Intensive and Critical Care Nursing最新文献

{"title":"Nursing surveillance for clinical deterioration among intensive care unit patients: A scoping review","authors":"Yeonju Kim ,&nbsp;Yesol Kim ,&nbsp;Jiin Kim ,&nbsp;Mona Choi","doi":"10.1016/j.iccn.2025.104218","DOIUrl":"10.1016/j.iccn.2025.104218","url":null,"abstract":"<div><h3>Objectives</h3><div>To comprehensively examine and summarize the existing knowledge on nursing surveillance for clinical deterioration among intensive care unit patients by presenting study and subject, clinical deterioration, and nursing surveillance characteristics in quantitative and qualitative studies.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in five electronic databases. Literature addressing nursing surveillance for detecting clinical deterioration among adult intensive care unit patients was included. Surveillance identified in quantitative studies was categorized into four nursing data types (scales, assessment records, activity records, and notes). Themes and subthemes were identified from qualitative studies. This review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline.</div></div><div><h3>Results</h3><div>Twenty-four sources of evidence were included. Most studies were published since 2012 and conducted in developed countries. Forty-seven clinical deterioration events were identified, and prolonged length of stay was the most frequently identified events. Forty-two surveillance variables were categorized into nursing data types. Assessment records were the most frequently used nursing surveillance variables, yet notes were insufficiently employed. Qualitatively identified surveillance was categorized into six themes: vigilance and monitoring, detection and decision making, integrated documentation practice, collaborative communication, intervention and risk management, and interaction with information technology systems.</div></div><div><h3>Conclusions</h3><div>The integration of quantitative surveillance data with qualitative elements has the potential to enhance patient safety in intensive care environments. This scoping review offers valuable insights for nursing researchers, educators, practitioners, and stakeholders by presenting a comprehensive understanding of nursing surveillance. By synthesizing evidence that connects surveillance variables with specific nursing data types, this review highlights more effective use of surveillance data in the early detection of clinical deterioration among intensive care patients.</div></div><div><h3>Implications for clinical practice</h3><div>This paper provides a comprehensive understanding of nursing surveillance, including the utilization of nursing surveillance data and the implementation of nursing surveillance research into clinical practice.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104218"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026605","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":"Reducing opioid exposure in ICU: exploring multidimensional approaches – Letter on Du Toit et al.","authors":"Xiaoyu Liu ,&nbsp;Yang Yang ,&nbsp;Yuehua Yan","doi":"10.1016/j.iccn.2025.104157","DOIUrl":"10.1016/j.iccn.2025.104157","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104157"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719286","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":"Effect of ultrashort-acting β-blocker on the mortality of patients with sepsis or septic shock: A systematic review and trial sequential meta-analysis of randomized controlled trials","authors":"Po-Yu Huang ,&nbsp;Ting-Hui Liu ,&nbsp;Jheng-Yan Wu ,&nbsp;Ya-Wen Tsai ,&nbsp;Wan-Hsuan Hsu ,&nbsp;Min-Hsiang Chuang ,&nbsp;Hung-Jen Tang ,&nbsp;Chih-Cheng Lai","doi":"10.1016/j.iccn.2025.104265","DOIUrl":"10.1016/j.iccn.2025.104265","url":null,"abstract":"<div><h3>Background</h3><div>Adrenergic responses, particularly tachycardia, play a role in sepsis-related complications. Ultrashort-acting β-blockers have been evaluated in randomized controlled trials (RCTs) for their impact on sepsis outcomes, but conflicting results have been reported. This systematic review and <em>meta</em>-analysis aim to provide an updated perspective on the impact of ultrashort-acting β-blockers on the clinical outcomes of sepsis.</div></div><div><h3>Methods</h3><div>A comprehensive search of PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> was conducted from inception to January 12, 2024. RCTs investigating the clinical effects and safety of ultrashort-acting β-blockers in sepsis or septic shock were included. Meta-analyses were performed using random-effects models, and trial sequential analysis (TSA) was conducted to evaluate the reliability of cumulative evidence. The primary outcome was 28-day mortality rate.</div></div><div><h3>Results</h3><div>A total of 2253 patients involved in 27 RCTs were included. Ultrashort-acting β-blockers significantly reduced the 28-day mortality rate (31.6% versus 48.4%; risk ratio [RR] 0.66; 95% CI 0.56–0.78). TSA provided robust evidence for the 28-day and in-hospital mortality benefit. The survival benefit remains evident in subgroups of patients with septic tachycardia (RR, 0.66; 95% CI, 0.47–0.93), septic cardiomyopathy (RR, 0.61; 95% CI, 0.44–0.83), Chinese populations (RR, 0.64; 95% CI, 0.54–0.76), and those treated with esmolol (RR, 0.64; 95% CI, 0.56–0.73). For patients with septic shock, only those with tachycardia demonstrated a statistically significant difference in mortality rates (RR, 0.70; 95% CI, 0.55–0.88).</div></div><div><h3>Conclusions</h3><div>Adjuvant ultrashort-acting β-blocker therapy demonstrated potential benefits in improving survival for patients with sepsis or septic shock.</div></div><div><h3>Implications for clinical practice</h3><div>This study highlights the potential benefits of adjuvant ultrashort-acting β-blocker therapy for the treatment of sepsis or septic shock in terms of enhanced survival and other clinical advantages, including reduced heart rate and cardiovascular biomarkers. Furthermore, such therapy did not appear to impair cardiac function and hemodynamic stability.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104265"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380576","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":"Stakeholder perspectives on the reduction of opioid exposure in ICU: A modified Delphi survey – Letter on Du Toit et al.","authors":"Parth Aphale,&nbsp;Himanshu Shekhar,&nbsp;Shashank Dokania","doi":"10.1016/j.iccn.2025.104200","DOIUrl":"10.1016/j.iccn.2025.104200","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104200"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809624","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":"Nurses’ impact on blood pressure after sedation bolus use: Untangling “nurse effects”","authors":"Christian Vincelette ,&nbsp;Francois Martin Carrier ,&nbsp;Michael Yu ,&nbsp;Michael Chassé","doi":"10.1016/j.iccn.2025.104276","DOIUrl":"10.1016/j.iccn.2025.104276","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104276"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497992","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":"Sonic overload: Alarm annoyance and its ripple effects on clinicians and patients","authors":"Alexandra G. Lee ,&nbsp;Kendall J. Donohue ,&nbsp;Joseph J. Schlesinger","doi":"10.1016/j.iccn.2025.104268","DOIUrl":"10.1016/j.iccn.2025.104268","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104268"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497994","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":"Reconsidering silence: methodological and theoretical reflections on ICU soundscape research – Letter on Louwers et al.","authors":"Heng Zhou,&nbsp;Yilin Jiang,&nbsp;Naina A. Samah","doi":"10.1016/j.iccn.2025.104182","DOIUrl":"10.1016/j.iccn.2025.104182","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104182"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771680","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":"The restraint-free ICU: not quite there yet","authors":"Tommaso Rosà,&nbsp;Gaia Tempo,&nbsp;Massimo Antonelli","doi":"10.1016/j.iccn.2025.104261","DOIUrl":"10.1016/j.iccn.2025.104261","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104261"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380622","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":"When comfort eludes intention: ShotBlocker®, breastfeeding, and neonatal distress – Letter on Dinç et al.","authors":"Zhuocheng Bao","doi":"10.1016/j.iccn.2025.104195","DOIUrl":"10.1016/j.iccn.2025.104195","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104195"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809917","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":"Effective nursing interventions for infection prevention and control in acute and critically ill patients with a peripherally inserted venous catheter: an umbrella review","authors":"José Costa ,&nbsp;Joana Teixeira ,&nbsp;Eliana Sousa ,&nbsp;Maria do Rosário Pinto","doi":"10.1016/j.iccn.2025.104250","DOIUrl":"10.1016/j.iccn.2025.104250","url":null,"abstract":"<div><h3>Introduction</h3><div>Infections related to peripherally inserted venous catheters are among the most serious and frequent complications in acute and critical care. If unaddressed, these infections markedly escalate morbidity, mortality, and healthcare expenditures.</div></div><div><h3>Objective</h3><div>To synthesize scientific evidence about effective nursing interventions that prevent and control infections in acute and critically ill patients with peripherally inserted venous catheters.</div></div><div><h3>Methods</h3><div>This umbrella review followed Joanna Briggs Institute guidelines and the PRISMA statement for reporting systematic reviews. A systematic search was carried out in CINAHL, MEDLINE, JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, Web of Science, and SCOPUS. Rayyan software supported study extraction and selection. Each study was assessed for methodological quality, grade of recommendation, and level of evidence.</div></div><div><h3>Results</h3><div>Six systematic reviews were included, allowing the identification of nursing-led interventions that demonstrably reduce catheter-related infection. Evidence supports infection risk reduction through chlorhexidine gluconate for skin preparation, insertion and maintenance bundles, and strategies to support bundle implementation. Additional effective interventions include in-line filters, limiting device dwell time, minimizing continuous antibiotic infusions, and avoiding using Teflon cannulas, instead of polyethylene or Vialon cannulas. For patients with peripherally inserted central catheters (PICCs), quantified grip exercises improved circulation and reduced infection and thrombosis risk. Integrated short peripheral catheters were associated with significantly fewer complications than non-integrated ones.</div></div><div><h3>Conclusions</h3><div>Nurses are pivotal in preventing peripherally inserted venous catheter-related infection through specific evidence-based interventions. Nurse leaders should also prioritize selecting lower-risk devices to enhance patient outcomes and reduce complications.</div></div><div><h3>Implications for clinical practice</h3><div>This review underscores the need for nurses to consistently implement evidence-based interventions to prevent infections related to venous catheters, reduce complications, and improve patient outcomes. It reinforces the importance of ongoing education, institutional support, and leadership in fostering safer practices in acute and critical care environments.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104250"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575112","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}