Nursing in Critical Care最新文献

{"title":"Environmentally Sustainable Waste Segregation and Linen Use in a Burn and Polytrauma Intensive Care Unit: A Nurse-Led Quality Improvement Initiative.","authors":"María Ibarra Hernández, Jorge Bonastre Juliá, Roberto González Fernández, Sara González Martín, Saray López Tornero, Eva Martín Morente, Yuliana Monsalve Cárdenas, Javier Remondo Blanco, Raquel Rincón Domínguez, Juana Janet Silva Leiguez, Jesús Díez-Sebastián, Manuel Quintana Díaz","doi":"10.1111/nicc.70165","DOIUrl":"https://doi.org/10.1111/nicc.70165","url":null,"abstract":"<p><strong>Background: </strong>The healthcare sector is a significant producer of greenhouse gas emissions, with intensive care units (ICUs) being major contributors. The environmental impact of medical waste largely depends on disposal methods; proper segregation can enhance recycling potential.</p><p><strong>Local problem: </strong>High variability in waste segregation and excessive linen consumption in the burn and polytrauma ICU.</p><p><strong>Methods: </strong>This quality improvement initiative in a 10-bed burn and polytrauma Spanish ICU used a pre-post interventional study design to address poor waste segregation and excessive linen use challenges.</p><p><strong>Interventions: </strong>Following educational workshops, placement of posters and reducing chemical waste container size, the workflow for medical waste segregation was improved. During a 60-day baseline period, packaging waste, chemical waste and linen were measured for burn victims, polytrauma cases and conventional ICU patients. A new intervention focused on packaging and chemical waste segregation practices, classifying plastic or glass containers with less than 10% medication remaining as recyclable. Measurements were repeated during a subsequent 112-day intervention period.</p><p><strong>Results: </strong>Significant differences were observed during the baseline period: average packaging waste per shift was 251.51 g (range: 62.34-440.68; p = 0.02) and average daily packaging waste was 754.53 g (range: 187.02-1322.02; p = 0.02) for burn victims compared with other groups. When comparing both periods, total chemical waste decreased from 5.34 kg (range: 4.06-6.62) to 2.07 kg (range: 1.76-2.38), with average chemical waste per patient per day dropping from 790 g (range: 582.10-998.20) to 304.70 g (range: 260.50-348.90), both statistically significant (p = 0.001). Linen usage indicated a decrease in variability despite not reaching statistically significant differences (p = 0.154).</p><p><strong>Conclusions: </strong>This study demonstrated that improving segregation criteria reduced variability in waste management within an ICU setting. Chemical waste was successfully decreased while increasing recyclables, showing that transforming a conventional ICU into a sustainable one is both feasible and effective.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70165"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Centred Approaches to Prevent ICU-Acquired Weakness: Insights From Early Mobilisation Participation.","authors":"Hui Zhang, Yu Sheng, Qing Li, Zunzhu Li, Hongbo Luo, Qinglai Zhang, Frances Fengzhi Lin","doi":"10.1111/nicc.70158","DOIUrl":"10.1111/nicc.70158","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit-acquired weakness (ICU-AW) affects approximately 50% of critically ill patients, leading to prolonged recovery, increased healthcare costs and reduced quality of life. Early mobilisation is a promising intervention to mitigate ICU-AW, but its effectiveness is often limited by inconsistent patient participation and a lack of patient-centred approaches.</p><p><strong>Aim: </strong>To explore how varying levels of patient participation in early mobilisation are associated with ICU-AW incidence, thereby informing personalised intervention strategies.</p><p><strong>Study design: </strong>A prospective cohort observational study.</p><p><strong>Results: </strong>A total of 152 patients were enrolled in the study between July and November 2023. After excluding 11 patients with incomplete data, 141 patients were included in the final analysis. An association was observed between levels of early mobilisation participation and muscle strength at ICU discharge (area under the curve = 0.788, cut-off ≥ 3, 95% CI: 0.712-0.864, p < 0.001). Patients with higher participation (≥ 3) demonstrated significantly stronger muscle strength and lower ICU-AW incidence than those with lower participation (< 3). Factors influencing participation included age, sex, surgical status and mechanical ventilation.</p><p><strong>Conclusions: </strong>Patient participation is a critical determinant of recovery outcomes in early mobilisation interventions. Tailored, patient-centred strategies are essential to optimise recovery and reduce ICU-AW risk.</p><p><strong>Relevance to clinical practice: </strong>This study underscores the importance of integrating patient-centred approaches into ICU care, particularly highlighting the crucial role of critical care nurses in enhancing participation in early mobilisation. By fostering a supportive and personalised environment, nurses can significantly improve recovery outcomes, reduce ICU-AW and lower healthcare costs.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70158"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978025","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 Presence of Family Members During Brainstem Testing: An Ethical Dilemma.","authors":"Natalie L McEvoy, Pierce Geoghegan, Sophia Downey, Jos Latour, Alan Gaffney, James O'Rourke, Gerard F Curley","doi":"10.1111/nicc.70161","DOIUrl":"10.1111/nicc.70161","url":null,"abstract":"<p><p>The purpose of this article was to discuss the ethical issues relevant to inviting family members to witness brainstem testing in the intensive care unit (ICU). To highlight these issues, we begin by discussing a hypothetical clinical case of a patient admitted to the ICU following an out-of-hospital cardiac arrest. A brief review of the literature on current practice will be presented, followed by a balanced discussion on the practice of permitting relatives to witness brainstem testing under the ethical principles of beneficence, non-maleficence, autonomy and justice. Finally, we will present a discussion on international recommendations surrounding this practice as well as a proposed research agenda to further understand the risks and benefits of family members witnessing brainstem testing. We conclude that offering family members the opportunity to witness brainstem tests in the ICU may support them in understanding the term brain death and might contribute to their closure.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70161"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076102","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":"Correction to 'Understanding oral care in the intensive care unit: A qualitative study of nurse experiences and practices with mechanically ventilated patients'.","authors":"","doi":"10.1111/nicc.70164","DOIUrl":"https://doi.org/10.1111/nicc.70164","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70164"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977934","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 Role of Neonatal Nurses in Mechanical Ventilation Management.","authors":"Ntombifikile Klaas, Tsholofelo Matlhola","doi":"10.1111/nicc.70150","DOIUrl":"10.1111/nicc.70150","url":null,"abstract":"<p><strong>Background: </strong>Nurses have a critical role in managing mechanical ventilation (MV) in neonatal intensive care units (NICUs). Despite their critical role in day-to-day MV management, their role in key decisions, particularly extubating and weaning, remains limited.</p><p><strong>Aim: </strong>To describe the role of neonatal nurses in MV management in neonatal intensive care units.</p><p><strong>Study design: </strong>Descriptive survey design: Data were collected using the Survey of Mechanical Ventilation and Weaning Roles and Responsibilities questionnaire. Census sampling was used to select 108 nurses working in NICUs from two university-affiliated hospitals in Gauteng, South Africa. Descriptive and comparative statistics were applied to analyse the data.</p><p><strong>Results: </strong>This study achieved an 83.3% response rate, revealing that MV decisions were predominantly collaborative between nurses and doctors. While 90% of nurses were involved in patient evaluation and ventilator adjustments, their role in extubation decisions was limited (45.6%), with doctors making most extubation decisions (54.4%). Oxygen titration was the most frequently managed ventilator setting by neonatal nurses. Nurses' perceived autonomy and influence in MV decision-making had median scores of 6.0, with higher perceived nursing autonomy significantly linked to independent decision-making (OR = 1.55; 95% CI = 1.22-1.97; χ²(1) = 12.86; p < 0.001) and higher influence scores significantly predicting autonomous decisions (OR = 1.86; 95% CI = 1.40-2.47; χ²(1) = 18.34; p < 0.001). However, only 36% of ICUs had weaning protocols, and ongoing MV education was lacking.</p><p><strong>Conclusion: </strong>The study underscores the need for enhanced education, structured training and standardised protocols to strengthen nurses' competency, perceived autonomy and confidence in MV management. While nurses actively participate in ventilation-related decisions, their autonomy remains limited, particularly in extubation decisions.</p><p><strong>Relevance to clinical practice: </strong>Optimising neonatal outcomes requires well-prepared nurses who can actively and confidently contribute to MV-related decisions. Enhancing nurses' autonomy through structured education and standardised protocols is crucial for improving neonatal outcomes and promoting safer, more effective care and strengthens collaboration in NICUs.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70150"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876641","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 factors of ventilator-associated events in patients on mechanical ventilation: A scoping review.","authors":"Evy Dwi Rahmawati, Dian Rizki Ramadhani, Afrianti Pakalessy, Sri Setiyarini","doi":"10.1111/nicc.13261","DOIUrl":"10.1111/nicc.13261","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated events (VAE) are associated with higher mortality rates. Understanding the risk factors for VAE provides preventive strategies for reducing them. Several studies have been conducted on VAE risk factors. However, the findings were inconsistent.</p><p><strong>Aim: </strong>This scoping review aimed to explore the existing evidence on risk factors of VAEs in intensive care unit (ICU) patients.</p><p><strong>Study design: </strong>Searches were performed across eight databases including Pubmed, ProQuest, Scopus, ScienceDirect, BMJ, Web of Science, Taylor & Francis and Ebsco from 26 March to 5 April 2024, complemented by backward and forward citation tracking-eligible studies criteria: participants aged 18 years and older reporting on VAE risk factors. The publication must have occurred between 2013 and 2024, be available as full text and be written in English. A total of 19 studies met the inclusion criteria and were analysed.</p><p><strong>Results: </strong>Forty-four risk factors were identified. Decreased level of consciousness, chronic lung diseases, invasive operation, duration of MV, trauma, fluid overload, reintubation, enteral feeding, administration of sedation and stress ulcer prophylaxis were the most frequently reported risk factors for VAE.</p><p><strong>Conclusions: </strong>This review identified several potential risk factors for VAE; some factors have varying results or lack evidence. Further research is needed to confirm the role of these factors in reducing VAE or to clarify inconsistent findings.</p><p><strong>Relevance to clinical practice: </strong>These findings provide information on the risk factors for VAE. Nurses must identify the presence of these risk factors in all adult ICU patients receiving invasive mechanical ventilation (IMV) and manage them to prevent the occurrence of VAE.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13261"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068728","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":"Critical Care Outreach Team Nurses' Approaches to End-of-Life Conversations: An Interpretive Descriptive Study.","authors":"Marley Gregorio, Yolanda Babenko-Mould, Brandi Vanderspank-Wright","doi":"10.1111/nicc.70159","DOIUrl":"https://doi.org/10.1111/nicc.70159","url":null,"abstract":"<p><strong>Background: </strong>Critical care outreach team (CCOT) nurses are part of hospital emergency response teams, assessing and mobilising resources for decompensating patients. Although a significant proportion of this role involves addressing end-of-life (EOL) issues, this role is ill-defined in the literature and in practice.</p><p><strong>Aim: </strong>To explore the experiences of CCOT nurses with EOL conversations.</p><p><strong>Study design: </strong>A qualitative interpretive descriptive methodology guided the study. A semi-structured interview guide was used to collect audio-recorded individual interview data from CCOT nurses from seven hospitals in Ontario. Interview data were analysed using a thematic analysis approach.</p><p><strong>Results: </strong>Data from 11 CCOT nurse participants revealed two key themes: 'Acquiring skills to discuss end-of-life issues' and 'Dynamic approaches to end-of-life conversations'. CCOT nurses' role in EOL conversations diverged significantly from their practice as bedside critical care nurses, assuming additional autonomy and responsibility in these conversations. Although CCOT nurses frequently had to navigate EOL discussions, they reported very little training to assist in acquisition of this skill. Despite no uniform education being provided to CCOT nurses, all nurses across multiple unrelated organisations reported using similar approaches.</p><p><strong>Conclusions: </strong>Findings from this study suggest that navigating EOL issues is an important learning need for CCOT nurses, pointing towards the need for more robust education at organisational, provincial and national levels. Additional research is recommended to quantify the participation of CCOT nurses in EOL discussions, expanding knowledge about the extent of their involvement. Further research is also warranted to delineate and support nursing scope of practice within this role, informing policy and guidelines.</p><p><strong>Relevance to clinical practice: </strong>CCOT nurses encounter EOL issues in their daily practice. Additional education and increased role clarity are recommended to support nurses in this practice area.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70159"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994361","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":"Mitigating the impact of emotional exhaustion among young intensive care unit nurses: A structural equation model based on the conservation of resources theory.","authors":"Xiaona Zhang, Haitao Huang, Hua Du, Dan Li","doi":"10.1111/nicc.13266","DOIUrl":"10.1111/nicc.13266","url":null,"abstract":"<p><strong>Background: </strong>As the backbone of the intensive care unit nursing team, young nurses' emotional and psychological well-being is related to the physiological health and life outcomes of critically ill patients.</p><p><strong>Aim: </strong>Exploring the impact of access to and utilization of organizational resources on emotional exhaustion among intensive care unit nurses.</p><p><strong>Study design: </strong>A cross-sectional survey. SPSS 27.0 was used for descriptive analysis and Pearson correlation analysis. AMOS 25.0 was used to construct the structural equation model and conduct the Bootstrap test.</p><p><strong>Results: </strong>A total of 447 valid questionnaires were ultimately included, with a validity rate of 91.2%. The results showed that the turnover intention of young intensive care unit nurses was high (2.06 ± 0.67). Emotional exhaustion positively predicts nurses' turnover intentions (β = 0.30, p < .001). Inclusive leadership (β = 0.075, 95% CI: 0.04 to 0.116, p < .001) and distributive justice (β = 0.090, 95% CI: 0.059 to 0.132, p < .001), as organizational resources, respectively moderate the relationship between emotional exhaustion and turnover intention, and play a chain-mediated role in their relationship (β = 0.055, 95% CI: 0.036 to 0.081, p < .000). Additionally, the study did not show a direct effect of emotional exhaustion on work engagement (β = -0.07, p = .083). Instead, this relationship is mediated through distributive justice (but not inclusive leadership) (β = -0.203, 95% CI: -0.258 to -0.146, p < .001). At the same time, inclusive leadership and distributive justice serve as serial mediators in the mechanism by which emotional exhaustion affects work engagement (β = -0.125, 95% CI: -0.167 to -0.096, p < .000).</p><p><strong>Conclusions: </strong>This study emphasizes that organizational resources can effectively alleviate the impact of emotional exhaustion among young intensive care unit nurses.</p><p><strong>Relevance to clinical practice: </strong>Health care institutions and nursing managers need to recognize the importance of utilizing organizational resources and take necessary measures to alleviate emotional exhaustion among intensive care unit nurses. By implementing effective policies, they can enhance nurses' work engagement and retain nursing talent.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13266"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048714","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":"Insights from the top-cited papers in the critical care nursing literature: A bibliometric and visualized analysis.","authors":"Sameh Eltaybani, Natalie McEvoy","doi":"10.1111/nicc.13236","DOIUrl":"10.1111/nicc.13236","url":null,"abstract":"<p><strong>Background: </strong>Highly cited papers in critical care nursing can offer valuable insights for all stakeholders engaged in the research process by highlighting key research trends, guiding resource allocation and shaping future research priorities.</p><p><strong>Aim: </strong>To gain insights from the top-cited papers in the top critical care nursing journals.</p><p><strong>Study design: </strong>This was a bibliometric analysis of the top-cited papers in the top critical care nursing journals as reported by the Journal Citation Report 2023-released in June 2024. Data were tabulated and visualized using Microsoft Excel and the VOSviewer software.</p><p><strong>Results: </strong>Forty papers from the top four critical care nursing journals (Intensive and Critical Care Nursing [ICCN], Nursing in Critical Care [NICC], Australian Critical Care [ACC] and American Journal of Critical Care [AJCC]) were analysed. Half of the analysed papers were related to the COVID-19 pandemic, and mental health was the most addressed theme (n = 11 papers). Papers from the ICCN featured contributions from 17 countries, the highest among the journals analysed, followed by NICC, with contributions from 11 countries. Articles received more citations than reviews (median [interquartile range]: 18 [9-23] vs. 8 [8-11.5]), and open-access papers were cited about twice those published under a subscription model (19 [16-31] vs. 9 [8-15]). In ICCN, 9 of the 10 analysed papers were published open access compared with 3 in NICC and ACC and 2 in AJCC.</p><p><strong>Conclusions: </strong>The identified themes in this paper underscore the dynamic nature of the field of critical care nursing and the ongoing efforts to address key challenges in critical care nursing practice and health care delivery. Publishing open-access articles on trending topics and collaborating internationally seem to be effective approaches for gaining more citations.</p><p><strong>Relevance to research: </strong>Understanding these prevalent themes has significant implications for guiding research priorities, informing clinical practice, shaping policy and improving patient outcomes. Academic journals need to encourage increasing the representation of researchers from the Global South in both journals' editorial boards and submissions to the journals.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13236"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985407","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":"Nurses' Views on Barriers to Oral Care in Non-Mechanically Ventilated Patients in the Intensive Care Unit: A Qualitative Study.","authors":"Auxillia Madhuvu, Marilyn Andrews, Carly Rienecker, Ashilta Prasad, Wendy Pollock","doi":"10.1111/nicc.70173","DOIUrl":"10.1111/nicc.70173","url":null,"abstract":"<p><strong>Background: </strong>Optimal oral care is essential in preventing non-ventilator hospital-associated pneumonia and enhancing patient comfort. However, nurses' clinical oral care practices for patients not on mechanical ventilation in the intensive care unit are both underreported and understudied.</p><p><strong>Aim: </strong>To explore intensive care nurses' clinical oral care practices for patients not on mechanical ventilation in intensive care units.</p><p><strong>Study design: </strong>A qualitative descriptive study using semi-structured in-depth individual interviews. Intensive care nurses with more than 6 months experience were recruited via the professional association, the Australian College of Critical Care Nurses and snowballing. Purposive sampling was used, and information power was used to indicate when to stop data collection. Interviews were undertaken with ten intensive care nurses working with adult patients between May and September 2023. The interviews were audio-recorded, transcribed and analysed using Framework Analysis.</p><p><strong>Results: </strong>Most of the participants had a postgraduate qualification in intensive care nursing. Four main themes were derived from the data: (i) challenging patient needs and prioritisation of care, (ii) inadequate knowledge and education, (iii) perception of inadequate use of evidence-based practice and equipment and (iv) structured support needed for evidence-based practice.</p><p><strong>Conclusions: </strong>These themes highlight ongoing issues with nurses' knowledge and education and implementation of available evidence-based practice. Findings suggest the need for a well-established policy to underpin practice. The barriers faced by intensive care nurses need to be addressed to enhance the quality of patient care.</p><p><strong>Relevance to clinical practice: </strong>Improving oral care in non-mechanically ventilated patients would decrease the rates of hospital-associated pneumonia, systemic diseases such as respiratory and cardiovascular diseases, and promote patient comfort. A comprehensive strategy using an implementation framework is required to address nurses' knowledge gaps and techniques that enhance evidence-based practices.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 5","pages":"e70173"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034549","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}