Nursing in Critical Care最新文献

{"title":"Measuring the needs of older adult patients in intensive care units: A translation and validation study of the NAPinICU questionnaire.","authors":"Hanaa Abou El-Soued Hussein, Eman Arafa Hassan, Azza Abd Elrazek Baraka, Magda Mahmoud Mohamed Al-Gameel","doi":"10.1111/nicc.13038","DOIUrl":"10.1111/nicc.13038","url":null,"abstract":"<p><p>The NAPinICU questionnaire, specifically designed to assess the needs of older adult patients in intensive care units, serves as a valuable tool for understanding and addressing their unique requirements. This study applied a cross-cultural translation process, followed by a cross-sectional survey to measure patients' needs and evaluate the psychometric properties of the Arabic-translated version of the NAPinICU questionnaire. The older adults' translated questionnaire demonstrated high content validity, good test-retest reliability and acceptable internal consistency. Discriminative validity confirmed significant differences in needs ratings between university and private hospital patients. This translated and validated tool can help in assessing the needs of older adults in intensive care units. Assessment of these patients' needs assists in enhancing the quality of care delivered to them by nurses and other healthcare providers.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13038"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724919","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":"Core competency in palliative care among intensive care unit nurses: A latent profile analysis.","authors":"Qin Guan, Xiaoling Zhu, Zhipeng Xue, Mengyun Peng","doi":"10.1111/nicc.70021","DOIUrl":"10.1111/nicc.70021","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit (ICU) nurses play a leading role in integrating palliative care into ICU practices, which requires them to possess professional and comprehensive palliative care core competencies.</p><p><strong>Aim: </strong>To explore the current status of ICU nurses' palliative care core competency and to examine the factors influencing different subgroups of core competency.</p><p><strong>Study design: </strong>A quantitative, cross-sectional study. A random sampling of 342 ICU nurses from five hospitals participated in this study from March to April 2024. A latent profile analysis (LPA) was conducted to identify subgroups based on the Palliative Care Nurses' Core Competences (PCNCC) scale. Differences between the variables, including sociodemographic characteristics, autonomous learning capacity, job satisfaction and subgroups, were explored using multivariate logistic regression. This cross-sectional study used the STROBE checklist.</p><p><strong>Results: </strong>The mean score for palliative care core competency among ICU nurses was (58.96 ± 21.56). There were three different subgroups of palliative care core competency, namely, the 'low palliative care core competency group (31.2%)', the 'medium palliative care core competency group (47.2%)' and the 'low palliative care core competency group (21.6%)'. Professional title (odds ratio [OR] = 0.161, 95% confidence interval [CI]: 0.038-0.673, p = .012), position (OR = 0.111, 95% CI: 0.013-0.975, p = .047), work experiences (OR = 0.169, 95% CI: 0.030-0.965, p = .046) and autonomous learning capacity (OR = 3.298, 95% CI: 1.390-7.822, p = .007) were significant factors affecting the medium-level group, while position (OR = 0.101, 95% CI: 0.011-0.918, p = .042) and autonomous learning capacity (OR = 3.878, 95% CI: 1.447-10.396, p = .007) significantly influenced the low-level group.</p><p><strong>Conclusions: </strong>The majority of ICU nurses were categorized in the low and medium-level palliative care core competency group; professional title, position, work experience and autonomous learning capacity were the main influencing factors.</p><p><strong>Relevance to clinical practice: </strong>ICU nurses should receive specific knowledge and training on palliative care, especially young nurses with limited work experience. Nursing managers and educators should provide targeted intervention strategies for nurses with different autonomous learning capacities to improve their core competencies in palliative care.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e70021"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665333","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":"Association of early versus late tracheostomy with prognosis in hypoxic-ischaemic encephalopathy patients: A propensity-matched cohort study.","authors":"Yeling Li, Dingyuan Wan, Hongmei Liu, Keying Guo, Yilin Liu, Lihong Zhao, Ming Li, Jijie Li, Yiwen Liu, Wei Dong","doi":"10.1111/nicc.13268","DOIUrl":"10.1111/nicc.13268","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing for exchanging an endotracheal tube for a tracheostomy cannula in patients with hypoxic-ischaemic encephalopathy is controversial.</p><p><strong>Aim: </strong>This study aimed to evaluate the effects of early versus late tracheostomy on the prognosis of patients with hypoxic-ischaemic encephalopathy.</p><p><strong>Study design: </strong>The study was an observational retrospective study that followed the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. We included adults with hypoxic-ischaemic encephalopathy who underwent tracheostomy between January 2012 and September 2020. The patients were classified into early or late tracheostomy groups. To eliminate differences in baseline characteristics, propensity score matching was conducted, and the outcomes between the two groups were compared.</p><p><strong>Results: </strong>A total of 132 patients were included, and through propensity score matching, 54 pairs of patients were matched. The early tracheostomy group showed a significant reduction in the duration of mechanical ventilation (median, 12 days; interquartile range 7-20 vs. median, 28 days; interquartile range, 15.75-58.25, p < .001), intensive care unit length of stay (median, 14.5 days; interquartile range, 6.75-26 vs. median, 35 days; interquartile range, 20-59, p < .001) and hospital length of stay (median, 19.5 days; interquartile range, 10.87-36.5 vs. median, 39.5 days; interquartile range, 22-66, p < .001). Over a 1-year follow-up period, there were no significant differences between the two groups regarding inhospital mortality (57.4% vs. 46.3%, p = .248), 30-day mortality (59.3% vs. 46.3%, p = .177) and 1-year mortality (61.1% vs. 48.1%, p = .176).</p><p><strong>Conclusions: </strong>In patients with hypoxic-ischaemic encephalopathy undergoing mechanical ventilation, early tracheostomy is associated with a reduction in the duration of mechanical ventilation and decreased intensive care unit and hospital length of stay.</p><p><strong>Relevance to clinical practice: </strong>For patients with hypoxic-ischaemic encephalopathy who are at a high risk of requiring prolonged mechanical ventilation, the benefits of early tracheostomy suggest considering it a viable treatment option.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13268"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517131","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":"Experiences of nurses working in intensive care units regarding oral care: A qualitative study.","authors":"Büşra Nur Özel, Sevda Korkut, Oktay Bektaş","doi":"10.1111/nicc.13300","DOIUrl":"10.1111/nicc.13300","url":null,"abstract":"<p><strong>Background: </strong>Although oral care practices are an important part of nursing care in intensive care units, it is reported that oral care practices are disrupted and not performed at the desired level because of various factors.</p><p><strong>Aim: </strong>This study was conducted to examine the experiences of intensive care nurses regarding oral care.</p><p><strong>Study design: </strong>Phenomenology design, one of the qualitative research methods, was used in the study. Seven nurses working in the intensive care units of a tertiary hospital were included in the study. Data were collected using semi-structured interviews. The interviews were conducted face-to-face in a quiet room, and the interviews were audio-recorded with the participants' permission. After the voice recordings were transcribed, codes, categories and themes were created. The collected data were analysed using inductive content analysis. Results are presented with direct quotations.</p><p><strong>Results: </strong>Three themes were uncovered: 'Barriers and challenges to oral care', 'consequences of ineffective oral care' and 'reasons for unmet/ineffective oral care'. The participants had problems in practice because of patient, nurse or institutional factors. The nurses also reported that some of the difficulties they encountered during oral care caused them fear and stress, which led to reluctance to perform oral care. The nurses argued that when they wanted to apply oral care, they could not do so because of patient, time and material-related problems. In addition, the difficulties experienced by nurses during oral care practices were related to inadequate oral care practices, especially during nursing education.</p><p><strong>Conclusions: </strong>The importance of oral care for intensive care patients and the importance of nurses' developed self-efficacy in providing this care were revealed. In line with the results obtained, the number of trainings on oral care practice activities should be increased and the content of the trainings should be expanded.</p><p><strong>Relevance to clinical practice: </strong>The difficulties experienced by nurses during oral care practices in intensive care may be caused by many factors such as patient, nurse or institutional factors. It has been stated that inadequate training causes great stress in those who perform this practice for the first time in a complex environment such as intensive care and that the negativities experienced cause reluctance to perform this practice. In order to effectively implement this practice that the patient needs, nurses must first have the necessary competence. For this, nurses need to be supported with in-service training after graduation.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13300"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517135","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":"Relationship between work productivity and patient safety attitudes among intensive and critical care nurses: A structural equation modelling approach.","authors":"Öznur Erbay Dalli","doi":"10.1111/nicc.13290","DOIUrl":"10.1111/nicc.13290","url":null,"abstract":"<p><strong>Background: </strong>Intensive care units present various challenges that can affect the productivity of nurses who play a critical role in ensuring patient safety; however, the relationship between these nurses' work productivity and patient safety attitudes has not been sufficiently explored.</p><p><strong>Aim: </strong>To investigate the relationship between work productivity and patient safety attitudes among intensive and critical care nurses (ICCNs) using structural equation modelling (SEM).</p><p><strong>Study design: </strong>This cross-sectional study involved 372 ICCNs who were members of the Turkish Society of Critical Care Nurses. Data were collected via an online survey using the Nurse Information Form, the Attitudes Toward Productivity Scale (ATPS) and the Patient Safety Attitude Questionnaire (PSAQ).</p><p><strong>Results: </strong>A significant positive correlation was found between the total ATPS and the PSAQ score (r = .704, p < .01). The SEM analysis revealed that teamwork climate (β = .192, p = .001), perceptions of management (β = .141, p = .001) and job satisfaction (β = .482, p = .001) positively predicted attitudes towards productivity, while stress recognition had a negative impact (β = -.219, p = .001). The model accounted for 62.2% of the variance in attitudes towards productivity and demonstrated good fit indices (χ²/df = 3.566; GFI = 0.989; CFI = 0.991; RMSEA = 0.078).</p><p><strong>Conclusions: </strong>Teamwork climate, perceptions of management, job satisfaction and stress recognition significantly influence work productivity among ICCNs. Enhancing these factors can improve ICCNs' productivity and foster positive patient safety attitudes, ultimately leading to better patient care outcomes in intensive care settings.</p><p><strong>Relevance to clinical practice: </strong>Health care institutions need to adopt strategies to increase ICCNs' work productivity and patient safety attitudes, such as teamwork support initiatives, leadership development programmes for managers, professional development opportunities and stress reduction interventions. Positive working environment and favourable working conditions can improve ICCNs' well-being and performance, leading to better patient care outcomes in intensive care settings.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13290"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517232","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":"Patient and family experiences of early cognitive rehabilitation in critical illness: A qualitative study protocol.","authors":"Marie Oxenbøll Collet, Louise Skov Svendsen, Anne Højager Nielsen, Eva Laerkner, Ingrid Egerod","doi":"10.1111/nicc.13254","DOIUrl":"10.1111/nicc.13254","url":null,"abstract":"<p><strong>Background: </strong>Physical, mental and cognitive impairments are known severe adverse outcomes in critically ill patients who have beenadmitted to an intensive care unit (ICU). Early rehabilitation interventions such as lighter sedation and increased mobilization have improved patient outcomes, but evidence for early cognitive rehabilitation is sparse.</p><p><strong>Aim: </strong>The study aims to describe the experiences of ICU survivors and their families regarding early cognitive stimulation as part of rehabilitation during and after ICU admission.</p><p><strong>Design: </strong>Our study has a qualitative, descriptive design using individual and dyad interviews as well as focus groups with ICU survivors and their families.</p><p><strong>Methods: </strong>Eligible participants are adult ICU survivors and families who are able to recall events during and after the ICU stay. We will use purposeful sampling in the outpatient clinic in the Department of Intensive Care at the Copenhagen University Hospital. We plan to conduct five individual patient interviews, four dyad interviews with patients and families, and two focus groups with patients. All interviews will follow a semi-structured interview guide based on the study objectives and input from a patient and public involvement (PPI) panel. We will use the framework method for analysis and invite the PPI panel to participate in the analysis process to strengthen the findings. Written informed consent will be obtained from all participants, and data will be anonymized before analyses.</p><p><strong>Relevance for clinical practice: </strong>This study protocol provides a methodological framework to understand early cognitive rehabilitation from the perspectives of ICU survivors and their families. This study protocol presents one of the first studies to investigate the concept of early cognitive rehabilitation during critical illness from this perspective. The findings will facilitate a tailored approach to early rehabilitation to be investigated in further studies.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13254"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558750","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":"Real world data on the management of non-cytotoxic drug extravasation: An observational retrospective study in paediatric and adult patients.","authors":"Marta Blazquez-Vidal, Ines Garcia-Del Valle, Patricia Amoros-Reboredo, Miguel Angel Diaz-Herrera, Laura Val-Prat, Monica Sanmartin-Suñer","doi":"10.1111/nicc.70020","DOIUrl":"https://doi.org/10.1111/nicc.70020","url":null,"abstract":"<p><strong>Background: </strong>The extravasation of non-cytotoxic drugs is a risk posed by intravenous therapy, particularly in critically ill patients who often require multiple intravenous medications. This risk must be promptly addressed to prevent morbidity, increased therapy costs and prolonged length of stay, especially in critical care units. Therefore, it is critical to define the specific measures that should be undertaken to approach each situation.</p><p><strong>Aim: </strong>The aim of this research was to describe the extravasation of non-cytotoxic drugs occurring in a tertiary hospital and to assess the effectiveness and safety of the internal protocol applied.</p><p><strong>Study design: </strong>This was a single-centre, retrospective, observational study based on real world data from adult and paediatric patients experiencing extravasation of a non-cytotoxic drug between June 2018 and June 2023. To perform the analysis, demographic, patient, intravenous therapy, extravasation and treatment variables were collected and computed using descriptive statistics.</p><p><strong>Results: </strong>The analysis included 61 patients. The median age was 63.0 (IQR 3.5-74.5) years, and participants were grouped into neonates, children and adults. Among the subjects studied, 80% had at least one risk factor that made them liable to experience an extravasation. Drug groups involved were radiological contrasts (42.6%), parenteral nutrition and electrolytes (29.5%), vasoactive and cardiovascular system drugs (14.8%), antibiotics (8.2%), other analgesics and antipyretics (1.6%), expectorants (1.6%) and alimentary tract and metabolism drugs (1.6%). Adequacy of the protocol was reported in 73.8% of the cases with complete recovery.</p><p><strong>Conclusions: </strong>The work reported here contributes to improving evidence about the management of extravasation episodes. Our findings suggest that patient-centred team-based protocolizing is a key strategy to achieve the effectiveness and safety of non-cytotoxic drugs in real world practice. This protocol could allow other institutions to enhance safety related to intravenous therapy. Moreover, maintaining a surveillance strategy will enable the continuous collection of data on these adverse events, facilitating ongoing improvement and reinforcement of good practices.</p><p><strong>Relevance to clinical practice: </strong>Implementing a standardized protocol for managing non-cytotoxic drug extravasation can significantly enhance patient safety and improve outcomes in both adult and paediatric populations in critical care settings.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e70020"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665280","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":"Analysis of admissions to intensive care units that could be supported on an intermediate care unit.","authors":"Jérôme Tack, Arnaud Bruyneel, Fabio Taccone, Fréderic Thys, Christian Mélot, Phillipe Van Wilder, Magali Pirson","doi":"10.1111/nicc.13043","DOIUrl":"10.1111/nicc.13043","url":null,"abstract":"<p><strong>Background: </strong>Only one third of European countries use intermediate care units (IMCs). An IMC makes it possible to manage patients who do not require intensive care but who need a higher level of nursing care that cannot be provided on the general ward. In Belgium, there are no national criteria for ICU admission or discharge, and no policies regarding IMC care or for differentiating ICU intensity levels.</p><p><strong>Aim: </strong>The aim of our study was to analyse the profile of ICU patients in Belgium on the basis of registered nursing activity in order to quantify the number of ICU days potentially transferable to an IMC.</p><p><strong>Study design: </strong>The study was conducted on 310 ICU beds. Patients admitted to the study were recruited during two different one-month periods in 2018 and were included into a prospective database that evaluated nursing workload carried out in 15 hospitals in the French-speaking part of Belgium. The number of ICU days that could be supported on an IMC was defined according to the Nursing Activities Score (NAS) items.</p><p><strong>Results: </strong>A total of 3279 ICU patients for a total of 13 942 ICU days were included. 4987 days (35.8%) were considered as \"transferable\" to an IMC. The proportion of ICU days transferable to an IMC was highly variable among hospitals, ranging from 20.4% to 59.5% of all ICU days. On the day of ICU admission, 665/2142 (31.0%) of the patients were already identified as transferable to an IMC; this percentage significantly increased on day 2 (972/2066, 47.1%) and day 3 (650/1390, 46.7%).</p><p><strong>Conclusions: </strong>In Belgian ICUs, 35.8% of ICU hospital days, as per recorded NAS, do not necessitate intensive monitoring. These 35.8% of days of ICU hospitalization could be supported on an IMC.</p><p><strong>Relevance for clinical practice: </strong>In this study, a significant number of days spent in the ICU could be supported on an IMC, this could alleviate the workload of nurses and reduce the occupancy rate of intensive care units.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13043"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730984","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 optimum blood glucose level and mortality in critically ill patients with septic shock: A real-world time-series data analysis.","authors":"Gulizeba Muhetaer, Ce Sun, Qian-Qian Ma, Yu Zhang, Jun-Wei Zhang, Yi-Le Ning","doi":"10.1111/nicc.13304","DOIUrl":"https://doi.org/10.1111/nicc.13304","url":null,"abstract":"<p><strong>Background: </strong>Sepsis remains a significant health challenge in ICU, with septic shock requiring meticulous glycaemic management due to metabolic dysregulation. Existing research highlights the detrimental effects of both hyperglycaemia and hypoglycaemia on septic patient outcomes, emphasizing the need for effective glycaemic control. Despite extensive studies, optimal glycaemic targets in septic shock patients remain contentious and unclear, necessitating further research.</p><p><strong>Aim: </strong>Our study aims to identify optimal glycaemic targets for patients in septic shock by analysing time-series blood glucose data.</p><p><strong>Study design: </strong>This retrospective observational study utilized the MIMIC-IV database, encompassing ICU patients diagnosed with septic shock from 2008 to 2019. We extracted time-series blood glucose data and applied the Stineman interpolation to achieve a standardized resolution. The primary analysis involved calculating the time-weighted average blood glucose (TWA-BG) and examining its relationship with 28-day mortality using a restricted cubic spline model within a Cox regression framework. Sensitivity analyses with multiple models and subgroup analyses were used to reveal the robustness of the results.</p><p><strong>Results: </strong>From 34 677 identified septic patients, 11 375 met the inclusion criteria. The optimal TWA-BG range, associated with the lowest 28-day mortality risk, was determined to be 105 to 131 mg/dL. Patients within this range exhibited significantly lower mortality rates compared to those with higher or lower TWA-BG levels. Sensitivity analyses confirmed these findings, indicating robustness across various subgroups and analytical models.</p><p><strong>Conclusions: </strong>Our findings suggest that maintaining TWA-BG levels between 105 and 131 mg/dL minimizes the risk of 28-day, ICU, and in-hospital mortality in patients with septic shock.</p><p><strong>Relevance to clinical practice: </strong>The results provide evidence-based guidance for ICU nursing interventions, advocating for a precise TWA-BG range to be maintained for septic shock patients, thus potentially setting new benchmarks for glycaemic control in critical care settings.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13304"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring critical care nurses' experiences of redeployment to general medical-surgical wards for covering staff shortages: A qualitative research study.","authors":"Naim Abdulmohdi, Yingchang Huang","doi":"10.1111/nicc.13267","DOIUrl":"10.1111/nicc.13267","url":null,"abstract":"<p><strong>Background: </strong>The impact of redeployment on staff was not widely recognized before the COVID-19 pandemic. The redeployment of critical care nurses is frequently employed in health care organizations as a last-minute staffing management approach without proper infrastructure. Studies exploring the feelings and experiences of redeployed critical care nurses in this manner are sparse.</p><p><strong>Aim: </strong>The aim of this study was to develop an understanding of the experiences of critical care nurses during their redeployment to cover shifts in the general wards.</p><p><strong>Study design: </strong>This study adopted a qualitative research design to explore critical care nurses' experiences of redeployment. Ten critical care nurses attending a postgraduate critical care course in one university were recruited between January and April 2019. Data were collected using a focus group which was thematically analysed.</p><p><strong>Results: </strong>Three themes were identified: 'challenges in transitioning to ward settings', 'concerns regarding patient safety and satisfaction' and 'insufficient infrastructure and support'. Participants expressed concerns about patient and staff safety during redeployment, describing feelings of anxiety and undervaluation.</p><p><strong>Conclusions: </strong>The study illuminates the intricate challenges experienced by redeployed critical care nurses, highlighting the crucial need for comprehensive support, targeted training and strategic planning to safeguard patients' care and nurses' well-being during periods of staff shortages in health care settings. These findings emphasize the importance of proactive measures in fostering a resilient and adaptable health care workforce. This is a small study involving only one focus group of 10 critical care nurses, which may limit the transferability of the findings. As a result, the findings may not fully reflect the experiences of critical care nurses from other sites.</p><p><strong>Relevance to clinical practice: </strong>The study reveals that critical care nurses experience challenges and stress when redeployed to general wards because of insufficient support and infrastructure. It emphasizes the need for comprehensive strategies, such as job rotation, tailored training and collaborative efforts to address redeployment challenges. Research could focus on developing and testing different models of job rotation between critical care and general wards, evaluating their impact on nurse satisfaction, confidence, competence and overall experience. The findings highlight the importance of organizational support, leadership and local guidelines for effective teamwork. Conducting longitudinal studies to track the experiences of redeployed critical care nurses over an extended period would be beneficial. This approach would provide insights into the long-term effects of redeployment on job satisfaction, burnout and retention.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13267"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517138","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}