Nursing in Critical Care最新文献

{"title":"Correction to \"Investigating key factors of feeding intolerance in sepsis: A scoping review\".","authors":"","doi":"10.1111/nicc.70076","DOIUrl":"https://doi.org/10.1111/nicc.70076","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70076"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175610","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":"Effectiveness of spiritual care interventions among patients in the intensive care unit: A systematic review and meta-analysis.","authors":"Lingling Li, Meng Chen, Ningning Yu, Qixia Zhang","doi":"10.1111/nicc.13202","DOIUrl":"10.1111/nicc.13202","url":null,"abstract":"<p><strong>Background: </strong>Spiritual care interventions can be an important source of emotional support for patients in the intensive care unit (ICU). However, there is wide variation in the literature and no quantitative assessment to synthesize the results of these studies.</p><p><strong>Aim: </strong>To examine the effectiveness of spiritual care interventions on disease-related physiological parameter and treatment outcomes and psychosocial well-being outcomes among patients in the ICU.</p><p><strong>Study design: </strong>A comprehensive search was conducted across 11 databases from inception to 27 May 2024. Studies involving the implementation of spiritual care interventions for patients in the ICU were included. Cochrane's bias risk tool and JBI Critical Appraisal Checklist were used to examine the methodological quality of included studies. Review Manager 5.3 was used to conduct meta-analyses.</p><p><strong>Results: </strong>A total of 18 studies were included. Meta-analysis showed that spiritual care interventions could significantly reduce mean arterial pressure (MAP) (MD: -12.12, 95% CI: [-23.68, -0.56], p = .04), length of stay in the ICU (MD: -5.49, 95% CI: [-8.99, -2.00], p = .002), and improved consciousness (MD: 3.91, 95% CI: [1.42, 6.39], p = .002), anxiety (SMD: -1.78, 95% CI: [-3.06, -0.50], p = .006), spiritual well-being (SMD: 1.57, 95% CI: [0.05, 3.08], p = .04) and comfort (MD: 15.53, 95% CI: [10.81, 20.25], p < .01) among patients in the ICU, but had no significant effects on heart rate (HR), respiratory rate (RR), pulse rate (PR), blood pressure (BP), oxygen saturation (SpO₂), duration of ventilator use and pain.</p><p><strong>Conclusions: </strong>Spiritual care interventions could reduce MAP and length of stay in the ICU; improve consciousness, anxiety, spiritual well-being and comfort among patients in the ICU; and are still inconclusive for HR, RR, PR, BP, SpO₂, duration of ventilator use and pain. Urgent efforts are needed to better integrate spiritual care interventions into clinical care to enhance patient well-being.</p><p><strong>Relevance to clinical practice: </strong>Spiritual care interventions could improve well-being of patients in the ICU.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13202"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523644","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":"Braden score predicts 30-day mortality risk in patients with ischaemic stroke in the ICU: A retrospective analysis based on the MIMIC-IV database.","authors":"Yonglan Tang, Xinya Li, Hongtao Cheng, Shanyuan Tan, Yitong Ling, Wai-Kit Ming, Jun Lyu","doi":"10.1111/nicc.13125","DOIUrl":"10.1111/nicc.13125","url":null,"abstract":"<p><strong>Background: </strong>Ischaemic stroke remains a significant global health challenge, associated with high mortality rates. While the Braden Scale is traditionally employed to assess pressure ulcer risk, its potential to predict mortality among the intensive care unit (ICU) patients with ischaemic stroke has not been thoroughly investigated.</p><p><strong>Aim: </strong>This study evaluates the predictive value of the Braden Scale for 30-day mortality among patients with ischaemic stroke admitted to ICU.</p><p><strong>Study design: </strong>We conducted a retrospective analysis of 4710 adult patients with ischaemic stroke from the Medical Information Mart for Intensive Care (MIMIC)-IV database. The association between the Braden Scale scores and 30-day mortality was assessed using receiver operating characteristic (ROC) curve analysis, Cox regression models and Kaplan-Meier survival estimates.</p><p><strong>Results: </strong>Patients with Braden Scale scores ≤ 15.5 showed significantly higher 30-day mortality rates (p-value < 0.001; hazard ratio (HR): 2.08, 95% confidence interval (CI): 1.71-2.53). The area under the ROC curve (AUC) was 0.71, demonstrating good predictive performance. Multivariate analysis confirmed the Braden Scale as an independent predictor of mortality, after adjusting for age, gender and comorbidities.</p><p><strong>Conclusions: </strong>The Braden Scale effectively identifies high-risk ischaemic stroke patients in ICU settings, endorsing its integration into routine assessments to facilitate early intervention strategies.</p><p><strong>Relevance to clinical practice: </strong>Integrating the Braden Scale into routine ICU evaluations can enhance mortality risk stratification and improve patient care tailoring.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13125"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731563","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":"Prevalence of sleep disturbances among intensive care nurses: A systematic review and meta-analysis.","authors":"Fengxiang Gong, YuChen Mei, Yuting He, Chao Tang","doi":"10.1111/nicc.13151","DOIUrl":"10.1111/nicc.13151","url":null,"abstract":"<p><strong>Background: </strong>Demanding intensive care unit (ICU) work environments may lead to sleep disturbances in nurses, impacting their health and potentially patient safety. Yet, the prevalence remains unclear around the world.</p><p><strong>Aim: </strong>To quantify the prevalence of sleep disturbances in intensive care nurses.</p><p><strong>Study design: </strong>Systematic review and meta-analysis. A database search was conducted in Embase, PubMed, Web of Science, Scopus and CINAHL from their inception to April 2024 for relevant studies. Data from observational studies (cross-sectional or cohort) that reported the prevalence of sleep disturbances, assessed using the Pittsburgh Sleep Quality Index (PSQI > 5), pooled in random-effects meta-analyses. Subgroup analyses were used to investigate variations in the prevalence estimates in terms of available variables. A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant protocol was registered in PROSPERO (CRD42023476428).</p><p><strong>Results: </strong>In total, 24 articles were included in this study published from 1996 to 2023. Included studies were from 15 unique countries. Almost all of the studies were descriptive cross-sectional studies (n = 22; 91.7%). The included studies encompassed a range of intensive care nurses, from 42 to 605, involving a total of 3499 intensive care nurses. The reported proportion of intensive care nurses with sleep disturbances ranged from 20.0% to 100.0%, with a median of 76.7% (interquartile range: 62.9-85.7). The pooled prevalence of sleep disturbances in intensive care nurses was 75.1% (95% confidence interval: 37.2-53.1; 95% prediction interval: 30.5-95.4).</p><p><strong>Conclusions: </strong>Sleep disturbance is a common issue in intensive care nurses. The study results highlight the importance of implementing effective interventions as early as possible to improve ICU sleep quality.</p><p><strong>Relevance to clinical practice: </strong>High prevalence of sleep disturbances among intensive care nurses necessitates global interventions. Gender-neutral approaches that acknowledge comparable risks and stable prevalence over time require long-term strategies. Raising awareness through programmes is vital for implementing evidence-based interventions to promote sleep health in intensive care nurses.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13151"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001295","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":"Correction to \"The effect of hygienic care practices given to stroke patients on vital signs of patients: A self-comparison pre-experimental study\".","authors":"","doi":"10.1111/nicc.70050","DOIUrl":"https://doi.org/10.1111/nicc.70050","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70050"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995140","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 the extracorporeal membrane oxygenation specialists' impact on intensive care unit staff retention.","authors":"Jenelle Sheasby, Suzanne Krais, Aasim Afzal, Timothy J George","doi":"10.1111/nicc.70029","DOIUrl":"10.1111/nicc.70029","url":null,"abstract":"<p><strong>Background: </strong>Little is known about how the role of the extracorporeal membrane oxygenation (ECMO) specialist (ES) impacts intensive care unit (ICU) staff retention. Our facility allows staff ICU registered nurses (RNs) and respiratory therapists (RTs) to dual in the role of ES.</p><p><strong>Aim: </strong>The aim of this project was to identify any contributing factors the role of the ES may have on ICU staff retention.</p><p><strong>Methods: </strong>A retrospective review of Human Resource (HR) records of all ICU RNs and RTs was conducted and compared those who held the concurrent role of ES against those who did not, for length of tenure. We also surveyed 17 qualifying ES to identify any major factors that contribute to their retention.</p><p><strong>Results: </strong>A total of 242 employees, 206 (85.1%) ICU RNs and 36 (14.9%) RTs' records were analysed, 13 (6.3%) were ES ICU RNs, and 193 (93.7%) non-ES ICU RNs. Similarly, 4 (11.1%) were ES RTs, and 32 (88.9%) non-ES RTs. The ES ICU RNs had a significantly longer length of tenure 6.11 [4.49-8.05] compared to non-ES ICU RNS at 2.34 [1.27-4.30] years (p < .001). Likewise, the ES RTs' 13.47 [8.23-21.84] years exceeded the tenure of non-ES RTs at 3.85 [1.37-10.67] years (p = .03). The ES survey identified four key factors of the ES role that positively contribute to staff retention: financial incentives, advanced skill set, team cohesion and the rarity of opportunity.</p><p><strong>Conclusion: </strong>This project found that the role of the ES may uniquely positively impact the retention of ICU RNs and RTs.</p><p><strong>Relevance to clinical practice: </strong>Staff turnover in the ICU is a universal problem for all facilities. Interestingly, this project discovered supporting evidence that the role of the ECMO specialist may positively impact the retention of ICU staff that partakes in this role. Thus, it affects centres that currently have an ECMO programme but could also be used as a decisive tool for those centres that are considering developing one.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70029"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774749","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":"Relationship between death anxiety and resilience among critical care nurses in Oman.","authors":"Mohammed Qutishat","doi":"10.1111/nicc.13177","DOIUrl":"10.1111/nicc.13177","url":null,"abstract":"<p><strong>Background: </strong>Critical care nurses encounter numerous work-related stressors that might lead to depression and anxiety. Areas with higher patient mortality can lead to burnout, higher turnover and death anxiety. The possession of resilience and good attitudes towards mental health is of utmost importance for nurses, given their role as influential figures within society.</p><p><strong>Aim: </strong>The aim of this study was to examine the relationship between death anxiety and resilience among critical care nurses in Oman.</p><p><strong>Study design: </strong>This study employed a cross-sectional design with convenience sampling, sending 300 invitations via a URL link on a popular social media platform for critical care nurses in Oman. Out of 218 responses, the initial response rate was 72.7%. After data cleansing to remove incomplete and illegible submissions, the final sample consisted of 183 nurses who completed the Templer Death Anxiety Scale and the Connor-Davidson Resilience Scale (CD-RISC). The survey was conducted in December 2023.</p><p><strong>Results: </strong>The study found that the mean death anxiety and resilience scores were 38.23 (SD = 6.96) and 37.62 (SD = 5.32), respectively. Most of the participants exhibited a low level of death anxiety and a moderate level of resilience. The results of this study found a significant proportional correlation between death anxiety and resilience among critical care nurses in Oman (p = .000); nurses with a higher degree of resilience were shown to be significantly correlated with a lower level of death anxiety. The results showed that resilience explained 14.9% of the variation in death anxiety.</p><p><strong>Conclusions: </strong>The research in Oman reveals that critical care nurses in the country experience moderate death fear. This anxiety stems from the demanding nature of their profession, which involves providing care for critically ill patients in high-pressure environments. Factors such as cultural and religious beliefs and educational attainment are also influencing this anxiety. Resilience is positively associated with the ability to confront challenges with courage, and a positive correlation exists between resilience and death anxiety. This suggests that nurses with higher resilience may also experience higher death anxiety because of their profession's inherent responsibilities and decision-making.</p><p><strong>Relevance to clinical practice: </strong>The study on critical care nurses in Oman highlights that workplace stress and high death anxiety negatively impact their well-being and patient care quality. Factors like job demands, cultural beliefs and education influence these experiences, with resilience playing a key role in coping. Enhancing resilience and coping strategies can improve care quality and reduce turnover in nursing.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13177"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373548","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":"Early prediction of sepsis in emergency department patients using various methods and scoring systems.","authors":"Yun-Feng Song, Hao-Neng Huang, Jia-Jun Ma, Rui Xing, Yu-Qi Song, Li Li, Jin Zhou, Chun-Quan Ou","doi":"10.1111/nicc.13201","DOIUrl":"10.1111/nicc.13201","url":null,"abstract":"<p><strong>Background: </strong>Early recognition of sepsis, a common life-threatening condition in intensive care units (ICUs), is beneficial for improving patient outcomes. However, most sepsis prediction models were trained and assessed in the ICU, which might not apply to emergency department (ED) settings.</p><p><strong>Aim: </strong>To establish an early predictive model based on basic but essential information collected upon ED presentation for the follow-up diagnosis of sepsis observed in the ICU.</p><p><strong>Study design: </strong>This study developed and validated a reliable model of sepsis prediction among ED patients by comparing 10 different methods based on retrospective electronic health record data from the MIMIC-IV database. In-ICU sepsis was identified as the primary outcome. The potential predictors encompassed baseline demographics, vital signs, pain scale, chief complaints and Emergency Severity Index (ESI). 80% and 20% of the total of 425 737 ED visit records were randomly selected for the train set and the test set for model development and validation, respectively.</p><p><strong>Results: </strong>Among the methods evaluated, XGBoost demonstrated an optimal predictive performance with an area under the curve (AUC) of 0.90 (95% CI: 0.90-0.91). Logistic regression exhibited a comparable predictive ability to XGBoost, with an AUC of 0.89 (95% CI: 0.89-0.90), along with a sensitivity and specificity of 85% (95% CI: 0.83-0.86) and 78% (95% CI: 0.77-0.80), respectively. Neither of the five commonly used severity scoring systems demonstrated satisfactory performance for sepsis prediction. The predictive ability of using ESI as the sole predictor (AUC: 0.79, 95% CI: 0.78-0.80) was also inferior to the model integrating ESI and other basic information.</p><p><strong>Conclusions: </strong>The use of ESI combined with basic clinical information upon ED presentation accurately predicted sepsis among ED patients, strengthening its application in ED.</p><p><strong>Relevance to clinical practice: </strong>The proposed model may assist nurses in risk stratification management and prioritize interventions for potential sepsis patients, even in low-resource settings.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13201"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512658","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":"NICC News: Vol 30, Issue 3.","authors":"Louise Stayt","doi":"10.1111/nicc.70068","DOIUrl":"https://doi.org/10.1111/nicc.70068","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70068"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182807","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":"An optimal cut-off point for the Chelsea Critical Care Physical Assessment Tool to diagnose intensive care unit-acquired weakness in patients with mechanical ventilation: A multicentre observational study.","authors":"Yuchen Wu, Yatao Liu, Guoqiang Wang, Ang Zheng, Zhigang Zhang, Huaping Wei, Xin Wang","doi":"10.1111/nicc.70018","DOIUrl":"10.1111/nicc.70018","url":null,"abstract":"<p><strong>Background: </strong>The Chelsea Critical Care Physical Assessment Tool (CPAx) may be an optimal tool for diagnosing intensive care unit-acquired weakness (ICU-AW). However, we do not know the cut-off point for the diagnosis of ICU-AW.</p><p><strong>Aim: </strong>To ascertain the best cut-off point for CPAx to diagnose ICU-AW in adult patients with mechanical ventilation.</p><p><strong>Study design: </strong>A multicentre, prospective cross-sectional study. Participants were recruited from five ICUs in China that ranged from 20 June 2021 to 31 July 2023. The Medical Research Council Sum Scale (MRC-ss) <48 was taken as the standard to calculate the area under the curve (AUC) of CPAx. The cut-off point was determined by the maximum value of Youden Index (YI_max). The kappa (κ) test was used to test the consistency of the MRC-ss and CPAx.</p><p><strong>Results: </strong>The AUC at baseline, weaning and discharge time point was 0.87 (95% CI 0.81-0.93), 0.96 (95% CI 0.92-0.99) and 0.91 (95% CI 0.86-0.96), respectively. Correspondingly, The YImax was 0.62, 0.91 and 0.65. The best cut-off point of CPAx score to diagnose ICU-AW at baseline, weaning and discharge time point was 30.5 (sensitivity = 72%, specificity = 89%), 31.5 (sensitivity = 95%, specificity = 90%) and 31.5 (sensitivity = 94%, specificity = 71%), respectively. Due to the CPAx being an ordinal scale, it was determined preliminarily that the cut-off point for the CPAx to diagnose ICU-AW was 31 points. We took CPAx ≤31 and MRC-ss <48 as criteria to diagnose ICU-AW and test the consistency of MRC-ss and CPAx. The results showed that there was no significant difference in the incidence of ICU-AW at different time points.</p><p><strong>Conclusions: </strong>The optimal cut-off point for the CPAx to diagnose ICU-AW is a score of 31 and it has good sensitivity and specificity.</p><p><strong>Relevance to clinical practice: </strong>The CPAx ≤31 score to diagnose ICU-acquired weakness (ICU-AW) has good sensitivity and specificity, and it can help to predict the risk of ICU-AW and guide medical personnel to make interventions.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70018"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774776","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}