Intensive and Critical Care Nursing最新文献

{"title":"The ongoing challenge: ICU and beyond − managing nursing workload","authors":"Alberto Lucchini, Lilia de Souza Nogueira, Stefano Bambi","doi":"10.1016/j.iccn.2024.103917","DOIUrl":"10.1016/j.iccn.2024.103917","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103917"},"PeriodicalIF":4.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723393","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":"Obesity paradox of sepsis in long-term outcome: The differential effect of body composition","authors":"Hye Ju Yeo ,&nbsp;Ha Lim Kim ,&nbsp;Min Wook So ,&nbsp;Jong Myung Park ,&nbsp;Dohyung Kim ,&nbsp;Woo Hyun Cho","doi":"10.1016/j.iccn.2024.103893","DOIUrl":"10.1016/j.iccn.2024.103893","url":null,"abstract":"<div><h3>Background</h3><div>The obesity paradox has been widely studied recently; however, its impact on the long-term prognosis of sepsis and the protective mechanism of body mass have not yet been sufficiently revealed.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated the association between obesity and 1-year survival after sepsis in a single university-affiliated hospital and examined the differential effects of muscle mass and adiposity.</div></div><div><h3>Results</h3><div>Adult patients with sepsis or septic shock (n = 1492)<!--> <!-->were classified into obese (n = 300) and nonobese (n = 1192) groups. One-year mortality due to sepsis was lower in the obese than in the nonobese (52.0 % vs. 64.8 %; p &lt; 0.001). In multivariate Cox analysis, one-year mortality due to sepsis was independently associated with body mass index (BMI) (hazard ratio 0.96). In the subgroup analysis, 705 were divided into four groups according to the psoas muscle index (PMI) and body fat percentage (BFP) to assess the differential impact of body fat and muscle mass on the one-year outcome of sepsis. One-year mortality was significantly different among the four groups (high BFP/low PMI, 60.6 %; high BFP/high PMI, 42.1 %; low BFP/high PMI, 34.8 %; low BFP/low PMI, 63.2 %; p = 0.002). The adjusted hazards ratio of one-year mortality of sepsis, which was normalized to the low BFP/high PMI group, were 1.2 (p = 0.585), 2.2 (p = 0.016), and 2.3 (p = 0.009) in groups of high BFP/high PMI, high BFP/low PMI, and low BFP/low PMI, respectively.</div></div><div><h3>Conclusion</h3><div>An obesity paradox has been observed in the long-term outcomes of patients with sepsis, and muscle mass may be more critical than fat mass as a protective mechanism against obesity.</div></div><div><h3>Implications for clinical practice</h3><div>A high BMI is linked to a more favorable long-term prognosis in sepsis, with muscle mass playing a more critical role than fat mass. A proactive nutritional and conditioning program may benefit patients anticipating major procedures and potential ICU admission. Such preparation could enhance their resilience and improve outcomes when facing critical illness, including sepsis.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103893"},"PeriodicalIF":4.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Music as healing in ICU survivors: The road ahead in seeking the right tone” [Intensive Crit Care Nurs. 86 (2025) 103828]","authors":"Meropi Mpouzika ,&nbsp;Margo van Mol","doi":"10.1016/j.iccn.2024.103919","DOIUrl":"10.1016/j.iccn.2024.103919","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103919"},"PeriodicalIF":4.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723613","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":"Challenges perceived by pediatric intensive care unit nurses in caring for maltreated children and adolescents: A qualitative phenomenological study","authors":"Po-Lin Huang ,&nbsp;Ching-Hsuan Lin ,&nbsp;Wei-Chieh Tseng ,&nbsp;Bih-Shya Gau","doi":"10.1016/j.iccn.2024.103887","DOIUrl":"10.1016/j.iccn.2024.103887","url":null,"abstract":"<div><h3>Objectives</h3><div>This study explores the challenges and experiences faced by paediatric intensive care unit (PICU) nurses while caring for maltreated paediatric patients. Research Methodology/Design: A qualitative study was conducted using face-to-face semi-structured interviews from February to May 2022. The data were transcribed verbatim and a simple thematic analysis was used.</div></div><div><h3>Setting</h3><div>Twenty PICU nurses from National Taiwan University Children’s Hospital were recruited through purposive and snowball sampling.</div></div><div><h3>Findings</h3><div>Ten sub-themes were identified and synthesised into three primary themes: ‘unstable nurse-patient relationships’, highlighting the tensions and communication challenges between nurses, and the families of maltreated children and adolescents; ‘insufficient pertinent competencies in handling child maltreatment’, pointing to nurses’ lack of sensitivity, experience, and requisite skills for addressing child maltreatment; and ‘challenges in multidisciplinary team collaboration’, which underscores nurses’ feelings of being overwhelmed and apprehensions regarding the continuity of care as various professional teams are involved.</div></div><div><h3>Conclusion</h3><div>PICU nurses face considerable stress while caring for maltreated children and adolescents. This can be attributed to unstable nurse-patient relationships, insufficient care-related competencies of nurses, and the complexities introduced by multidisciplinary team interventions. Therefore, priority actions include continuous in-service education, sharing pertinent professional experiences, enhancing nurses’ sensitivity toward maltreatment, establishing standard operating procedures, and developing comprehensive case management systems and multidisciplinary expertise tailored to the needs of PICU nurses.</div></div><div><h3>Implications for clinical practice</h3><div>Understanding the stressors and challenges encountered by PICU nurses in caring for maltreated children and adolescents can guide the design and implementation of interventions by current hospital decision-making bodies or child protection medical centres to enhance the clinical working environment. These interventions can aim to bolster the competencies of nurses and promote joint efforts in delivering superior medical care.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103887"},"PeriodicalIF":4.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723392","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":"Patient-psychologist telemedicine interactions in an intensive care unit recovery clinic: Qualitative secondary analysis","authors":"Ali A. Hussain ,&nbsp;Abigail C. Jones ,&nbsp;Megan M. Hosey ,&nbsp;Amy Kiehl ,&nbsp;Valerie Danesh ,&nbsp;Joanne McPeake ,&nbsp;Kelly Toth ,&nbsp;Tammy L. Eaton ,&nbsp;Han Su ,&nbsp;James C. Jackson ,&nbsp;Leanne M. Boehm","doi":"10.1016/j.iccn.2024.103886","DOIUrl":"10.1016/j.iccn.2024.103886","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to describe the content of patient-psychologist mental health related dialogues during a telemedicine intensive care unit recovery clinic visit.</div></div><div><h3>Research methodology/design</h3><div>Qualitative descriptive study nested within a randomized controlled pilot trial to assess a telemedicine intensive care unit recovery clinic feasibility and preliminary efficacy. Participants included adults hospitalized with sepsis and/or respiratory failure. Telemedicine visits occurred at 3- and 12-weeks post-discharge involving a critical care pharmacist, physician, and psychologist. The psychologist conducted cognitive and mental health screenings, providing tailored brief psychotherapy and education. Audio-recorded visits were transcribed verbatim and underwent inductive reflexive thematic analysis.</div></div><div><h3>Setting</h3><div>Intensive care unit recovery clinic at an academic medical center in the southeastern United States.</div></div><div><h3>Main outcome measures</h3><div>N/A.</div></div><div><h3>Findings</h3><div>17 participants completed 31 telemedicine intensive care unit recovery clinic visits between December 2019 and March 2022. Caregivers participated in 13 visits. Participant experiences and psychologist responses were identified and separated into two overarching themes: 1) Patient-Identified Challenges and 2) Psychologist-Delivered Strategies. Patient subthemes included 1) mental health challenges (negative thoughts), 2) minimization of mental health impact, and 3) use of coping methods. Psychologist subthemes included 1) rapport building and validation 2) use of psychological assessments, and 3) psychological interventions.</div></div><div><h3>Conclusion</h3><div>The collaborative effort, including a psychologist, exemplifies the role of a mental health professional within the multidisciplinary intensive care unit recovery clinic team, contributing to a comprehensive approach in identifying and managing post-intensive care syndrome impairments. The focus extends to shaping compassionate care strategies for addressing mental health challenges associated with post-intensive care syndrome, fostering a holistic approach to whole-person recovery.</div></div><div><h3>Implications for clinical practice</h3><div>A mental health professional (e.g., psychologist, psychiatrist, psychiatric nurse practitioner) can contribute to shaping care strategies for the mental health symptoms associated with post-intensive care syndrome, fostering whole-person recovery after hospital discharge.</div></div><div><h3>Clinical trial registration number</h3><div>NCT03926533.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103886"},"PeriodicalIF":4.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What are the perceived barriers for nurses providing end-of-life care for patients and their families from culturally diverse backgrounds in ICU? An integrative review","authors":"Kylie O’Neill ,&nbsp;Melissa J. Bloomer","doi":"10.1016/j.iccn.2024.103883","DOIUrl":"10.1016/j.iccn.2024.103883","url":null,"abstract":"<div><h3>Background</h3><div>Cultural diversity is increasing worldwide. The provision of end-of-life care for people who have culturally diverse rituals, customs and beliefs can present barriers for critical care nurses in delivering high quality end-of-life care.</div></div><div><h3>Aim</h3><div>To synthesise research evidence about the perceived barriers for critical care nurses providing end-of-life care for patients and their families from diverse cultural backgrounds in ICU.</div></div><div><h3>Research Question</h3><div>What are the perceived barriers for nurses providing end-of-life care for patients and their families from culturally diverse backgrounds in ICU?</div></div><div><h3>Design</h3><div>Following protocol registration, a structured integrative review was undertaken across Medline, Embase, APA PsycINFO, CINAHL Complete, Cochrane library, Google Scholar and ProQuest Dissertation and Theses Global databases. A total of 823 records were independently assessed against inclusion and exclusion criteria. All included studies were assessed for quality. Narrative synthesis was used to report findings.</div></div><div><h3>Results</h3><div>Fifteen studies published between 2010 and 2022 were included. Findings are presented according to four themes: (i) <em>Language and communication</em>, (ii) <em>(Dis) Comfort with religion</em>, (iii) <em>Consensus challenges</em> and (iv) <em>Caring at the end of life</em>.</div></div><div><h3>Conclusion</h3><div>Recognising cultural diversity provides opportunity for critical care nurses to build awareness and understanding of cultural diversity as a way of optimising end-of-life care, through routine cultural assessment, advocating for professional interpreters to enhance communication and demonstrating openness to diverse cultural needs, preferences and practices.</div></div><div><h3>Implications for Clinical Practice</h3><div>The obvious first step in countering perceived challenges to end-of-life care is to increase awareness by acknowledging and respecting difference and diversity. Cultural assessments for all patients admitted to critical care would be an ideal first step in addressing challenges associated with cultural diversity. Greater access to professional interpreters to overcome language barriers is also essential to optimising communication and consensus in decision-making at the end of life.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103883"},"PeriodicalIF":4.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of implementing a communication board to improve communication interactions of mechanically ventilated patients in intensive care units at one Sri Lankan hospital − A pilot randomised controlled trial","authors":"Nipuna R. Kuruppu ,&nbsp;Wendy Chaboyer ,&nbsp;Georgia Tobiano ,&nbsp;Anuja Abayadeera ,&nbsp;Kristen Ranse","doi":"10.1016/j.iccn.2024.103891","DOIUrl":"10.1016/j.iccn.2024.103891","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility of implementing a communication board in intensive care units in terms of participant recruitment and retention, intervention fidelity, and ability to collect patient outcome data.</div></div><div><h3>Design</h3><div>A prospective, two-arm, unblinded, pilot randomised controlled trial.</div></div><div><h3>Research methodology</h3><div>Adult, conscious, mechanically ventilated intensive care patients were recruited between August and November 2023. All participants received routine communication practices; the intervention group also received the communication board. Prior to the study, all nurses were trained on using the communication board. Patient or proxy consent was obtained. Data were collected from patients, nurses, patients’ medical records, and screening, tracking, intervention fidelity, and contamination logs.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome data was feasibility of participant recruitment, retention, and intervention fidelity, which was recorded daily until seven days of follow-up or pre-defined trial endpoints. Secondary patient outcomes (anxiety, satisfaction, ease of communication) were assessed at recruitment and approximately 24 h after recruitment or soon after extubation, whichever occurred first.</div></div><div><h3>Setting</h3><div>Two intensive care units in one Sri Lankan tertiary care hospital.</div></div><div><h3>Results</h3><div>Of the 123 patients, 60 (75.0%) were recruited and randomised (30 control; 30 intervention). All intervention group patients received the communication board (100% intervention fidelity), and 58 (96.7%) completed the follow-up. On recruitment, 12.5% of secondary patient outcome data was missing, and 9.9% on follow-up, predominantly associated with the 10-item ease of communication scale.</div></div><div><h3>Conclusions</h3><div>Conducting a larger, definitive communication board trial is feasible but collecting secondary patient outcome data, especially ease of communication was challenging. Study procedures need to be refined prior to a larger trial.</div></div><div><h3>Implications for clinical practice</h3><div>The use of communication boards in intensive care units may improve patient-centred care for ventilated patients but requires further, high quality effectiveness trials.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103891"},"PeriodicalIF":4.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The link between norepinephrine administration and pressure injury risk in patients with COVID-19-related ARDS – Response to Tang et al.","authors":"Farshid Rahimi-Bashar,&nbsp;Athanasios Chalkias,&nbsp;Keivan Gohari-Moghadam,&nbsp;Morteza Izadi,&nbsp;Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2024.103899","DOIUrl":"10.1016/j.iccn.2024.103899","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103899"},"PeriodicalIF":4.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683982","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":"Sustainability in ICU: Less plastic, greener future - Letter on Eid et al.","authors":"Alberto Lucchini,&nbsp;Emanuele Rezoagli,&nbsp;Marco Giani,&nbsp;Stefano Bambi","doi":"10.1016/j.iccn.2024.103897","DOIUrl":"10.1016/j.iccn.2024.103897","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103897"},"PeriodicalIF":4.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683978","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 effect of the Yakson and Gentle Human Touch methods applied to preterm infants during endotracheal aspiration on pain, comfort, and physiological parameters","authors":"Seda Çağlar ,&nbsp;Şadiye Dur ,&nbsp;Nagehan Ustabaş Yıldız ,&nbsp;İpek Güney Varal","doi":"10.1016/j.iccn.2024.103898","DOIUrl":"10.1016/j.iccn.2024.103898","url":null,"abstract":"<div><h3>Background</h3><div>Preterm infants in the neonatal intensive care unit are exposed to various painful procedures; thus, different non-pharmacological pain control techniques are used to alleviate pain.</div></div><div><h3>Objectives</h3><div>The aim of this study is to determine the effect of Yakson and Gentle Human Touch (GHT) methods during endotracheal suctioning on pain, comfort, and physiological parameters response in preterm infants.</div></div><div><h3>Design</h3><div>A randomised controlled crossover trial.</div></div><div><h3>Setting</h3><div>This study was conducted in the neonatal intensive care unit between July 2022 and June 2023.</div></div><div><h3>Methods</h3><div>Thirty infants were included in this study based on inclusion criteria. The samples randomly received a sequence of suctioning with Yakson and GHT and routine care. Neonatal Pain Agitation and Sedation Scale (N-PASS) and COMFORTneo were used to collect the data.</div></div><div><h3>Results</h3><div>The pain and comfort scores of preterm infants who received GHT and Yakson touch during and after endotracheal suctioning were statistically significantly lower than the infants in the routine care (p &lt; 0.001). It was determined that the difference was in favour of the Yakson group (p &lt; 0.001). The infants who received GHT and Yakson application had lower heart rates and higher oxygen saturation levels after the application compared to the control group (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The application of Yakson and GHT during endotracheal aspiration in preterm infants has been found to be effective in pain and comfort management, as well as in the regulation of physiological parameters.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103898"},"PeriodicalIF":4.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683980","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}