Enfermeria intensiva最新文献

{"title":"Endotracheal suctioning technique: A routine procedure masked by simplicity or a dangerous illusion of mastery?","authors":"Angels Aloy-Orozco","doi":"10.1016/j.enfie.2026.500624","DOIUrl":"https://doi.org/10.1016/j.enfie.2026.500624","url":null,"abstract":"","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 4","pages":"500624"},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149290631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do we really mean by early mobilization in critically ill patients? A critical reflection and proposal for conceptual standardization.","authors":"José Julián Bernal-Sánchez, Vilma Eugenia Muñoz-Arcos, Esther Cecilia Wilches-Luna","doi":"10.1016/j.enfie.2026.500619","DOIUrl":"https://doi.org/10.1016/j.enfie.2026.500619","url":null,"abstract":"","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 4","pages":"500619"},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149290621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular complications of intravenous vancomycin: Safety of peripheral, midline and central catheters. A scoping review","authors":"Irrintzi Fernández-Aedo PhD, RN,&nbsp;Sendoa Ballesteros-Peña PhD, MPH, RN,&nbsp;Gorka Vallejo-De La Hoz PhD RN,&nbsp;Julia Fernandez-Alonso PhD","doi":"10.1016/j.enfie.2026.500622","DOIUrl":"10.1016/j.enfie.2026.500622","url":null,"abstract":"<div><h3>Introduction</h3><div>Vancomycin treats severe infections by resistant bacteria, but its acidity and local toxicity demand careful intravenous administration. Central venous catheters reduce these risks but pose complications. Midline catheters offer a less invasive alternative, though evidence remains limited.</div></div><div><h3>Objectives</h3><div>To map and describe the available clinical evidence on the safety and vascular complications associated with peripheral intravenous administration of vancomycin, compared with other vascular access devices, focusing on the type of complications reported, their diagnostic methods, and the methodological characteristics of the studies.</div></div><div><h3>Method</h3><div>A scoping review was conducted following the PRISMA-ScR guidelines. A comprehensive literature search was performed in Medline (via PubMed), Web of Science, Cochrane Library, CINAHL, and CUIDEN databases to identify studies reporting on intravenous vancomycin administration, catheter type and associated complications.</div></div><div><h3>Results</h3><div>Four studies met the inclusion criteria—two clinical trials and two cohort studies—with sample sizes ranging from 14 to 1087 participants. All studies reported complications attributed to vancomycin, regardless of catheter type. Two studies reported low rates of certain complications in patients receiving vancomycin through midline catheters, while other studies described complications associated with peripheral administration or recommended central access based on clinical considerations.</div></div><div><h3>Conclusion</h3><div>The available studies report heterogeneous findings regarding vascular complications associated with different vascular access devices for vancomycin administration. The evidence is limited and methodologically diverse, highlighting important gaps in the literature regarding outcome definitions, diagnostic approaches, and comparative evaluation across catheter types.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 4","pages":"Article 500622"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swanson's theory of caring applied to mechanical ventilation weaning in the ICU: Humanizing care","authors":"Juan Ramón Milanés Gragera RN,&nbsp;Noemí Román Román RN,&nbsp;Inmaculada Galán Sánchez RN,&nbsp;Verónica Merino Durán RN,&nbsp;Jorge Macías Blanco RN","doi":"10.1016/j.enfie.2026.500620","DOIUrl":"10.1016/j.enfie.2026.500620","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To analyze the scientific evidence on the application of Swanson's Theory of Caring in the process of invasive mechanical ventilation weaning in Intensive Care Units (ICU), identifying nursing interventions that correspond to Swanson's five theoretical processes (knowing, being with, doing for, enabling, and maintaining belief) and assessing their implications for clinical practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Scoping review conducted according to the methodological framework of Arksey and O’Malley (2005), enhanced by Levac et al. (2010), and the updated JBI guidance for scoping reviews (Peters et al., 2020). Reporting followed the PRISMA extension for Scoping Reviews (PRISMA-ScR). A search of scientific literature published between January 2020 and January 2026 was performed in PubMed/MEDLINE, SciELO, CUIDEN, Cochrane Library and CINAHL, complemented by backward citation tracking. Forty-five articles were included after applying rigorous selection criteria, through independent screening by two reviewers with discrepancies resolved by consensus. Data were analyzed through structured extraction and narrative synthesis, organizing interventions according to Swanson's five caring processes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The review identified multiple nursing interventions during ventilator weaning that showed conceptual correspondence with Swanson's theory. Only 8 of the 45 articles (18%) explicitly used Swanson's framework, and a single study directly linked it to ventilator weaning, identifying a significant knowledge gap. The “knowing” process includes individualized assessment using validated scales and continuous monitoring. “Being with” is manifested through therapeutic presence, effective communication, and facilitation of family contact. “Doing for” encompasses sedation titration, ventilation management, and respiratory physiotherapy techniques. “Enabling” comprises health education, use of augmentative communication systems, and support in decision-making. “Maintaining belief” is materialized through positive reinforcement, management of realistic expectations, and emotional accompaniment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Swanson's Theory of Caring provides a relevant and potentially operational theoretical framework to structure and humanize nursing care during ventilator weaning in the ICU. The conceptual correspondence identified suggests that its systematic application could contribute to improving patient experience, reducing psychological complications, and optimizing weaning outcomes. Implementation gaps are evident due to the absence of prospective studies, scarcity of data to quantify the impact of relational care on the weaning process, and the absence of specific protocols that merge the NANDA-NIC-NOC taxonomy and the Swanson theoretical framework. Prospective studies applying Swanson's framework from the design phase are required to evaluate the specific impact of interventions ","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 4","pages":"Article 500620"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing management of postoperative hemorrhagic shock: A case study in intensive care","authors":"Ana Amado RN,&nbsp;Maria Marques PhD,&nbsp;Adriano Pedro PhD,&nbsp;Cláudia Mendes PhD","doi":"10.1016/j.enfie.2026.500623","DOIUrl":"10.1016/j.enfie.2026.500623","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative hemorrhagic shock is a time-critical complication associated with high morbidity and mortality, particularly in older surgical patients, requiring rapid, coordinated management in the intensive care unit (ICU). This case report describes specialized nursing management guided by the International Classification for Nursing Practice (ICNP®/CIPE®) and Benner’s Clinical Wisdom Theory.</div></div><div><h3>Case presentation</h3><div>An 89-year-old woman underwent emergency gastrojejunostomy for intestinal obstruction and subsequently developed hemorrhagic shock with profound anemia (hemoglobin nadir 5.8 g/dL), severe hyperlactatemia (12 mmol/L), hypothermia (33.6 °C), peripheral hypoperfusion, and hypotension (mean arterial pressure &lt;65 mmHg). She required orotracheal intubation, invasive mechanical ventilation, and deep sedation. Diagnostic reassessment included serial hemoglobin and arterial blood gas analyses, lactate trending, invasive hemodynamic monitoring, and surgical re-exploration with intraoperative upper endoscopy, which suggested an upper gastrointestinal source (suspected Mallory–Weiss type lesion) treated endoscopically. Nursing priorities, structured using ICNP®, focused on perfusion restoration and correction of the lethal triad (hypothermia, acidosis, coagulopathy), multimodal analgesia, continuous monitoring, prevention bundles (infection and pressure injury prevention), and structured family communication.</div></div><div><h3>Discussion</h3><div>The patient progressively stabilized, with hemoglobin increasing to 9.6 g/dL, lactate decreasing to &lt;1 mmol/L, normothermia recovery, discontinuation of vasopressors, and no documented ICU-acquired complications during the ICU stay. This case highlights how standardized nursing language (ICNP®/CIPE®), combined with advanced clinical reasoning and evidence-based ICU bundles, can improve the structure, traceability, and continuity of nursing care in postoperative hemorrhagic shock.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 4","pages":"Article 500623"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149159961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and attitudes toward advance directives among ICU nurses","authors":"Beatriz Yánez-Quintana RN, MSN,&nbsp;Jesús María González-Martín BSc, MSc, PhD,&nbsp;María Dolores Nuez-Déniz RN,&nbsp;Laura Tejera-Aguiar RN,&nbsp;Yaiza Gutiérrez-Fernández RN","doi":"10.1016/j.enfie.2026.500618","DOIUrl":"10.1016/j.enfie.2026.500618","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>End-of-life decision-making in Intensive Care Units (ICUs) may be hindered not only by the absence of advance directives (ADs), but also by limited knowledge among ICU nurses. The aim of this study was to analyse knowledge and attitudes regarding advance directives among ICU nurses.</div></div><div><h3>Method</h3><div>An observational, descriptive, cross-sectional and multicentre study was conducted among ICU nurses working in public hospitals in Las Palmas (Spain). An anonymous electronic questionnaire was used. Statistical analysis was performed using R Core Team 2024.</div></div><div><h3>Results</h3><div>A total of 229 responses were obtained from a population of 260 professionals, yielding a response rate of 88.1%. Most participants were women (75.6%) and had a median of 6 years of ICU experience (interquartile range: 3–14). Overall, 87.7% reported not having received specific training on advance directives (ADs). Although attitudes toward ADs were highly favorable (scores above 9/10), the level of knowledge was limited, particularly regarding legal aspects, procedures, documentation, and content.</div></div><div><h3>Conclusions</h3><div>A discrepancy exists between nurses’ favorable attitudes toward ADs and their limited practical knowledge. The implementation of targeted training programs, along with the development of institutional protocols, could enhance the integration of ADs into ICU clinical practice.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 4","pages":"Article 500618"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149248215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of eye masks and earplugs in intensive care units: systematic review","authors":"Jorge Ciborro-Montes MSc,&nbsp;Julio Fernández-Garrido PhD","doi":"10.1016/j.enfie.2026.500607","DOIUrl":"10.1016/j.enfie.2026.500607","url":null,"abstract":"<div><h3>Background</h3><div>Delirium is a common neuropsychiatric disorder but underdiagnosed in intensive care units due to the different presentations it can manifest. Nurses have an important role to play in preventing its onset and promoting sleep in their patients.</div></div><div><h3>Aim</h3><div>To describe the efficacy of the use of eye masks and earplugs in adult patients admitted to intensive care units on sleep quality and the development of delirium.</div></div><div><h3>Methods</h3><div>Systematic literature review of randomized clinical trials. During June and July 2024, the CINHAL, ScienceDirect, Medline, LILACS, ProQuest, Web of Science, and BioMed Central databases were consulted, applying filters based on time period, population, type of study, topic, and scientific journal. Studies were selected that analyzed the use of eye masks and earplugs as nursing care and whose methodological quality achieved a medium-high score using the CASPe tool.</div></div><div><h3>Results</h3><div>We found (N = 3742) studies. After applying filtering and selection criteria, a total of eight (n = 8) clinical trials were collected. With a total of 611 participants, it was observed that the use of eye masks and earplugs improved subjective sleep quality, while the data obtained on the incidence of delirium reflected an inconclusive result for its prevention due to the heterogeneity of the results.</div></div><div><h3>Conclusions</h3><div>Studies indicate that the use of sleep masks and earplugs in intensive care unit patients can improve sleep quality and reduce delirium. However, comfort and tolerance vary among patients, and it is crucial to consider duration of use and removals only for short periods of time. Although some studies show significant benefits, others find no relevant differences, suggesting the need for further research to optimize its use. The review has not received any funding.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 3","pages":"Article 500607"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spirituality in nursing professionals working in critical health care settings: Systematic review and meta-analysis","authors":"Edna Margarita Osorio-Durán RN, MSc, PhD candidate,&nbsp;Mónica López de-Ávila RN,&nbsp;Jennifer Rojas-Reyes RN, MSc, PhD,&nbsp;Wilson Cañon-Montañez RN, MSc, PhD,&nbsp;Alba Luz Rodríguez-Acelas RN, MSc, PhD","doi":"10.1016/j.enfie.2026.500606","DOIUrl":"10.1016/j.enfie.2026.500606","url":null,"abstract":"<div><h3>Introduction</h3><div>Spirituality, recognized as an essential aspect of nursing care, contributes to well-being and resilience in critical care settings. Its integration into practice strengthens the meaning and sense of meaning and purpose in the lives of nursing professionals.</div></div><div><h3>Objective</h3><div>To systematically review the evidence on spirituality among nursing professionals working in critical healthcare settings.</div></div><div><h3>Methodology</h3><div>A systematic review and meta-analysis were conducted following the PRISMA guidelines. The protocol was registered in PROSPERO (CRD42023371984). Searches were performed from inception to april 2024 in the following databases: Medline/PubMed, Embase, Lilacs, Cochrane CENTRAL, and Web of Science. The meta-analysis of individual means was performed using a random-effects model. Untransformed means (MRAW) were used to estimate the 95% confidence intervals of individual studies, while the I² and tau² statistics assessed heterogeneity.</div></div><div><h3>Results</h3><div>A total of 1175 studies were identified, 34 of which were included in the systematic review and 4 in the meta-analysis. A prevalence of 58,8% was observed in non-experimental quantitative studies, with “spirituality education and meeting spiritual needs” being the main theme. Meta-analyses were conducted on studies using scales to assess spirituality levels, particularly the Spiritual Care Competence Scale (SCCS), which showed the best performance with an MRAW of 98,56 (IC 95%: 97,86; 99,25; I²: 0,0%), indicating a moderate level of competence in spiritual care.</div></div><div><h3>Conclusions</h3><div>The findings highlight the importance of spirituality in professional performance in critical care settings, emerging as a key component for promoting well-being by strengthening resilience in the face of caregiving challenges.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 3","pages":"Article 500606"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of aerosol therapy in invasive mechanical ventilation: Effective device positioning and the role of nurse","authors":"Carmen Carrera Castro RN","doi":"10.1016/j.enfie.2026.500613","DOIUrl":"10.1016/j.enfie.2026.500613","url":null,"abstract":"<div><h3>Introduction</h3><div>Aerosol therapy during invasive mechanical ventilation is a common practice in intensive care units, however, its effectiveness is highly dependent on technical factors. Variability in device positioning and nursing technique produces substantial differences between the nominal dose and the fraction of drug that reaches the lungs, underscoring the need for standardized placement to enhance both safety and therapeutic efficiency.</div></div><div><h3>Objective</h3><div>To examine recent scientific evidence to determine the optimal positioning of aerosol delivery devices within the ventilator circuit, thereby guiding nursing practice toward standardized, evidence-informed procedures.</div></div><div><h3>Methodology</h3><div>Systematized review (2018–2025) conducted in PubMed, BVSalud, and complementary academic search engines. MeSH, DeCS, and free-text terms related to aerosol therapy and mechanical ventilation were used. The PIO framework was applied following PRISMA guidelines and GRADE assessment. From 165 initial records, eight original studies were included.</div></div><div><h3>Results</h3><div>Vibrating mesh nebulizers demonstrated greater efficiency when positioned on the inspiratory limb, either near the Y-piece (10−15 cm) or at the humidifier inlet. Jet nebulizers showed optimal placement varying according to the device type (continuous, breath-actuated, or synchronized), although their overall performance was inferior to that of vibrating mesh nebulizers. Metered-dose inhalers were most effective when positioned on the inspiratory limb before the Y-piece, particularly when used with a spacer.</div></div><div><h3>Conclusions</h3><div>The available evidence suggests that device positioning influences the efficiency of aerosol therapy during invasive mechanical ventilation. Vibrating mesh nebulizers and properly positioned inhalers may improve pulmonary drug delivery; however, the overall certainty of the evidence remains low.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 3","pages":"Article 500613"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effectiveness of training in basic and assisted communication techniques for intensive care nurses","authors":"Marta Prats-Arimon PhD, BD, MSc, RN,&nbsp;Montserrat Puig-Llobet PhD, BD, RN,&nbsp;Mar Eseverri-Rovira RN, MSc,&nbsp;Elisabeth Gallart PhD, BD, MSc, RN,&nbsp;David Téllez-Velasco RN, MSc,&nbsp;Zaida Agüera PhD, BD, MsMH,&nbsp;Teresa Lluch-Canut PhD, MsMH, RN,&nbsp;Miguel Angel Hidalgo Blanco PhD, MSc, RN,&nbsp;Mª Carmen Moreno-Arroyo PhD, MSc, RN","doi":"10.1016/j.enfie.2026.500601","DOIUrl":"10.1016/j.enfie.2026.500601","url":null,"abstract":"<div><h3>Introduction</h3><div>Specialised training in communication techniques is necessary for intensive care nurses to communicate effectively with critical care patients.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness and satisfaction of a training programme in basic communication skills (BCS) and augmentative and alternative communication (AAC).</div></div><div><h3>Methods</h3><div>A two-phase mixed-methods design was used: phase I was cross-sectional descriptive, and phase II was quasi-experimental. A total of 120 nurses working in the intensive care units of Vall d’Hebron Hospital were recruited for phase I, of whom 30 were included in phase II. The intervention consisted of a training programme in BCS and AAC, accredited by the University of Barcelona and comprising four modules, lasting six hours. Participants’ perception of their communication skills was assessed, as well as evaluation of the knowledge acquired through a written test and nurses’ satisfaction with the programme through an ad hoc questionnaire.</div></div><div><h3>Results</h3><div>Regarding BCS, 71.4% (<em>n</em> = 86) of participants had received training and 78.3% (<em>n</em> = 94) stated they used them. Regarding AAC knowledge, 88.3% (<em>n</em> = 106) reported lack of familiarity with these techniques. Nurses who received training demonstrated significant improvements in their perception of verbal communication use (MD −0.46; <em>P</em> &lt; .001), non-verbal communication (MD −1.20; <em>P</em> &lt; .001), AAC knowledge (MD −1.96; <em>P</em> &lt; .001) and importance of effective communication (MD −0.16; <em>P</em> = .02). The post-test knowledge level obtained an average score (&gt;3 out of 4). 83% (<em>n</em> = 25) of nurses were very satisfied with the training and 18% (<em>n</em> = 5) were satisfied.</div></div><div><h3>Conclusion</h3><div>Training in HCB and AAC led to significant improvement in ICU nurses’ knowledge regarding communication with critically ill patients experiencing communication difficulties. Furthermore, the training was positively received by nurses.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 3","pages":"Article 500601"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148321311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}