Nursing in Critical Care最新文献

{"title":"Knowledge, Attitude and Practice Concerning Central Line-Associated Bloodstream Infection Prevention Among ICU Nurses in China: A Multicenter, Cross-Sectional Study.","authors":"Xiaofeng He, Chunlei Li, Zhe Wang, Mayi Yang, Tianjun Zhou, Ying Gu, Yuxia Zhang, Wenchao Wang, Yan Hu","doi":"10.1111/nicc.70047","DOIUrl":"https://doi.org/10.1111/nicc.70047","url":null,"abstract":"<p><strong>Background: </strong>Globally, there has been a general decline in the occurrence of central line-associated bloodstream infection (CLABSI). Still, CLABSI remains a common healthcare-associated infection in the ICUs of hospitals in developing countries.</p><p><strong>Aim: </strong>The aim of the study was to assess knowledge, attitude and practice among ICU nurses in China concerning CLABSI prevention.</p><p><strong>Study design: </strong>A multicentre, cross-sectional study was designed. A self-designed questionnaire, informed by a literature review and expert consultation, was utilised to assess the knowledge, attitude and practice of ICU nurses. The widely used electronic data collection tool in China, known as the Wen Juan Xing platform, facilitated data gathering via the internet. A total of 989 ICU nursing staff from 22 large tertiary public hospitals in China completed the online survey between 1 May 2024 and 30 June 2024.</p><p><strong>Results: </strong>The proportion of ICU nurses with good (≥ 80% accurate response) knowledge, attitude and practice was 31.14%, 45.50% and 89.99%, respectively. ICU nurses' knowledge and attitude were mainly influenced by their age, ICU experience and professional level, meanwhile, their practice differences were found by their gender and educational level. In addition, nursing programs or processes, previous training experience and whether need more information were significantly associated with nurses' knowledge, attitude and practice.</p><p><strong>Conclusions: </strong>In summary, Chinese ICU nurses demonstrated inadequate levels of knowledge and attitude towards CLABSI prevention. Study findings suggest that arranging training in refreshing, taking advantage of experienced nurses' leading roles and changing safety culture might be useful in enhancing ICU nurses' knowledge, attitude and practice.</p><p><strong>Relevance to clinical practice: </strong>The results of this research imply that the government, nursing associations and hospitals themselves should provide tailored training programs, improve safety culture and explore dynamic assessment methods to promote optimal knowledge, attitude and practice relevant to CLABSI prevention among ICU nurses in China.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70047"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055415","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":"Communication difficulties in mechanically ventilated voiceless patients in intensive care units: A qualitative study.","authors":"Sara Brambilla, Davide Ausili, Giulia Locatelli, Stefania Di Mauro, Giacomo Bellani, Michela Luciani","doi":"10.1111/nicc.70037","DOIUrl":"10.1111/nicc.70037","url":null,"abstract":"<p><strong>Background: </strong>Mechanically ventilated patients are unable to verbally communicate due to the endotracheal tube or tracheostomy, rendering them temporarily 'voiceless'. More and more patients are conscious during mechanical ventilation because of a new paradigm based on mild/no sedation. Communicating with conscious voiceless patients can be complex and frustrating, leading to negative outcomes and experiences for patients, family members and health care professionals.</p><p><strong>Aim: </strong>To explore the negative effects of the inability to communicate verbally among voiceless patients in intensive care units (ICUs), considering the perspectives of voiceless patients, health care professionals and family members.</p><p><strong>Study design: </strong>This qualitative study uses Interpretive Description methodology. Semi-structured interviews were conducted with patients, family members and health care professionals. Data were collected at three ICUs in Italy over 3 months. Data were analysed using the Rapid and Rigorous qualitative data analysis.</p><p><strong>Results: </strong>Forty-three people were interviewed (10 patients, 13 caregivers, 13 nurses and 7 physicians). Three major themes were identified: perception of communication difficulties, negative impacts on relationships and emotions, and negative effects on care. These findings indicate that communication difficulties in ICU have negative emotional and psychological consequences for all participants and the health care provided.</p><p><strong>Conclusions: </strong>Effective communication with voiceless patients is essential for their well-being and quality of care. Future research should focus on identifying and evaluating tailored communication methods for voiceless patients.</p><p><strong>Relevance to clinical practice: </strong>This study emphasizes the importance of interventions improving voiceless communication, including training health care professionals and critical care nurses in alternative communication strategies, providing psychological support to voiceless patients, and encouraging extended family presence.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70037"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781335","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":"Health care providers' perceptions of family participation in essential care in the intensive care unit: A qualitative study.","authors":"Boukje M Dijkstra, Lisette Schoonhoven, Karin M Felten-Barentsz, Margriet J M van der Valk, Johannes G van der Hoeven, Lilian C M Vloet","doi":"10.1111/nicc.13188","DOIUrl":"10.1111/nicc.13188","url":null,"abstract":"<p><strong>Background: </strong>Family participation in essential care may benefit patients and relatives.</p><p><strong>Aim: </strong>To examine the needs, perceptions and preferences of health care providers about family participation in essential care in the adult intensive care unit.</p><p><strong>Study design: </strong>A qualitative descriptive study using inductive thematic analysis. Three focus group interviews with a total of 30 intensive care unit health care providers, consisting of 20 critical care nurses, one nursing assistant, five physicians, three physical therapists and one speech therapist working in three Dutch intensive care units.</p><p><strong>Results: </strong>One overarching theme, balancing interests, and four main themes emerged: looking after the patient's interests, taking the relatives' perspective into account, looking after interests of intensive care unit health care providers and conditions for family participation. The first theme, looking after the patient's interests, included three sub-themes: insecurity about patient's wishes and needs, patient safety concerns and potential benefits for the patient. The second theme, taking the relatives' perspective into account, was also characterized by three sub-themes: concerns about the relatives' possible burden, potential benefits for the relative and the relationship between patient and relative. The third theme, looking after interests of intensive care unit health care providers, included three sub-themes: attitude towards family participation in essential care, differing perceptions of essential care and concerns about intensive care unit health care provider's burden. The last theme, conditions for family participation, included two sub-themes: establishing a relationship and considering family participation in essential care as a process.</p><p><strong>Conclusions: </strong>Health care providers' perceptions and preferences regarding family participation in essential care in the intensive care unit are summarized in the overarching theme balancing interests. This overarching theme also reflects the needs and perceptions of patients and relatives.</p><p><strong>Relevance to clinical practice: </strong>These findings may support critical care nurses and other health care providers when encouraging family participation in essential care.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13188"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480248","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":"The Impact of Nurse-Patient Ratios on Patient Outcomes in Intensive Care Units.","authors":"Ashraf Abdelrhman Elbashir Elmdni","doi":"10.1111/nicc.70054","DOIUrl":"10.1111/nicc.70054","url":null,"abstract":"<p><strong>Background: </strong>Intensive care units (ICUs) are complex and fast-paced environments where nurse-to-patient ratios significantly influence patient outcomes. Existing research highlights the relationship between staffing levels and outcomes such as mortality, hospital-acquired infections, length of ICU stays, patient safety incidents, and nurse job satisfaction.</p><p><strong>Aim: </strong>This systematic review aims to evaluate the impact of nurse-to-patient ratios on patient outcomes and nurse well-being in ICUs, providing evidence to guide staffing policies.</p><p><strong>Study design: </strong>A systematic review of 20 studies conducted across various locations was undertaken. The review includes retrospective cohort studies, cross-sectional designs, and other methodologies. The studies were analysed to determine the influence of staffing levels on patient and nurse outcomes.</p><p><strong>Results: </strong>Safe nurse staffing levels were associated with a 14% reduction in hospital mortality, shorter ICU stays, a 20% improvement in infection prevention, and an average ICU stay reduction of 1.5 days. Enhanced patient satisfaction by 18% in units with adequate staffing. Conversely, lower staffing ratios were linked to a 25% increase in adverse events, nurse fatigue, and diminished patient safety outcomes. The findings underscore the necessity of adequate staffing strategies and the adoption of workforce technologies to enhance care quality in ICUs.</p><p><strong>Conclusions: </strong>This review highlights the critical role of nurse-to-patient ratios in improving patient outcomes and nurse well-being in ICUs. Future research should focus on standardizing methodologies to evaluate staffing strategies and exploring their long-term impacts on both patient and nurse outcomes.</p><p><strong>Relevance to clinical practice: </strong>These findings emphasize the importance of implementing evidence-based staffing policies and integrating supportive technologies to ensure optimal care delivery and staff satisfaction in ICUs.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70054"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183541","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":"Long-Term Effects of Daily Versus Alternate-Day Chlorhexidine Bathing on Central-Line-Associated Blood Stream Infection in Medical Intensive Care Units: A Four-Year Observational Study.","authors":"Yi-Chen Lin, Hao-Yun Chang, Hui-Ji Lin, Pao-Yu Chen, Shiao-Pei Wang, Pao-Yu Chuang, Yee-Chun Chen, Chia-Chun Tang","doi":"10.1111/nicc.70049","DOIUrl":"https://doi.org/10.1111/nicc.70049","url":null,"abstract":"<p><strong>Background: </strong>Daily chlorhexidine gluconate (CHG) bathing may reduce central line-associated bloodstream infections (CLABSI) in critically ill patients, but evidence remains inconclusive, particularly regarding long-term effects and varying frequencies of use.</p><p><strong>Aim: </strong>This study aimed to examine the association between different CHG bathing frequencies and CLABSI rates in medical intensive care units (MICUs).</p><p><strong>Study design: </strong>A retrospective analysis was conducted in three MICUs in northern Taiwan from March 2018 to June 2022. One MICU implemented daily CHG bathing for 21 months, followed by every-other-day CHG bathing for 30 months, while two MICUs used water and soap as standard care. CLABSI rates per 1000 central line days and other clinical outcomes were compared.</p><p><strong>Results: </strong>Across 46 409 central line days and 5482 admissions, 357 CLABSI events were recorded. No significant difference in CLABSI rates was found between the CHG and standard care groups (IRR = 1.1, p = 0.36) or between the different CHG bathing frequencies (IRR = 0.68, p = 0.06). Other clinical outcomes showed no significant differences.</p><p><strong>Conclusions: </strong>CHG bathing, whether daily or alternate-day, was not significantly associated with lowering CLABSI rates in MICU. The association may vary depending on hospital-specific conditions and infection profiles.</p><p><strong>Relevance to clinical practice: </strong>CHG bathing should not be regarded as a universal infection control strategy in ICUs. It should be evaluated within the context of each ICU's specific conditions and infection prevention strategy.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70049"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038660","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":"Perspectives on Death and the Awareness of Mortality in Relatives of Intensive Care Patients: A Descriptive Study.","authors":"İbrahim Salih Palazoğlu, Zeliha Koç","doi":"10.1111/nicc.70060","DOIUrl":"https://doi.org/10.1111/nicc.70060","url":null,"abstract":"<p><strong>Background: </strong>Various factors, including their psychology, their perspective on the world, their religion, the culture in which they live and their previous experiences, may affect an individual's perception and awareness of mortality.</p><p><strong>Aim: </strong>This study was conducted to determine perspectives on death and awareness of mortality in relatives of patients who were receiving treatment in the intensive care unit of a university hospital in Turkey.</p><p><strong>Study design: </strong>This descriptive and correlational study was conducted at a university hospital in Turkey between July 15, 2022, and May 15, 2024. A total of 305 relatives of intensive care patients participated in the study. Data were collected using a Relatives' Introductory Information Form, the Multidimensional Mortality Awareness Measure (MMAM) and the Death Perspectives Scale (DPS). A structural equation model (SEM) was developed using the maximum likelihood approach to investigate the direct effects on the dependent variable. The impact of the DPS subscale scores on the MMAM scores was analysed through path analysis.</p><p><strong>Results: </strong>The path coefficients between the MMAM and the subscales of the DPS, specifically Afterlife-of-Reward (β = 0.213), Unknown (β = 0.125), Failure (β = 0.156) and Courage (β = 0.145), were found to be statistically significant. This model was found to explain 30.1% of the variation in the MMAM scores.</p><p><strong>Conclusions: </strong>This study found a relationship between the levels of awareness of mortality and death perspective in the relatives of patients.</p><p><strong>Relevance to clinical practice: </strong>Intensive care nurses should provide family-centred care. Death counselling and education should be provided in order to prepare relatives to accept the impending death of the patient.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70060"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081710","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":"Nurse-led evidence-based quality improvement programme to improve intensive care unit patient sleep quality.","authors":"Weidi Wang, Xinyan Cao, Jiabin Luan, Qi Zhang, Chun Cai, Juan Han","doi":"10.1111/nicc.70028","DOIUrl":"10.1111/nicc.70028","url":null,"abstract":"<p><strong>Background: </strong>Patients in the intensive care unit (ICU) suffer from significant sleep disturbances, which can negatively impact their healing and overall health. Nurses, as the primary caregivers, need to have expertise in sleep management to ensure better patient outcomes. Implementing nurse-led, evidence-based sleep protocols in ICUs is crucial.</p><p><strong>Aim: </strong>This study aimed to improve ICU patients' sleep quality by developing and implementing a nurse-led, evidence-based SLEEP Bundle, including Sleep initiative, Light control, Eye mask and earplugs usage, Environment noise cancellation and Provision of non-pharmacological (aromatherapy and music therapy) and pharmacological (dexmedetomidine and painkillers) support.</p><p><strong>Methods: </strong>The Framework of Evidence-based Continuous Quality Improvement and the Ottawa Model of Research Use framework were used to guide the development, implementation and assessment of the SLEEP Bundle. A quasi-experimental study was conducted in a 12-bed surgical intensive care unit (SICU), assessing patient-perceived sleep quality, nurses' self-report knowledge, attitudes and actions regarding patient sleep conditions and nurses' adherence to the interventions.</p><p><strong>Interventions: </strong>In order to successfully translate evidence into clinical practice, the protocol was crafted with significant nurse involvement, input in sleep promotion materials and a flexible continuing education component, which provided credits to encourage nurse participation. A sleep-aid kit, complete with non-pharmacological tools, and a system of regular quality control and feedback were integral to the clinical application of the protocol.</p><p><strong>Results: </strong>The intervention significantly enhanced ICU patients' sleep quality, as evidenced by a significant increase in Richards-Campbell Sleep Questionnaire scores from 62 (IQR = 48-72) to 70 (IQR = 62-76) (95% CI [-10.000, -6.000], Z = -6.100, p < .001). Nurses demonstrated a 100% agreement in knowledge items and a significant upsurge in action items following the intervention. Concurrently, adherence to practice standards showed notable improvements in sleep management practices, including enhanced sleep quality assessment, daytime functional exercise support and compliance with environmental regulations, along with increased use of earplugs, eye masks and aromatherapy/music therapy.</p><p><strong>Conclusions: </strong>The study highlights the effectiveness and feasibility of a nurse-led sleep management strategy, as demonstrated by improved patient outcomes and increased nurse adherence to sleep promotion interventions.</p><p><strong>Relevance to clinical practice: </strong>The significant improvements in sleep quality as well as the increased adherence to evidence-based interventions by nurses suggest that this SLEEP Bundle could be effectively translated to other clinical settings.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70028"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789406","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":"Developing an ultrasound-guided enteral nutrition protocol for critically ill patients based on the Delphi method.","authors":"Zeyu Li, Wei He, Dun Tian, Yang Sun, Qing Yang, Lan Cao","doi":"10.1111/nicc.70023","DOIUrl":"10.1111/nicc.70023","url":null,"abstract":"<p><strong>Background: </strong>Enteral nutrition is widely recommended in intensive care units, but its implementation is accompanied by some problems.</p><p><strong>Aim: </strong>This study aimed to develop a current-evidence-based, operable and repeatable ultrasound-guided enteral nutrition (EN) programme for critically ill patients.</p><p><strong>Study design: </strong>First, based on a literature review, we integrated guidelines, expert consensus, systematic review and clinical experimental studies on critically ill patients. Subsequently, after careful evaluation and selection of relevant EN management data, we formulated a preliminary draft of an ultrasound-guided EN protocol for critically ill patients. Based on feedback from Delphi experts, the protocol was revised, and the final version of the programme was constructed.</p><p><strong>Results: </strong>After two rounds of consultation, the expert opinions reached a consensus. The expert positive coefficient was 1.00, and the expert authority coefficient was 0.935. After the second round of consultation, the coefficient of variation for the importance score ranged from 0.04 to 0.19, and that for the feasibility score ranged from 0.04 to 0.21. The difference in Kendall harmony coefficients was statistically significant (p < .05). The final programme comprised four Level I, 15 Level II and 40 Level III projects.</p><p><strong>Conclusions: </strong>The EN protocol for critically ill patients established in this study is comprehensive and feasible and can provide guidance for clinical practice.</p><p><strong>Relevance to clinical practice: </strong>This study adopted the Delphi method to develop an ultrasound-guided EN programme for critically ill patients, providing a new protocol by which critical care nurses can implement EN. This protocol provides a reliable and comprehensive basis for ensuring the quality and safety of EN management in critically ill patients in the future.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70023"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796456","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":"Nurses' compliance to ventilator-associated pneumonia prevention bundle and its effect on patient outcomes in intensive care units.","authors":"Fatma Al-Harthi, Huda Al-Noumani, Gerald Amandu Matua, Harith Al-Abri, Annie Joseph","doi":"10.1111/nicc.70043","DOIUrl":"https://doi.org/10.1111/nicc.70043","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) is a significant healthcare-associated infection. Compliance with VAP guidelines reduces infection and leads to better patient outcomes.</p><p><strong>Aim: </strong>The study investigated the VAP rate, nurses' compliance with the VAP bundle and the correlation between nurses' compliance with the VAP bundle and key patient-related outcomes.</p><p><strong>Study design: </strong>This descriptive correlational prospective study was conducted at two tertiary hospitals. All intensive care unit patients on mechanical ventilators who met the inclusion criteria for 48 h or more were recruited. Data were analysed using descriptive statistics, Chi-square, independent t-test and Spearman's rank correlation.</p><p><strong>Results: </strong>Out of the 103 patients recruited, 22.3% of patients developed VAP, with a VAP rate of 5.6 per thousand ventilator days. Nurses' compliance with VAP guidelines in both hospitals was 69% and decreased over the admission period. Compliance with the VAP bundle was linked to less length of stay (rho = -0.260, p < .008), fewer mechanical ventilation days (rho = -0.300, p < .002) and less hospital cost (rho = -0.266, p < .007). The mean compliance with the VAP care bundle was higher in the non-VAP group (M = 72.9, SD = 23.79) than in patients who developed VAP (M = 56.6, SD = 18.96).</p><p><strong>Conclusions: </strong>The findings underscore the critical need for healthcare organizations to prioritize strategies to enhance compliance with VAP guidelines for improved patient outcomes.</p><p><strong>Relevance to clinical practice: </strong>Ongoing quality improvement efforts through regular audits of the VAP bundle implementation are crucial for reducing infections and complications and improving patient outcomes. Future research is recommended to investigate factors that impact nurses' adherence to VAP guidelines to develop interventions to enhance compliance.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70043"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007831","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":"Content Validation of the Behavioural Indicators of Pain Scale in Critically Ill Patients With Acquired Brain Injury: A Delphi Study.","authors":"Candelas López-López, Ignacio Latorre-Marco, María Del Mar Sánchez-Sánchez, Carmen María Sarabia-Cobo, Montserrat Solís-Muñoz, Teresa Pérez-Pérez, Juan Roldan-Merino, Gemma Robleda-Font","doi":"10.1111/nicc.70053","DOIUrl":"10.1111/nicc.70053","url":null,"abstract":"<p><strong>Background: </strong>Pain assessment in critically ill patients with acquired brain damage and disorders of consciousness is challenging.</p><p><strong>Aim: </strong>To evaluate the content validity of an adapted version of the Behavioural Indicators of Pain Scale (Spanish: Escala de Conductas Indicadoras de Dolor [ESCID]) in patients with acquired brain damage, disorders of consciousness and an artificial airway.</p><p><strong>Study design: </strong>Modified e-Delphi study. Five rounds of e-Delphi study to assess the content validity of the ESCID were conducted. Ten experienced clinical experts specialized in the area of interest were recruited. The starting point for the e-Delphi study was a questionnaire containing 30 behavioural indicators of pain. The expert panel evaluated the content validity of the 30 items based on four criteria: relevance, pertinence, clarity and usefulness. Each criterion was scored on a Likert-type scale ranging from 1 'strongly disagree' to 5 'strongly agree'. Upon completion of all five e-Delphi rounds, a face validity test was performed.</p><p><strong>Results: </strong>Of the initial 30 behavioural indicators, 10 remained after the final round. These items were defined and categorized and included in the final version of the instrument. The degree of consensus among the experts was high with regard to the content validity of these 10 indicators. In terms of face validity, 70% of the experts considered that the writing and comprehensibility of nine of the 10 items was 'good'.</p><p><strong>Conclusions: </strong>A strong consensus was reached by the expert panel through the e-Delphi technique. The 10 items represent the content of the behavioural response to pain in this population.</p><p><strong>Relevance to clinical practice: </strong>This study is the first step to adapt Behavioural Indicators of Pain Scale for use in this patient population. This adapted scale will provide clinicians with a specific tool to improve pain detection and management.</p><p><strong>Trial registration: </strong>The protocol is registered with ClinicalTrials.gov: NCT04898491, available at: https://classic.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/NCT04898491.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70053"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143821","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}