Nursing in Critical Care最新文献

{"title":"Exploring Video Calls and PTSD Symptoms in Family Members of Severe COVID-19 Patients Post-ICU Discharge: A Mixed-Methods Study.","authors":"Ayako Noguchi, Nobuyuki Nosaka, Akiko Mizoe, Takashi Takeuchi, Kenji Wakabayashi","doi":"10.1111/nicc.70114","DOIUrl":"10.1111/nicc.70114","url":null,"abstract":"<p><strong>Background: </strong>Preventing post-traumatic stress disorder (PTSD) symptoms in family members of intensive care unit (ICU) patients underscores the importance of patient-family interactions. The COVID-19 pandemic restricted direct visits, prompting video calls as an alternative.</p><p><strong>Aim: </strong>To examine the association between video calls and the development of PTSD symptoms in family members of patients admitted to a COVID-19 ICU.</p><p><strong>Study design: </strong>This mixed-methods study was conducted at a single facility in Tokyo. Video calls were introduced in August 2020 and were used based on family preferences. Using quantitative data obtained from a questionnaire postal survey and the qualitative analysis of free-text responses, family members of severe COVID-19 ICU patients from July 2020 to June 2022 completed self-administered questionnaires, including the Impact of Event Scale-Revised (IES-R) and open-ended questions regarding the patient's ICU stay. Multivariate logistic regression analysis assessed the association between video calls and PTSD symptoms (IES-R > 24). Free-text responses were analysed using text mining techniques.</p><p><strong>Results: </strong>Out of the 97 eligible families, 68 participated. Video calls were not significantly associated with a reduction in PTSD symptoms. Among those who experienced video calls, text analysis showed that participants with PTSD symptoms more frequently used words related to \"doctors,\" whereas those without symptoms more often mentioned \"nurses.\"</p><p><strong>Conclusion: </strong>Video calls did not significantly reduce PTSD symptoms in family members of ICU patients with severe COVID-19. However, the presence of bedside nurses during video calls may help foster a sense of connection and support.</p><p><strong>Relevance to clinical practice: </strong>When implementing video calls (i.e., virtual visitation), active involvement and compassionate presence of bedside nurses may enhance the emotional quality of communication. Structured approaches that support nurse-family interaction may contribute to better psychological outcomes for families.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70114"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610273","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 Open Visiting Policies on Patient, Family and Nursing Care: Nurses' Perceptions in Saudi Intensive Care Units.","authors":"Rawia Ahmad Abdalla, Samer Nabil Alhalabi, Shabab Shail Alotaibi, Maryam Omar Omran, Tareq Jamal Abdulbari, Ramona Raymond Faddoul, Iman Bachir Elkouwatly","doi":"10.1111/nicc.70110","DOIUrl":"https://doi.org/10.1111/nicc.70110","url":null,"abstract":"<p><strong>Background: </strong>Family involvement in intensive care unit (ICU) and coronary care unit (CCU) care, supported by open visitation policies, is beneficial for patient outcomes. However, concerns about the impact on nursing care, patient safety and workflow lead to varying beliefs and attitudes among nurses.</p><p><strong>Aim: </strong>This study aimed to assess nurses' beliefs and attitudes towards visitation in ICUs and CCUs and identify demographic factors associated with these attitudes.</p><p><strong>Study design: </strong>A cross-sectional study was conducted in a Saudi healthcare system, involving eight hospitals. Between July and August 2023, a convenience sample of nurses completed the Beliefs and Attitudes towards Visitation in ICU Questionnaire (BAVIQ). Descriptive statistics were used to describe demographic factors, and Pearson's correlations and multivariable linear regression analyses examined associations between demographic variables and nurses' beliefs and attitudes.</p><p><strong>Results: </strong>A total of 265 nurses participated (66% response rate). The mean scores for nurses' beliefs and attitudes were 1.86 (SD = 0.44) and 1.99 (SD = 0.61), respectively, on a 5-point Likert scale (0-4). Regression analysis showed a significant positive association between beliefs and attitudes (β = 0.310, 95% CI: 0.143 to 0.477, p < 0.001). Working in ICU or CCU (β = -0.206, 95% CI: -0.334 to -0.079, p = 0.002) and nationality (β = 0.157, 95% CI: 0.014 to 0.299, p = 0.032) were associated with nurses' beliefs, while higher educational levels (β = -0.169, 95% CI: -0.335 to -0.003, p = 0.046) were negatively associated with nurses' attitudes.</p><p><strong>Conclusion: </strong>Nurses held low to moderate levels of belief and attitudes towards open visitation in ICUs. Factors like ICU or CCU experience and education level were negatively associated with these beliefs and attitudes. Interventions to increase nurses' understanding of open visitation's benefits are recommended to improve the acceptance of such policies.</p><p><strong>Relevance to clinical practice: </strong>This study highlights the need to address nurses' concerns about open visitation policies in ICUs and CCUs, focusing on the impact on nursing care, patients' privacy and workflow efficiency.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70110"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610277","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 Impact of Digital Culture, Digital Competence and Clinical Decision Support System Usability on Critical Care Nurses' Clinical Judgement: A Moderated Moderation Analysis.","authors":"Ahmed Abdelwahab Ibrahim El-Sayed, Samira Ahmed Alsenany, Boshra Karem Mohamed El-Sayed, Hala Ahmed Abdullah Alfaraidy, Maha Gamal Ramadan Asal","doi":"10.1111/nicc.70118","DOIUrl":"https://doi.org/10.1111/nicc.70118","url":null,"abstract":"<p><strong>Background: </strong>In the context of increasingly digital healthcare systems, clinical judgement among critical care nurses is shaped not only by clinical experience but also by the broader digital environment. Digital culture, digital competence and clinical decision support systems (CDSSs) usability are pivotal factors influencing how nurses make timely, informed clinical decisions. However, the complex interplay among these factors remains underexplored.</p><p><strong>Aim: </strong>To examine the impact of digital culture on critical care nurses' clinical judgement, investigate the moderating role of digital competence and examine how CDSSs usability affects this moderation.</p><p><strong>Study design: </strong>This descriptive cross-sectional study was conducted among 550 critical care nurses working in 28 intensive care units across 10 hospitals located in Cairo and Alexandria in Egypt and Riyadh in Saudi Arabia. Data were collected via four validated instruments and analysed via moderated moderation analysis (PROCESS Models 1 and 3) to test direct and interaction effects among digital culture, digital competence, CDSSs usability and clinical judgement.</p><p><strong>Results: </strong>Digital culture significantly predicted clinical judgement. This effect was moderated by digital competence, which enhanced the positive association. A significant three-way interaction revealed that the relationship was strongest when both digital competence and CDSSs usability were high. The full model explained 53.9% of the variance in clinical judgement capability.</p><p><strong>Conclusions: </strong>Digital culture enhances clinical judgement, particularly when supported by high digital competence and usable CDSSs.</p><p><strong>Relevance to clinical practice: </strong>Clinical effectiveness in critical care nursing requires strong digital competence, a supportive digital culture and user-friendly CDSSs to enable accurate, timely and informed clinical judgement and decisions.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70118"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676462","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":"Trajectory and determinants of intensive care unit-acquired weakness in critical illness: A multicentre, prospective, longitudinal study.","authors":"Xue-Xian Chen, Jing Xiong, Jin-Xia Chen, Chen-Juan Luo, Yao-Ning Zhuang, Mei-Lian Xu, Hong Li, Ting-Ting Wu","doi":"10.1111/nicc.13209","DOIUrl":"10.1111/nicc.13209","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit-acquired weakness (ICU-AW) is prevalent and adversely affects patient outcomes. Muscle strength progression and response to rehabilitation differ across ICU populations. However, the trajectories, determinants and prognoses of muscle strength changes remain unclear.</p><p><strong>Aim: </strong>This study aimed to investigate the trajectory and determinants of ICU-AW in critical illness and its impact on 60-day postadmission mortality.</p><p><strong>Study design: </strong>A multicentre prospective cohort study was conducted, involving critically ill patients from 10 ICUs across five tertiary hospitals in Fujian Province, China. Patients were evaluated using the Medical Research Council (MRC) scale at three time points: within 48 h of ICU admission or within 24 h of regaining consciousness (T1), within 24 h of ICU discharge (T2) and at the time of hospital discharge (T3). The latent class growth mixed model was utilized for data analysis, and multivariable logistic regression was employed to examine the determinants of muscle strength trajectories.</p><p><strong>Results: </strong>This study encompassed 343 patients from five tertiary hospitals. Three latent trajectory groups were identified: a low-level decline group (5.83%), a medium-level stability group (25.36%) and a high-level recovery group (68.81%). Multivariable logistic regression revealed that Charlson comorbidity index (CCI) and alcohol consumption significantly influenced the trajectory of muscle strength development in ICU patients (p < .05). The mortality rate at 60 days was significantly higher in both the low-level decline and medium-level stability groups compared with the high-level recovery groups (p < .05).</p><p><strong>Conclusions: </strong>This study identified three muscle strength trajectories in ICU patients: low-level decline, medium-level stability and high-level recovery. CCI and alcohol consumption significantly influenced these trajectories. The lower 60-day mortality rate in the high-level recovery group underscores the need for early intervention and tailored care.</p><p><strong>Relevance to clinical practice: </strong>Developing targeted rehabilitation strategies for those at risk of low-level decline or medium-level stability group is challenging and may potentially improve recovery and outcomes.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13209"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781684","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":"Preoperative anxiety and depressive symptoms predicted higher incidence of delirium post coronary artery bypass graft surgery.","authors":"Mohannad Eid Aburuz, Haya Ibrahim Ali Abu Maloh, Fatma Refaat Ahmed","doi":"10.1111/nicc.13204","DOIUrl":"10.1111/nicc.13204","url":null,"abstract":"<p><strong>Background: </strong>Anxiety, depressive symptoms and delirium are common among patients undergoing coronary artery bypass graft surgery (CABG). Postoperative delirium is associated with diverse negative outcomes among those patients, including delayed extubation and prolonged length of stay (LoS). Existing literature has recorded the incidence and associated risk factors with delirium among patients undergoing CABG, but limited studies have checked the particular impacts of preoperative anxiety and depressive symptoms (ADS) on the incidence of postoperative delirium.</p><p><strong>Aim: </strong>To determine the impact of ADS on the incidence of postoperative delirium among patient undergoing elective CABG.</p><p><strong>Study design: </strong>This was a prospective cohort study among 400 patients, 220 (55%) males and 180 (45%) females, who underwent elective CABG. The sample was recruited from six major hospitals in Jordan. ADS were measured prior to the operation using the Hospital Anxiety and Depression Scale. Delirium was screened using the Confusion Assessment Method for the Intensive Care Unit by trained research assistants twice daily from the second to the fifth day postoperatively. Data were analysed using logistic and multiple regression analyses.</p><p><strong>Results: </strong>160 patients (40%) developed delirium postoperatively. Regression analysis showed that older age, female sex, duration of surgery ≥7 h, depressed, anxious, and anxious and depressed categories were independent predictors for higher incidence rates of delirium. Additionally, the occurrence of delirium was an independent predictor for longer hospital/ICU LoS.</p><p><strong>Conclusions: </strong>CABG patients may experience delirium more frequently and require a longer hospital stay if they have prior anxiety or depression. Controlling ADS might decrease delirium incidence and shorten the LoS.</p><p><strong>Relevance to clinical practice: </strong>Our findings underscore the critical role nurses play in identifying and addressing psychological issues before CABG. By recognising and managing preoperative ADS, nurses can potentially reduce the risk of delirium following CABG.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13204"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711794","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":"More self-efficacy is associated with longitudinally higher health-related quality of life in mechanically ventilated COVID-19 ICU survivors: The prospective MaastrICCht cohort.","authors":"Laura M Tiels, Marieke S J N Wintjens, Sophie Waardenburg, Frank van Rosmalen, Sander M J van Kuijk, Iwan C C van der Horst, Regien Luiten, Bas C T van Bussel, Walther N K A van Mook, Bea Hemmen, Susanne van Santen","doi":"10.1111/nicc.13241","DOIUrl":"10.1111/nicc.13241","url":null,"abstract":"<p><strong>Background: </strong>More self-efficacy leads to greater confidence in one's ability to perform actions to achieve treatment goals. Therefore, self-efficacy may affect patient recovery and health-related quality of life (HRQoL) after ICU discharge.</p><p><strong>Aim: </strong>In a cohort of mechanically ventilated COVID-19 survivors, we examined the associations between self-efficacy at 3 months and HRQoL at 3, 12 and 24 months after discharge.</p><p><strong>Study design: </strong>Mechanically ventilated survivors of the MaastrICCht cohort that completed a self-efficacy assessment with the General Self-Efficacy Scale (GSES) were included. HRQoL was measured using the EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), subdivided into a health utility score (EQ-HUS) and visual analogue scale (EQ-VAS). Linear regression models were used to investigate associations between self-efficacy and HRQoL and were adjusted for age, sex, body mass index (BMI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, ICU length of stay and hospital discharge location.</p><p><strong>Results: </strong>In 87 ICU survivors, more self-efficacy at 3 months after ICU discharge was associated with longitudinally higher EQ-HUS (β = 0.01; 95% CI: 0.01-0.02; p < 0.001) and higher EQ-VAS (β = 1.00; 95% CI: 0.66-1.35; p < 0.001) up to 2 years after ICU discharge. After adjustment for age, sex, BMI, APACHE II score, ICU length of stay, and hospital discharge location, associations were similar.</p><p><strong>Conclusions: </strong>More self-efficacy at 3 months after ICU discharge was associated with longitudinally higher HRQoL up to 2 years after ICU discharge in mechanically ventilated COVID-19 survivors.</p><p><strong>Relevance to clinical practice: </strong>Screening for self-efficacy in patients post-ICU as well as developing interventions to improve self-efficacy are a target post-ICU to enhance HRQoL over the long term.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13241"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980632","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":"'Paediatric Emergency Course' for nursing continuing professional development programme evaluation: ARCS Motivational Design Model.","authors":"Aysel Başer, Murat Anil","doi":"10.1111/nicc.13238","DOIUrl":"10.1111/nicc.13238","url":null,"abstract":"<p><strong>Background: </strong>Paediatric emergency and critical care require skilled nurses, but they often face a lack of motivation during continuing professional development. Motivation-based, engaging activities in training programmes are essential to sustain interest and improve learning outcomes in these high-stress environments.</p><p><strong>Aim: </strong>This study aims to develop, implement and evaluate the effectiveness of a Paediatric Emergency Course (PEC) using the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivational Design Model to equip nurses with the knowledge and skills needed to manage paediatric patients in emergency and critical care settings.</p><p><strong>Study design: </strong>The study employed a quasi-experimental pretest/post-test design. The PEC was conducted from 1 June to 31 December 2023, with the participation of 57 nurses working in emergency and critical care units. To evaluate the programme's effectiveness, a paired t-test was used for pre-test and post-test comparisons, and logistic regression analysis was conducted to determine the factors affecting course success (lecture test activities and motivational tactics).</p><p><strong>Results: </strong>Pre-lecture assessments averaged 9.55, significantly increasing to 16.88 post-lecture (out of 22), indicating a substantial improvement in knowledge after the lecture series (t = -20.26, df = 55, p < .001; 95% CI [-8.05, -6.60]). Similarly, pre-course scores rose from 7.21 to 17.14 post-course (out of 25), reflecting significant gains in overall understanding and competency (t = -20.83, df = 56, p < .001; 95% CI [-10.89, -8.97]). Logistic regression analysis demonstrated that a one-unit increase in post-lecture test scores increased the likelihood of course success by 22.5%, with an odds ratio of 1.225 (B = .203, SE = 0.092, p = .028; 95% CI [1.023, 1.468]). Additionally, motivational design significantly influenced course success, increasing the likelihood by 433.3%, with an odds ratio of 5.333 (B = 1.674, SE = 0.363, p < .001; 95% CI [3.134, 9.074]).</p><p><strong>Conclusion: </strong>The PEC continuing education programme, developed using the ARCS Motivational Design Model to support the professional development of nurses in emergency and critical care, was successfully implemented. These results suggest that both knowledge acquisition and motivational factors play a substantial role in enhancing course success among participants. Significant improvements in pre- and post-test results, along with high scores on the motivational design scale, demonstrated the effectiveness of the programme.</p><p><strong>Relevance to clinical practice: </strong>The use of motivation-enhancing tactics and strategies in training has led to successful outcomes, demonstrating that structured programmes designed with these methods can significantly improve the clinical competencies, expertise, decision-making and patient safety of nurses working in paediatric emergency a","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e13238"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531006","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 Nursing Workforce Retention From an Irish Perspective: A National Survey.","authors":"Natalie L McEvoy, Nicki Credland, Derek Cribbin, Gerard F Curley, Niamh Humphries","doi":"10.1111/nicc.70094","DOIUrl":"10.1111/nicc.70094","url":null,"abstract":"<p><strong>Background: </strong>Retention of critical care nurses has been identified as a growing international concern for a multitude of reasons. There is a dearth of evidence in the literature on this topic from an Irish perspective.</p><p><strong>Aim: </strong>The aim of the survey is to explore the factors influencing workforce retention among adult critical care nurses in Ireland.</p><p><strong>Study design: </strong>A cross-sectional, electronic survey of adult critical care nurses working in the Republic of Ireland was undertaken between May and July 2024. This survey is a modified version of the Critical Care Network Leads (CC3N) National Adult Critical Care Nursing Workforce Retention Survey. Anonymous quantitative and qualitative data were collected.</p><p><strong>Results: </strong>In total, 257 participant responses were recorded. 58% (n = 149/237) of participants who responded to this question stated they plan to leave their current role. 36% (n = 88/245) of respondents indicated that inadequate staffing was the main reason driving their intention to leave their current job, followed by lack of pay recognition. Participants described what they enjoy about their roles, factors that would encourage them to stay despite intending to leave, and any unmet needs in their current position. Three main qualitative themes were identified: Enjoyment at Work; Encouragement at Work; and Engagement at Work.</p><p><strong>Conclusion: </strong>This study clearly highlights the issues that impact on intention to leave decisions. An understanding of these issues is key to ensuring the critical care nursing workforce plan in Ireland is designed with nurses as key stakeholders. This is essential to ensure that the Irish healthcare system has the right nurses with the right skills in the right place at the right time to deliver safe, high-quality, expert care.</p><p><strong>Relevance to clinical practice: </strong>This study provides valuable insights into the factors influencing the retention of adult critical care nurses in Ireland, a workforce vital to the delivery of high-quality, specialist care. The findings underscore the urgent need for healthcare leaders and policymakers to address modifiable workplace issues such as staffing levels, recognition of pay and support structures. By highlighting what nurses value in their roles and what might motivate them to stay, this research informs targeted, evidence-based strategies for improving job satisfaction and workforce stability.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70094"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561857","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":"Family Members' Recollections of the Care of ECMO Patients Transferred From a Spoke Hospital to a Hub Hospital: A Qualitative Study.","authors":"Marta Villa, Davide Ausili, Flavia Pegoraro, Giancarla Nava, Martina Giulia Bassi, Sabrina Bramati, Cavaliere Manuela, Giannella Simone, Roberto Rona, Marco Giani, Alberto Lucchini","doi":"10.1111/nicc.70105","DOIUrl":"https://doi.org/10.1111/nicc.70105","url":null,"abstract":"<p><strong>Background: </strong>Patients with severe hypoxaemia due to Adult Respiratory Distress Syndrome may require extracorporeal membrane oxygenation (ECMO). ECMO centres, known as 'hub hospitals', provide mobile teams that can initiate ECMO treatment at local 'spoke' hospitals before transferring patients to hub facilities. This hub-and-spoke system is operational throughout northern Italy.</p><p><strong>Aim: </strong>To explore the experiences and perceptions of family members when their loved ones received ECMO treatment and were subsequently relocated from a spoke hospital to a hub hospital.</p><p><strong>Study design: </strong>Semi-structured phone interviews with thematic analysis. Family members of patients transferred with ECMO from a spoke to a hub hospital were recruited for this study. Data analysis followed the principles of thematic synthesis.</p><p><strong>Results: </strong>Six phone interviews were conducted with family members eligible for the study. Three main themes and nine subthemes were generated from interview data: (1) The 'Wait' (subthemes: Fear, despair and anguish; Disbelief; Confusion and disorientation; Daily clinical news), (2) The 'Trust' (Trust in healthcare professionals; Hope and optimism; Technology), and (3) The 'Gratitude' (Fortune and awareness; Commitment, humanity and to take care of). Each relative's experience was unique; however, several common behaviours and emotional patterns emerged during the interviews. The ECMO process was perceived as a collaborative experience involving the interplay between patients, their family members and healthcare providers.</p><p><strong>Conclusions: </strong>Family members' experience with ECMO patients indicates that ECMO is perceived as a crisis-focused intervention that provides last-minute hope. Despite the dire circumstances, the narratives shared by the interviewees provided the ability to reflect on their ICU experiences.</p><p><strong>Relevance to clinical practice: </strong>The findings of this small, single-location study indicate that including the viewpoints of patients' families in future qualitative research and follow-up initiatives for former ICU patients could provide further understanding of how family members perceive the experience of a patient undergoing ECMO. The involvement of family members is crucial when providing care to critically ill patients. This is particularly relevant for critical care nurses who play a key role in supporting families during ECMO.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70105"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610274","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 Relationship Between Alarm Fatigue and Medical Error Tendency in Intensive Care Unit Nurses: The Mediating Affect of Role Overload.","authors":"Esra Sarioğlu, Mustafa Amarat","doi":"10.1111/nicc.70121","DOIUrl":"10.1111/nicc.70121","url":null,"abstract":"<p><strong>Background: </strong>Investigating all the reasons that may create a tendency for medical errors in interdisciplinary work due to critical patient care and monitoring in intensive care units is important for reliable health service delivery.</p><p><strong>Aim: </strong>The primary purpose of this study was to determine the alarm fatigue levels of intensive care nurses, examine the effect of this fatigue on the tendency to make medical errors and determine the mediating role of role overload in the relationship between the two concepts.</p><p><strong>Study design: </strong>This cross-sectional survey study included 250 intensive care nurses from Ordu. In addition to the personal information form, the 'Nurses Alarm Fatigue Scale', 'Nurses Medical Error Tendency Scale' and 'Role overload Scale' were used in the study. After verifying the data's validity and reliability, the SPSS and AMOS package programs were used for the analyses.</p><p><strong>Results: </strong>The increase in the level of alarm fatigue caused an increase in role overload by 33% and a 9% effect on medical error tendency. The increase in role overload caused a 9% increase in nurses' tendency to medical errors. In addition, it was revealed that their total effect on each other was 11%. There was a positive correlation between role overload, alarm fatigue and medical error tendency, and this relationship was statistically significant.</p><p><strong>Conclusion: </strong>This research will help us develop effective strategies by better understanding the factors that may lead to medical error tendencies among intensive care nurses responsible for the care of critically ill patients. Although it is not easy to solve alarm fatigue because the alarm response that is not acted upon or the alarm response is impaired is caused by technical, clinician and organisational factors, studies have attempted to be analytical.</p><p><strong>Relevance to clinical practice: </strong>Considering alert fatigue and role overload in reducing the propensity of critical care nurses to make medical errors can significantly increase the accuracy and integrity of patient care and improve outcomes.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 4","pages":"e70121"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700249","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}