Intensive and Critical Care Nursing最新文献

{"title":"Correlation between subjective and objective cognitive function in post-intensive care patients: a dual-center prospective cohort study","authors":"Rens W.J. Kooken ,&nbsp;Søs Bohart ,&nbsp;Arjen J.C. Slooter ,&nbsp;Thordis Thomsen ,&nbsp;Bram Tilburgs ,&nbsp;Mark van den Boogaard","doi":"10.1016/j.iccn.2025.104081","DOIUrl":"10.1016/j.iccn.2025.104081","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the correlation between a subjective and objective cognitive screening tool in intensive care unit (ICU) survivors three months post-discharge, and to explore differences in associated factors.</div></div><div><h3>Research design</h3><div>Prospective cohort study.</div></div><div><h3>Setting</h3><div>Two Dutch university ICUs.</div></div><div><h3>Main outcome measures</h3><div>Correlation between subjective (Cognitive Failure Questionnaire [CFQ-14]) and objective (modified Telephone Interview for Cognitive Status [TICS-m]) cognitive function scores and associated clinical and demographic factors.</div></div><div><h3>Results</h3><div>Among 372 included patients (July 2020-July 2022), 20.1 % (n = 75) had cognitive impairment (based only on a CFQ-14 score ≥43, n = 19 (5.1 %); based only on a TICS-m score ≤33, n = 52 (13.9 %); meeting both criteria, n = 4 (1.1 %)). CFQ-14 and TICS-m scores were weakly correlated (r = −0.11, p = 0.03). Using multivariable linear regression, depression scores (Hospital Anxiety and Depression Scale) were significantly associated with standardized CFQ-14 scores (adjusted β 0.16; 95%CI 0.09–0.24; p &lt; 0.01), whereas age (adjusted β −0.03; 95%CI −0.04–−0.01; p &lt; 0.01) and sedation-induced coma (adjusted β −0.49; 95%CI −0.91–−0.07; p = 0.02) were significantly associated with standardized TICS-m scores.</div></div><div><h3>Conclusion</h3><div>Subjective cognitive complaints do not reliably correspond with objective cognitive impairment, and vice versa. Depression scores were associated with subjective cognition, whereas age and sedation-induced coma were associated with objective cognition.</div></div><div><h3>Implication for clinical practice</h3><div>Nurses and physicians, particularly in post-ICU clinics, should be mindful that subjective and objective cognitive screening tools, although both valuable, adress different aspects and should not be considered interchangeable. Self-reported cognitive problems may be driven by emotional distress (e.g., depressive symptoms) rather than objective cognitive impairment.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104081"},"PeriodicalIF":4.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive care nurses’ attitudes about the importance of family involvement in adult intensive care: A multicentre cross-sectional study","authors":"Isha Verkaik ,&nbsp;Nini H. Jonkman ,&nbsp;Fredrike Blokzijl ,&nbsp;Anja H. Brunsveld-Reinders ,&nbsp;Andrea A. Esmeijer ,&nbsp;Ina Mulder ,&nbsp;Ineke van de Pol ,&nbsp;Jolanda Qualm ,&nbsp;Martin Rinket ,&nbsp;Ilona R. Roeters ,&nbsp;Dolf Weller ,&nbsp;Paul J.T. Rood ,&nbsp;Frederique Paulus ,&nbsp;Anne M. Eskes","doi":"10.1016/j.iccn.2025.104065","DOIUrl":"10.1016/j.iccn.2025.104065","url":null,"abstract":"<div><h3>Introduction</h3><div>Family involvement in intensive care (IC) benefits patients and families, but requires nurses to go beyond. ICU nurses are facing the additional task of offering support for family members and involving them in care activities. This requires a positive attitude towards family participation. This study aims to describe the attitudes of ICU nurses towards involving family members in nursing care and to investigate the association of demographic and professional characteristics with these attitudes.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in ten hospitals across the Netherlands. ICU nurses received an online questionnaire including the Families Importance to Nursing Care (FINC-NA) scale (with scores ranging from 22 to 110). The data were analysed using descriptive statistics and multiple linear regression.</div></div><div><h3>Results</h3><div>The FINC-NA questionnaire was completed by 583 ICU nurses (42% response rate). The mean attitude of ICU nurses was 73.3 (SD 8.78). In general, ICU nurses viewed the family as important in care provision. However, ICU nurses showed a less positive attitude on the subscales “promoting family involvement’’ and “family as a burden’’. A less positive attitude towards family involvement was significantly associated with working more clinical hours per week and ICU nurses working in a university hospital rather than a teaching hospital.</div></div><div><h3>Conclusion</h3><div>ICU nurses showed a less positive attitude towards involving families in care compared to nurses from other clinical settings.</div></div><div><h3>Implications for Clinical Practice</h3><div>In order to establish a more family focused approach in clinical practice, special attention is needed for ICU nurses who work more clinical hours and in a university hospital. Besides, guidelines on family involvement in the ICU may improve nurses’ attitudes.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104065"},"PeriodicalIF":4.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulse pressure monitoring: A crucial bedside tool for nursing practice","authors":"Filippo Binda","doi":"10.1016/j.iccn.2025.104079","DOIUrl":"10.1016/j.iccn.2025.104079","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104079"},"PeriodicalIF":4.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of tracheostomy on ICU stay in adult patients with ARDS: A systematic review","authors":"Veronica Rossi ,&nbsp;Filippo Binda ,&nbsp;Claudio Cordani ,&nbsp;Federica Marelli ,&nbsp;Serena Tammaro ,&nbsp;Sabrina Colombo ,&nbsp;Alice Fantini ,&nbsp;Annalisa Carlucci ,&nbsp;Giacomo Grasselli","doi":"10.1016/j.iccn.2025.104076","DOIUrl":"10.1016/j.iccn.2025.104076","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the impact of tracheostomy on clinical outcomes in adults with acute respiratory distress syndrome (ARDS) who require mechanical ventilation (MV).</div></div><div><h3>Methods</h3><div>This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Three electronic databases including PubMed, The Cochrane Library, and EMBASE to identify relevant studies on ARDS patients receiving MV were searched from inception to July 31, 2024. The reviewers assessed the risk of bias of included studies according to the Cochrane Risk of Bias 1 tool or JBI checklists, as appropriate. Two reviewers independently screened the literature and extracted the data. Outcomes among patients who underwent tracheostomy were compared and analyzed.</div></div><div><h3>Results</h3><div>Twenty studies involving 4,022 patients with ARDS who required tracheostomy were included, comprising 2 randomized controlled trials, 5 prospective studies, 12 retrospective studies, and 1 case series. On average, tracheostomized patients spent 30.2 days in the ICU and 44.8 days in the hospital, with an overall mean duration of MV of 27 days. Tracheostomy-related adverse events were reported in 15 studies and local bleeding was the most common complication. Of the 1,074 patients with tracheostomy, 626 (58.3%) were successfully weaned from the ventilator. Mortality outcomes were documented in 18 studies, indicating that 883 out of 2,302 (38.4%) of these patients died during hospitalization.</div></div><div><h3>Conclusion</h3><div>Tracheostomy in MV patients with ARDS does not have a clearly defined impact on ICU length of stay due to variability in study findings. However, it remains a safe intervention with generally minor complications. Future research should focus on standardized weaning protocols and multidisciplinary rehabilitation strategies to potentially improve patient outcomes.</div></div><div><h3>Implications for clinical practice</h3><div>Tracheostomy allows for a more controlled and gradual weaning process in patients with ARDS requiring prolonged MV. Moreover, although current evidence does not indicate a significant reduction in ICU length of stay, tracheostomy contributes to more effective patient management during the weaning by facilitating oral hygiene, improving mobility, and enabling both verbal communication and oral feeding.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104076"},"PeriodicalIF":4.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nurse-driven protocol for early weaning from mechanical ventilation in patients with acute respiratory failure: A pilot study","authors":"Jean-Adoumngar Moussanang ,&nbsp;Guillaume Thery ,&nbsp;Ophélie Marcq ,&nbsp;Sarah Sellam ,&nbsp;Damien Jolly ,&nbsp;Bruno Mourvillier ,&nbsp;Antoine Goury","doi":"10.1016/j.iccn.2025.104060","DOIUrl":"10.1016/j.iccn.2025.104060","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the compliance and acceptance of a nurse-driven early weaning protocol from the initiation of spontaneous ventilation (SV) to extubation in patients with acute respiratory failure (ARF) in the intensive care unit (ICU).</div></div><div><h3>Methods</h3><div>This monocentric, prospective pilot study included patients admitted to the ICU with ARF and requiring invasive mechanical ventilation (IMV) for more than 48 h, between February 2021 and April 2024. The weaning protocol (WP) was initiated after a successful 30-minute SV trial with pressure support (PS). Every 3 h, nurses reduced PS by 2 cmH₂O, fraction of inspired oxygen (FiO₂) by 5%, and positive end-expiratory pressure (PEEP) according to a predefined protocol. When minimum PS and PEEP levels were reached, the patient was extubated after a successful T-tube test. The primary outcome was compliance with the WP assessed by the percentage of time spent in agreement with WP. The secondary outcome was nurse acceptance, assessed by an anonymous survey on a visual analogue scale from 0 to 10.</div></div><div><h3>Results</h3><div>Of the 50 patients enrolled, 30 (60 %) had COVID-19 pneumonia. The median duration of IMV was 21 days per patient [IQR: 10–34], with a median WP duration of 11 days [IQR: 4–21.5]. Protocol compliance was 76 %. Thirty-two of 37 nurses (86 %) completed the survey and rated the acceptance of the WP as 8/10 [IQR: 7.75–9]. Workload was identified as a barrier to compliance with a median score of 5/10 [IQR: 2–7]. We reported 9/50 (18 %) extubation failures.</div></div><div><h3>Conclusions</h3><div>This nurse-driven protocol for early weaning of patients with ARF had good compliance and acceptance by the nurse team despite the COVID-19 pandemic health crisis.</div></div><div><h3>Implications for Clinical Practice</h3><div>It is essential to incorporate nursing feedback if we are to improve the protocols for ventilatory weaning patients in ICU.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104060"},"PeriodicalIF":4.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of patient diaries on children, families, and healthcare professionals in paediatric intensive care settings: A scoping review","authors":"Fiona Lynch ,&nbsp;Jos M. Latour ,&nbsp;Ruth Endacott","doi":"10.1016/j.iccn.2025.104087","DOIUrl":"10.1016/j.iccn.2025.104087","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this scoping review was to understand the current landscape, features, and volume of evidence that address the review question: what is the impact of Paediatric Intensive Care Unit (PICU) patient diaries on children, families, and healthcare professionals (HCPs)? To provide context: descriptions of diary models was also provided.</div></div><div><h3>Method</h3><div>The search strategy was structured using the Population, Concept, and Context model to focus the review question. The inclusion criteria were intentionally broad to include all studies published in English from January 2016 until November 2024. The databases CINAHL, Medline, and EMBASE were used to retrieve articles, and grey literature was scoped using Google Scholar. Articles were reviewed and summarised.</div></div><div><h3>Results</h3><div>Thirteen articles on the impact of PICU diaries have provided understanding on: the definition of PICU diaries, and perspectives on how diaries impacted the child, parents, and the HCP. The studies were mostly conducted in Europe. The methods used in the studies were quantitative (n = 4), qualitative (n = 4), mixed methods (n = 1), prospective descriptive study (n = 1), and a quality improvement project (n = 1). Two papers were scoping and systematic reviews and included for completeness. PICU diaries are well received but there are implementation challenges, and concerns about the professional implications of diary use.</div></div><div><h3>Conclusion</h3><div>The literature scoped provided insights on the variety of diary models, the perceived value, and challenges of using diaries, whilst illuminating the current gaps in the evidence around the impact of PICU diaries.</div></div><div><h3>Implications for clinical Practice</h3><div>PICU diaries represent a low-cost, feasible intervention that enhances understanding and fosters stronger connections between parents, their child, and healthcare professionals. While PICU staff generally evaluated the diaries positively, concerns regarding professional and legal implications persist. Further research and professional guidance are needed to address these concerns and establish best practices for diary use in the PICU setting.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104087"},"PeriodicalIF":4.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating nursing care: Being there until the end","authors":"Alessandro Galazzi,&nbsp;Alberto Lucchini,&nbsp;Margo van Mol","doi":"10.1016/j.iccn.2025.104080","DOIUrl":"10.1016/j.iccn.2025.104080","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104080"},"PeriodicalIF":4.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delirium in the ICU: Steps forward and the road ahead","authors":"Leona Bannon ,&nbsp;Bronagh Blackwood","doi":"10.1016/j.iccn.2025.104068","DOIUrl":"10.1016/j.iccn.2025.104068","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104068"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and enablers in nurses implementing light sedation in intubated and ventilated children: A qualitative exploratory descriptive study","authors":"Abdul Qayum ,&nbsp;Debbie Long ,&nbsp;Jane Harnischfeger ,&nbsp;Michele Cree ,&nbsp;Michaela Waak ,&nbsp;Karin Plummer","doi":"10.1016/j.iccn.2025.104047","DOIUrl":"10.1016/j.iccn.2025.104047","url":null,"abstract":"<div><h3>Objective</h3><div>To explore barriers and enablers in nurses implementing light sedation in mechanically ventilated children.</div><div>Design: A qualitative exploratory descriptive study.</div><div>Setting: The study was conducted in a quaternary paediatric intensive care unit in Queensland, Australia.</div></div><div><h3>Methods</h3><div>Focus groups (n = 4) were conducted with nurses (n = 32) caring for children requiring mechanical ventilation and sedation. The Capability, Opportunity and Motivation model of Behaviour change (COM-B) provided the conceptual framework for this study. Qualitative data were thematically analysed.</div></div><div><h3>Findings</h3><div>Nurse reported challenges in balancing sedation needs with patient safety.</div><div>Knowledge and experience with sedation management in mechanically ventilated children, and continuity of care, positively influenced light sedation. Resources in both the physical and social environment, including family engagement, play a positive role in enhancing the practice of light sedation. Light sedation in the younger paediatric population, and those with delirium, was identified as challenging. Nonpharmacological measures facilitated management of lightly sedated patients whereas inconsistent practice among physicians and lack of nursing autonomy were identified as barriers.</div></div><div><h3>Conclusions</h3><div>The practice of light sedation is most effectively promoted when it is prioritized at the organisational level. Ensuring adequate human resources, modifying the physical environment, and fostering collaboration among multidisciplinary teams, including family, are all likely to enhance its implementation. Nurses’ knowledge and experience in sedation management, alongside continuity of care and utilising nonpharmacological interventions, can further promote its practice. However, factors such as nurses’ concerns for their own professional and patient safety, high acuity levels in the unit, and a lack of support may hinder the adoption of light sedation practices.</div></div><div><h3>Implications for clinical practice</h3><div>The findings from this study suggest engaging multidisciplinary team to support light sedation practice. Likewise, training and skill development of nurses in the assessment and management of sedation may help implement light sedation. Continuity of care, adequate staffing, patient visibility and minimising stimulation should be considered to support the same. Nurses need to be empowered to practice light sedation, and sedation protocols may be helpful in this regard.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104047"},"PeriodicalIF":4.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key aspects of attracting nursing talent to the intensive care unit through training and education – Letter to Fernandez-Castillo et al.","authors":"Xiaojing Hu","doi":"10.1016/j.iccn.2025.104078","DOIUrl":"10.1016/j.iccn.2025.104078","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"90 ","pages":"Article 104078"},"PeriodicalIF":4.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}