Nursing in Critical Care最新文献

{"title":"The effect of classical and harp music on comfort, physiological parameters and cerebral oxygenation among premature infants: A multi-arm randomized controlled trial.","authors":"Sevinc Akkoyun, Fatma Tas Arslan, Tugba Kacmaz","doi":"10.1111/nicc.13279","DOIUrl":"https://doi.org/10.1111/nicc.13279","url":null,"abstract":"<p><strong>Background: </strong>Music has many positive effects on premature infants. Studies on the comfort and cerebral oxygenation of music in premature infants are limited.</p><p><strong>Aim: </strong>To examine the effects of classical and harp music on the comfort, heart rate, respiratory rate, oxygen saturation and cerebral oxygenation of premature infants in a neonatal intensive care unit (NICU).</p><p><strong>Study design: </strong>This was a three-group randomized controlled trial.</p><p><strong>Methods: </strong>This study was conducted on 84 medically stable premature infants in an NICU of a medical faculty hospital. There were three groups: the classical music group (n = 28), the harp music group (n = 28) and the routine care group (n = 28). Two or three days a week, on different days, three sessions a day, a total of 15 sessions and 30 min of classical or harp music practice were performed. The sound levels of the classical or harp music were controlled between 50 and 55 dB. No music was applied to premature infants in the routine care group. For each session, physiological parameters, cerebral oxygenation and comfort level were evaluated and measured at pretest and post-test.</p><p><strong>Results: </strong>According to the time and group interaction, high comfort levels were observed in the classical/harp music group (p = 0.001, <math> <semantics> <mrow><msup><mi>η</mi> <mn>2</mn></msup> </mrow> <annotation>$$ {eta}^2 $$</annotation></semantics> </math>  = 0.196, CI = 0.169-0.222), heart rate (p = 0.001, <math> <semantics> <mrow><msup><mi>η</mi> <mn>2</mn></msup> </mrow> <annotation>$$ {eta}^2 $$</annotation></semantics> </math>  = 0.018, CI = 0.009-0.030) and respiratory rate were low in the classical music group (p = 0.001, <math> <semantics> <mrow><msup><mi>η</mi> <mn>2</mn></msup> </mrow> <annotation>$$ {eta}^2 $$</annotation></semantics> </math>  = 0.019, CI = 0.010-0.031) and oxygen saturation was high in the classical music group (p = 0.027, <math> <semantics> <mrow><msup><mi>η</mi> <mn>2</mn></msup> </mrow> <annotation>$$ {eta}^2 $$</annotation></semantics> </math>  = 0.006, CI = 0.001-0.013). There was a statistically significant difference between the average cerebral oxygenation values by group (p = 0.001, <math> <semantics> <mrow><msup><mi>η</mi> <mn>2</mn></msup> </mrow> <annotation>$$ {eta}^2 $$</annotation></semantics> </math>  = 0.029, CI = 0.017-0.043).</p><p><strong>Conclusions: </strong>Classical or harp music is beneficial for increasing the comfort level of premature infants. Classical music is useful for stabilizing and improving heart rate, respiratory rate and oxygen saturation in premature infants.</p><p><strong>Relevance to clinical practice: </strong>Music is effective in increasing the comfort of premature infants and stabilizing their physiological parameters and can be applied by neonatal intensive care nurses.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13279"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606818","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":"Efficacy of virtual reality in alleviating post-ICU syndrome symptoms: A systematic review and meta-analysis.","authors":"Qingwei Liu, Yuchen Zhang, Xin Chen, Bao Ding, Xiaojing Guo, Yubiao Gai","doi":"10.1111/nicc.70004","DOIUrl":"https://doi.org/10.1111/nicc.70004","url":null,"abstract":"<p><strong>Background: </strong>Post-intensive care syndrome (PICS) is a prevalent condition among critically ill patients, significantly impacting their recuperation and overall quality of life.</p><p><strong>Aim: </strong>To evaluate the potential of virtual reality (VR) technology in mitigating PICS symptoms, with the aim of informing clinical practice and nursing care.</p><p><strong>Study design: </strong>This systematic review and meta-analysis searched PubMed, Embase, Web of Science, CINAHL, the Cochrane Library, CNKI, WanFang and Weepu databases through 5 April 2024. This study included randomized controlled trials (RCTs) examining the impact of VR on PICS. The risk of bias in included RCTs was assessed using the Cochrane risk of bias tool. Meta-analysis was performed using RevMan 5.4 software.</p><p><strong>Results: </strong>A total of seven RCTs involving 538 critically ill patients met the inclusion criteria. VR intervention significantly reduced anxiety levels (I² = 14%, SMD = -0.19, 95% CI: -0.38 to -0.01, p = .04), depression levels (I² = 49%, SMD = -0.39, 95% CI: -0.69 to -0.08, p = .01), and the incidence of post-traumatic stress disorder (PTSD) (I² = 1%, SMD = -0.39, 95% CI: -0.69 to -0.09, p = .01). There was no significant effect on quality of life (I² = 1%, SMD = 0.18, 95% CI: -0.16 to 0.52, p = .31). No evidence of publication bias was identified (all p > .05). VR technology demonstrates potential in mitigating the symptomatology associated with PICS in critically ill patients.</p><p><strong>Conclusions: </strong>The integration of VR technology within the critical care nursing toolkit holds promise as an innovative adjunct in the comprehensive care paradigm for critically ill patients.</p><p><strong>Relevance to clinical practice: </strong>By leveraging the immersive and interactive capabilities of VR, it may be possible to mitigate the symptoms and sequelae associated with PICS.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e70004"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring clinical rehabilitation practices for bronchopulmonary dysplasia in neonatal intensive care unit: A qualitative study.","authors":"Fang He, Xin Yu, Li Sun, Yan Lin, Yingchun Zeng","doi":"10.1111/nicc.70007","DOIUrl":"10.1111/nicc.70007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Bronchopulmonary dysplasia (BPD) is a common complication in premature infants, particularly those born extremely preterm, and is a significant risk factor for neurodevelopmental impairment. Rehabilitation therapy has been shown to improve both pulmonary and neurological functions in infants with BPD. However, in China, there is no consensus on the optimal timing, type, frequency or follow-up of rehabilitation exercises for these infants. Understanding the current clinical practices, challenges and areas for improvement is essential to enhancing outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate current clinical rehabilitation practices for BPD in the Neonatal Intensive Care Unit (NICU).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Qualitative descriptive study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 12 informants participated in this study. Four major themes were identified: (1) Non-standardized rehabilitation practices: Inconsistent frequency and intensity of rehabilitation therapy, delayed initiation and lack of follow-up. (2) Lack of consensus and collaboration: Absence of expert consensus on rehabilitation practices and insufficient interdisciplinary communication. (3) Limited parental involvement in rehabilitation: Minimal kangaroo care, low engagement in caregiver training and limited support for family participation in rehabilitation. (4) Nurses' involvement in rehabilitation therapy is limited, with issues including unstandardized positioning management, minimal participation in rehabilitation coordination and a lack of proactive feedback on BPD infants' rehabilitation tolerance. (5) Inadequate rehabilitation environment: Constraints such as limited space, lack of family-centred wards, insufficient equipment and environmental issues with noise and lighting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Rehabilitation practices for BPD in the NICU are inconsistent, with limited interdisciplinary collaboration and suboptimal parental involvement. The study underscores the need for establishing a multidisciplinary team and developing evidence-based, culturally tailored rehabilitation protocols. Improving parental participation, creating appropriate rehabilitation spaces, managing environmental factors like noise and lighting, nurses should participate in training on positioning management and assist with rehabilitation therapy, actively providing feedback to the medical team on the tolerance of BPD infants and enhancing equipment availability will contribute to the early recovery of infants with BPD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Relevance to clinical practice: &lt;/strong&gt;This study highlights critical gaps in current rehabilitation practices for BPD in NICUs, suggesting that a standardized, evidence-based approach is needed to optimize care. Clinicians should focus on fostering multidisciplinary collaboration, enhancing parental involvement and improving the physical environment of NICUs to support the rehabilitation process for prematur","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e70007"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544380","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":"Interruptions and downtime of continuous renal replacement therapy in critically ill adults: A retrospective observational study.","authors":"Zhen-Hua Zhao, Lin Yu, Li-Hua Qiu, Xing-Min Xing, Ling Lin, Jing Zhou, Hui Zhou, Bo Feng, Yuan-Yuan Yao","doi":"10.1111/nicc.13265","DOIUrl":"10.1111/nicc.13265","url":null,"abstract":"<p><strong>Background: </strong>The effective treatment time of continuous renal replacement therapy (CRRT) is significantly important. Downtime caused by interruptions is still unclear during a circuit filter.</p><p><strong>Aim: </strong>This study aimed to analyse the interruptions and downtime during a circuit filter through the data recorded by the internal data storage cards of the CRRT machine.</p><p><strong>Methods: </strong>This is a single-centre retrospective observational study. From August 2019 to April 2020, all patients who received CRRT treatment with the Prismaflex device (Gambro, America) were enrolled.  After downloading the data from the internal data storage cards, it was meticulously sorted and verified using Excel. Statistical analyses were performed using SPSS software (version 22.0).</p><p><strong>Results: </strong>A total of 143 CRRT circuits in 59 patients were analysed. The overall median circuit life was 39.22 (IQR, 24.07-60.25) h, median amount of interruption was 67 (IQR, 42-100), causing a median downtime of 1.98 (IQR, 1.20-2.85) h and a median downtime proportion (ratio of downtime/circuit life) of 4.58% (IQR, 3.50-6.69). Circuit downtime was mainly caused by bag change (1.17 ± 0.66 h [p < 0.001]). Circuits in the group of downtime proportion >10% had longer downtime (2.53 ± 3.37 h, p < 0.001) and more circuit alarms (45.54 ± 42.87, p < 0.001), and alarms cost much more time to be fixed (1.03 [IQR, 0.42-2.24] h, p < 0.001). No variation was found in downtime among groups according to circuit lifespan.</p><p><strong>Conclusions: </strong>Interruptions in a circuit can accumulate into non-negligible downtime. Specialized nursing actions through education and training are of great significance to avoid unnecessary interruptions.</p><p><strong>Relevance to clinical practice: </strong>Nurses' behaviour is related to the downtime of CRRT. Intensive care unit (ICU) nurses should be trained to inculcate the behaviours, including keeping sufficient bags at patient's bedside, changing solution bags actively, adressing alarms swiftly, arranging the examinations and the initiation of a CRRT reasonably.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13265"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531847","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":"Unveiling the conceptual and intellectual map of care bundle research in ICUs: Trends, key issues, and collaborative networks.","authors":"İlknur Özkan, Cansu Polat Dünya, Seçil Taylan","doi":"10.1111/nicc.13234","DOIUrl":"10.1111/nicc.13234","url":null,"abstract":"<p><strong>Background: </strong>Care bundles are evidence-based practices intended to improve patient outcomes and have become a significant focus in intensive care.</p><p><strong>Aim: </strong>This study aims to identify research trends, key topics, leading researchers, and significant collaborations in care bundle research within ıntensive care units by mapping the conceptual and intellectual structure of the field.</p><p><strong>Study design: </strong>Data were collected from the Web of Science database, covering publications from 2010 to 2024. The search terms included 'bundle*' or 'bundle* care' and 'intensive care unit' or 'critical care'. The analysis used tools like the Biblometrix package in R and VOSviewer, focusing on performance metrics, co-citation analysis, co-occurrence network analysis, and thematic mapping.</p><p><strong>Results: </strong>The annual growth rate of publications on care bundles is 6.26%. The most prolific journals include Critical Care Medicine, the American Journal of Infection Control, and Infection Control and Hospital Epidemiology. Thematic mapping shows research is concentrated on critical areas such as infection control, patient safety, and quality improvement. While some themes, like 'intensive care units' and 'central line-associated bloodstream infection', are well-developed and central, others like 'maternal safety consensus' and 'safety consensus bundle' are highly developed but less central. Emerging themes like 'acute kidney injury' suggest potential areas for future research.</p><p><strong>Conclusions: </strong>This bibliometric analysis offers a comprehensive overview of intensive care unit care bundle research, highlighting a strong focus on critical issues like infection control, patient safety, and care quality improvement.</p><p><strong>Relevance to clinical practice: </strong>The study provides crucial insights for clinical practice by identifying key research trends and underexplored topics related to intensive care unit care bundles. These findings can guide the development of more effective care protocols, promote multidisciplinary collaboration, and enhance healthcare professional education, ultimately contributing to optimized patient care and high standards in the intensive care unit through improved care bundle implementation.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13234"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034783","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":"Contributors to fatigue among nurses working in critical care units: A qualitative study.","authors":"Reyhaneh Abbaszadeh, Fazlollah Ahmadi, Mitra Khoobi, Anoshirvan Kazemnejad, Mojtaba Vaismoradi","doi":"10.1111/nicc.13091","DOIUrl":"10.1111/nicc.13091","url":null,"abstract":"<p><strong>Background: </strong>Fatigue is a growing concern among nurses who provide care to unstable and critically ill patients in critical care wards. It has various negative consequences for both nurses and patients.</p><p><strong>Aim: </strong>To explore and describe contributors to fatigue among nurses working in critical care units.</p><p><strong>Study design: </strong>A qualitative content analysis.</p><p><strong>Results: </strong>Participants were 21 nurses chosen using purposeful sampling. They were working in different critical care units at different hospitals in nine urban areas of Iran. Semi-structured interviews were used to collect data, and conventional content analysis was used to develop categories and subcategories. The analysis of data on the nurses' perspectives and experiences led to developing nine categories as contributors to fatigue: 'compassion fatigue', 'extensive network of interactions', 'sound and alarm fatigue', 'psychological tensions', 'managerial and organizational tensions', 'lack of motivation and incentives', 'individual characteristics of nurses', 'physical and mental pressure', and requirements of special care and situational complexity'.</p><p><strong>Conclusions: </strong>Understanding the factors that influence the experience of fatigue among nurses working in critical care units is essential for maintaining a reliable and high-quality health care environment within health care facilities.</p><p><strong>Relevance to clinical practice: </strong>The experience of fatigue by critical care nurses can increase the possibility of practice errors, reduce patient safety and quality of care, and enhance staff burnout and turnover. Proactive policies should be formulated to assess nurses' fatigue levels and implement strategies for effective fatigue management. This approach aims to enhance both patient safety and job satisfaction in the workplace.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13091"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959981","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":"Infant feeding and criticality in children.","authors":"Lauren R Sorce, Lisa A Asaro, Martha A Q Curley","doi":"10.1111/nicc.13103","DOIUrl":"10.1111/nicc.13103","url":null,"abstract":"<p><strong>Background: </strong>Data support the protective effects of human breast milk (HBM) feeding in acute illness but little is known about the impact of HBM feeding on the criticality of infants.</p><p><strong>Aim: </strong>To explore the relationship between early HBM feeding and severity of illness and recovery in critically ill children requiring intubation and mechanical ventilation for acute respiratory failure (ARF).</p><p><strong>Study design: </strong>Prospective cohort study of mothers of patients aged 1-36 months who participated in the acute and follow-up phases of the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) clinical trial. Participants completed a survey describing HBM dose fed during their infant's first month of life.</p><p><strong>Results: </strong>Of 138 patients, 70 (51%) received exclusive HBM feedings (90%-100% total feeds) and 68 (49%) did not. We found no group differences in severity of illness on paediatric intensive care unit (PICU) admission or severity of paediatric acute respiratory distress syndrome (PARDS) within the first 24-48 h of intubation/mechanical ventilation (Pediatric Risk of Mortality [PRISM] III-12 score median: 5 vs. 5, p = .88; moderate/severe PARDS: 53% vs. 54%, p = .63). While median time to recovery from ARF was reduced by 1 day in patients who received exclusive HBM feedings, the difference between groups was not statistically significant (median 1.5 vs. 2.6 days, hazard ratio 1.40 [95% confidence interval, 0.99-1.97], p = .06).</p><p><strong>Conclusions: </strong>Human breast milk dose was not associated with severity of illness on PICU admission in children requiring mechanical ventilation for ARF.</p><p><strong>Relevance to clinical practice: </strong>Data support the protective effects of HBM during acute illness and data from this study support a clinically important reduction in time to recovery of ARF. Paediatric nurses should continue to champion HBM feeding to advance improvements in infant health.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13103"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460650","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":"A new classification for emergency critically ill patients and analysis of their adverse events during intrahospital transport: A cluster analysis.","authors":"Ying An, Kai Cao, Fei Li, Qi Lu, Ya-Mei Guan, Zhen-Hui Lu, Ai-Ping Wang, Zi-Rong Tian","doi":"10.1111/nicc.13099","DOIUrl":"10.1111/nicc.13099","url":null,"abstract":"<p><strong>Background: </strong>Critical patients may experience various adverse events during transportation within hospitals. Therefore, quickly evaluating and classifying patients before transporting them from the emergency department and focusing on managing high-risk patients are critical. At present, no unified classification method exists; all the current approaches are subjective.</p><p><strong>Aim: </strong>To ensure transportation safety, we conducted a cluster analysis of critically ill patients transferred from the emergency department to the intensive care unit.</p><p><strong>Study design: </strong>Single-centre cohort study. This study was conducted at a comprehensive first-class teaching hospital in Beijing. Convenience sampling and continuous enrolment were employed. We collected data from 1 January 2019, to 31 December 2021. All patients were transferred from the emergency department to the intensive care unit, and cluster analysis was conducted using five variables.</p><p><strong>Results: </strong>A total of 584 patients were grouped into three clusters. Cluster 1 (high systolic blood pressure group) included 208 (35.6%) patients. Cluster 2 (high heart rate and low blood oxygen group) included 55 (9.4%) patients. Cluster 3 (normal group) included the remaining 321 (55%) patients. The oxygen saturation levels of all the patients were lower after transport, and the proportion of adverse events (61.8%) was the highest in Cluster 2 (p < .05).</p><p><strong>Conclusions: </strong>This study utilized data on five important vital signs from a cluster analysis to explore possible patient classifications and provide a reference for ensuring transportation safety.</p><p><strong>Relevance to clinical practice: </strong>Before transferring patients, we should classify them and implement targeted care. Changes in blood oxygen levels in all patients should be considered, with a focus on the occurrence of adverse events during transportation among patients with high heart rates and low blood oxygen levels.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13099"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494220","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":"Understanding oral care in the intensive care unit: A qualitative study of nurse experiences and practices with mechanically ventilated patients.","authors":"Li SuWen, Huang YuYang, Bu Wei","doi":"10.1111/nicc.13296","DOIUrl":"10.1111/nicc.13296","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in the intensive care unit (ICU), often linked to poor oral care. Despite its importance, oral care is frequently neglected in ICU settings, leading to increased morbidity and health care costs.</p><p><strong>Aim: </strong>To explore the challenges ICU nurses face in providing oral care to mechanically ventilated patients and identify their specific educational needs.</p><p><strong>Study design: </strong>This study employed a qualitative descriptive design to detail oral care experiences in the ICU. Standardized qualitative research reporting protocols ensured integrity. Data collection included observational methods using video and photographic records, followed by heuristic interviews.</p><p><strong>Results: </strong>Three key themes were identified: logistical challenges in providing ICU oral care, the need for more education and better resource allocation and the importance of ethical communication in nursing. Differences in policy implementation, spatial constraints and communication barriers highlighted the need for improved education, better resource management and enhanced communication strategies while maintaining patient dignity.</p><p><strong>Conclusions: </strong>ICU nurses encounter challenges in oral care because of spatial constraints, technical difficulties and lack of knowledge. Targeted education, resource allocation and better communication can improve oral care quality, reduce VAP incidence and enhance patient outcomes.</p><p><strong>Relevance to clinical practice: </strong>Comprehensive training programmes and addressing psychological barriers are critical to enhancing ICU nurses' effectiveness in oral care. Improved communication practices and balancing patient dignity with medical demands are essential for maintaining high standards of care.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13296"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544437","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":"Effect of ambidextrous leadership on clinical nurse leadership: The mediating role of psychological empowerment among critical care nurses.","authors":"Baofeng Zhang, Ke Zhao, Zhan Yang","doi":"10.1111/nicc.13293","DOIUrl":"https://doi.org/10.1111/nicc.13293","url":null,"abstract":"<p><strong>Background: </strong>In critical care departments, the clinical leadership of nurses who specialize in critical care nursing significantly influences care quality and clinical outcomes. The leadership styles of head nurses are closely associated with clinical nurse leadership. Ambidextrous leadership, which integrates transactional and transformational leadership, is a common leadership style.</p><p><strong>Aim: </strong>This study was conducted to determine whether psychological empowerment mediates the relationship between ambidextrous leadership and clinical nurse leadership among critical care nurses.</p><p><strong>Study design: </strong>A cross-sectional descriptive design was employed. Critical care nurses were recruited from five tertiary hospitals in Zhengzhou, China, using convenience sampling. Measures were the socio-demographic characteristics of participants, the Chinese version of the clinical leadership survey, the ambidextrous leadership style scale and the psychological empowerment scale. Data were analysed using IBM SPSS v. 21.0. IBM AMOS v. 24.0 was used to construct a structural equation model and bootstrap to test the mediating effect of psychological empowerment.</p><p><strong>Results: </strong>The results of the structural equation model analysis show that the direct effects of ambidextrous leadership on clinical nurse leadership were 0.173, p = .001, and the total effects were 0.225, p = .001; the indirect effects were 0.052, p = .035 (95% confidence intervals = 0.126-0.223), respectively. Furthermore, psychological empowerment moderated the relationship between ambidextrous leadership and clinical nurse leadership.</p><p><strong>Conclusion: </strong>The mediating effects of psychological empowerment on ambidextrous leadership and clinical nurse leadership were found among critical care nurses.</p><p><strong>Relevance to clinical practice: </strong>This study contributes to clinical nurse leadership among critical care nurses. By adopting ambidextrous leadership, head nurses in critical care departments can improve nurses' clinical leadership. Training is recommended for head nurses' ambidextrous leadership in critical care. In addition, head nurses should give critical care nurses more psychological empowerment to improve their clinical leadership.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 2","pages":"e13293"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606103","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}