Nursing in Critical Care最新文献

{"title":"Association between laboratory data-based frailty index and clinical health outcomes in critically ill older patients: A retrospective correlational study.","authors":"Hyunju Ji, Jae Jun Lee, Kyung Hee Lee","doi":"10.1111/nicc.13222","DOIUrl":"https://doi.org/10.1111/nicc.13222","url":null,"abstract":"<p><strong>Background: </strong>Although frailty assessment is crucial for understanding critically ill patients' prognosis, traditional frailty measures require substantial efforts and time from health care professionals. To address this limitation, the laboratory frailty index (FI-LAB) based on laboratory clinical data was developed. However, knowledge regarding its correlation with health outcomes among critically ill older patients is limited.</p><p><strong>Aim: </strong>To identify the association between the FI-LAB and acute, mid- and long-term outcomes among critically ill older adults.</p><p><strong>Study design: </strong>This retrospective correlational study used electronic health records of 2106 older patients who were admitted to the intensive care unit at a tertiary hospital in Seoul, Korea. Acute and mid-term outcomes included occurrence of delirium and in-hospital mortality, and the long-term outcome included 1-year mortality. Logistic regression was used to explore the relationships across FI-LAB, delirium, and in-hospital mortality, while Cox proportional hazard regression was used to analyse the relationship between FI-LAB and 1-year mortality.</p><p><strong>Results: </strong>Frailty assessed by FI-LAB was significantly associated with increased risk of delirium (odds ratio [OR] = 6.21, 95% confidence interval [CI] = 2.31-25.39, p = .009), in-hospital mortality (OR = 2.38, 95% CI = 1.15-5.79, p = .014), and 1-year mortality (hazard ratio = 2.47, 95% CI = 1.16-5.25, p = .019) after controlling for covariates.</p><p><strong>Conclusions: </strong>The study highlighted the importance of using FI-LAB for screening frailty in critically ill older adults. Health care providers can improve patients' acute, mid- and long-term outcomes to develop more individualised management plans based on FI-LAB scores.</p><p><strong>Relevance to clinical practice: </strong>The FI-LAB score calculated from routine laboratory data can be used by nurses as a screening tool to identify frail older adults in critical care. Early detection of frailty would allow for closer monitoring and the implementation of interventions to reduce delirium and mortality.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e13222"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059167","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":"First clinical practice experiences of nursing students in intensive care unit: A qualitative study.","authors":"Ezgi Yıldız, Zuhal Gülsoy, Şerife Karagözoğlu","doi":"10.1111/nicc.70017","DOIUrl":"10.1111/nicc.70017","url":null,"abstract":"<p><strong>Background: </strong>Nursing students' practice experiences in the intensive care unit will greatly influence their acquisition of professional skills and the development of their future nursing roles.</p><p><strong>Aim: </strong>This study aimed to determine nursing students' first clinical practice experiences in the intensive care unit.</p><p><strong>Study design: </strong>The type of research is qualitative research. The study data were collected from 14 students who were doing clinical practice in the anaesthesia intensive care unit of a university hospital. Face-to-face individual interviews were conducted with each student. A semi-structured interview guide was used in the interviews. Data were analysed with MAXQDA Analytics Pro 2020. This study adhered to the COREQ checklist for reporting.</p><p><strong>Results: </strong>Four main themes were reached: 'First Emotions in the Intensive Care Unit', 'Experiences Related to the Perception of Profession', 'Experiences Related to Patient Care' and 'Experiences Related to Personal Development'. It was determined that the most prominent feelings in these clinical practice experiences of the students were fear in patient care, satisfaction and professional image in professional acquisition, and making life more meaningful in their perspective on life.</p><p><strong>Conclusions: </strong>Students evaluated the intensive care clinical practice as beneficial in terms of professional and personal development. It is recommended that an orientation program be organized for students before intensive care clinical practice.</p><p><strong>Relevance to clinical practice: </strong>Qualified critical care nurses of the future are a product of a qualified nursing clinical education today.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70017"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722433","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":"Overcoming barriers to infection prevention and control compliance in intensive care units: A call for strategic change.","authors":"Noor Hasmee, Bhupendra Singh, Vinod Arora, Kumari Sangam, Mamita Gurung","doi":"10.1111/nicc.70012","DOIUrl":"10.1111/nicc.70012","url":null,"abstract":"","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70012"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774748","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 effect of nursing care based on Comfort Theory of Kolcaba on comfort, satisfaction and sleep quality of intensive care patients.","authors":"Ebubekir Kaplan, Aylin Özakgül","doi":"10.1111/nicc.70033","DOIUrl":"10.1111/nicc.70033","url":null,"abstract":"<p><strong>Background: </strong>It has been reported that factors such as immobility, pain, invasive interventions, separation from family, presence of unfamiliar people, constant noise and frequent sleep interruptions in intensive care units cause deterioration in comfort and sleep problems associated with deterioration in comfort, high levels of anxiety and restlessness.</p><p><strong>Aim: </strong>The aim of this randomized controlled trial was to investigate the effect of nursing care based on Kolcaba's Comfort Theory on the comfort, satisfaction and sleep quality of intensive care unit patients.</p><p><strong>Study design: </strong>The sample of the study consisted of 40 experimental and 40 control group patients who agreed to participate in the study between April 2023 and July 2023. The data were collected by the Patient Information Form, General Comfort Questionnaire (GCQ), Newcastle Satisfaction with Nursing Scale (NSNS), Richard-Campbell Sleep Questionnaire (RCSQ) and Comfort Behaviour Checklist (CBC). Patients in the control group received conventional care by intensive care nurses. Patients in the experimental group received individualized nursing care based on the Comfort Theory of Kolcaba during their stay in the intensive care unit. The SPSS 26 program was used for statistical analyses of the data.</p><p><strong>Results: </strong>The experimental and control groups were homogeneous in terms of demographic and disease characteristics, and no significant difference was found between the groups in terms of pre-test GCQ, NSNS, RCSQ, CBC and pain level mean scores. Compared with the pre-test evaluation of the experimental group, the post-test GCQ, NSNS, RCSQ and CBC total scores increased (p < 0.001). There was a significant difference in GCQ, NSNS, RCSQ and CBC levels between the experimental and control groups (p < 0.001). There was a significant decrease in pain scores between the experimental and control groups (p < 0.001).</p><p><strong>Conclusions: </strong>As a result of this study, it was found that nursing care based on Comfort Theory of Kolcaba had a positive effect on the comfort, satisfaction and sleep quality of intensive care patients.</p><p><strong>Relevance to clinical practice: </strong>Nursing care based on the Comfort Theory can be considered an appropriate method in clinical practice, especially in improving the quality of care of patients in the coronary intensive care unit.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70033"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055416","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 effect of listening to the voice recording of relatives on chest pain, anxiety and depression in patients hospitalized in the coronary intensive care unit: A randomized controlled trial.","authors":"Yasemin Kalkan Uğurlu, Dilek Küçük Alemdar","doi":"10.1111/nicc.13199","DOIUrl":"10.1111/nicc.13199","url":null,"abstract":"<p><strong>Background: </strong>After acute myocardial infarction, the prevalence of anxiety and depression is quite high in patients because of severe chest pain, distance from relatives, unfamiliar environment and orientation problems.</p><p><strong>Aim: </strong>To assess the effect of listening to the voice recordings of relatives of patients with acute myocardial infarction who were treated in the coronary intensive care unit (ICU) on chest pain, anxiety and depression parameters of the patients.</p><p><strong>Study design: </strong>In the study, which was conducted as a randomized controlled trial, voice recordings of the family members of the patients were created and played to the patients through a music pillow. The study was carried out with 60 patients, 30 experimental and 30 control groups. Three tests were applied to the patients 15 min before, and 15 and 30 min after the application. The data of the study were collected using the Patient Introduction Form, Hospital Anxiety Depression Scale, Visual Analogue Scale and Patient Follow-up Form.</p><p><strong>Results: </strong>It was found that there was a significant decrease in the anxiety level of the patients in the intervention group after listening to the audio recording (p < .001, 95% CI: -3.796; -0.070). However, there was no significant difference between the pain and depression scores of the control and intervention groups (p > .05).</p><p><strong>Conclusions: </strong>In the ICUs of patients with acute myocardial infarction, it may be recommended to play audio recordings of their relatives to reduce the severity of anxiety.</p><p><strong>Relevance to clinical practice: </strong>In the intensive care setting, the use of voice recordings of relatives can be used as an effective, non-pharmacological intervention to reduce anxiety in patients with acute myocardial infarction. This approach may potentially improve overall recovery by reducing patient anxiety in the intensive care setting.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13199"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548773","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 effect of an open-heart surgery patient care protocol on post-sternotomy pain, anxiety and quality of care: A randomized controlled trial.","authors":"Necibe Dağcan Şahin, Gülşah Gürol Arslan","doi":"10.1111/nicc.13193","DOIUrl":"10.1111/nicc.13193","url":null,"abstract":"<p><strong>Background: </strong>Open-heart surgery patients face many problems because of post-sternotomy pain. Care protocols can eliminate pain and pain-related problems by providing holistic care.</p><p><strong>Aim: </strong>The aim of this study was to examine the effect of an open-heart surgery patient care protocol developed in the study on post-sternotomy pain, anxiety and quality of care.</p><p><strong>Study design: </strong>The study was carried out as a double-blind randomized controlled trial. The sample size was calculated. Considering some attrition, the sample size was increased by 10% for each group, and a total of 68 participants, including 34 in each group, were included in the sample. Data were collected using a 'Patient Information Form', a 'Post-Sternotomy Pain Follow-up Form', the 'Numeric Rating Scale', the 'State Anxiety Inventory' and the 'Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire'. The patients in the experimental group were given care in accordance with the protocol, which was developed in the study, on postoperative days 0, 1 and 2.</p><p><strong>Results: </strong>The statistical evaluation showed a significant difference between the mean scores of the experimental (F = 7.28; p < .001) and control groups (F = 2.42; p < .05) on the pain assessment scale. It was determined that the number of analgesics used in the experimental group was statistically significantly lower than in the control group. Intra-group comparisons showed that there was a difference between the mean pre-test and post-test state anxiety scale scores of the groups (p < .001). The experimental group had higher mean scores on the Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire than that of the control group (p < .001).</p><p><strong>Conclusions: </strong>The protocol developed in the study was found to be effective in reducing pain, the use of NSAIDs and opioids, and anxiety levels and increasing the level of quality of care.</p><p><strong>Relevance to clinical practice: </strong>The protocol was original and feasible in that it included independent nursing interventions to improve the quality of care by reducing pain and anxiety. Particularly, the use of protocols in intensive care units was nurses' strongest resource in patient care management. Thus, the protocol, which was prepared for intensive care patients who most frequently experience pain and anxiety, was promising for nurses in improving the quality of care by reducing pain and anxiety. However, it is necessary to conduct further studies involving longitudinal follow-up in samples and institutions with similar conditions.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13193"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480252","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":"Development and validation of an enteral feeding interruption management scale for ICU medical staff: A knowledge-, attitude- and practice-based approach.","authors":"Yuanyuan Mi, Fei Tian, Lifei Wang, Chenglin Xiang, Liang Sun","doi":"10.1111/nicc.70024","DOIUrl":"10.1111/nicc.70024","url":null,"abstract":"<p><strong>Background: </strong>Enteral feeding interruption (EFI) is a frequent issue in ICU settings, affecting nutritional adequacy and delaying recovery in critically ill patients. While tools exist to assess patients' nutritional status, no instrument evaluates ICU staff's knowledge, attitude and practice (KAP) in EFI management.</p><p><strong>Aim: </strong>To develop a reliable and valid EFI management scale for ICU medical staff based on the KAP model.</p><p><strong>Study design: </strong>This instrument development study followed the STROBE guidelines, utilizing a cross-sectional, multi-centre approach in Wuhan. A convenience sample of 400 ICU staff from eight tertiary A hospitals and two tertiary B hospitals was included between May 2021 and March 2022. A preliminary scale was constructed through literature review, interviews and expert consultations. The sample was used to assess the scale's reliability and validity.</p><p><strong>Results: </strong>The final EFI management scale comprised 41 items across three dimensions, with cumulative variance contributions of 70.341%, 70.437% and 66.550%. Cronbach's α ranged from 0.919 to 0.947, with test-retest reliability between 0.488 and 0.836. The total scale had a Cronbach's α of 0.953 and test-retest reliability of 0.977. Content validity indices (I-CVI) ranged from 0.800 to 1.000, and the scale-level CVI was 0.975.</p><p><strong>Conclusions: </strong>The EFI Management KAP Scale is a valid, reliable tool for assessing ICU medical staff's management of EFI.</p><p><strong>Relevance to clinical practice: </strong>The EFI Management KAP Scale addresses a critical gap in the standardized evaluation of critical care nurses' knowledge, attitudes and practices regarding enteral feeding interruptions. By providing a validated tool, this scale enables the identification of specific barriers and facilitators to optimal enteral nutrition delivery in critically ill patients. Its application can guide targeted educational interventions, inform policy adjustments and enhance multidisciplinary collaboration in the ICU. Ultimately, this scale supports improved enteral nutrition management, reducing complications associated with feeding interruptions and contributing to better patient outcomes in critical care settings.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70024"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Prediction Models of Subsyndromal Delirium in Critically Ill Patients: A Systematic Review and Meta-Analysis.","authors":"Fei Wu, Tong Wang, Yana Xing, Weixin Cai, Ran Zhang","doi":"10.1111/nicc.70063","DOIUrl":"10.1111/nicc.70063","url":null,"abstract":"<p><strong>Background: </strong>The number of predictive models for assessing the risk of subsyndromal delirium (SSD) in critically ill patients is increasing, yet the quality and applicability of these models in clinical practice remain unclear.</p><p><strong>Aim: </strong>To systematically review and critically evaluate the existing risk prediction models.</p><p><strong>Study design: </strong>Eleven Chinese and English databases, including PubMed, Web of Science and Embase, were searched from their inception to August 16, 2024. Two researchers independently screened the literature, extracted data and assessed the risk of bias and applicability using the prediction model risk of bias assessment tool. Meta-analysis was conducted using Stata 17.0.</p><p><strong>Results: </strong>Eight studies were included. The SSD incidence in ICU patients ranged from 8.97% to 34.5%. The most commonly used predictors were the APACHE II score and age. The reported area under the curve (AUC) ranged from 0.788 to 0.923, with the pooled AUC value for the five validated models being 0.87 (95% CI: 0.82-0.92). Six studies had a high risk of bias, while two had an unclear risk.</p><p><strong>Conclusions: </strong>The eight included models demonstrated good performance in early identification and screening of high-risk critically ill patients for SSD, but they all exhibited a high risk of bias regarding model quality.</p><p><strong>Relevance to clinical practice: </strong>ICU professionals should carefully select and validate existing models based on their specific clinical settings before applying them. Alternatively, they can conduct new models incorporating multimodal data and artificial intelligence algorithms, utilizing large sample sizes, robust research designs and multi-center external validation.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70063"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081711","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":"Dynamic change and risk factors of intense thirst in patients admitted to neuro-intensive care unit: An observational study.","authors":"Peng Zhao, Yansi Luo, Lijun Xiang, Meng Cao, Xuemei Song, Lin Liao, Mingyu Yan, Lei Cheng, Zhihui Zhu, Xiaomei Zhang","doi":"10.1111/nicc.13184","DOIUrl":"10.1111/nicc.13184","url":null,"abstract":"<p><strong>Background: </strong>Thirst is a clinical discomfort symptom reported by most patients admitted to intensive care unit (ICU). Little is known about the dynamic change and risk factors of intense thirst in neuro-intensive care unit (Neuro-ICU).</p><p><strong>Aim: </strong>The objective of this study was to explore the dynamic change and determine the risk factors of intense thirst in patients admitted to Neuro-ICU, providing reference for personalized interventions of intense thirst.</p><p><strong>Study design: </strong>The study design is a prospective observational study. Demographic and disease-related, treatment, physiological and biochemical data were collected for 230 patients from Neuro-ICU of a hospital from May 2023 to November 2023. We assessed thirst intensity on numeric rating scale (NRS) of 0-10 (10 = worst possible thirst) at eight time points: 7:00, 9:00, 11:00, 13:00, 15:00, 17:00, 19:00 and 21:00 and a self-designed general information questionnaire based on safety protocol for thirst management to analyse the risk factors of intense thirst in Neuro-ICU patients. If thirst scores were more than 7, we defined it as intense thirst. This study followed the STROBE checklist for cross-sectional studies.</p><p><strong>Results: </strong>A total of 230 Neuro-ICU patients were observed. The dynamic analysis results showed an overall downward trend in thirst intensity, with the highest NRS thirst scores at 07:00 (6.13 ± 2.14) and the lowest at 21:00 (4.02 ± 2.72). The investigation of the current situation showed that the incidence of intense thirst in Neuro-ICU patients was 47.4%. Intense thirst in Neuro-ICU patients was predicted by dysphagia (odds ratio [OR] = 1.436, 95% confidence interval [CI]:1.063-1.941), open mouth breathing (OR = 2.201, 95% CI:1.041-4.656), high glucose (OR = 2.584, 95% CI:1.097-6.087), xerostomia (OR = 3.049, 95% CI:1.950-4.767) (all p < .05).</p><p><strong>Conclusion: </strong>The intensity of thirst was dynamically changing and the incidence of intense thirst in Neuro-ICU patients was relatively high. Timely assessment of Neuro-ICU patients' thirst severity and identification of those at high risk can ensure the implementation of effective interventions based on patients' characteristics.</p><p><strong>Relevance to clinical practice: </strong>Thirst is a pervasive distressing symptom often reported by critically ill patients. This study revealed that the clinical nurses need to enhance their focus on dynamic change of thirst, which is helpful for improving the efficiency of bundled thirst interventions at the suitable time.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13184"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512657","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":"Associations of Intensive Care Unit Acquired Weakness and Postoperative Delirium in Surgical Intensive Care Unit: A Prospective Observation Study.","authors":"Jin Qiu, Yingtong Meng, Zhiqing Yang, Rongrong Ren, Jiao Chen, Hanjun Huang, Tienan Feng, Xiaohua Ge","doi":"10.1111/nicc.70061","DOIUrl":"10.1111/nicc.70061","url":null,"abstract":"<p><strong>Background: </strong>To date, studies assessing the relationship between intensive care unit acquired weakness (ICU-AW) and postoperative delirium (POD), two of the most common complications in the intensive care unit (ICU), are lacking.</p><p><strong>Aim: </strong>To explore the association of the occurrence of POD, POD subtypes and POD duration with ICU-AW in a surgical intensive care unit (SICU).</p><p><strong>Study design: </strong>This study was a prospective observational study. Four hundred and two postoperative patients in a SICU at a tertiary hospital in Shanghai, China, participated in the study. Data were collected through the electronic medical record system of the hospital between October 2022 and July 2023. POD was assessed using the Richmond agitation-sedation scale (RASS) and the Confusion Assessment Method for the intensive care unit (CAM-ICU). The Medical Research Council score (MRC score) was used to measure ICU-AW. The bivariate logistic regression analysis was used to analyse the relationship between ICU-AW and POD, and further, the influencing factors of ICU-AW.</p><p><strong>Results: </strong>Of the 402 analysed patients (mean age: 69.2 ± 14.84, 59.7% male), 121 (30.10%) patients developed ICU-AW, and 92 (22.89%) patients developed POD. Of the ICU-AW group, 53 (43.80%) patients screened positive for POD. The occurrence of POD (odds ratio (OR), 0.227 95% CI: 0.052-0.981), hypoactive POD (OR, 4.241 95% CI: 1.490-12.072) and POD duration (OR, 2.649; 95% CI: 1.422-4.935) were independently associated with ICU-AW. Moreover, diabetes (OR, 1.710; 95% CI: 1.036-2.823) and Interleukin-6 (IL-6) (OR, 1.001; 95% CI: 1.000-1.001) were also significantly correlated with ICU-AW.</p><p><strong>Conclusions: </strong>ICU-AW was associated with POD, POD subtypes and POD duration in the SICU patients. Screening for hypoactive POD should be used as part of routine risk assessment in the SICU focused on identifying ICU-AW and specifying a timely and targeted plan during the early stages of the postoperative period.</p><p><strong>Relevance to clinical practice: </strong>While closely monitoring ICU patients with high IL-6 levels and diabetes, nurses should assess the type and duration of POD in patients and implement care interventions to prevent the development of ICU-AW.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70061"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081726","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}