Intensive & critical care nursing最新文献

{"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, Melissa J Bloomer","doi":"10.1016/j.iccn.2024.103883","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103883","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>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.</p><p><strong>Research question: </strong>What are the perceived barriers for nurses providing end-of-life care for patients and their families from culturally diverse backgrounds in ICU?</p><p><strong>Design: </strong>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.</p><p><strong>Results: </strong>Fifteen studies published between 2010 and 2022 were included. Findings are presented according to four themes: (i) Language and communication, (ii) (Dis) Comfort with religion, (iii) Consensus challenges and (iv) Caring at the end of life.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Implications for clinical practice: </strong>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.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103883"},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","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, Wendy Chaboyer, Georgia Tobiano, Anuja Abayadeera, Kristen Ranse","doi":"10.1016/j.iccn.2024.103891","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103891","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>A prospective, two-arm, unblinded, pilot randomised controlled trial.</p><p><strong>Research methodology: </strong>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.</p><p><strong>Main outcome measures: </strong>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.</p><p><strong>Setting: </strong>Two intensive care units in one Sri Lankan tertiary care hospital.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Implications for clinical practice: </strong>The use of communication boards in intensive care units may improve patient-centred care for ventilated patients but requires further, high quality effectiveness trials.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103891"},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","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, Athanasios Chalkias, Keivan Gohari-Moghadam, Morteza Izadi, Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2024.103899","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103899","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103899"},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of inclusive leadership in optimizing patient-centered care among ICU nurses.","authors":"Daniel Joseph E Berdida, Rizal Angelo N Grande","doi":"10.1016/j.iccn.2024.103900","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103900","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103900"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683984","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":"Sustainability in ICU: Less plastic, greener future - Letter on Eid et al.","authors":"Alberto Lucchini, Emanuele Rezoagli, Marco Giani, Stefano Bambi","doi":"10.1016/j.iccn.2024.103897","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103897","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103897"},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","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, Şadiye Dur, Nagehan Ustabaş Yıldız, İpek Güney Varal","doi":"10.1016/j.iccn.2024.103898","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103898","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Design: </strong>A randomised controlled crossover trial.</p><p><strong>Setting: </strong>This study was conducted in the neonatal intensive care unit between July 2022 and June 2023.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 < 0.001). It was determined that the difference was in favour of the Yakson group (p < 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 < 0.001).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103898"},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival rates with favorable neurological outcomes after in-hospital and out-of-hospital cardiac arrest: A prospective cohort study.","authors":"Ali Ait Hssain, Athanasios Chalkias, Amir Vahedian-Azimi, Hussam Elmelliti, Ans Alamami, Rabee Tawel, Marwa Morgom, Fatima Jamal Ullah, Rida Arif, Murad Mehmood, Hamas El Melliti, Mohamad Talal Basrak, Anzila Akbar, Abdulsalam Saif Ibrahim","doi":"10.1016/j.iccn.2024.103889","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103889","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the survival rates with favorable neurological outcomes among patients who experienced in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA).</p><p><strong>Design: </strong>This prospective cohort study assessed 554 adult patients with IHCA or OHCA referred to Hamad General Hospital, Qatar, between February 2015 and November 2021. Neurologic outcomes were measured using the Cerebral Performance Category (CPC) score. Survival rate and neurologic status were re-evaluated at 28 days, hospital discharge, and one year after cardiac arrest (CA).</p><p><strong>Findings: </strong>For all participants, the hospital discharge and one-year survival rates with a favorable neurological outcome (CPC ≤ 2) were 18.5 % and 19.5 %, respectively. Specifically, among patients with IHCA, the rates were 20.5 % and 19 %, while in patients with OHCA, the rates were 16.4 % and 19.9 %, respectively. Multivariate regression analysis indicated that factors male sex (OR: 2.129, 95 % CI: 1.168-3.881, P = 0.014), initial shockable rhythm (OR: 1.691, 95 % CI: 1.024-2.788, P = 0.041), and the use of ECPR (OR: 1.944, 95 % CI: 1.178-3.209, P = 0.009) were associated with increased likelihood of survival with favorable neurological outcomes at 28 days. Conversely, older age, presence of comorbidities, infection, higher APACHE II score, longer hospital stays, and undergoing tracheostomy were linked to decreased chances of survival with favorable neurological outcomes at different time points.</p><p><strong>Conclusion: </strong>Survival with good neurological outcomes after OHCA was 20.3 %, 16.4 %, and 19.9 % at 28 days, hospital discharge, and one year, respectively. Among patients with IHCA, survival with good neurological outcomes was 20.5 %, 20.5 %, and 19 % at 28 days, hospital discharge, and one year, respectively.</p><p><strong>Implications for clinical practice: </strong>Care of CA patients in a cardiac arrest center is associated with improved long-term survival with favorable neurological outcomes. Prioritizing early intervention for shockable rhythms and utilizing ECPR where appropriate could enhance patient prognosis.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103889"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683967","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":"Kotter's 8-step change model to improve hand hygiene compliance in intensive care unit: A 41-month prospective longitudinal quality improvement study.","authors":"Fen Hu, Ying Wang, Rui Cao, Chang Hu, Bilong Feng, Jin Li, Xinbo Ding, Jing Ma, Huilin Li, Pei Wang, Ying Xu, Dandan Xu, Juanjuan Pei, Xiaoping Zhu, Jie Chen, Ke Liang, Zhiyong Peng, Kianoush Kashani, Bo Hu, Yufeng Yuan","doi":"10.1016/j.iccn.2024.103877","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103877","url":null,"abstract":"<p><strong>Background: </strong>Despite numerous studies assessing bundled interventions to enhance hand hygiene compliance (HHC), compliance rates persist at suboptimal levels. Our objective was to employ Kotter's Change Model (KCM) to enhance HHC and conduct a comprehensive process evaluation among medical staff within the intensive care unit (ICU).</p><p><strong>Methods: </strong>KCM was implemented at the ICU of Zhongnan Hospital of Wuhan University from March 2018 to August 2021, with a 41-month longitudinal monitoring of HHC. The primary outcome focused on the absolute monthly change in HHC. Secondary outcomes encompassed the HHC characteristics across different phases, varying trends in HHC concerning different hand hygiene opportunities and occupations, quarterly incidences of central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI).</p><p><strong>Results: </strong>This study included 20,222 hand hygiene actions and 24,195 opportunities. The overall HHC was 83.58 % (95 %CI, 83.11 %-84.04 %). Following the KCM implementation, HHC surged from 35.71 % (95 % CI, 22.99 %-50.83 %) to 87.75 % (95 % CI, 85.53 %-89.67 %), reflecting a notable increase of 145.73 %. The most rapid growth in HHC occurred post-patient contact, elevating from 35.29 % to 89.8 %. Despite escalating patient numbers and treatment complexities annually, the quarterly rates of CLABSI (0 ‰-3.53 ‰) and CAUTI (0.96 ‰-4.26 ‰) remained consistently low.</p><p><strong>Conclusion: </strong>Utilizing KCM systematically alters healthcare providers' perception of hand hygiene, fostering an environment that advocates for and sustains improved HHC among ICU personnel.</p><p><strong>Implications for clinical practice: </strong>The Kotter's change model can be an effective framework for healthcare organizations to systematically improve and maintain hand hygiene compliance among healthcare providers, which can in turn help reduce healthcare-associated infections.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103877"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678165","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":"Effect size estimates of risk factors for post-intensive care syndrome: A systematic review and meta-analysis.","authors":"Shuang Gao, Xifeng Liang, Zhixiu Pan, Xiuping Zhang, Liwen Zhang","doi":"10.1016/j.iccn.2024.103888","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103888","url":null,"abstract":"<p><strong>Objective: </strong>To provide updated evidence on the risk factors and accurately quantify the effect size of the risk factors associated with post-intensive care syndrome (PICS), encompassing cognitive, mental, physical and socio-economic domains.</p><p><strong>Research methodology: </strong>We conducted a systematic review of literature from January 2010 to October 2023. The meta-analysis was conducted to calculate an effect size for every risk factor, and odds ratio and 95% confidence intervals were used as summary statistics.</p><p><strong>Results: </strong>Of 67,468 retrieved studies, 160 were included in qualitative synthesis, 102 were included in quantitative synthesis. A total of 60 factors were identified, categorized into 17 person-related, 23 disease-related and 20 ICU-related categories. The strongest correlations with cognitive health were observed for previous cognitive problems, sedatives and delirium. Factors most strongly correlated with mental health included previous mental problems, delirium, lack of social support, illicit drug and bad experience in ICU. The strongest correlations with physical health involved previous mental problem, delirium, organ dysfunction of neurologic and respiratory support. For socio-economic domains, older age and female were identified as significant risk factors.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis identified and quantified the person, disease, and ICU-related risk factors associated with PICS. These findings may enable clinicians to better recognize the patient at high risk for PICS at an early stage during their stay in ICU.</p><p><strong>Implications for clinical practice: </strong>A thorough investigation of risk factors across the four domains of PICS is necessary to gain a holistic understanding. The identification and integration of risk factors associated with PICS empower critical care multidisciplinary teams to optimize management strategies, thereby assisting ICU survivors a better recovery. Since multiple risk factors may be simultaneously associated with the four domains of post-intensive care syndrome, it is imperative to develop a comprehensive prediction algorithm.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103888"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678164","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":"The link between norepinephrine administration and pressure injury risk in patients with COVID-19-related ARDS - Letter on Mahmoodpoor et al.","authors":"Wei-Zhen Tang, Wei-Ze Xu, Run-Ren Pan, Hong-Yu Xu, Tai-Hang Liu","doi":"10.1016/j.iccn.2024.103865","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103865","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103865"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634952","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}