American Journal of Critical Care最新文献

"Leave No Question Unanswered": Nurses' Role in Preparing Children's Families During End-of-Life Care. “不留任何疑问”：护士在临终关怀中为儿童家庭做准备的角色。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025791

Elizabeth G Broden Arciprete, Ijeoma J Eche-Ugwu, Danielle D DeCourcey, Abby R Rosenberg, Jennifer M Snaman

{"title":"\"Leave No Question Unanswered\": Nurses' Role in Preparing Children's Families During End-of-Life Care.","authors":"Elizabeth G Broden Arciprete, Ijeoma J Eche-Ugwu, Danielle D DeCourcey, Abby R Rosenberg, Jennifer M Snaman","doi":"10.4037/ajcc2025791","DOIUrl":"https://doi.org/10.4037/ajcc2025791","url":null,"abstract":"Background: Parents who report feeling prepared for symptoms and circumstances around their child's end of life report less adverse bereavement outcomes. Yet, the actions that bedside clinicians can initiate to help families feel prepared for a child's death remain unclear.Objectives: To identify actions that nurses engage in to prepare families for the dying process.Methods: A deductive approach was used to analyze qualitative data from focus groups and interviews with 20 pediatric intensive care unit nurses.Results: Most of the 20 nurse participants identified as White women (n = 17; 85%). They reported a broad range of pediatric intensive care unit experience (1-24 years), and most (n = 17; 85%) had cared for at least 10 patients nearing end of life. The study included 3 categories of preparatory actions: leveraging experience and familiarity (processes nurses used to ready themselves to support families navigating end-of-life care), coordinating collaborative team support (optimizing interprofessional teamwork and developing adaptable care plans), and titrating family-responsive support (adjusting interactions or behaviors based on the family's needs).Conclusions: Combining nurse experience and familiarity, clinical team collaborations, and family-responsive support may offer a comprehensive approach to preparing families of children nearing end of life. Studying end-of-life preparation with larger samples of nurses and families is necessary. Nurses may incorporate these actions into their serious illness care to help support families of children nearing end of life.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 5","pages":"380-384"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Racial Disparities in Cardiogenic Shock Outcomes: Single-Center Retrospective Study. 心源性休克结果的种族差异：单中心回顾性研究。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025563

Rafik I Issa, Sarah K Adie, Vince D Marshall, Scott W Ketcham, Matthew C Konerman

{"title":"Racial Disparities in Cardiogenic Shock Outcomes: Single-Center Retrospective Study.","authors":"Rafik I Issa, Sarah K Adie, Vince D Marshall, Scott W Ketcham, Matthew C Konerman","doi":"10.4037/ajcc2025563","DOIUrl":"10.4037/ajcc2025563","url":null,"abstract":"Background: Race influences outcomes in patients with cardiovascular diseases. However, the impact of race on cardiogenic shock outcomes is unclear.Methods: This retrospective cohort study included adult patients admitted to a cardiac intensive care unit for cardiogenic shock from June 2019 through June 2023. For analysis, patients were divided into 3 racial groups: White, Black, and other. Baseline demographics, comorbidities, admission source, and Sequential Organ Failure Assessment scores were collected. Primary outcomes were hospital and cardiac intensive care unit mortality. Secondary outcomes were hospital and cardiac intensive care unit lengths of stay and temporary mechanical circulatory support use. Propensity score weighting was used; pairwise comparisons between each group were performed.Results: The analysis included 2458 patients (1959 White, 327 Black, 172 other). Black patients were younger, were less likely to be admitted from the emergency department (and more likely to be admitted from inpatient wards), and had higher Sequential Organ Failure Assessment scores than patients in the other 2 groups. Propensity-weighted pairwise comparisons demonstrated no significant differences in hospital and cardiac intensive care unit mortality. However, Black patients had significantly longer hospital (incidence rate ratio, 1.31; P < .001) and cardiac intensive care unit (incidence rate ratio, 1.33; P = .03) stays than did White patients but not patients in the \"other\" group. Temporary mechanical circulatory support use did not differ among groups.Conclusions: The results highlight disparities in clinical management of cardiogenic shock and the need for further research to address these inequities.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 5","pages":"385-389"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response. 响应。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025789

Valerie J Renard, Parisa Farahani, Amy L B Frazier, Lana Wahid, Leanne M Boehm, Marianna LaNoue, Oluwatosin Akingbule, Hanzhang Xu, David Edelman, Truls Østbye

引用次数: 0

Ethics, Artificial Intelligence, and Critical Care Nursing. 伦理、人工智能和重症护理。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025758

Catherine Green

引用次数: 0

Pulmonary Artery Catheter Guidelines for Invasive Hemodynamic Monitoring on the Cardiology Progressive Care Unit. 心内科进展监护病房有创血流动力学监测肺动脉导管指南。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025808

Ryan MacGillivray, Linda Hoke

引用次数: 0

Acting on Purpose in Clinical Care and Research. 临床护理与研究中的目的性行为。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025653

Cindy L Munro, Lakshman Swamy

引用次数: 0

Registered Nurses and Meaningful Recognition: Contemporary Preferences of a Diverse Workforce. 注册护士和有意义的认可：多元化劳动力的当代偏好。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025995

Michelle C Hehman, Nicole M Fontenot, Carliss D Ramos, Joanne D Muyco, Alexis E Hayes, Regis E Meyer, Kevin Asirifi

{"title":"Registered Nurses and Meaningful Recognition: Contemporary Preferences of a Diverse Workforce.","authors":"Michelle C Hehman, Nicole M Fontenot, Carliss D Ramos, Joanne D Muyco, Alexis E Hayes, Regis E Meyer, Kevin Asirifi","doi":"10.4037/ajcc2025995","DOIUrl":"https://doi.org/10.4037/ajcc2025995","url":null,"abstract":"Background: Meaningful recognition acknowledges the value of individuals' professional contributions to an organization's work. Long recognized as necessary to retain nurses, it includes formal awards programs, informal feedback processes, salary, and scheduling flexibility. With demographic characteristics of the nursing workforce changing, new research is needed to understand how contemporary nurses view meaningful recognition.Objectives: To evaluate nurses' perceptions of meaningful recognition and the health of their work environment and to explore associations between demographic characteristics and meaningful recognition preferences.Methods: Participants were registered nurses from a large, urban health care system. Study instruments included the Meaningful Recognition Questionnaire, Healthy Work Environment Assessment Tool, and open-ended questions. Analysis of variance was used to test associations between demographics and meaningful recognition preferences.Results: Surveys were completed by 565 nurses (mean [SD] age, 43 [11] years; 521 women [92.2%]). Salary was the most valued form of recognition, followed by private verbal feedback and written acknowledgment. Unlike earlier studies, professional development opportunities were the least valued form of recognition, reflecting a shift in nurse preferences. Demographic differences influenced recognition preferences, highlighting the need for personalized and inclusive recognition programs.Conclusions: Effective meaningful recognition is crucial to foster a healthy work environment and improve nurse retention. Updating recognition practices to align with evolving nurse preferences and demographic changes is essential to maintain a supportive and engaging work environment.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 5","pages":"335-344"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Personalizing Meaningful Recognition. 个性化有意义的认可。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025964

Cindy Cain

引用次数: 0

Ventilator Liberation: Evaluating Staff Perceptions of Practice and Policy Adherence. 呼吸机解放：评估员工对实践和政策遵守的看法。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025622

Bailey Paul Rankin, Dongjuan Xu, Kara Doucet

{"title":"Ventilator Liberation: Evaluating Staff Perceptions of Practice and Policy Adherence.","authors":"Bailey Paul Rankin, Dongjuan Xu, Kara Doucet","doi":"10.4037/ajcc2025622","DOIUrl":"https://doi.org/10.4037/ajcc2025622","url":null,"abstract":"Background: Major critical care organizations advocate for combined spontaneous awakening and breathing trials to expedite ventilator liberation and minimize the complications associated with prolonged intubation. Evaluating staff perceptions of ventilator liberation may enhance protocol changes and implementation.Objectives: To assess staff perceptions of ventilator weaning practices, barriers to timely extubation, and potential organizational improvements in a Midwest regional health care system.Methods: In an exploratory, cross-sectional study, a 29-question survey was administered to 91 licensed staff in 6 intensive care units to assess demographics, extubation practices, extubation delays, and opportunities for improvement. Means and SDs were used to describe continuous variables; frequencies and percentages were used to describe categorical variables. Chi-square tests were used to evaluate occupational differences, and 2 investigators independently coded responses to identify themes and resolve discrepancies through discussion and consensus.Results: More than half of the 91 respondents reported high comfort with ventilator liberation. More than 60% perceived extubation timing as being longer than ideal. Respondents identified staffing ratios, communication failures, distractions, and sedation weaning practices as factors delaying extubation. Identified improvement opportunities were protocol development, enhanced practices related to the roles of critical care physicians and advanced practice providers, and better staff education.Conclusions: The survey highlighted staff opinions on ventilator liberation and key improvement factors. Addressing staff concerns will aid in refining organizational policies to improve patient and organizational outcomes.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 5","pages":"372-379"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Readmission Risk Prediction Algorithms for Sepsis. 改进脓毒症再入院风险预测算法。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025926

Sang Bin You, Kathryn H Bowles

引用次数: 0