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The article discusses the increasing trend of healthcare worker strikes globally, focusing on the ethical implications of clinicians striking in critical care settings. It provides historical context on healthcare strikes, highlighting the impact of legislation on workers' rights. The text explores the impact of strikes on patient outcomes, emphasizing the need for further research. It also addresses the complex relationship between workers' rights and patient care, advocating for a comprehensive discourse involving clinicians, administrators, policymakers, and the public to address these issues. [Extracted from the article]

Aims and objectives: The purpose of this systematic review was to evaluate interventions that have been used to engage families in direct care activities (active family engagement) in adult, paediatric, and neonatal intensive care unit (ICU) settings. Background: Family engagement is universally advocated across ICU populations and practice settings; however, appraisal of the active family engagement intervention literature remains limited. Search strategy: Ovid Medline, PsycArticles & PsycInfo, Scopus, and CINAHL were searched for family interventions that involved direct care of the patient to enhance the psychological, physical, or emotional well‐being of the patient or family in neonatal, paediatric, or adult ICUs. Inclusion/exclusion criteria: Studies were included if an active family engagement intervention was evaluated. Studies were excluded if they were not published in English or reported non‐interventional research. Results: A total of 6210 abstracts were screened and 19 studies were included. Most studies were of low to moderate quality and were conducted in neonatal ICUs within the United States. Intervention dosage and frequency varied widely across studies. The interventions focused on developmental care (neonatal ICU) and involved families in basic patient care. Family member outcomes measured included satisfaction, stress, family‐centred care, confidence, anxiety, and depression. Most studies found improvements in one or more outcomes. Conclusions: There is a paucity of literature about active family engagement interventions, especially in adult and paediatric populations. The optimal dosage and frequency of family engagement interventions remains unknown. Our systematic review found that data are limited on the relationship between family engagement and patient outcomes, and provides a timely appraisal to guide future research. Relevance to Clinical Practice: Further research on the efficacy of family engagement interventions is warranted. The translation of active family engagement interventions into clinical practice should also be supported. [ABSTRACT FROM AUTHOR]

To date, many pandemic policies are still in place in hospitals across the United States,1 which raises ethical concerns as well. These policies often undermine established family-centred care practices and pose potential long-term psychological and medical risks to paediatric patients and their families.5 It is vital that revision to these policies be considered so they realign with family-affirming care. Abbreviation NICU neonatal intensive care unit In 2020, neonatal intensive care units (NICUs) modified visitation policies as a preventative measure to reduce SARS-CoV-2 transmission. [Extracted from the article]

Catheter-associated asymptomatic bacteriuria (CAABU) is frequent in intensive care units (ICUs) and contributes to the routine use of antibiotics and to antibiotic-resistant infections. While nurses are responsible for the implementation of CAABU-prevention guidelines, variability in how individual nurses contribute to CAABU-free rates in ICUs has not been previously explored. This study’s objective was to examine the variability in CAABU-free outcomes of individual ICU nurses. This observational cross-sectional study used shift-level nurse-patient data from the electronic health records from two ICUs in a tertiary medical center in the US between July 2015 and June 2016. We included all adult (18+) catheterized patients with no prior CAABU during the hospital encounter and nurses who provided their care. The CAABU-free outcome was defined as a 0/1 indicator identifying shifts where a previously CAABU-free patient remained CAABU-free (absence of a confirmed urine sample) 24–48 hours following end of shift. The analytical approach used Value-Added Modeling and a split-sample design to estimate and validate nurse-level CAABU-free rates while adjusting for patient characteristics, shift, and ICU type. The sample included 94 nurses, 2,150 patients with 256 confirmed CAABU cases, and 21,729 patient shifts. Patients were 55% male, average age was 60 years. CAABU-free rates of individual nurses varied between 94 and 100 per 100 shifts (Wald test: 227.88, P<0.001) and were robust in cross-validation analyses (correlation coefficient: 0.66, P<0.001). Learning and disseminating effective CAABU-avoidance strategies from top-performers throughout the nursing teams could improve quality of care in ICUs. [ABSTRACT FROM AUTHOR]

With the global pandemic driving the adoption of digital health, understanding the predictors or determinants of digital health usage and information sharing gives an opportunity to advocate for broader adoption. We examined the prevalence and predictors of digital health usage and information-sharing behaviors among American adults. Data were from the Health Information National Trends Survey 5 Cycle 4. More than two-thirds used a digital resource for health-related activities (eg, to check test results). About 81% were willing to share their digital data with their provider, 75% with family, and 58% with friends. Only 14% shared health information on social media. Gender, education, device types, and performance expectancy of digital health were common factors associated with both digital health usage and information-sharing behaviors. Other predictors included rurality, patient portal access, income, and having a chronic disease. Of note, we found that Asian American Pacific Islanders, compared with Whites, were less likely to share information with providers. Performance expectancy was a significant determinant of information sharing. Those diagnosed with diabetes were 4% less likely to share information with their providers. With the growing digital divide, there is a need to advocate for more usable and accessible digital health to assist with person-centered care., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)