Intensive & critical care nursing最新文献

{"title":"Scandinavian healthcare professionals' perceptions of rehabilitation practices in the intensive care unit. A cross-sectional survey.","authors":"Anne Højager Nielsen, Ranveig Lind, Eva Åkerman, Anne Sophie Ågård, Marie Oxenbøll Collet, Hanne Birgit Alfheim, Anna Holm, Helle Svenningsen","doi":"10.1016/j.iccn.2024.103842","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103842","url":null,"abstract":"<p><strong>Objective: </strong>To describe healthcare professionals' perception of current early rehabilitation practices and their preconditions, focusing on functional and cognitive stimulation facilitated by nurses and other healthcare professionals in Scandinavian intensive care units (ICUs).</p><p><strong>Design: </strong>Cross-sectional electronic survey administered to healthcare professionals. The survey was developed in Danish, translated into Norwegian and Swedish, and delivered using Google Forms. The qualitative data were analysed using the framework method.</p><p><strong>Setting: </strong>Scandinavian ICUs.</p><p><strong>Results: </strong>Practices facilitated by nurses and other healthcare professionals in the ICU often began with weaning from the ventilator and reducing sedation. This was followed by increased mobilisation and building physical strength. There was attention to optimising nutrition, swallowing function, and oral intake. Enabling communication and employing cognitively stimulating activities and bodily stimulation to engage the patient's mind were also framed as rehabilitation. To avoid delirium and overexertion, it was important to balance rest and activity and to shield the patient from unnecessary stimulation. Furthermore, it was important to support the patient's will to live and to involve the family in rehabilitation. Post-discharge rehabilitation activities included reaching out to patients discharged to wards and homes.</p><p><strong>Conclusion: </strong>Rehabilitation was described as progressing from passive to active as patients gained consciousness and strength. Weaning, balancing rest and activity, supporting the patient's life courage and will to recover, open visitation policies, and multi-professional collaboration were important prerequisites for rehabilitation.</p><p><strong>Implications for practice: </strong>All aspects of patient care can function as important opportunities for physical and cognitive rehabilitation. Balancing rest and activity is important for conserving the patient's energy for rehabilitation.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103842"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407396","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":"A scoping review to map the implications of reusing single-use endotracheal suctioning catheter practices in mechanically ventilated patients.","authors":"Mohamed H Eid, Kevin Hambridge, Patricia Schofield, Jos M Latour","doi":"10.1016/j.iccn.2024.103848","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103848","url":null,"abstract":"<p><strong>Introduction: </strong>Currently there is limited evidence of the frequency of using endotracheal suctioning catheters. Due to limited resources, many low- and middle-income countries still reuse single-use suction catheters multiple times during the length of a nursing shift. This scoping review was conducted to map the impact of reusing single-use endotracheal suctioning catheters practices on mechanically ventilated patients' outcomes.</p><p><strong>Methods: </strong>The scoping review was conducted in accordance with the JBI methodology for scoping reviews. Four databases systematically searched using predefined keywords (CINAHL, EMBASE, MEDLINE, GLOBAL HEALTH). Key electronic journals were hand searched, while reference lists of included documents and grey literature sources were screened thoroughly. Two independent reviewers completed the study selection and data extraction. A third reviewer made the final decision on any disagreements disputed records.</p><p><strong>Results: </strong>In total 22 articles were identified, and 14 non-duplicate records were screened, and 8 articles were screened for full text. Six articles met the inclusion criteria and were included in this review. Differences were observed on the findings of included studies, two studies identified that reusing single-use suction catheter might increases the risk of respiratory infection, while two other studies identified no difference in contamination rate between single used or multiple-used catheters. One study indicated that reusing single-use catheters are a safe and cost-effective intervention and finally one study reported that reusing single-use catheters might reduce incidence of ventilator associated pneumonia if flushed with chlorhexidine after suctioning.</p><p><strong>Conclusions: </strong>There is no strong evidence of the frequency of using endotracheal suction catheters. Further research is needed comparing single-used versus multiple-used endotracheal suction catheters in mechanically ventilated patients.</p><p><strong>Implication for clinical practice: </strong>Nurses in resource-limited countries can follow their hospital policy regarding the changing frequency of endotracheal suction catheters due to lack of a robust evidence. Flushing suction circuits with chlorhexidine while reusing single-use catheters might reduce the risk of respiratory infections in these hospitals.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103848"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367966","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":"Prediction intervals and DOI plots for prevalence meta-analysis - Letter on Ma et al.","authors":"Ishfaq Ahmad, Muhammed Shabil, Sanjit Sah","doi":"10.1016/j.iccn.2024.103850","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103850","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103850"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367969","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":"Insights and recommendations for optimizing the ARDS prone ventilation model - Letter on Yan et al.","authors":"Chenglong Liang, Chen Zhou, Jingye Pan","doi":"10.1016/j.iccn.2024.103851","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103851","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103851"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367968","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":"Critical care nurses' experiences on environmental sustainability: A qualitative content analysis.","authors":"Davide Bartoli, Francesco Petrosino, Luciano Midolo, Gianluca Pucciarelli, Francesca Trotta","doi":"10.1016/j.iccn.2024.103847","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103847","url":null,"abstract":"<p><strong>Background: </strong>Intensive care units (ICUs) are the primary producers of greenhouse gas emissions within hospitals, due to the use of several invasive materials. Nurses represent a large portion of the healthcare workforce and can be pivotal in promoting sustainability practices. Several international reports have suggested that nursing can help achieve the sustainable development objectives set by the United Nations.</p><p><strong>Aims: </strong>The purpose is to explore behaviour related to environmental sustainability in intensive care nurses.</p><p><strong>Study design: </strong>A qualitative content analysis comprised of in-depth interviews involving 27 ICU nurses, who were each asked the same open-ended question. The transcripts collected were then analyzed and organized by a team of independently-working researchers. The analysis of the extrapolated concepts was carried out following the Neem M. (2022) method. The study is supported by a grant from the Centre of Excellence for Nursing Scholarship, Rome, July 2024.</p><p><strong>Findings: </strong>The main recurring themes are as follows: (1) concepts of environmental sustainability in ICUs, (2) critical issues related to sustainable intervention in the ICUs (3) proactive environmental sustainability attitudes in ICUs. Time to know, define criticality, and improve is the conceptualization of sustainable behaviors experienced by ICU nurses.</p><p><strong>Conclusions: </strong>Taking the time to know and define the critical issues for implementing sustainable behaviours in the ICU, turned out to be the key to enforce the mindset of green nursing thinking.</p><p><strong>Implications to clinical practice: </strong>Sustainability behaviours need to be proposed and verified by ICU managers by creating sustainability teams and promoting a good working environment, founding the progression to green ICUs by focusing on health impact education and mindfulness.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103847"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367967","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":"Educational interventions reduce the severity of post intensive care syndrome-family - Letter on Hayes et al.","authors":"Farshid Rahimi-Bashar, Athanasios Chalkias, Keivan Gohari-Moghadam, Malihe Salimi-Bani, Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2024.103799","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103799","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103799"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989784","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":"Early changes in skin surface temperature to predict fever - Letter to Chung et al.","authors":"Fengju Xie, Xiaoping Feng","doi":"10.1016/j.iccn.2024.103779","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103779","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103779"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984215","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":"Association of norepinephrine with pressure ulcer development in critically ill patients with COVID-19-related acute respiratory distress syndrome: A dose-response analysis.","authors":"Ata Mahmoodpoor, Athanasios Chalkias, Morteza Izadi, Kievan Gohari-Moghadam, Farshid Rahimi-Bashar, Ayişe Karadağ, Masoum Khosh-Fetrat, Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2024.103796","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103796","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the correlation between varying doses of norepinephrine (NE) and the incidence of pressure injuries (PIs) in COVID-19 patients in intensive care units (ICUs).</p><p><strong>Design: </strong>A retrospective multicenter study was conducted on 1,078 COVID-19 patients admitted to ICUs with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. The research spanned from March 2020 to April 2021 across five university-affiliated hospitals in Iran. Univariate and multivariate binary logistic regression analyses, along with linear and non-linear dose-response assessments, were utilized to evaluate the relationship between NE dosages and the probability of PI development.</p><p><strong>Findings: </strong>The multivariate analysis revealed a significant association between higher doses of NE administered over 24 h (OR: 1.832, 95 % CI: 1.218-2.754, P=0.004) and cumulative doses (OR: 1.408, 95 % CI: 1.204-1.975, P=0.048) with the occurrence of PIs. Moreover, patients receiving high NE doses had a nearly fourfold increased risk of developing PIs, regardless of PIs stage, compared to those on low or moderate doses (>15 µg/min vs. ≤ 15 µg/min; OR: 4.401, 95 % CI: 3.339-5.801, P=0.001). Although the linear dose-response analysis did not show a significant correlation between NE doses (µg/min) and PI development (P>0.05), the non-linear analysis indicated that NE doses ≤ 9 µg/min were associated with a reduced risk of PI development.</p><p><strong>Conclusion: </strong>Maintaining NE infusion within the range of 1-9 µg/min appears to be most effective in reducing the likelihood of PIs in ICU patients with COVID-19. Lower NE doses (≤9 µg/min) were associated with a lower risk of PI development, suggesting that factors beyond NE dosage or the use of other vasopressors may play a crucial role in PI formation in this patient cohort.</p><p><strong>Implications for clinical practice: </strong>Rather than suggesting a specific threshold, clinicians should consider further studies to determine the optimal dose that balances microvascular perfusion and patient outcomes. It is crucial to comprehensively evaluate additional factors and selectively use vasopressors. Individualized care, including regular monitoring and personalized treatment plans, is essential for achieving the best outcomes in this patient population.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103796"},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908708","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":"Relationship between microaspiration and ventilator-associated events: A post-hoc analysis of a randomized controlled trial.","authors":"Guillaume Millot, Hélène Behal, Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Julien Labreuche, Isabelle Alves, Franck Minacori, Hugues Georges, Patrick Herbecq, Cyril Fayolle, Patrice Maboudou, Farid Zerimech, Malika Balduyck, Saad Nseir","doi":"10.1016/j.iccn.2024.103778","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103778","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between ventilator-associated events (VAE) and microaspiration in intubated patients has not be studied. The objective of this study was to evaluate the relationship between abundant microaspiration of oropharyngeal secretions or gastric contents and the incidence of VAE.</p><p><strong>Patients and methods: </strong>This was a post hoc analysis of the BESTCUFF study, which was a multicenter, cluster randomized, cross-over, controlled, open-label trial in adult patients ventilated for over 48 h. All tracheal aspirates were sampled for 48 h following enrollment, with quantitative measurement of pepsin and alpha-amylase. VAE were identified using National Healthcare Safety Network criteria, based on PEEP or FiO₂ variations compared to stable parameters in previous days. The primary objective was to assess the relationship between abundant global microaspiration and the incidence of VAE, adjusted for pre-specified confounding factors (sex, SAPS II score and Glasgow coma scale).</p><p><strong>Results: </strong>261 patients were included, of which 31 (11.9%) developed VAE, with an overall median age of 65 (interquartile range 52-74), a majority of male patients (164, 62.8%), a median SAPS II score of 50 [40-61], a median SOFA score of 8 [5-11], and acute respiratory failure as main reason for ICU admission (117, 44.8%).The incidence of VAE was not significantly associated with abundant global microaspiration (adjusted cause-specific hazard ratio (cHR): 1.55 [0.46-5.17), abundant gastric microaspiration (adjusted cHR: 1.24 [0.61-2.53), or with abundant oropharyngeal microaspiration (adjusted HR: 1.07 [0.47-2.42]).</p><p><strong>Conclusions: </strong>Our results suggest no significant association between abundant global, gastric or oropharyngeal microaspiration and the incidence of VAE.</p><p><strong>Implications for clinical practice: </strong>This study underscores that measuring microaspiration in intubated critically ill patients might not be useful to predict the diagnosis of VAE or to evaluate interventions aiming at preventing these complications.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103778"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790637","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":"Stepwise implementation of prevention strategies and their impact on ventilator-associated pneumonia incidence: A 13-Year observational surveillance study.","authors":"Bert Maertens, Stijn Blot, Diana Huis In 't Veld, Koen Blot, Annelies Koch, Katrien Mignolet, Elise Pannier, Tom Sarens, Werner Temmerman, Walter Swinnen","doi":"10.1016/j.iccn.2024.103769","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103769","url":null,"abstract":"<p><strong>Objective: </strong>To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.</p><p><strong>Design: </strong>Historical observational surveillance study conducted over 13 years.</p><p><strong>Setting: </strong>A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.</p><p><strong>Participants: </strong>Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.</p><p><strong>Interventions: </strong>Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, chlorhexidine oral care, and daily sedation assessment.</p><p><strong>Measurements and main results: </strong>A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.</p><p><strong>Conclusions: </strong>Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.</p><p><strong>Implications for practice: </strong>The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103769"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753666","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}