Intensive and Critical Care Nursing最新文献

{"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}

{"title":"The implementation of a noise reduction bundle in the intensive care unit: A qualitative process evaluation","authors":"Jeanette Vreman,&nbsp;Mark van den Boogaard,&nbsp;Johannes G. van der Hoeven,&nbsp;Joris Lemson,&nbsp;Bram Tilburgs","doi":"10.1016/j.iccn.2025.104305","DOIUrl":"10.1016/j.iccn.2025.104305","url":null,"abstract":"<div><h3>Objective</h3><div>To explore factors that influenced the application of a noise reduction bundle in daily practice as experienced by healthcare professionals.</div></div><div><h3>Methods</h3><div>Between April and June 2024, seven semi-structured focus group interviews were conducted. Recorded interviews were transcribed and coded. Using Flottorp’s checklist for identifying determinants of practice, data were categorized to identify factors influencing the bundle’s application. The analysis was carried out collaboratively by multiple researchers.</div></div><div><h3>Results</h3><div>The focus group interviews were conducted with 31 participants: nursing staff and physicians. A total of 37 factors were identified. Facilitating factors were: phased implementation, clear communication and work instructions, addressing the theme regularly, routine-building, supportive materials, reminders, training, technical assistance, engaged leadership, key nurses, feedback. Hindering factors were: limited urgency, lack of outcome expectancy, limited adherence of the interventions, limited raising of issues, absence of noise norms, unsuitable environment.</div></div><div><h3>Conclusions</h3><div>This process evaluation of the randomized clinical trial investigating a bundle of noise-reducing interventions, demonstrates that successful ICU noise reduction requires a structured implementation and attention to contextual and cultural factors. While engaged leadership and feedback facilitated adoption, a limited sense of urgency and the absence of shared noise norms impeded sustainability. An integrated approach—combining technical solutions with behavioral strategies, and promoting team ownership and open communication—is essential.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104305"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688867","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":"Time-limited ICU trials: A method for value-based rapid response team decision-making","authors":"Ashwin Subramaniam ,&nbsp;Melissa J. Bloomer ,&nbsp;Daryl Jones","doi":"10.1016/j.iccn.2025.104308","DOIUrl":"10.1016/j.iccn.2025.104308","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104308"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822489","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":"Refining the understanding of ICU Nurses’ attitudes toward family involvement: Key methodological, conceptual, contextual, and statistical considerations - Letter on Verkaik et al.","authors":"Fatemeh Bahramnezhad ,&nbsp;Farshid Rahimi-Bashar ,&nbsp;Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2025.104197","DOIUrl":"10.1016/j.iccn.2025.104197","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104197"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608078","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 delirium in cardiosurgical patients on short- and long-term mortality","authors":"Baland Mohammad ,&nbsp;Peter Nydahl ,&nbsp;Hanna Gravert ,&nbsp;Christina Grothusen ,&nbsp;Katharina Huenges ,&nbsp;Christine Friedrich ,&nbsp;Wiebke Sommer ,&nbsp;Assad Haneya ,&nbsp;Gregor Warnecke ,&nbsp;Bernd Panholzer","doi":"10.1016/j.iccn.2025.104252","DOIUrl":"10.1016/j.iccn.2025.104252","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative delirium (POD) is a common and serious complication in intensive care unit (ICU) patients after cardiac surgery. Its long-term impact remains uncertain. The aim was to determine the association between postoperative delirium and 8-year all-cause mortality in adult cardiac ICU patients.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analysed patients admitted to a university hospital ICU following cardiac surgery. Data from pre-, peri-, and postoperative phases were collected. The primary outcome was mortality up to 8 years after ICU discharge. Secondary outcomes included POD incidence, ICU readmission, mortality at day 7 and 30 post-discharge, and ICU and hospital length of stay (LoS). Regression analyses were conducted to examine associations.</div></div><div><h3>Results</h3><div>The study included 551 patients, predominantly male (71 %, n = 397), with a median age of 72 (IQR 64–77) years. POD was diagnosed in 18.7 % (n = 103). Overall, the 8-year mortality rate was 16.7 % (n = 92). Compared to non-POD patients, those with POD had significantly higher 6–8 years mortality (n = 9 (8.7 %) vs. n = 16 (3.6 %), p = 0.033). Patients with POD had a longer LoS in ICU (median 4 vs. 2 days, p &lt; 0.001) and hospital (15 vs. 12 days, p &lt; 0.001), as well as higher ICU readmission rates within 30 days (12.3 % vs. 6.6 %, p = 0.037). POD patients also showed higher mortality at 30 days (3.8 % vs. 0.9 %, p = 0.028). However, after adjusting for confounders, POD was no longer significantly associated with long-term 6–8 years mortality (p = 0.205).</div></div><div><h3>Conclusions</h3><div>POD affects nearly one in five patients after cardiac surgery and is associated with adverse short-term outcomes, including longer stays and higher readmission and early mortality rates. Its independent effect on long-term mortality may be limited. Further studies are needed to explore its influence on quality of life and cognitive function.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104252"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508687","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 tracheal tube in the prevention of ventilator-associated pneumonia: critical component or minor player?","authors":"Kostoula Arvaniti,&nbsp;Stijn Blot,&nbsp;Elena Conoscenti","doi":"10.1016/j.iccn.2025.104292","DOIUrl":"10.1016/j.iccn.2025.104292","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104292"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716891","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":"Vasopressor therapy in septic shock","authors":"Mathieu Jozwiak ,&nbsp;Michelle S Chew ,&nbsp;Ashish K Khanna","doi":"10.1016/j.iccn.2025.104307","DOIUrl":"10.1016/j.iccn.2025.104307","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104307"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797023","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":"From family-centred care to humanisation of ICUs: A paediatric lens on future directions","authors":"Pei-Fen Poh ,&nbsp;Ying Gu ,&nbsp;Jos M. Latour","doi":"10.1016/j.iccn.2025.104321","DOIUrl":"10.1016/j.iccn.2025.104321","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104321"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797022","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}