Nursing in Critical Care最新文献

{"title":"The effect of an open-heart surgery patient care protocol on post-sternotomy pain, anxiety and quality of care: A randomized controlled trial.","authors":"Necibe Dağcan Şahin, Gülşah Gürol Arslan","doi":"10.1111/nicc.13193","DOIUrl":"10.1111/nicc.13193","url":null,"abstract":"<p><strong>Background: </strong>Open-heart surgery patients face many problems because of post-sternotomy pain. Care protocols can eliminate pain and pain-related problems by providing holistic care.</p><p><strong>Aim: </strong>The aim of this study was to examine the effect of an open-heart surgery patient care protocol developed in the study on post-sternotomy pain, anxiety and quality of care.</p><p><strong>Study design: </strong>The study was carried out as a double-blind randomized controlled trial. The sample size was calculated. Considering some attrition, the sample size was increased by 10% for each group, and a total of 68 participants, including 34 in each group, were included in the sample. Data were collected using a 'Patient Information Form', a 'Post-Sternotomy Pain Follow-up Form', the 'Numeric Rating Scale', the 'State Anxiety Inventory' and the 'Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire'. The patients in the experimental group were given care in accordance with the protocol, which was developed in the study, on postoperative days 0, 1 and 2.</p><p><strong>Results: </strong>The statistical evaluation showed a significant difference between the mean scores of the experimental (F = 7.28; p < .001) and control groups (F = 2.42; p < .05) on the pain assessment scale. It was determined that the number of analgesics used in the experimental group was statistically significantly lower than in the control group. Intra-group comparisons showed that there was a difference between the mean pre-test and post-test state anxiety scale scores of the groups (p < .001). The experimental group had higher mean scores on the Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire than that of the control group (p < .001).</p><p><strong>Conclusions: </strong>The protocol developed in the study was found to be effective in reducing pain, the use of NSAIDs and opioids, and anxiety levels and increasing the level of quality of care.</p><p><strong>Relevance to clinical practice: </strong>The protocol was original and feasible in that it included independent nursing interventions to improve the quality of care by reducing pain and anxiety. Particularly, the use of protocols in intensive care units was nurses' strongest resource in patient care management. Thus, the protocol, which was prepared for intensive care patients who most frequently experience pain and anxiety, was promising for nurses in improving the quality of care by reducing pain and anxiety. However, it is necessary to conduct further studies involving longitudinal follow-up in samples and institutions with similar conditions.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13193"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480252","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":"Development and validation of an enteral feeding interruption management scale for ICU medical staff: A knowledge-, attitude- and practice-based approach.","authors":"Yuanyuan Mi, Fei Tian, Lifei Wang, Chenglin Xiang, Liang Sun","doi":"10.1111/nicc.70024","DOIUrl":"10.1111/nicc.70024","url":null,"abstract":"<p><strong>Background: </strong>Enteral feeding interruption (EFI) is a frequent issue in ICU settings, affecting nutritional adequacy and delaying recovery in critically ill patients. While tools exist to assess patients' nutritional status, no instrument evaluates ICU staff's knowledge, attitude and practice (KAP) in EFI management.</p><p><strong>Aim: </strong>To develop a reliable and valid EFI management scale for ICU medical staff based on the KAP model.</p><p><strong>Study design: </strong>This instrument development study followed the STROBE guidelines, utilizing a cross-sectional, multi-centre approach in Wuhan. A convenience sample of 400 ICU staff from eight tertiary A hospitals and two tertiary B hospitals was included between May 2021 and March 2022. A preliminary scale was constructed through literature review, interviews and expert consultations. The sample was used to assess the scale's reliability and validity.</p><p><strong>Results: </strong>The final EFI management scale comprised 41 items across three dimensions, with cumulative variance contributions of 70.341%, 70.437% and 66.550%. Cronbach's α ranged from 0.919 to 0.947, with test-retest reliability between 0.488 and 0.836. The total scale had a Cronbach's α of 0.953 and test-retest reliability of 0.977. Content validity indices (I-CVI) ranged from 0.800 to 1.000, and the scale-level CVI was 0.975.</p><p><strong>Conclusions: </strong>The EFI Management KAP Scale is a valid, reliable tool for assessing ICU medical staff's management of EFI.</p><p><strong>Relevance to clinical practice: </strong>The EFI Management KAP Scale addresses a critical gap in the standardized evaluation of critical care nurses' knowledge, attitudes and practices regarding enteral feeding interruptions. By providing a validated tool, this scale enables the identification of specific barriers and facilitators to optimal enteral nutrition delivery in critically ill patients. Its application can guide targeted educational interventions, inform policy adjustments and enhance multidisciplinary collaboration in the ICU. Ultimately, this scale supports improved enteral nutrition management, reducing complications associated with feeding interruptions and contributing to better patient outcomes in critical care settings.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70024"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774743","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":"Risk Prediction Models of Subsyndromal Delirium in Critically Ill Patients: A Systematic Review and Meta-Analysis.","authors":"Fei Wu, Tong Wang, Yana Xing, Weixin Cai, Ran Zhang","doi":"10.1111/nicc.70063","DOIUrl":"10.1111/nicc.70063","url":null,"abstract":"<p><strong>Background: </strong>The number of predictive models for assessing the risk of subsyndromal delirium (SSD) in critically ill patients is increasing, yet the quality and applicability of these models in clinical practice remain unclear.</p><p><strong>Aim: </strong>To systematically review and critically evaluate the existing risk prediction models.</p><p><strong>Study design: </strong>Eleven Chinese and English databases, including PubMed, Web of Science and Embase, were searched from their inception to August 16, 2024. Two researchers independently screened the literature, extracted data and assessed the risk of bias and applicability using the prediction model risk of bias assessment tool. Meta-analysis was conducted using Stata 17.0.</p><p><strong>Results: </strong>Eight studies were included. The SSD incidence in ICU patients ranged from 8.97% to 34.5%. The most commonly used predictors were the APACHE II score and age. The reported area under the curve (AUC) ranged from 0.788 to 0.923, with the pooled AUC value for the five validated models being 0.87 (95% CI: 0.82-0.92). Six studies had a high risk of bias, while two had an unclear risk.</p><p><strong>Conclusions: </strong>The eight included models demonstrated good performance in early identification and screening of high-risk critically ill patients for SSD, but they all exhibited a high risk of bias regarding model quality.</p><p><strong>Relevance to clinical practice: </strong>ICU professionals should carefully select and validate existing models based on their specific clinical settings before applying them. Alternatively, they can conduct new models incorporating multimodal data and artificial intelligence algorithms, utilizing large sample sizes, robust research designs and multi-center external validation.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70063"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081711","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":"Dynamic change and risk factors of intense thirst in patients admitted to neuro-intensive care unit: An observational study.","authors":"Peng Zhao, Yansi Luo, Lijun Xiang, Meng Cao, Xuemei Song, Lin Liao, Mingyu Yan, Lei Cheng, Zhihui Zhu, Xiaomei Zhang","doi":"10.1111/nicc.13184","DOIUrl":"10.1111/nicc.13184","url":null,"abstract":"<p><strong>Background: </strong>Thirst is a clinical discomfort symptom reported by most patients admitted to intensive care unit (ICU). Little is known about the dynamic change and risk factors of intense thirst in neuro-intensive care unit (Neuro-ICU).</p><p><strong>Aim: </strong>The objective of this study was to explore the dynamic change and determine the risk factors of intense thirst in patients admitted to Neuro-ICU, providing reference for personalized interventions of intense thirst.</p><p><strong>Study design: </strong>The study design is a prospective observational study. Demographic and disease-related, treatment, physiological and biochemical data were collected for 230 patients from Neuro-ICU of a hospital from May 2023 to November 2023. We assessed thirst intensity on numeric rating scale (NRS) of 0-10 (10 = worst possible thirst) at eight time points: 7:00, 9:00, 11:00, 13:00, 15:00, 17:00, 19:00 and 21:00 and a self-designed general information questionnaire based on safety protocol for thirst management to analyse the risk factors of intense thirst in Neuro-ICU patients. If thirst scores were more than 7, we defined it as intense thirst. This study followed the STROBE checklist for cross-sectional studies.</p><p><strong>Results: </strong>A total of 230 Neuro-ICU patients were observed. The dynamic analysis results showed an overall downward trend in thirst intensity, with the highest NRS thirst scores at 07:00 (6.13 ± 2.14) and the lowest at 21:00 (4.02 ± 2.72). The investigation of the current situation showed that the incidence of intense thirst in Neuro-ICU patients was 47.4%. Intense thirst in Neuro-ICU patients was predicted by dysphagia (odds ratio [OR] = 1.436, 95% confidence interval [CI]:1.063-1.941), open mouth breathing (OR = 2.201, 95% CI:1.041-4.656), high glucose (OR = 2.584, 95% CI:1.097-6.087), xerostomia (OR = 3.049, 95% CI:1.950-4.767) (all p < .05).</p><p><strong>Conclusion: </strong>The intensity of thirst was dynamically changing and the incidence of intense thirst in Neuro-ICU patients was relatively high. Timely assessment of Neuro-ICU patients' thirst severity and identification of those at high risk can ensure the implementation of effective interventions based on patients' characteristics.</p><p><strong>Relevance to clinical practice: </strong>Thirst is a pervasive distressing symptom often reported by critically ill patients. This study revealed that the clinical nurses need to enhance their focus on dynamic change of thirst, which is helpful for improving the efficiency of bundled thirst interventions at the suitable time.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13184"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512657","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":"Associations of Intensive Care Unit Acquired Weakness and Postoperative Delirium in Surgical Intensive Care Unit: A Prospective Observation Study.","authors":"Jin Qiu, Yingtong Meng, Zhiqing Yang, Rongrong Ren, Jiao Chen, Hanjun Huang, Tienan Feng, Xiaohua Ge","doi":"10.1111/nicc.70061","DOIUrl":"10.1111/nicc.70061","url":null,"abstract":"<p><strong>Background: </strong>To date, studies assessing the relationship between intensive care unit acquired weakness (ICU-AW) and postoperative delirium (POD), two of the most common complications in the intensive care unit (ICU), are lacking.</p><p><strong>Aim: </strong>To explore the association of the occurrence of POD, POD subtypes and POD duration with ICU-AW in a surgical intensive care unit (SICU).</p><p><strong>Study design: </strong>This study was a prospective observational study. Four hundred and two postoperative patients in a SICU at a tertiary hospital in Shanghai, China, participated in the study. Data were collected through the electronic medical record system of the hospital between October 2022 and July 2023. POD was assessed using the Richmond agitation-sedation scale (RASS) and the Confusion Assessment Method for the intensive care unit (CAM-ICU). The Medical Research Council score (MRC score) was used to measure ICU-AW. The bivariate logistic regression analysis was used to analyse the relationship between ICU-AW and POD, and further, the influencing factors of ICU-AW.</p><p><strong>Results: </strong>Of the 402 analysed patients (mean age: 69.2 ± 14.84, 59.7% male), 121 (30.10%) patients developed ICU-AW, and 92 (22.89%) patients developed POD. Of the ICU-AW group, 53 (43.80%) patients screened positive for POD. The occurrence of POD (odds ratio (OR), 0.227 95% CI: 0.052-0.981), hypoactive POD (OR, 4.241 95% CI: 1.490-12.072) and POD duration (OR, 2.649; 95% CI: 1.422-4.935) were independently associated with ICU-AW. Moreover, diabetes (OR, 1.710; 95% CI: 1.036-2.823) and Interleukin-6 (IL-6) (OR, 1.001; 95% CI: 1.000-1.001) were also significantly correlated with ICU-AW.</p><p><strong>Conclusions: </strong>ICU-AW was associated with POD, POD subtypes and POD duration in the SICU patients. Screening for hypoactive POD should be used as part of routine risk assessment in the SICU focused on identifying ICU-AW and specifying a timely and targeted plan during the early stages of the postoperative period.</p><p><strong>Relevance to clinical practice: </strong>While closely monitoring ICU patients with high IL-6 levels and diabetes, nurses should assess the type and duration of POD in patients and implement care interventions to prevent the development of ICU-AW.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70061"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081726","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":"Geriatric Nutritional Risk Index as a Predictor of Delirium and Pressure Injuries in Critically Ill Older Patients With Ischaemic Stroke: An Observational Cohort Study.","authors":"Dong Wang, Ankang Liu, Xiaoru Liang, Hanyuan Fan, Biyuan Han, Liming He, Yingying Hong, Qianfeng Li","doi":"10.1111/nicc.70059","DOIUrl":"10.1111/nicc.70059","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is a prevalent phenomenon among patients with ischaemic stroke, and it is associated with a multitude of adverse health outcomes.</p><p><strong>Aim: </strong>To evaluate the Geriatric Nutritional Risk Index (GNRI) as a predictor of both delirium and pressure injuries in critically ill older adults with ischaemic stroke.</p><p><strong>Study design: </strong>An observational cohort study of 969 patients with ischaemic stroke conducted at a tertiary academic medical centre in the United States, divided into two groups based on GNRI scores: at risk of malnutrition (GNRI ≤ 98) and not at risk (GNRI > 98). Delirium was assessed via the Confusion Assessment Method for the Intensive Care Unit and nursing notes; pressure injuries were identified through direct clinical observation using the International Pressure Injury Staging System. Multivariable logistic regression, propensity score matching, and inverse probability of treatment weighting were used for analysis.</p><p><strong>Results: </strong>Patients at risk for malnutrition had a significantly higher prevalence of delirium and pressure injuries compared with those not at risk (66.4% vs. 46.4% for delirium and 30.3% vs. 9.7% for pressure injuries, both p < 0.001). Multivariable analysis showed that lower GNRI scores were significantly associated with increased risks of both delirium (OR: 1.75, 95% CI: 1.28-2.40, p < 0.001) and pressure injuries (OR: 2.70, 95% CI: 1.79-4.09, p < 0.001). The results remained consistent even after propensity score matching and inverse probability of treatment weighting analyses.</p><p><strong>Conclusions: </strong>The study shows that the GNRI is an effective predictor of the risk of pressure injury and delirium in older adults with ischaemic stroke.</p><p><strong>Relevance to clinical practice: </strong>The assessment and management of nutritional status using GNRI in clinical practice has the potential to facilitate the early detection of high-risk patients and the implementation of targeted nutritional interventions.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70059"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144151","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":"Parents' experiences of psychotherapeutic support on the neonatal unit: A mixed methods systematic review to inform intervention development for a multicultural population.","authors":"Kirsty Jane, Dean Wood, Katie Gallagher, Polly Livermore, Helen Shoemark, Glenn Robert","doi":"10.1111/nicc.13194","DOIUrl":"10.1111/nicc.13194","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Parents of infants admitted to neonatal intensive care require support to minimize the impact on their mental health and to encourage engagement with their infants to support infant neurodevelopment. Many interventions aim to address this need, but there is a lack of research considering the accessibility of these for a multicultural population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To systematically identify sources of psychotherapeutic support available for parents with infants admitted to neonatal care (NNU, neonatal intensive care unit [NICU] and special care units), assess their accessibility and acceptability and identify challenges and facilitators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Six electronic databases with no restrictions on language or date were used to identify relevant studies following Preferred Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Publications were included in the review if they reviewed parent experience of an intervention actively in place to support parent experience during the neonatal unit stay. Any studies where the intervention's primary aim was infant focused, such as developmental care, were excluded. All publications were quality-assessed using quality appraisal tools appropriate for their design type. Data were extracted line by line using Sekhon et al.'s theoretical acceptability framework and questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 3309 studies were found, of which 36 studies met the inclusion criteria. Included studies were published worldwide between 2000 and 2023 and explored 15 different interventions. Challenges for parental engagement were due to preconceived ideas about intervention requirements and parents' ability to participate in them. Timely information and providers' experience in delivering the intervention were reported to support engagement and as being valuable for enhancing participant knowledge. The emotional content of interventions was found to be challenging by parents across most studies. This was prominent in interventions designed to be carried out in a group format and where keepsakes were created. However, the value of these interventions was in reducing parents' feelings of isolation through increased social support and providing a starting point for conversations with wider family and friends about the family's neonatal experience. Participant demographics were poorly reported, with only two studies taking into consideration the ethicality of the intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Poor reporting of participant demographics, and a focus on mothers as participants, means findings are not transferrable to the wider population of parents in neonatal units. Future studies should consider how to ensure that research and interventions are accessible to multicultural populations to improve the understanding of the acceptability of interventions. Better knowledge of neonates and the NNU setting amongst interve","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13194"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523645","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":"Comment on \"Delirium prevalence in emergency department patients: A systematic review and meta-analysis\".","authors":"Ganesh Bushi, Muhammed Shabil, Sanjit Sah","doi":"10.1111/nicc.13205","DOIUrl":"10.1111/nicc.13205","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13205"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548772","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":"Clinical alarm management in intensive care units: A scoping review.","authors":"Chunqing Yang, Ping Gao, Hanlin Ji, Duolin Luo, Hao Chen, Qingwen Hu, Xiaoqun Xu","doi":"10.1111/nicc.70042","DOIUrl":"10.1111/nicc.70042","url":null,"abstract":"<p><strong>Background: </strong>Clinical alarms are highly prevalent in intensive care units (ICUs), serving to alert health care providers when patients' physiological parameters exceed preset thresholds or when medical devices malfunction. However, clinical alarms also introduce new challenges that threaten patient safety. Therefore, enhancing the management of clinical alarms is of critical importance. ICU nurses are the first responders to clinical alarms, and their ability to manage alarms is closely linked to patient safety. Although many studies have investigated ICU nurse-led strategies for managing clinical alarms, a comprehensive overview of the methods and indicators for alarm management in these settings is still lacking.</p><p><strong>Aim: </strong>To identify and map management approaches, interventions and evaluation metrics for clinical alarms in ICUs.</p><p><strong>Study design: </strong>A systematic search was conducted in PubMed, The Cochrane Library, Web of Science, CINAHL, EMBASE, CNKI, SinoMed and Wan Fang Data databases to include studies related to the management of clinical alarms in ICUs.</p><p><strong>Results: </strong>The included studies (n = 23), guided by various approaches and frameworks, implemented different strategies for managing clinical alarms in ICUs. The primary management measures can be summarized as follows: tailoring alarm parameters, providing education and training on alarm management, standardizing the operation of medical devices, developing and applying assistive tools and technologies and establishing standardized alarm response procedures and protocols. Evaluation metrics addressed three levels: the alarm system, health care professionals and patients.</p><p><strong>Conclusions: </strong>The management of clinical alarms in ICUs remains an area of ongoing exploration, with a primary focus on the management of monitor alarms. Although some progress has been made, more comprehensive and systematic studies are still needed.</p><p><strong>Relevance to clinical practice: </strong>This review summarizes and consolidates studies on the management of clinical alarms in ICUs, highlighting the importance of multidisciplinary collaboration and the implementation of intelligent alarm management systems. Future research should focus on strengthening interdepartmental collaboration, conducting more specialized studies based on the differences between various ICU specialties, enhancing ICU nurses' alarm management capabilities and further ensuring patient safety.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70042"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025019","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 the experience of cardiothoracic ICU clinicians during the COVID-19 pandemic: A grounded theory study.","authors":"Leah Hughes, Benjamin Shelley, Joanne McPeake","doi":"10.1111/nicc.13186","DOIUrl":"10.1111/nicc.13186","url":null,"abstract":"<p><strong>Background: </strong>Prior to the COVID-19 pandemic a flexible approach to visiting was adopted by many Intensive Care Units in the United Kingdom. Due to the rapid spread globally of COVID-19, significant policy changes were put in place, including the restriction on visitors to patients in hospital. Evidence has emerged demonstrating the negative impact of these restrictions on patients with COVID-19, their families and the staff caring for them. However, there is limited data about the impact of these restrictions in the non-COVID ICU environment.</p><p><strong>Aim: </strong>This study aimed to explore the experiences of staff caring for non-COVID-19 patients in a cardiothoracic critical care unit during the COVID-19 pandemic.</p><p><strong>Study design: </strong>This qualitative research study adopted a grounded theory methodological approach. This methodology was used due to the unique situation, with no prior research available. We recruited healthcare staff that worked in a cardiothoracic critical care unit during the COVID-19 pandemic. Semi structured interviews were carried out, transcribed, and analysed. Using the data collected, a theory was constructed.</p><p><strong>Results: </strong>Interviews were carried out with 20 healthcare staff from a range of professions including nurses, doctors, and allied health professionals. Following data analysis four main categories emerged from the data: impact and implementation of visiting restrictions; the dehumanisation of patients; end-of-life care and witnessing distress. From these four categories, a theory has emerged suggesting that healthcare staff in a non-covid ICU were regularly exposed to potentially moral injurious events, despite being shielded from caring for patients with COVID-19.</p><p><strong>Conclusions: </strong>This study provides a theory that healthcare staff caring for non-COVID-19 critical care patients during the period of visiting restrictions were exposed to potentially morally injurious events.</p><p><strong>Relevance to clinical practice: </strong>Repeated exposure to potentially morally injurious events can lead to the development of moral injury and its adverse consequences. This study highlights the need to support all staff in the post COVID era, including those who worked in a non-COVID environment.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13186"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512661","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}