Intensive and Critical Care Nursing最新文献

{"title":"From cost to investment: Why ICU nurse staffing metrics must be weighted for nursing workload","authors":"Koen Van den Heede, Nicolas Bouckaert, Carine Van de Voorde","doi":"10.1016/j.iccn.2026.104354","DOIUrl":"10.1016/j.iccn.2026.104354","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"94 ","pages":"Article 104354"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146145099","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 importance of eye protection during prone positioning – Letter on Han et al.","authors":"Federica Marelli , Alessia Galli , Giada Ruggi , Filippo Binda","doi":"10.1016/j.iccn.2025.104311","DOIUrl":"10.1016/j.iccn.2025.104311","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"94 ","pages":"Article 104311"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792295","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":"Mapping the discourse of environmental sustainability in intensive care nursing: a lexicometric exploration of professional meaning-making","authors":"Mariachiara Figura ,&nbsp;Francesca Trotta ,&nbsp;Luciano Midolo ,&nbsp;Francesco Petrosino ,&nbsp;Gianluca Pucciarelli ,&nbsp;Davide Bartoli","doi":"10.1016/j.iccn.2025.104317","DOIUrl":"10.1016/j.iccn.2025.104317","url":null,"abstract":"<div><h3>Introduction</h3><div>Intensive Care Units (ICUs) are among the most resource-intensive hospital environments, contributing substantially to healthcare’s environmental footprint. While sustainable practices are increasingly recognized as essential, little is known about how critical care nurses linguistically frame and make sense of sustainability within their professional culture and daily work.</div></div><div><h3>Aim</h3><div>To explore how critical care nurses construct and articulate meanings of environmental sustainability in their professional discourse.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with 29 critical care nurses across diverse hospital settings. Narratives were analyzed using Automatic Analysis of Textual Data (IRaMuTeQ) with similarity analysis to map term relationships and uncover semantic clusters. Statistical associations (χ² ≥ 3.84; p &lt; 0.05) guided identification of lexical hubs and thematic subnetworks. Computational findings were integrated with qualitative interpretation to ensure contextual depth and rigor.</div></div><div><h3>Results</h3><div>The central lexical hub, <em>sustainability</em>, connected clusters reflecting reflective engagement, collaborative responsibility, organizational structures, and systemic gaps. Secondary hubs included <em>environment</em> (ecological impact and cost considerations), <em>practice</em> (behavioral integration), <em>patient</em> (embedded in bedside care), and <em>waste</em> (material handling, energy use, lifecycle awareness). Nurses framed sustainability as both a professional duty and systemic challenge, mediated by organizational support, personal commitment, and environmental constraints.</div></div><div><h3>Conclusions</h3><div>ICU nurses’ discourse reveals sustainability as a multidimensional construct bridging ethics, operational practice, and systemic limitations. Lexicometric mapping provides a structured view of how sustainability is embedded in professional narratives, offering insights to inform targeted educational and organizational strategies.</div></div><div><h3>Implications for clinical practice</h3><div>Integrating sustainability into professional identity enhances patient care and environmental responsibility. These findings deepen understanding of which dimensions of environmental sustainability can be meaningfully enacted through professional culture and organizational alignment, rather than through the direct imposition of fixed behavioural routines.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"94 ","pages":"Article 104317"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829379","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":"Determinants and trajectories of functional recovery in ICU survivors: a multidimensional perspective – Letter on Mesina et al.","authors":"Yan Wu ,&nbsp;Guanjie Chen","doi":"10.1016/j.iccn.2026.104356","DOIUrl":"10.1016/j.iccn.2026.104356","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"94 ","pages":"Article 104356"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138250","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":"Feasibility of implementing a multi-component intervention of environmental control in mechanically ventilated ICU patients to improve sleep: A pilot randomized controlled trial","authors":"Vanessa Oviedo ,&nbsp;Leyla Alegría ,&nbsp;Douglas Leonard ,&nbsp;Rodrigo Cádiz ,&nbsp;Pablo Brockmann ,&nbsp;Paula Repetto ,&nbsp;Mario Henríquez ,&nbsp;Gonzalo Labarca ,&nbsp;Margarita Carrasco ,&nbsp;Ana Moya ,&nbsp;Idalid Rojas ,&nbsp;Macarena Amthauer ,&nbsp;Hugo Vidal ,&nbsp;María Paz Carrera ,&nbsp;Jan Bakker","doi":"10.1016/j.iccn.2026.104349","DOIUrl":"10.1016/j.iccn.2026.104349","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the feasibility of implementing a multi-component intervention in the ICU to promote sleep in critically ill patients.</div></div><div><h3>Trial design</h3><div>A prospective, two-parallel-group, unblinded, pilot randomized controlled trial.</div></div><div><h3>Methods</h3><div>Adult patients ventilated for at least 48 h with no or superficial sedation in the past 24 h were recruited. They were randomized to receive a multi-component ICU environmental control intervention (dynamic light therapy, auditory masking, and rationalization of nighttime care) or standard care. A family member of each participant consented to the study.</div></div><div><h3>Main outcome measures</h3><div>The primary outcomes were the feasibility of enrolling and retaining participants and the fidelity of the intervention. Secondary outcomes were sleep quantity (assessed by polysomnography and actigraphy) and sleep quality (assessed by Richards-Campbell Sleep Questionnaire), the prevalence of delirium at day three post-randomization, and neuropsychological impairment at six months post-ICU discharge.</div></div><div><h3>Setting</h3><div>An intensive care unit in a tertiary care teaching hospital in Santiago, Chile.</div></div><div><h3>Results</h3><div>122 patients were screened; 17 were randomized, 9 to intervention and 8 to control. 78% (7) and 100% (8) stayed in ICU until day three. All 8 in the intervention group received the full intervention until ICU discharge. The enrollment rate was 94%. The 6-month follow-up rate was 35%, as some patients died. All participants who completed the study nights expressed very high satisfaction.</div></div><div><h3>Conclusions</h3><div>This pilot study demonstrates the feasibility and acceptability of the intervention and informs methodological refinements for a future trial.</div></div><div><h3>Implications for clinical practice</h3><div>Implementing a multi-component environmental control intervention in intensive care units could improve short- and long-term outcomes in ventilated patients; however, further high-quality efficacy trials are required.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104349"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076759","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":"Effectiveness of intermittent pneumatic compression cushion in preventing sacrococcygeal intraoperative acquired pressure injuries during cardiac surgery: a randomized controlled trial","authors":"Yan Zhang ,&nbsp;Wei Gao ,&nbsp;Yi Zhang ,&nbsp;Yuyan Lin ,&nbsp;Na Chen ,&nbsp;Caixia Sun ,&nbsp;Yaoyao Hu ,&nbsp;Huijun Chen ,&nbsp;Min Xu ,&nbsp;Weijian Wang","doi":"10.1016/j.iccn.2025.104278","DOIUrl":"10.1016/j.iccn.2025.104278","url":null,"abstract":"<div><h3>Background</h3><div>Intraoperative Acquired Pressure Injury (IAPI) is a common complications in cardiac surgery, with reported incidence rates of 14.3–30%. Conventional pressure redistribution methods have limited effectiveness during lengthy procedures. This study evaluated the efficacy of intermittent pneumatic compression (IPC) cushions in preventing sacrococcygeal IAPI in cardiac surgery patients and developed a predictive nomogram for risk assessment.</div></div><div><h3>Methods</h3><div>In this prospective, single-center randomized controlled trial, patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were randomized to receive either IPC cushion (n = 94) or standard gel pad (n = 95). The primary outcome was the incidence of sacrococcygeal IAPI. Secondary outcomes included intraoperative changes in regional tissue oxygen saturation (rSO₂) and postoperative skin temperature differentials (ΔT). Risk factors were identified through logistic regression analysis, and a predictive nomogram was constructed and validated.</div></div><div><h3>Results</h3><div>The IAPI incidence was significantly lower in the IPC group compared to the control group (3.19 % vs. 18.95 %, P = 0.001). The IPC group demonstrated higher sacrococcygeal rSO₂ values during CPB and rewarming phases (P &lt; 0.05). Postoperative sacrococcygeal ΔT was significantly lower in the IPC group [0.0 (–0.1, 0.1) vs 0.3 (–0.3, 0.5); P = 0.001]. Multivariate logistic regression identified lower preoperative sacrococcygeal rSO₂ (OR = 0.94, 95 % CI: 0.90–0.98), absence of IPC intervention (OR = 0.06, 95 % CI: 0.01–0.28), and diabetes mellitus (OR = 7.98, 95 % CI: 2.20–29.01) as independent risk factors for IAPI. The nomogram demonstrated excellent discrimination (AUC = 0.857, 95 % CI: 0.776–0.937) and calibration (χ² = 1.09, P = 0.997).</div></div><div><h3>Conclusion</h3><div>IPC cushions effectively reduce IAPI incidence during cardiac surgery by improving sacrococcygeal tissue perfusion. Skin temperature differentials correlate with IAPI risk and may serve as early indicators for prevention. The validated predictive nomogram offers a practical tool for risk assessment and targeted preventive strategies in clinical practice.</div></div><div><h3>Implications for clinical practice</h3><div>This study introduced an innovative application of IPC for preventing intraoperative IAPI in cardiac surgery patients, demonstrating its effectiveness in lowering the incidence of IAPI.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104278"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590590","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":"Patients need undisturbed sleep to heal: fight noise with noise?","authors":"Mathias Basner,&nbsp;Makayla Cordoza","doi":"10.1016/j.iccn.2025.104267","DOIUrl":"10.1016/j.iccn.2025.104267","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104267"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608143","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":"“Who are they? What does that mean for care?”: An exploratory descriptive study of clinicians’ experiences of caring for patients and family members from culturally diverse backgrounds","authors":"Krishnaswamy Sundararajan ,&nbsp;Ashwin Subramaniam ,&nbsp;Scott Hanson-Easey ,&nbsp;Campbell Thompson ,&nbsp;Caroline Phelan ,&nbsp;Sarah Doherty ,&nbsp;Mark Plummer ,&nbsp;Mohammad Afzal Mahmood ,&nbsp;Melissa J Bloomer","doi":"10.1016/j.iccn.2025.104291","DOIUrl":"10.1016/j.iccn.2025.104291","url":null,"abstract":"<div><h3>Introduction</h3><div>Cultural diversity is a broad term used to encompass ethnic and racial diversity, multiculturalism, diverse languages, religions, practices, beliefs and identities of people. In ICU, people who are culturally diverse are at increased risk of marginalisation, sub-optimal care, higher morbidity and mortality. Ethnocultural biases and stereotypical assumptions can negatively influence ICU care.</div></div><div><h3>Aim</h3><div>To explore the experiences of nurses, physicians and allied health professionals (clinicians) in caring for patients and their family members from culturally diverse backgrounds.</div></div><div><h3>Methods</h3><div>Ethical approval was granted for an exploratory descriptive study. Convenience sampling was used to recruit clinicians involved in patient care, from two ICUs in Australia. Semi-structured individual interviews were undertaken to gather data, with interviews audio recorded and auto-transcribed. Data were analysed using inductive content analysis.</div></div><div><h3>Findings</h3><div>Twenty clinicians participated, with interviews lasting 26 min (mean). Analysis revealed four main themes: (i) Cultural sensitivity and responsiveness, which describes the importance of cultural sensitivity and responsiveness in care; (ii) Complexities of communication, which includes descriptions of strategies to overcome communication barriers; (iii) At the end of life, which describes end-of-life care challenges, particularly in the context of brain death and organ donation; and (iv) The way forward, offering suggestions for optimising care for patients and family members who were culturally diverse.</div></div><div><h3>Conclusions</h3><div>Cultural diversity complicates patient and family care and communication in the ICU. These findings emphasise the importance of clinicians’ sensitivity and openness to difference, and that it is clinicians’ responsibility to overcome cultural and linguistic differences, not the critically ill patient or their family.</div></div><div><h3>Implications for clinical practice</h3><div>Achieving greater openness and awareness requires ICU and healthcare leaders to promote the use of professional interpreters to their full scope of expertise, development of culturally-specific resources and creation of a wider community network of cultural representatives to bridge cultural gaps.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104291"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608094","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":"Effectiveness of virtual reality interventions for delirium prevention in intensive care units: A systematic review and meta-analysis","authors":"Surui Liang ,&nbsp;Xiaojiao Wang ,&nbsp;Jing Jing Su ,&nbsp;Eliza Mi Ling Wong ,&nbsp;Lorna Kwai Ping Suen","doi":"10.1016/j.iccn.2025.104318","DOIUrl":"10.1016/j.iccn.2025.104318","url":null,"abstract":"<div><h3>Objectives</h3><div>This systematic review aimed to evaluate the effectiveness of virtual reality (VR) interventions for delirium prevention in adult intensive care units (ICU) patients.</div></div><div><h3>Methods</h3><div>This review followed the PRISMA guidelines. A comprehensive search was conducted across 11 English and Chinese electronic databases, including PubMed, Web of Science, EMBASE, PsycINFO, AMED, CINAHL Complete, Cochrane Library, CNKI, Wanfang, Weipu, and CBM from 2012 December to September 2025. Eligible studies included randomised controlled trials (RCTs) that assessed VR-based interventions for ICU delirium prevention, compared with standard care or control conditions. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool.</div></div><div><h3>Results</h3><div>Eight RCTs published between 2021 and 2025 met the inclusion criteria, involving 764 participants (mean age: 63 years; sample sizes ranging from 50 to 150). VR interventions primarily delivered visual and auditory stimuli, including natural scenes (n = 4 studies), interactive games (n = 3 studies), and family-related media (n = 2 studies), typically administered once or twice daily for 15–20 min. Findings indicate that VR may serve as a promising non-pharmacological intervention, with pooled results showing a significant reduction in delirium incidence (n = 5 articles, OR = 0.56, 95 % CI = 0.33 to 0.93, I² = 16 %; low certainty). VR interventions also demonstrated potential benefits for psychological outcomes, including significant reductions in anxiety (n = 5 studies, SMD = −2.08, 95 % CI = −3.31 to −0.86, low certainty) and depression (n = 4 studies, SMD = −1.16, 95 % CI = −2.12 to −0.21, I² = 93 %; low certainty), and improvements in sleep quality (n = 3 studies, MD = 2.71, 95 % CI = 0.23 to 5.19, low certainty), and mechanical ventilation duration (n = 3 studies, MD = −3.86, 95 % CI = −6.68 to −1.05, low certainty). Evidence for other outcomes, including ICU length of stay, pain, and cognitive function, was limited or inconclusive.</div></div><div><h3>Conclusions</h3><div>With low certainty, VR interventions effectively reduce ICU delirium incidence and may improve psychological outcomes (anxiety and depression) and sleep. Further high-quality trials are needed to confirm these benefits and guide clinical use.</div></div><div><h3>Implications for Clinical Practice</h3><div>VR holds promise as an innovative adjunctive approach for delirium prevention in ICU care and may enhance patient comfort and recovery, pending confirmation from future large-scale trials.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104318"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797025","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":"Language, culture and communication vulnerability – Letter on Istanboulian et al.","authors":"Melissa J Bloomer ,&nbsp;Krishnaswamy Sundararajan","doi":"10.1016/j.iccn.2025.104270","DOIUrl":"10.1016/j.iccn.2025.104270","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104270"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371060","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}