl":"https://doi.org/10.1111/nicc.70202","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70202"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193722","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":"ICU Nurses' Proficiency in Recognising Patient-Ventilator Asynchrony: A Cross-Sectional Study.","authors":"Yinfeng Xu, Huadong Wang, Yong Zhang, Hengjie Han, Xianming Ge","doi":"10.1111/nicc.70183","DOIUrl":"https://doi.org/10.1111/nicc.70183","url":null,"abstract":"<p><strong>Background: </strong>Patient-ventilator asynchrony (PVA) is a prevalent complication in mechanically ventilated patients, leading to delays in weaning, prolonged ICU stays and increased mortality. Ventilator waveform analysis, a non-invasive and reliable diagnostic method, is essential for detecting PVA. However, its accuracy relies heavily on the interpretive skills of healthcare providers.</p><p><strong>Aim: </strong>This study aimed to assess the ability of ICU nurses to recognise PVA using ventilator waveforms and examined the influence of gender, clinical experience and mechanical ventilation-related training on their recognition performance.</p><p><strong>Study design: </strong>A cross-sectional survey was conducted from November 2023 to April 2024 at seven tertiary hospital ICUs in four regions of China. A standardised questionnaire was used to collect demographic, clinical experience and training information. The recognition ability of nurses was evaluated based on their ability to identify six common PVA types through nine ventilator waveform images, with a maximum score of 9.</p><p><strong>Results: </strong>A total of 168 out of 195 eligible ICU nurses completed the survey, resulting in a response rate of 86.15%. The overall PVA recognition ability among ICU nurses was low, with a mean score of 4.6. Male nurses had significantly higher scores than female nurses. Nurses with < 5 years of ICU experience had lower scores compared to those with 5-10 years and > 10 years of experience. There was no significant difference between the 5-10 years and > 10 years groups (p = 0.25). Nurses who received mechanical ventilation-related training scored significantly higher than untrained nurses. Among the trained nurses, those with > 100 h of training performed better than those with ≤ 100 h. Gender differences were no longer significant after training (p > 0.05).</p><p><strong>Conclusions: </strong>Specialised training in mechanical ventilation significantly improved ICU nurses' ability to recognise PVA. This training bridged gaps related to gender and clinical experience, enhancing the recognition skills necessary for effective mechanical ventilation management.</p><p><strong>Relevance to clinical practice: </strong>The ability of ICU nurses to accurately recognise PVA through ventilator waveform analysis is crucial for improving patient outcomes and the quality of care for mechanically ventilated patients. Training programmes should incorporate ventilator waveform interpretation to improve recognition and management of PVA.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70183"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187472","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":"Impact of delirium on post-discharge mortality in coronary care unit patients: A retrospective cohort study.","authors":"Hong-Bo Xu, Min Shu, Jia-Jun Wu, Rui-Fa Li, Xiao-Hua Lin, Hai-Gang Zhang","doi":"10.1111/nicc.13240","DOIUrl":"10.1111/nicc.13240","url":null,"abstract":"<p><strong>Background: </strong>Coronary care unit (CCU) patients surviving to discharge still face significant mortality. Delirium is common in CCU patients and has been associated with poorer CCU and in-hospital outcomes.</p><p><strong>Aim: </strong>To assess the association between delirium and mortality after hospital discharge in CCU survivors.</p><p><strong>Study design: </strong>This was a retrospective observational study that included patients admitted to CCU. All data were extracted from the Medical Information Mart for Intensive Care IV database. The exposure was delirium during CCU stay. The primary outcome was mortality 180 days after hospital discharge. Secondary outcomes included post-hospital discharge mortality at 90 days, length of CCU and hospital stays, and hospital discharge disposition.</p><p><strong>Results: </strong>Of the 3609 CCU patients included, 891 were considered delirium-positive during their CCU stay. Delirium was associated with an increased risk of mortality at 180 days after hospital discharge (adjusted hazard ratio [HR], 1.33; 95% confidence interval (CI), 1.08-1.64). Similar results were observed for 90-day post-discharge mortality (adjusted HR,1.43; 95% CI, 1.13-1.83). CCU patients who experienced delirium had longer stays in both the CCU and hospital (adjusted β, 2.11; 95% CI, 1.79-2.43 and 3.87; 95% CI, 3.06-4.69, respectively). They were also more likely to require nursing care after hospital discharge (adjusted odds ratio [OR], 1.65; 95% CI, 1.22-2.22).</p><p><strong>Conclusion: </strong>Delirium during CCU stay was associated with an increased risk of all-cause mortality up to 180 days in CCU patients who survived hospital discharge.</p><p><strong>Relevance to clinical practice: </strong>Delirium places CCU patients at a higher risk of post-discharge mortality and increased health care resource requirements. Given the high prevalence of delirium in CCU patients and its significantly deleterious impact on both short-term and long-term post-discharge mortality, nurses and physicians should enhance the post-discharge management of patients who experience delirium in order to improve prognosis. This also highlights the importance of preventing and managing delirium during hospitalization.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13240"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034742","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":"Experiences of Intensive Care Nurses after the 2023 Earthquake in Turkey: A Descriptive Qualitative Study.","authors":"Yasemin Yilmaz, Sabri Karahan","doi":"10.1111/nicc.70167","DOIUrl":"https://doi.org/10.1111/nicc.70167","url":null,"abstract":"<p><strong>Background: </strong>Healthcare systems in Turkey have been adversely affected by major earthquakes in recent years. These earthquakes have jeopardized the safety of bedridden patients and have also led to a variety of personal and professional issues for the nurses caring for them.</p><p><strong>Aim: </strong>The aim of the current study was to reveal the personal and patient care experiences of intensive care nurses who experienced the earthquakes that occurred in Turkey on 6 February 6, 2023.</p><p><strong>Study design: </strong>The exploratory descriptive approach, a type of qualitative method, was applied. The study data were collected from 13 nurses through face-to-face interviews. The COREQ guidelines were followed for qualitative research reporting.</p><p><strong>Results: </strong>After the data reached saturation, seven themes emerged within the categories of experiences during the earthquakes, early post-earthquake experiences and late post-earthquake experiences. These themes were 'fear', 'supporting patients' and 'family' in the category of experiences during the earthquakes; 'ethical care', 'family' and the 'care team' in the category of early post-earthquake experiences; and 'psychological effects' in the category of late post-earthquake experiences. Along with these themes, a total of 18 sub-themes including 'shock', 'panic', 'communication with family', 'sleep disturbances' and 'fear of earthquakes were identified'.</p><p><strong>Conclusion: </strong>The nurses continued to provide patient care despite the various psychological difficulties and ethical dilemmas they experienced. The psychological problems, in particular, continued into the late post-earthquake period and negatively affected their professional and social lives.</p><p><strong>Relevance to clinical practice: </strong>It is critical for nurses who take care of vulnerable patients in intensive care units to manage this process effectively during and after earthquakes, both on the professional and on the personal level. In order to minimize the negative effects of earthquakes on intensive care nurses, holistic support mechanisms should be developed and health policies should be planned to be resistant to the effects of natural disasters.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70167"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076624","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":"Impact of Early Mobilisation on the Clinical Outcomes of Patients With Traumatic Brain Injury.","authors":"Fei Xia, Caiyun Li, Yiwen Liu","doi":"10.1111/nicc.70166","DOIUrl":"10.1111/nicc.70166","url":null,"abstract":"<p><strong>Background: </strong>Early mobilisation (EM) is a rehabilitative approach hypothesised to improve functional and clinical outcomes in patients with traumatic brain injury (TBI). However, its benefits remain controversial.</p><p><strong>Aim: </strong>The aim of this study was to evaluate the influence of EM on neurological recovery, motor function, quality of life (QoL) and clinical outcomes in patients with TBI.</p><p><strong>Study design: </strong>A systematic review and meta-analysis was performed. We systematically searched PubMed, Embase, Cochrane Library, Wanfang and CNKI databases for relevant randomised controlled trials (RCTs). Outcomes included changes in National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Functional Independence Measure (FIM), QoL, mortality and adverse events. A random-effects model was used to pool the results by incorporating heterogeneity.</p><p><strong>Results: </strong>Eleven RCTs with 898 patients with TBI were included. EM significantly reduced NIHSS scores (MD: -4.51, 95% CI: -5.60 to -3.43, p < 0.001; I² = 0%) and improved FMA scores (MD: 5.39, 95% CI: 3.81-6.97, p < 0.001; I² = 31%), indicating enhanced neurological recovery and motor function. QoL scores also improved with EM (SMD: 0.80, 95% CI: 0.48-2.12, p < 0.001; I² = 42%). However, EM did not significantly influence FIM (p = 0.15) or mortality (p = 1.00). Trends towards lower adverse event rates were observed but did not reach statistical significance.</p><p><strong>Conclusions: </strong>EM is associated with improved neurological and motor recovery and enhanced QoL in patients with TBI. While its impact on mortality and adverse events requires further validation, this evidence supports incorporating EM into standard TBI rehabilitation protocols.</p><p><strong>Relevance to clinical practice: </strong>The findings of this meta-analysis highlight the importance of early mobilisation (EM) as a key component of rehabilitation for patients with traumatic brain injury. EM significantly improves neurological recovery, motor function and quality of life, supporting its integration into standard clinical practice. Given the potential for improved patient outcomes, healthcare providers, particularly nurses and rehabilitation specialists, should prioritise safe and individualised EM protocols to enhance functional recovery while minimising risks.</p><p><strong>Trial registration: </strong>The protocol of the meta-analysis has been registered at PROSPERO with the identifier CRD42025640625.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70166"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076673","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":"Is There a Relationship Between Disgust Sensitivity and Caring Behaviours of Intensive Care Nurses?","authors":"Nevin Doğan, Gülcan Eyüboğlu, Arnel Böke Kiliçli","doi":"10.1111/nicc.70162","DOIUrl":"10.1111/nicc.70162","url":null,"abstract":"<p><strong>Background: </strong>Disgust sensitivity, an intense reaction to aversive stimuli, may influence healthcare professionals' behaviours, particularly in critical care settings where nurses encounter bodily fluids and infections. Its impact on intensive care unit nurses remains underexplored.</p><p><strong>Aim: </strong>This study investigated the relationship between disgust sensitivity and caregiving behaviours among intensive care unit nurses.</p><p><strong>Study design: </strong>A descriptive, correlational study collected online data from November to December 2024 from 127 intensive care unit nurses in Turkey using the Descriptive Characteristics Form, Revised Disgust Sensitivity Scale and Caring Behaviors Inventory-24. Data were analysed using Mann-Whitney U, Kruskal-Wallis and Spearman correlation tests, reporting continuous variables as median (interquartile range, IQR) and categorical variables as counts and percentages.</p><p><strong>Results: </strong>Over half of the nurses reported high disgust towards vomit (61.4%), faeces (52%) and sputum (50.4%), with higher sensitivity among females, those enjoying their job, and those working 40-48 h weekly. While no significant overall relationship was found between disgust sensitivity and caring behaviours, subgroup analyses revealed that nurses with high disgust towards sputum, faeces or vomit had significantly lower Caring Behaviors Inventory-24 scores in assurance, knowledge and skills, respect and connectedness (p < 0.05).</p><p><strong>Conclusion: </strong>This study revealed that intensive care nurses often experience high levels of disgust, particularly towards bodily fluids, with variations based on gender, job satisfaction and working hours. While no significant overall relationship was found between disgust sensitivity and caring behaviours, specific disgust-eliciting situations (e.g., sputum, faeces, vomit) are associated with reduced caring scores in key domains. These findings highlight the need for future qualitative research and targeted training programmes to help nurses effectively manage disgust and sustain high-quality care.</p><p><strong>Relevance to clinical practice: </strong>Assessing and addressing disgust sensitivity in intensive care unit nurses can enhance caregiving quality and emotional resilience, informing targeted training and support strategies.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70162"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056005","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 Mediating Role of Moral Resilience in the Relationship Between Moral Distress and End-of-Life Care Attitudes and Behaviours Among Intensive Care Nurses.","authors":"Özkan Sir, Mağfiret Kaşıkçı, Ebubekir Kaplan","doi":"10.1111/nicc.70171","DOIUrl":"10.1111/nicc.70171","url":null,"abstract":"<p><strong>Background: </strong>Intensive care nurses experience moral distress due to moral conflicts, which negatively impact their attitudes and behaviours towards end-of-life care. Moral resilience is considered a potential factor in mitigating these negative effects.</p><p><strong>Aim: </strong>This study aims to examine the mediating role of moral resilience in the relationship between moral distress and intensive care nurses' attitudes and behaviours towards end-of-life care.</p><p><strong>Study design: </strong>A descriptive and cross-sectional study was conducted in accordance with the guidelines for observational studies (STROBE). The study was conducted with 228 intensive care nurses between December 2024 and February 2025. Data were collected using the 'Personal Information Form', 'Moral Distress Scale', 'Moral Resilience Scale' and 'Scale of Attitudes and Behaviours of Intensive Care Nurses Towards End-of-Life Care'. Statistical analyses were performed using SPSS 26.0 and AMOS V 24.0.</p><p><strong>Results: </strong>The moral distress levels of female nurses were higher and significantly higher than male nurses (OR 0.245; 95% CI 0.074-0.598; p = 0.011). Nurses with 11 years or more of work experience had a higher and significant level of moral distress compared to other nurses (OR 0.053; 95% CI 0.080-0.115; p = 0.012). The moral resilience level of nurses with 3-6 years of work experience was higher and significantly higher than other nurses (OR 0.067; 95% CI 0.048-0.107; p = 0.023). Moral distress negatively affects nurses' attitudes and behaviours towards end-of-life care. Moral resilience has a significant and positive effect on attitudes and behaviours. Moreover, moral resilience mediated the relationship between moral distress and attitudes and behaviours towards end-of-life care (β;-0.266, CI 95% -0.301-0.197).</p><p><strong>Conclusions: </strong>Moral distress negatively influences intensive care nurses' attitudes and behaviours in end-of-life care. Enhancing moral resilience can help mitigate these effects. The findings highlight the need for nursing education programmes and workplace interventions to strengthen nurses' moral resilience and improve their ability to manage moral distress.</p><p><strong>Relevance to clinical practice: </strong>While moral distress damages intensive care nurses' attitudes towards end-of-life care, moral resilience may help to reduce its negative effects. Supporting nurses is thought to improve the quality of adverse end-of-life care.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70171"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066203","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":"Perioperative management of a neonate with congenital biliary atresia complicated by severe pneumonia undergoing hepatic hilar jejunostomy: A case report.","authors":"Hao Zhang, Mingjiao Zhang","doi":"10.1111/nicc.13263","DOIUrl":"10.1111/nicc.13263","url":null,"abstract":"<p><p>The earlier a child with biliary atresia undergoes surgery after diagnosis, the better the prognosis. However, newborns often present with additional symptoms, most commonly pneumonia, which complicate in stabilizing the child's internal environment preoperatively, challenges anaesthetic management during surgery and hampers postoperative recovery. In current clinical practice, nursing care tends to focus more on symptomatic treatment rather than on a comprehensive pre- and postoperative assessment. This paper aimed to summarize the perioperative nursing experience of a neonate with biliary atresia and severe pneumonia. The study design of this article is a case report. After 17 days of intensive treatment and care, the child recovered and was discharged from the hospital, with ongoing progress noted during regular outpatient follow-ups. A thorough nursing assessment encompassing preoperative, intraoperative and postoperative care for children with biliary atresia, along with clearly defined nursing priorities at each stage, is essential for safeguarding the child's well-being throughout the perioperative period and supporting optimal postoperative recovery. This case study offers a comprehensive assessment of the child's condition throughout hospitalization. It highlights essential nursing interventions and monitoring strategies during the perioperative period, particularly preoperative and postoperative care. The insights gained can serve as a valuable reference for nursing practices in paediatric intensive care units, enhancing care for similar cases.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13263"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068682","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}