Search

Background: The development of nursing competencies in antimicrobial stewardship (AMS) is influenced by a two-dimensional model, encompassing both internal and environmental factors. In the context of Italian clinical nursing, this study aims to assess and measure these aspects. Methods: Employing a cross-sectional online survey design, nurses from various clinical specialties in Italy were involved. The questionnaire assessed individual variables, knowledge, attitudes, practices, as well as structural and process-related variables influencing AMS. Statistical analyses were performed, encompassing descriptive statistics, Pearson correlation, and multiple linear regression. Results: A total of 1,651 nurses aswered the survey, with a participation rate of 50.8%. The participant demographic revealed that 77% were female, and they had an average of 15 years of experience. Workplace and regional factors were found to significantly impact both AMS practices and attitudes. Surgical nurses reported higher practices scores (β = 0.467, P <.01), while critical care nurses scored lower (β= -0.398, P <.01). Regarding perceptions of structure, workplace characteristics significantly influenced nurses' scores, indicating lower perceptions among surgical nurses compared to their medical counterparts (β= -0.315, P <.01). Conclusions: The study reveals the intricate interplay between internal and external factors that impact nurses' AMS competence. This underscores the urgent need for targeted interventions and education initiatives to enhance nurses' AMS competencies. Specifically, addressing variations in settings and nurses' behaviours becomes imperative for achieving improved patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Work-related musculoskeletal disorders (WRMSDs) are significant concern in intensive care units (ICUs) due to distinct work environment. This study aims to comprehensively investigate determinants of WRMSDs and ergonomic challenges, specific to ICU nurses, providing valuable insights for targeted interventions. Methods: In this six-month convergent mixed methods study, 200 consenting nurses with over one year of experience from seven ICUs across three public tertiary hospitals of Ahmedabad participated. Structured questionnaires were used to collect data on socio-demographics, occupation, physical and workplace factors, risk perception, and musculoskeletal pain (through modified Nordic Musculoskeletal Questionnaire) and ergonomic issues using REBA (Rapid Entire Body Assessment) scale. Qualitative insights were obtained through in-depth interviews until saturation of responses. Statistical analysis involved chi-square, t-test and logistic regression, with a significance level set at p < 0.05. Thematic analysis was used to interpret the findings of qualitative study. Results: The study included predominantly female ICU nurses (78%) with a mean age of 34 years. A high prevalence of WRMSDs (84%) was observed, with the lower back and neck being the most affected regions. Nurses with WRMSDs reported significantly higher mean scores for physical factors (15.1 vs. 11.1, p = 0.00), physical workload (12.8 vs. 10.7, p = 0.001), work environment (13.1 vs. 10.1, p = 0.00), and risk perception (11.8 vs. 8.9, p = 0.00) compared to those without WRMSDs. Logistic regression identified key risk factors for WRMSDs, including longer ICU tenure [OR = 1.4 (1.13–1.66)], high shift frequency [OR = 2.7 (1.27–5.95)], higher physical factor score [OR = 1.2 (1.05–1.42)], higher physical workload score [OR = 1.2 (1.09–1.49)], higher risk perception [OR = 1.3 (1.10–1.78)], and lack of exercise [OR = 0.5 (0.27–0.93)]. The qualitative findings highlighted key ergonomic challenges, including inadequate equipment, heavy patient loads, poor posture during tasks, and insufficient breaks, contributing to WRMSDs among ICU nurses. Conclusion: The findings underscore urgent need for targeted interventions to address risk factors associated with WRMSDs, including ergonomic training, workplace modifications, and education programs to enhance risk awareness and preventive behaviours. Future research should focus on developing and evaluating comprehensive interventions that integrate both physical and work environment factors to effectively mitigate WRMSDs among ICU nurses. [ABSTRACT FROM AUTHOR]

Background: Endotracheal tube (ETT) placement is crucial for neonates with respiratory failure. Ultrasonography (US) has emerged as a valuable tool to detect ETT positioning, competing with traditional methods. Nurses, being front-line caregivers, can perform basic ultrasound examinations. This study aimed to assess whether a nurse inexperienced in US could identify the correct ETT position in neonates after a brief ultrasound training. Methods: This study included intubated neonates hospitalized in a NICU with a postmenstrual age of under 45 weeks. A NICU nurse, following a short ultrasound training, measured the distance of the ETT tip to the right pulmonary artery and aortic arch. Chest X-rays (CXRs) confirmed the ETT position. The neonates' ages, genders, weights, and examination times were recorded. Results: This study involved 67 neonates, including 40 (59.7%) males, with 39 (58.2%) weighing below 1500 g. The median time for correct ETT placement confirmation by CXR was 12.6 min, while US-assisted ETT recognition took 6 min initially and 5.1 min at the end of the training, which was a significant difference. No major differences were found in US distance based on the neonate's weight and age. Gender marginally influenced US distance (β = −0.089, p = 0.056). Conclusions: The NICU nurse responded well to ultrasound training, showing results comparable with CXR. Further studies with more patients and additional studied factors are needed to fully assess US's reliability in determining ETT positioning. [ABSTRACT FROM AUTHOR]

Background: Patients hospitalized outside of monitored environments may experience sudden clinical worsening requiring transfer to the Intensive Care Unit. Early detection based on the clinical nurse's identification of the risk of clinical deterioration represents an opportunity to prevent serious adverse events. Nurse worry is defined as the use of clinical reasoning combined with intuition that precedes the patient's clinical deterioration. Objective: The objective of this study was to evaluate nurse worry as a trigger for rapid response team activation in patients hospitalized in non-critical units and its association with the need in ICU admission. Methods: This retrospective cohort study utilized data retrieved from an anonymized institutional database used to monitor the actions of the rapid response team. Data collected from January 2021 to December 2022 were analyzed, encompassing patients over 18 years old admitted to non-critical units and evaluated by the rapid response team. Analyzed variables included demographic characteristics, MEWS score, and causes for activating the rapid response team, such as changes in vital signs and nurse worry. Main outcomes assessed were transfer to the ICU, medical procedures, and drug administration. Patients were divided into three groups for analysis: those triggered for RRT assessment exclusively by changes in vital signs, those triggered exclusively by nurse worry and those triggered by the nurse worry combined with changes in vital signs. Results: A total of 4634 rapid response team consultations were included, with 1574 triggered by changes in vital signs, 1263 triggered by nurse worry and 1797 triggered by the nurse worry associated with changes in vital signs. The group with nurse concern showed a lower need for transfers to the ICU (40%) compared to the group with changes in vital signs (50%) p < 0.001 although there was no difference in relation to the need for medical procedures,17% in both groups. Conclusion: The NW emerges as a relevant factor in triggering RRT and may be associated with improved outcomes, such as reduced need for ICU transfers. However, the observational design of the study does not allow for establishing causal relationships. [ABSTRACT FROM AUTHOR]

Background: Intensive care unit (ICU) nurses work under heavy workloads, which can lead to serious consequences for nurses' outcomes and patient safety. This study aimed to examine the relationship between professional quality of life (Pro QOL), and sleep quality among ICU nurses during the COVID-19 outbreak. Methods: A cross-sectional and multicentre study was conducted on 253 nurses in 20 COVID-19 ICUs in four major teaching hospitals from July 2021 to June 2022. Data were collected via a demographic information form, the Professional Quality of Life Scale, and the Pittsburgh Sleep Quality Index (PSQI). Results: Nurses in COVID-19 ICUs experienced moderate levels of compassion satisfaction, compassion fatigue, and poor sleep quality. The mean scores of the Pro QOL dimensions were 33.49 ± 6.77, 32.28 ± 8.83, and 29.58 ± 11.67 for compassion satisfaction, burnout, and secondary traumatic stress, respectively. The results revealed that 220 (87%) of the nurses experienced poor sleep quality. A significant relationship was shown between the Pro QOL dimensions and the mean total score of sleep quality, which can predict 0.45% of the variance (F = 7.11, p < 0.001, adjusted R2 = 0.45). Conclusion: Our results confirmed the link between the Pro QOL and sleep quality among ICU nurses. It is suggested that nurse managers implement practical interventions to improve the QWL of nurses in the ICUS. This will subsequently lead to improved outcomes for nurses and ensure patient safety. [ABSTRACT FROM AUTHOR]

Background: The neonatal stage is critical due to the high risk of mortality. The Neonatal Intensive Care Unit (NICU) is essential for preterm infants but can also increase the risk of developmental disorders. Various early intervention programs for preterm babies are being tested and combined into a developmental care model. This study aims to identify the components, content, and interventions of a developmental care model for preterm babies suitable for implementation in Indonesia. Methods: A modified Delphi study with three survey rounds was conducted. In the first round, six experts, including practitioners and academics, were selected. Practitioners were NICU nurses with over 10 years of experience, speakers on developmental care, and those applying it in practice, with research and publications on neonates. Academics were pediatric lecturers, researchers on preterm infant care, and those with relevant training. In the second and third rounds, 30 panelists (nurses or midwives with over 5 years of NICU experience) participated. Results: The first-round expert panel consisted of six experts (100% female) with 13-25 years of service: practitioners (66.7%) and academics (33.3%). For the second and third rounds, the panel included 30 experts (100% female): nurses (73.3%) and midwives (26.7%). Consensus was achieved in the third survey round with 75% cumulative agreement on interventions and training materials. The developmental care model comprised eight components with 126 interventions and 26 training materials. Conclusion: The study identified components, content, interventions, and training metrics for developmental care in NICU nursing practice for preterm babies. Future research should observe neonatal nurses implementing the seven basic developmental care interventions. [ABSTRACT FROM AUTHOR]

Background: Person-centered care focuses on individualized care that respects patients' values, preferences, and autonomy. To enhance the quality of critical care nursing, institutions need to identify the factors influencing ICU nurses' ability to provide person-centered care. This study explored the relationship between clinical judgment ability and person-centered care among intensive care unit (ICU) nurses, emphasizing how the ICU nursing work environment moderates this relation. Methods: A cross-sectional survey was conducted between September 4 and September 18, 2023, with 192 ICU nurses recruited from four general hospitals with a convenience sample (valid response rate = 97.4%). Participants completed online self-report structured questionnaires. The collected data were analyzed using hierarchical multiple regression and PROCESS macro Model 1, with a 95% bias-corrected bootstrap confidence interval to verify moderating effects. Results: Clinical judgment ability (β =.24, p <.001) and ICU nursing work environment (β =.50 p <.001) were found to be significant predictors of person-centered care. These two predictors explained the 47.0% of person-centered care in the final hierarchical regression model. Additionally, Clinical judgment (B = 0.28, p <.001, Boot. 95%CI = 0.13~0.42) and the ICU nursing work environment (B = 0.41, p <.001, Boot. 95%CI = 0.30~0.52) positively affected person-centered care, and the interaction term of clinical judgment and ICU nursing work environment (B = 0.16, p =.026, Boot. 95%CI = 0.02~0.30) also positively affected person-centered care. The moderating effect was particularly significant when the ICU nursing work environment score was 2.90 points (below 14.6%, above 85.4%) or higher on a scale of 1–5 and As the ICU nursing work environment score increased, the positive moderating effect also increased. Conclusions: The ICU nurses' clinical judgment ability positively affected person-centered care, and the nursing work environment moderated the relationship between clinical judgment ability and person-centered care. Therefore, strategies for enhancing person-centered care among ICU nurses should focus on developing educational programs to improve clinical judgment ability and implementing comprehensive efforts to effectively improve and manage the nursing work environment. [ABSTRACT FROM AUTHOR]

Background: Effective pain assessment in neonatal care is crucial for ensuring the well-being of newborns. However, barriers to its successful implementation persist. This study aims to identify the obstacles that hinder effective neonatal pain assessment by Neonatal Intensive Care Units (NICUs) nurses. Materials and Methods: This qualitative study was conducted using the method of conventional content analysis. Purposive sampling was employed from February to September 2023, selecting 14 female nurses working in NICUs of hospitals in Tehran and Karaj as participants. Indepth, semistructured interviews were conducted to collect the data. The software "MAXQDA" version 2016 was utilized for managing qualitative data. Results: Four main themes and eleven subthemes were identified: "Overtasked," "Discordant atmosphere," "Soulless care," and "Lack of awareness." Each of these main themes is further elaborated through the subsequent subthemes. Conclusions: This study found that the lack of knowledge and understanding of neonatal pain assessment tools, the busyness of nurses, lack of time, excessive documentation, and the inadequacy of staff relative to the number of newborns were the most significant obstacles to the assessment of newborn pain. Addressing these challenges is critical for optimal neonatal pain assessment and management, promoting the well-being of newborns. [ABSTRACT FROM AUTHOR]

Background: Nurses working in Intensive Care Unit (ICU) for COVID-19 are more at risk as they interact more with infected patients. Therefore, this study aimed to explore the experience of Indonesian nurses who work in ICU for COVID-19 patients. Materials and Methods: A qualitative hermeneutic phenomenological approach was used. A total of 20 nurses working in the respective ICUs of eight COVID-19 referral tertiary hospitals in Indonesia were recruited using purposive sampling. Semistructured individual video call interviews were conducted in June–September 2021; then, Diekelmann's hermeneutic phenomenological approach was used to analyze and interpret the data. Results: Thirteen subthemes describing the following four themes, namely, the pleasing and bad feelings, new challenges of working, nursing professional growth, and nurse resource management for COVID-19. Conclusions: This study describes nurses' experiences working in ICUs during the COVID-19 crisis, such as their feelings, perceived challenges, and received support. Nurse leaders play a significant role in providing adequate Personal Protective Equipment (PPE), flexible work shifts, and a caring and healing work environment. However, being aware of the limit of pressure that an individual can manage and providing adequate allowance as rewards for work in risky areas are essential to avoid burnout. [ABSTRACT FROM AUTHOR]

Critical care nursing is considered one of the most challenging and demanding fields in nursing. Critical care nurses work in high-stress environments, tending to patients who are experiencing acute illness and necessitate intensive care. Nurses play a crucial role in providing nursing care for critically ill patients, encompassing duties such as assessment, administration of medications, ventilator management, diligent monitoring, and responding to life-saving situations. Despite the significance of their contributions, there are limited assessment tools used to assess critical care nurses' perceptions about their roles and responsibilities in intensive care units (ICU). The main aim of this study was to develop a tool to assess the critical care nurses' knowledge, awareness, and perception of their roles and responsibilities in the critical care units. The researcher developed the Critical Care Nurses' Roles and Responsibilities Assessment Tool. Subsequently, the tool underwent content validity assessment by five nursing experts, resulting in a final tool with 17 Likert-scale items. The scores ranged from 17 to 85, with intervals indicating varying levels of awareness. To assess the nurses' perception of the roles and responsibilities identified in the tool, a study was conducted on 120 registered nurses working in the ICU units across 9 governmental hospitals in Jordan. Data were collected through an online questionnaire covering demographical data and the roles and responsibilities of critical care nurses in the ICU. The collected data were subjected to quantitative analysis using appropriate statistical methods. Regarding the results among the experts, the content validity index (CVI) of the tool was 0.93. Among the participants, Cronbach alpha was measured to assess the reliability and internal consistency of the tool and the result was 0.912. Regarding the nurses' perception, a small percentage of participants, specifically (9%), demonstrated a moderate level of agreement with the roles and responsibilities mentioned in the tool (mean of scores = 40 – 63). Conversely, a substantial majority of participants (91%), exhibited a high level of agreement (mean of scores = 64 – 85). In conclusion, the results of this study revealed a powerful and reliable tool that has earned widespread acclaim among experts and participants alike. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore tutoring experiences related to a high-risk newborn care simulation among nurses and nursing students to derive insights into developing effective neonatal nursing practice. Methods: A qualitative content-analysis study was conducted in March 2023. Data were collected through narrative surveys and focus group interviews with four neonatal intensive care unit nurses and 12 senior nursing students participating in a 1-day high-risk newborn care simulation program. A content analysis was performed on the collected data. Results: Three categories ("efforts to foster a sense of presence," "efforts to promote positive awareness of the neonatal intensive care unit," and "establishing one's role as an educator") and six subcategories were derived from the nurses' responses. Three categories ("growth through a realistic virtual simulation," "improved learning effects," and hope for continued development") and six subcategories were derived from the nursing students' responses. Conclusion: The nursing students experienced realistic practice with their nurse tutors in the high-risk newborn care simulation, which helped them form their professional identity as future nurses. After tutoring, the nurses' perceptions of nursing students changed positively, which affected their teaching methods. [ABSTRACT FROM AUTHOR]

Background: Complexity of care, adequate staffing levels, and workflow are key factors affecting nurses' workloads. There remain notable gaps in the current evidence regarding clinical complexity classification and related staffing adjustment, limiting the capacity for optimal staffing practices. This study aimed to adapt and validate the Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool (WANNNT-SC) for an Italian context to allow the assessment of newborns admitted to NICUs. Methods: This was a validation study. Results: To evaluate the reliability of the tool among different professionals, a correlation test was performed using Pearson's correlation, which revealed a strong correlation (r = 0.967, p = 0.01). In the test–retest phase, there was a significant correlation (r = 0.910 and p = 0.01). Using an analysis of variance, we found that the higher the I-WANNNT-SC score was, the higher the predicted death rate (F = 13.05 and p < 0.001). Conclusions: The Italian Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool represents the first tool available for an Italian context that aims to measure the nursing workload in neonatal intensive care. It could allow adjustments in nursing staffing based on NICU activities and patient needs. This study was prospectively approved by the local Ethics Committee "Palermo 1" (Protocol CI-NICU-00). [ABSTRACT FROM AUTHOR]

Background/Objectives: Medication errors are the most frequent and critical issues in healthcare settings, often leading to worsened clinical outcomes, increased treatment costs, extended hospital stays, and heightened mortality and morbidity rates. These errors are particularly prevalent in intensive care units (ICUs), where the complexity and critical nature of the care elevate the risks. Nurses play a pivotal role in preventing medication errors and require strategies and methods to enhance patient safety. This study aims to develop a comprehensive and evidence-based intervention to minimize medication errors by nurses in ICUs. Methods: This qualitative case study forms a part of a broader research project that commenced with a scoping review. Building on the review findings, a complex intervention was designed to address nurses' medication errors. A focus group of experts was conducted to validate the intervention designed, evaluating its contextual feasibility and relevance. Results: This study led to the development of a complex intervention whose relevance lies in its potential implementation within the studied context. The resulting intervention was structured around four main components—educational interventions, verification and safety methods, organizational and functional modifications, and an error reporting system—meticulously designed to leverage the ICU's existing resources. Conclusions: In conclusion, the proposed intervention has the potential to positively impact healthcare quality by reducing errors and promoting a culture of safety. Furthermore, this study's findings provide a relevant foundation for future research and practical applications, driving advancements in healthcare service excellence. [ABSTRACT FROM AUTHOR]

Amaç: Bu araştırma cerrahi yoğun bakım hemşirelerinde psikolojik dayanıklılık, algılanan stres ve tükenmişlik arasındaki ilişkinin incelenmesi amacıyla yapıldı. Gereç ve Yöntemler: Tanımlayıcı tipte olan araştırma Haziran-Aralık 2020 tarihleri arasında İzmir ilinde dört farklı hastanenin üçüncü düzey cerrahi yoğun bakım ünitelerinde yürütüldü. Araştırmanın örneklemini araştırmanın yürütüldüğü yoğun bakım ünitelerinde çalışan, deneyimi en az 6 ay olan 167 hemşire oluşturdu. Veriler birey tanılama formu, Psikolojik Dayanıklılık Ölçeği, Algılanan Stres Ölçeği ve Tükenmişlik Ölçeği aracılığı ile toplandı. Verilerin analizi için varyans analizi, Student’s t-testi, Mann–Whitney U testi, Kruskal Wallis ve korelasyon analizleri kullanıldı.Bulgular: Araştırma sonucunda yoğun bakım hemşirelerinin psikolojik dayanıklılık ölçeği puan ortalamasının 57.20±8.55, algılanan stres ölçeği puan ortalamasının 27.67±6.93 ve tükenmişlik ölçeği puan ortalamasının 3.44±1.04 olduğu bulundu. Bu araştırmada psikolojik dayanıklılık ve algılanan stres (r=-0.526, p:0,000), psikolojik dayanıklılık ve tükenmişlik (r=-0.557, p:0,000), algılanan stres ve tükenmişlik (r=0.723, p:0,000) arasında istatistiksel olarak anlamlı ilişki bulundu. Sonuç: Bu araştırmada yoğun bakım hemşirelerinin psikolojik dayanıklılık ve algılanan stres seviyelerinin orta düzeyde, tükenmişlik seviyelerinin tehlike sinyalinde olduğu bulundu. Araştırmaya göre yoğun bakım hemşirelerinde psikolojik dayanıklılık düzeyi arttıkça algılanan stres ve tükenmişlik düzeyinin azaldığı, tükenmişlik düzeyi arttıkça algılanan stres düzeyinin arttığı görüldü. Anahtar Kelimeler: Cerrahi yoğun bakım üniteleri, psikolojik dayanıklılık, stres, tükenmişlik, yoğun bakım hemşireliği.

Abstract Background Intensive care units are critical environments where various alarm systems play a pivotal role in patient monitoring and safety. Alarm fatigue can lead to slower response times and missed alarms, compromising patient safety and increasing stress and burnout among intensive care unit nurses. Understanding how intensive care unit nurses respond to and manage these alarms is crucial in evaluating their impact on patient care and nursing well-being. Methods This descriptive qualitative study explored the experiences of intensive care unit nurses in alarm management. Conducted in the medical and surgical intensive care units of a Northern Taiwan medical center, the study involved 15 nurses. Semi-structured interviews were utilized to investigate the working experiences of ICU nurses in alarm management and to identify their coping strategies for dealing with the constant inundation of medical device alarms. The interviews were transcribed, and content analysis was applied to identify key themes in the responses. Results The study revealed five main themes in intensive care unit nurses’ strategies for managing alarms: (1) Mastering alarm signals and acting; (2) Team monitoring for life preservation; (3) Enhancing senses and distinguishing carefully; (4) Learning from the lessons of incidents for vigilant reflection; and (5) Detach alarms’ influence on daily life. These coping strategies are effective in alarm management, safeguarding patients’ lives, enhancing the serenity of the clinical environment, and mitigating the physical and mental exhaustion caused by alarm fatigue. Conclusions Intensive Care Unit nurses develop various coping strategies to manage medical device alarms, based on their experience. These strategies are crucial in maintaining patient safety and reducing nurse alarm fatigue. They can also be used for nursing education and clinical training.

Objective: To analyse the interrater reliability of the NEUMOBACT checklist and verify whether consistent results are reproducible. Methods: A validation study with a cross-sectional design, compliant with the GRRAS checklist, among ICU nurses attending a SIMULAZERO course with an Objective Structured Clinical Evaluation simulation format, to verify transfer from theory to clinical practice of knowledge and skills in ventilator-associated pneumonia (VAP) and catheter-related bacteraemia (CRB) prevention. A minimum sample size of 111 pairs of nurse raters was calculated. Interrater agreement was analysed using Gwet's AC1 for each item and as a total for each of the three checklists in the NEUMOBACT instrument. Results: A total of 95 pairs of valid NEUMOBACT checklists were completed by 190 raters with a median age of 29 [25–35] years, 93.7% were female. At the Central Venous Catheter insertion station, Gwet's AC1 was 0.934 (95% CI [0.919–0.949]). Only 2 of the 17 items scored below 0.9. At the Endotracheal Suctioning station, Gwet's AC1 was 0.869 (95% CI [0.851–0.886]). Of the 26 items that made up this station, 16 had an agreement percentage above 0.9, a further 9 were between 0.821 and 0.884, and item 13 had a value of 0.789. At the Patient Care station, Gwet's AC1 was 0.911 (95% CI [0.896–0.927]). Of the 21 items, 17 showed an agreement percentage above 0.9 and 4 were between 0.810 and 0.894. Conclusions: The interrater reliability of the NEUMOBACT checklist shows substantial agreement between pairs of raters and is therefore validated in this large sample of ICU nurses. Relevance to clinical practice: The NEUMOBACT checklist can be useful for assessing skills before and after training in VAP and CRB prevention measures and during debriefing (post-simulation feedback), to reinforce the scientific evidence behind actions and decisions for items that have been performed incorrectly, thus consolidating training already received. [ABSTRACT FROM AUTHOR]

Background: Increasing the level of resilience and happiness of intensive care nurses can lead to an improvement in their psychological health. This study aimed to extract the possible effectiveness of mHealth application utilizing the micro-learning method on a mobile phone platform on the intensive care nurses' resilience and happiness. Materials and methods: This single-blind randomized controlled trial was conducted in 2022-24. Sixty nurses working in intensive care units at two hospitals in Tehran, Iran were recruited using purposive sampling and randomly assigned to either the intervention or control group. Techniques of resilience and increasing happiness were taught to the intervention group using the mHealth application based on the micro-learning method. No training was provided to the control group. For data collection, questionnaires of individual characteristics, Connor-Davidson Resilience, and Oxford Happiness were used. Results: Before the intervention, there was no significant difference between the mean of the subscales and the total score of resilience and happiness of the intervention and control groups (P < 0.05). However, after the intervention, there was a significant difference (P < 0.05). After using the mHealth application, the total resilience score of the intervention group increased from 67.30 ± 10.12 to 79.27 ± 5.87 (P < 0.0001), while the resilience of the control group changed from 68.80 ± 9.09 to 65.93 ± 8.44 (P = 0.548). Similarly, using the mHealth educational application based on micro-learning led to an increase in the happiness score of the intervention group from 38.50 ± 11.10 to 67.83 ± 8.84 (P < 0.0001), whereas the happiness score of the control group nurses after the intervention (38.93 ± 14.33) compared to the baseline (41.40 ± 14.51) did not change significantly (P = 0.388). Conclusions: The use of the mHealth application based on the micro-learning method played an effective role in training resilience and happiness skills in nurses. It is recommended to conduct more studies using this new educational approach. Trial registration: The study has been registered in the Iranian Registry of Clinical Trials (No. IRCT20221225056916N1, Date: 04/29/2023). [ABSTRACT FROM AUTHOR]

Background: Patients in critical care units who are connected to mechanical ventilators (MV) often face the risk of ventilator‐associated pneumonia (VAP). Therefore, the aim of current study is to describe critical care nurses' knowledge and adherence to evidence‐base guidelines (EBGs) for preventing the occurrence of VAP. Methodology: A cross‐sectional study was applied. Data were collected through a self‐administered questionnaire completed by all critical care nurses (n = 213) working at Palestinian hospitals. Descriptive and inferential statistic was utilized to describe ICU nurse's knowledge and adherence to VAP prevention EBGs. Results: The study revealed that the mean knowledge score for critical care nurses was (50.8%). Overall, the findings indicated that nurses' knowledge of VAP guidelines was at an average level. A statistically significant difference (p value = 0.049) in the knowledge level was observed based on nurses' qualifications. On the other hand, the study found that nurses' adherence to EBGs was an acceptable (mean = 8.3, 69.2%). No substantial differences in adherence level were identified based on respondents' characteristics. Conclusion: Critical care nurses possess an average level of knowledge regarding EBGs for preventing VAP, alongside demonstrating an acceptable level of adherence to these guidelines. [ABSTRACT FROM AUTHOR]

Introduction: The evolving landscape of healthcare in Jordan presents unique challenges and opportunities for nursing professionals. With a focus on critical care nurses, understanding the dynamics of professional autonomy and professionalism within this context is crucial for advancing nursing practice and improving patient care. Objectives: This study aimed to investigate the relationships between perceived nursing professional autonomy and professionalism among critical care nurses in Jordan. Methods: A descriptive correlation design was used among critical care nurses from five major Jordanian governmental hospitals. A total of 227 questionnaires were distributed, with a final sample size of 200 participants. Data were collected between August and September 2023. Professional autonomy and professionalism were measured using the Dempster Practice Behaviors Scale and the Nurses' Professionalism Inventory, respectively. We used the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines in the current study. Results: The study revealed moderate levels of perceived professional autonomy (mean DPBS total score: 103.94) and professionalism (mean NPI total score: 119.12) among participants. A significant positive correlation (r =.49, p <.001) was observed between these two constructs. However, demographic and work-related factors showed minimal influence on these perceptions. Conclusion: The study highlights the importance of professional autonomy and professionalism in improving nursing care in Jordan. It recommends targeted approaches like ongoing education and supportive workplace policies to bolster these aspects. These findings have significant implications for nursing policy and education across various healthcare settings. [ABSTRACT FROM AUTHOR]

Background/Objectives: The patient monitoring system is a critical tool commonly used in hospitals, making it essential to assess caregivers' user requirements and satisfaction with its usability. In intensive care units (ICUs), the usability of these systems is closely linked to the work efficiency of key users, such as nurses, and directly impacts patient safety and treatment outcomes. This study evaluates the usability of patient monitoring systems in intensive care units (ICUs), focusing on user requirements and satisfaction among nurses, the primary users. Usability is directly linked to work efficiency and patient safety, with post-marketing surveillance (PMS) data from overseas, highlighting issues such as unrecognized alarms, leading to worsened patient conditions. Methods: This study involved 22 ICU nurses who had used the system for over a year, assessing usability through testing, satisfaction surveys, the Health-ITUES, and eye-tracking analysis. Results: The results showed a high success rate (94%) and positive satisfaction scores (4.15, SD = 0.88), with a Health-ITUES score of 4.13 (SD = 0.78). Eye tracking revealed that some functions, including alarms, were overlooked or not recognized. Conclusions: Recommendations include improving the interface for alarm messages and recording deletion functions to enhance user satisfaction and patient safety. [ABSTRACT FROM AUTHOR]

Alcohol withdrawal syndrome is a significant global health concern affecting individuals with alcohol use disorder, particularly in hospital settings like intensive care units. Early diagnosis and management are crucial but often complicated by symptom overlap with other conditions. This study aims to evaluate the awareness and knowledge of surgical and medical intensive care unit nurses regarding AWS, focusing on risk factor identification, diagnosis, and care practices. A cross-sectional descriptive study was conducted from November 15 to December 01, 2021, involving 112 nurses from public and private hospitals. Data were collected via an online questionnaire developed from existing literature, which included demographic questions and a 20-item alcohol withdrawal syndrome awareness scale, where higher scores indicated better awareness. Statistical analysis utilized the Kolmogorov-Smirnov test for normality, Mann-Whitney U for twogroup comparisons, and Kruskal-Wallis H for multiple-group comparisons. A multivariate generalized linear model assessed the influence of independent variables on alcohol withdrawal syndrome awareness. Nurses scored an average of 9.92 out of 20 on the alcohol withdrawal syndrome awareness scale, indicating moderate knowledge. Significant differences in awareness were noted based on professional experience, intensive care unit type, and prior training. Nurses with 5 or more years of experience and those with specific training in alcohol withdrawal syndrome care exhibited higher awareness levels (p < .05). The study reveals a gap in alcohol withdrawal syndrome awareness among intensive care unit nurses, particularly those with less experience and training. Enhanced educational programs and practical exposure are essential for improving early identification and management of alcohol withdrawal syndrome in critical care settings. [ABSTRACT FROM AUTHOR]

Background: Paediatric critical care nurses face challenges in promptly detecting patient deterioration and delivering high-quality care, especially in low-resource settings (LRS). Patient monitors equipped with data-driven algorithms that monitor and integrate clinical data can optimise scarce resources (e.g. trained staff) offering solutions to these challenges. Poor algorithm output design and workflow integration, however, are important factors hindering successful implementation. This study aims to explore nurses' perspectives to inform the development of a data-driven algorithm and user-friendly interface for future integration into a continuous vital signs monitoring system for critical care in LRS. Methods: Human-centred design methods, including contextual inquiry, semi-structured interviews, prototyping and co-design sessions, were carried out at the high-dependency units of Queen Elizabeth Central Hospital and Zomba Central Hospital in Malawi between March and July 2023. Triangulating these methods, we identified what algorithm could assist nurses and used co-creation methods to design a user interface prototype. Data were analysed using qualitative content analysis. Results: Workflow observations demonstrated the effects of personnel shortages and limited monitor equipment for vital signs monitoring. Interviews identified four themes: workload and workflow, patient prioritisation, interaction with guardians, and perspectives on data-driven algorithms. The interviews emphasised the advantages of predictive algorithms in anticipating patient deterioration, underlining the need to integrate the algorithm's output, the (constant) monitoring data, and the patient's present clinical condition. Nurses preferred a scoring system represented with familiar scales and colour codes. During co-design sessions, trust, usability and context specificity were emphasised as requirements for these algorithms. Four prototype components were examined, with nurses favouring scores represented by colour codes and visual representations of score changes. Conclusions: Nurses in the LRS studied, perceived that data-driven algorithms, especially for predicting patient deterioration, could improve the provision of critical care. This can be achieved by translating nurses' perspectives into design strategies, as has been carried out in this study. The lessons learned were summarised as actionable pre-implementation recommendations for the development and implementation of data-driven algorithms in LRS. [ABSTRACT FROM AUTHOR]

Purpose: This article describes intensive care nurses' experiences of using communicative caring touch as stroking the patient's cheek or holding his hand. Our research question: "What do intensive care nurses communicate through caring touch?" Methods: In this qualitative hermeneutically based study data from two intensive care units at Norwegian hospitals are analysed. Eight specialist nurses shared experiences through individual, semi-structured interviews. Results: The main theme, Communicating safety and presence has four sub-themes: Amplified presence, Communicating security, trust and care, Creating and confirming relationships and Communicating openness to a deeper conversation. Communicative caring touch is offered from the nurse due to the patient's needs. Caring touch communicates person-centred care, invites to relationship while respecting the patient's dignity as a fellow human being. Caring touch conveys a human initiative in the highly technology environment. Conclusion: Caring touch is the silent way to communicate care, hope, strength and humanity to critical sick patients. This article provides evidence for a common, but poorly described phenomenon in intensive care nursing. [ABSTRACT FROM AUTHOR]

Prolonged mechanical ventilation is harmful for patients requiring prompt weaning approaches from an interprofessional team with different and overlapping scopes of practice. Nurses play a key role in interprofessional teams, and optimization of their role can reduce the duration of mechanical ventilation. Purpose: To understand the role of nurses in critical care in healthcare teams when weaning patients from mechanical ventilation. Methods: Multiple-case study with concurrent mixed methods data collection was conducted in two critical care units following a pilot study in Québec, Canada. A validated and adapted questionnaire, “Survey of Mechanical Ventilation and Weaning Role Responsibilities” was completed by nurses, respiratory therapists, and physicians (n = 102). Interviews (n = 49) were conducted, with content analysis completed. Descriptive statistics were generated for quantitative data. Rodgers et al. (2016) reporting standards for case studies were used. Results: Questionnaires showed that nurses had little involvement, autonomy, and influence over decisions related to weaning. However, in interviews, participants described several strategies used by nurses to support patients’ weaning from mechanical ventilation. Discussion: In the context of this research, the role of nurses in critical care is suboptimal when weaning patients from ventilators, however, in-depth knowledge of patient status, protocols, and education can support optimizing the nurse’s role in the weaning process. Conclusion: Strategies are needed to optimize the role of nurses in critical care when weaning patients from mechanical ventilation. [ABSTRACT FROM AUTHOR]

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Encephalitis, defined as inflammation of the brain tissue, is an uncommon yet serious condition that can lead to severe brain damage. Nursing care is critical in increasing the effectiveness of treatment in patients with encephalitis. In the case presented here, care was planned and implemented based on nursing diagnoses by field in the NANDA-I classification, NIC interventions, and NOC outputs. The patients' nursing diagnoses were identified as ineffective health management, imbalanced nutrition: less than body requirements, fluid volume deficit, constipation, impaired physical mobility, impaired verbal communication, hopelessness, impaired social interaction, ineffective sexuality, risk for impaired psychological health, risk for ineffective activity planning, risk for impaired independent decision making, hyperthermia, chronic pain, and risk for delayed development. The care plan for four of these diagnoses is presented. [ABSTRACT FROM AUTHOR]

To investigate the current situation of the touch comfort of nurses in the intensive care unit (ICU) of Grade A tertiary hospitals and analyse its influencing factors, to provide a basis for formulating intervention programmes. Methods: In August 2022, 343 nurses in the ICUs of eight tertiary-level hospitals in Shijiazhuang City, Hebei Province were surveyed, and the current situation of nurses' tactile comfort and the factors affecting it in the ICU were analysed using the Nurses' General Information Questionnaire, Nurses' Touch Comfort Scale, Nurses' Humanistic Qualities Self-Assessment Scale and Nursing Work Environment Scale. Results: The mean score for the tactile comfort of ICU nurses was (5.16± 1.25). Staffing, ICU nurses' family support, nursing work environment and nurses' humanistic qualities were positively correlated with ICU nurses and tactile comfort, whereas job title was negatively correlated with ICU nurses and tactile comfort. Conclusion: The touch comfort of nurses in ICUs is good, and the physiological dimension is at the medium level. Nursing managers could take comprehensive measures to strengthen the cultivation of nurses' humanistic quality, improve the nursing working environment in the ICU, improve nurses' touch comfort and promote the improvement of nursing service. [ABSTRACT FROM AUTHOR]

Aims: To examine the predictability of categorical and quantitative study variables on acute stroke knowledge amongst study participants. Design: Non‐experimental, descriptive correlational. Methods: A convenience sample of registered nurses caring for adult, hospitalized patients recruited from the urban Southeast. A three‐part survey was emailed to the nurses: demographics, stroke education and experience, and the Acute Stroke Management Questionnaire. Results: Intensive Care Unit and Emergency Department nurses had the highest level of stroke knowledge. Nurses reporting three or more post‐licensure education modalities had higher stroke knowledge scores than those reporting two or less. Practice setting, self‐perception of stroke knowledge, self‐identified knowledge of acute stroke management and three items related to code stroke were significantly correlated with stroke knowledge. Conclusion: Various methods of training and reinforcement of learning using varying teaching styles are effective in increasing nurses' stroke knowledge. Further stroke education is needed for nurses across the acute care setting. Implications: Future studies should explore lived experiences of nurses to gain understanding of nonquantifiable factors that nurses feel have strengthened their stroke knowledge. Impact: What Problem Did the Study Address? ○Addressing the gap in the knowledge of predictors of nurse stroke knowledge. Main Findings?: Practice setting, post‐licensure stroke education, code stroke familiarity, confidence and understanding were all predictive of the overall stroke knowledge. Whom Will the Research Have an Impact?: Nurses, nurse educators, patients experiencing and at risk for stroke. Reporting Method: The STROBE checklist was used to strengthen the reporting of the results. Patient or Public Contribution: Nurses voluntarily participated in this study by completing the online questionnaire. What Does This Paper Contribute to the Wider Global Clinical Community?: Provides predictors of stroke knowledge for nurse leaders to have a better understanding of nurses' educational needs.Provides evidence of a quick, effective measure of nurses' stroke knowledge. [ABSTRACT FROM AUTHOR]

Background: Comprehending and addressing the needs of caregivers during the post-intensive care unit (ICU) phase is vital for establishing sustainable support systems and improving the overall quality of life (QoL) for both patients and caregivers. Objective: To explore the experiences of family members (FMs) caring for loved ones three-months after ICU discharge and their related QoL. Methods and measures: A qualitative, descriptive research was conducted. Participants were recruited from two general ICUs in an Italian Academic Hospital. Data collection lasted two months and was performed with telephonic interviews led by ICU nurses. Thematic analysis was conducted using a hybrid approach, incorporating both deductive and inductive coding strategies. This process has been facilitated by Atlas.ti software. Results: Twenty-four FMs participated, representing a diverse range of familial relationships with the patients. Thematic analysis revealed four overarching themes: 1) QoL underwent transformations; 2) Positive emotions laden with significance; 3) Supporting role taken on by a caregiver; and 4) Life's transience through the meaning-making of the illness event. These themes highlighted the multifaceted nature of the caregiving experience. Conclusions: This study provides valuable insights into the challenges and dynamics faced by FMs following ICU discharge. Findings underscore the importance of addressing environmental challenges, cultivating positive emotions, and strengthening caregiver-patient relationships to enhance the caregiving experience and promote overall QoL. FMs can adapt their personal concepts and reach their full potential by learning to coexist with the demanding role of caregiver and achieve a new level of resilience and fulfillment. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Intensive Care Nursing is the property of Journal of Intensive Care Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Intensive Care Nursing is the property of Journal of Intensive Care Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Intensive care units are often presented as environments where ethical issues are common and decisions can determine the life or death of patients, and these units have unique challenges due to critical health care. In these units, the relationship between the medical team and the patient's relatives, their refusal of treatment, informed consent causes the nurses to have conflict in their decision making, therefore, this study aims to determine the level of clinical decision-making and moral distress and the relationship between them in intensive care units nurses. Methods: This cross-sectional study was conducted with a descriptive-analytical approach in 2023 in Gorgan city. The number of 198 nurses in the intensive care units of Gonbad Kavos hospitals in the north of Iran were investigated and evaluated using the Corley Moral Distress questionnaire (2002), and Laurie's Clinical Decision questionnaire (2001) in 2023. Independent T-test and anova analysis of variance were used for bivariate analysis. The significance level in this study was considered 0.05. Results: The results of the study showed that the mean and standard deviation of clinical decision making was 60.98 ± 10.25 (analytical-systematic level) and moral distress was 92.2 ± 23.61 (moderate level). There was a statistically significant relationship between clinical decision-making and nurses' moral distress (P < 0.001 and r = 0.370). The moral distress score had a statistically significant relationship with marriage, employment status, education level, age, work experience and duration of employment in the special department. Also, the clinical decision score had a statistically significant relationship with employment status, education level, age and work experience. Conclusion: According to these results, it seems that more attention should be paid to the moral distress of nurses in intensive care units, and it is necessary to improve their decision-making towards intuitive interpretation, which is done by designing and compiling training programs and workshops for nurses can be done, so that we can provide optimal nursing services to the patients of this department. [ABSTRACT FROM AUTHOR]

Background: Recognizing and appropriately responding to ethical considerations is a crucial element of ethical nursing practice. To mitigate instances of ethical incongruity in healthcare and to promote nurses' comprehension of their professional ethical responsibilities, it is imperative for researchers to accurately evaluate ethical sensitivity. Conducting a systematic review of the available instruments would enable practitioners to determine the most suitable instrument for implementation in the field of nursing. Aim: This review aims to systematically assess the measurement properties of instruments used to measure ethical sensitivity in nursing. Methods: A systematic literature search was conducted in July 2022 in the following electronic databases: Scopus, CINAHL, APAPsycINFO, Embase, Web of Science, and PubMed. Two reviewers independently screened and assessed the studies in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The updated criteria for good measurement properties are used to rate the result of measurement properties, and the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to grade the quality of the summarized evidence. Results: This review encompasses a total of 29 studies that describe 11 different instruments. Neither cross-cultural validity nor responsiveness was examined in any of the included studies. Whereas the majority of the instruments were conducted with at least some type of validity assessment, nearly all of the reliability results rated were indeterminate. Two instruments were recommended, the Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) and the Ethical Awareness Scale for nurses in intensive care units. It is recommended that new self-administration instruments for special nursing settings be developed in accordance with the item response theory (IRT)/Rasch model. Conclusion: The selection of ethical sensitivity measurement instruments in nursing, and further research on the development, psychometric, and cross-cultural adaptation of these instruments, could be conducted in accordance with the findings and suggestions of this systematic review. Strengths and limitations: • This review was conducted to assess 11 instruments that were used to measure ethical sensitivity in nursing in 29 studies. • The Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) and the Ethical Awareness Scale for nurses in intensive care units can be recommended, but further reliability and cross-cultural validity testing are needed. • The IRT/Rasch model is also recommended to measure ethical sensitivity in nursing. • The potential limitation of utilizing the COSMIN checklist for assessing methodological quality is worth considering. • Test–retest was considered inappropriate; thus, the reliability testing of ethical sensitivity measurement instruments still needs to be explored. [ABSTRACT FROM AUTHOR]

Background: Intensive care unit (ICU) patients face higher infection risks from invasive procedures, highlighting the critical role of ICU nurses in infection prevention. Clear differentiation between the patient and healthcare zones is essential for effective hand hygiene and disinfection, yet research on this topic is limited. Aim: To assess ICU nurses' perception of the concept of patient and healthcare zones and evaluate their similarity and accuracy in identifying the zones. Methods: A descriptive survey was conducted at a 2,732-bed tertiary hospital in Korea from 28 July to 27 August 2022. Participants were recruited from various ICUs through flyers. 225 questionnaires—with illustrations 27 item locations for three ICU scenarios—were made available at nursing stations for voluntary completion. Participants were asked to classify items into the patient zone or the healthcare zone. Similarity scores reflected participant agreement, while accuracy scores measured the proportion of correct answers. Participants' free-text opinions regarding zone classification were analysed thematically. Findings: 104 nurses participated voluntarily. Average similarity and accuracy were 84.7% and 82.7%, respectively. The top 8 items, with over 97% similarity and accuracy, were all frequently in contact with ICU patients (e.g., pulse oximeter, Levin tube, central line, urine bag, and patient bed). The bottom 7 items, with less than 80%, included the glucometer, flashlight, trolley, and sink. Participants with higher education levels had significantly higher similarity (p =.044) and accuracy (p =.033), whereas those already familiar with the patient-zone concept had significantly higher accuracy (p =.009). From the free-text analysis, participants considered factors beyond proximity to the patient, such as patient contact, room type, and distance. Conclusions: To address zone classification challenges, clear criteria for patient and healthcare zones, space redesign, and educational programs are recommended. Further research is necessary to improve greater clarity and consensus regarding patient and healthcare zones to enhance infection control practices. [ABSTRACT FROM AUTHOR]

Background: The majority of elderly individuals prefer to spend their final days in the Intensive Care Unit (ICU). ICU nurses are key providers in hospice care, and their attitudes toward death influence the quality of end-of-life nursing. Positive psychology emphasizes promoting positive attitudes toward death. A sense of meaning in life and resilience are critical aspects of positive psychology, which are essential for shaping ICU nurses' attitudes toward death. Objective: This study aims to investigate whether a sense of meaning in life indirectly affects attitudes toward death through the mediation of resilience. Method: A total of 212 ICU nurses from four tertiary general hospitals in Guangdong and Fujian provinces, China, participated in this study. They completed an online questionnaire, including the Death Attitude Profile-Revised, the Connor-Davidson Resilience Scale, and the China Meaning in Life Questionnaire for ICU nurses. Results: ICU nurses scored highest in natural acceptance (3.26 ± 0.53), followed by escaping acceptance (2.54 ± 0.59), and fear of death (2.53 ± 0.78). The proposed model fit the data well. Both the presence of meaning and the search for meaning were positive predictors of resilience (β = 0.313, p < 0.05; β = 0.256, p < 0.05). Resilience, the presence of meaning, and the search for meaning positively predicted natural acceptance (β = 0.299, p < 0.05; β = 0.294, p < 0.05; β = 0.177, p < 0.05). Conversely, these factors negatively predicted fear of death (β = −0.179, p < 0.05; β = −0.251, p < 0.05; β = −0.192, p < 0.05) and escaping acceptance (β = −0.208, p < 0.05; β = −0.208, p < 0.05; β = −0.219, p < 0.05). Mediation analysis indicated that resilience had a partial mediating role. Conclusion: The presence of meaning and the search for meaning influence attitudes toward death, with resilience serving as a partial mediator. It is recommended that nursing administrators consider ICU nurses' attitudes toward death and emphasize the importance of meaning in life and resilience in death education. This approach can help protect the psychological well-being of ICU nurses, promote a deeper understanding of life's meaning, and develop a scientific perspective on death. Such measures are crucial for providing better humanistic care and psychological comfort to terminally ill patients and their families, thereby improving the quality of end-of-life care. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to examine the reliability and validity of the Turkish version of the Nursing Activities Score. Methods: To validate the Turkish version of the Nursing Activities Score, a sample comprising 30 adult intensive care patients and 30 nurses was employed. After a pilot study, the internal consistency, Cronbach's alpha coefficient, was found to be p = 0.718. Following the significant internal consistency obtained in the pilot study, the correlation between Nursing Activities Score internal consistency and Critical Nursing Situation Index scores was examined in 150 adult intensive care patients and 150 nurses. Results: The assessment of inter-rater reliability showed a high level of agreement (99%) and an average Kappa index of 0.598 (p < 0.001). Concurrent validity was demonstrated through a statistically significant correlation between Nursing Activities Score and the Critical Nursing Situation Index (r = 0.71, p < 0.001) and multivariate regression analysis (R2 = 83%, p < 0.001). The validity is supported by the statistically significant relationship between Nursing Activities Score and Critical Nursing Situation Index. Conclusion: These results demonstrate that Nursing Activities Score is a valid and reliable tool for measuring nursing workload in Turkish intensive care units. Trial registration: Samsun University Samsun Training and Research Hospital, following ethics committee approval (Samsun University clinical research ethics committee (KAEK) 202312/2) and Clinical Trials (NCT04928040) registration. [ABSTRACT FROM AUTHOR]

Background: Good sepsis management is key to successful sepsis therapy and optimal patient outcomes. Objectives: This study aimed to determine obstacles among nurses and doctors to implementing the hour-1 sepsis bundle in a secondary hospital in Indonesia. Methods: This was a qualitative study with a phenomenological approach. Data were obtained from one-on-one in-depth interviews with 13 doctors and nurses in the intensive care unit and emergency department who were purposively sampled. Data were analyzed using content analysis. Results: Five main themes were revealed in the analysis: incomplete implementation of the hour-1 sepsis bundle, lack of knowledge about the hour-1 sepsis bundle, cost issues, lack of supporting facilities, and lack of coordination among health workers. Conclusions: Optimizing regional health laboratories, optimizing the use of quick Sequential Organ Failure Assessment (qSOFA) and SOFA, and creating a series of sepsis protocols within the hospital are some solutions that secondary hospitals can implement to ensure appropriate management of sepsis cases. Involvement of health policyholders and hospital management is needed to address these challenges. [ABSTRACT FROM AUTHOR]

Objective(s): The COVID-19 pandemic, with its sudden widespread shocked the whole world, especially the health care systems. Considering the vital role that nurses in the intensive care units played for COVID-19 patients, a deep understanding of nurses' lived experiences can help to improve their skills in dealing with stressful situations and the quality of patient care. Therefore, the present study was conducted to explore nurses' experiences in the intensive care units caring for patients with COVID-19. Methods: This was a qualitative study. Fifteen intensive care unit nurses were purposively selected. In-depth and semi- structured interviews and field notes were used to collect data. The text of the interviews was recorded and analyzed using the hermeneutic approach and the Diekelmann method. Results: Ten participants were women and five were men. The mean age of the participants was 32 years and the mean work experience in the critical department was six years. The three main themes that emerged from the data analysis in this study included conflicting emotions, the emergence of a new image of nursing, and the crystallization of professional nursing. Conclusion: Working in difficult and unknown conditions with countless challenges has resulted in mental and physical health decline in intensive care unit nurses. However, nurses who demonstrated a spirit of sacrifice did not abandon their diligent efforts to combat this unknown enemy and fulfilled their professional responsibilities to provide paramount care to patients. In doing so, the nurses showed society a new image of nursing. The results can be applied to management policies when planning for the future. [ABSTRACT FROM AUTHOR]

The article discusses the implementation of a sedation protocol in a medical intensive care unit in Singapore to reduce benzodiazepine use and improve sedation practices. The protocol was introduced to address challenges such as inconsistent sedation practices, high benzodiazepine use, and inadequate non-pharmacological interventions for delirium. Through training and simulation sessions, the protocol led to a significant reduction in benzodiazepine use, improved sedation outcomes, and a decrease in delirium rates. The initiative involved various stakeholders and aimed to harmonize sedation practices in the hospital's intensive care units. [Extracted from the article]

Copyright of Mediterranean Nursing & Midwifery is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Sepsis is a severe healthcare problem that affects millions of people worldwide every year, and it requires prompt management to reduce mortality. So, early detection and appropriate sepsis management during the first few hours improve outcomes. Aim: To evaluate the effect of implementing sepsis care bundle on clinical outcomes of critically ill patients. Subjects and Method: Study design: A quasi-experimental research design was utilized in this study. Setting: This study was conducted at the Anesthesia Intensive Care Unit (ICU) in Tanta Main University Hospitals and the surgical ICU in an International Educational Hospital affiliated to Tanta University Hospitals. Subjects: A purposive sample of 80 patients met the criteria for systemic inflammatory response syndrome was selected. Tools: Tool (I): Critically Ill Patient Assessment Sheet. Tool II: Critically Ill Patient's Clinical Outcomes Assessment. Results: the study indicated statistically significant improvements in physiological parameters and decreased the occurrence of septic shock, severe sepsis, and multiple organ failure syndrome with P<0.05. Conclusion: Implementing the sepsis care bundle for all critically ill sepsis cases can enhance their clinical outcomes and reduce complications, particularly multiple organ failure syndrome. Recommendations: The study should be replicated using large probability samples in different settings to generalize the results. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis represents a significant cause of morbidity and mortality among infants in healthcare settings. This study explored nurses' experiences in preventing and managing neonatal sepsis in the Tamale metropolis. Methods: An exploratory, descriptive qualitative cross-sectional study design was used, and data was collected using semi-structured interviews. The sample size was determined at the point of data saturation of fifteen participants. Thematic analysis was employed to identify codes, subthemes, and themes within the interview transcripts. Results: Three major challenges nurses face in preventing and managing neonatal sepsis, including (1) the absence of a protocol for handling newborns upon admission, (2) an excessive workload that made it difficult for staff to follow infection prevention protocols, and (3) inadequate, obsolete and/or lack of equipment that caused devices to be overused. The nurses also identified critical psychological and emotional difficulties they encounter as a result of working within such a stressful environment. Other activities nurses conducted were handwashing before and after every procedure, infection prevention, and separating the babies in the incubator. In managing babies with neonatal sepsis, nurses provided daily treatment, hygiene care, and supported activities of living. The nurses also assert that the availability of resources, appropriate staff, and critical skills are important for preventing and managing neonatal sepsis. Conclusion: The lack of basic working consumables like gloves, syringes, and needles, inadequate staff, and lack of defined protocol of care were identified as critical challenges that hamper the care provided in neonatal care units. Hospital authorities must focus attention on addressing the critical challenges faced by neonatal care units. Also, measures should be instituted to address the emotional and psychological concerns associated with nursing care. Future research must consider the level of influence of each of the challenges enumerated on nurses' overall health. Plain language summary: In many developing countries deaths of under-five children are associated with neonatal sepsis - an acute infection that occurs in those less than 28 days old. Nurses are critical in the care and services rendered to these babies and their families in the neonatal care units. This study assessed the experiences of nurses in providing care to neonates. The data was collected using an interview guide among nurses working in neonatal care units in the Tamale metropolis. Analysis was done using the thematic data analysis method. Some challenges were identified by nurses to be associated with the care of babies with neonatal sepsis. These challenges included a lack of definitive protocols of care; higher workload; inadequate, obsolete, and lack of basic equipment and consumables. Nurses employed handwashing techniques to prevent infection among babies with neonatal sepsis. Services providers must focus attention on providing the requisite support to nurses caring for babies with neonatal sepsis to improve the care experiences. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the current status of delirium care self-efficacy among nurses in the intensive care unit (ICU) and the level of their knowledge about delirium in the ICU, more importantly, to analyze factors influencing the delirium care self-efficacy of ICU nurses and to provide a theoretical basis for ICU nursing managers to develop strategies for effective delirium care and management. Methods: The study was based on a sample of 283 ICU nurses from eight hospitals in Chongqing selected using a convenience sampling method between July 2023 and September 2023. The tools used included a general information questionnaire, the Chinese version of the Delirium Care Self-Efficacy of ICU Nurses Scale, and the Chinese version of the ICU Delirium Knowledge Level Questionnaire. Results: The self-efficacy score (47.84 ± 9.93) of ICU nurses was positively correlated with the delirium knowledge level score (12.32 ± 3.47, r = 0.591, P < 0.001). Multivariate linear regression analysis identified the gender of the nurse, hospital level (tier), duration of ICU work experience, whether the nurse was a specialized ICU nurse, whether the nurse received delirium-related training, and the level of knowledge about delirium (all P < 0.05) as the influencing factors for the delirium care self-efficacy of ICU nurses. Conclusion: It is recommended that ICU nursing managers offer targeted interventions based on the influencing factors to improve the delirium care self-efficacy of ICU nurses and their delirium knowledge levels, thereby reducing the incidence of delirium and improving the quality of care provided for patients with delirium in the ICU. [ABSTRACT FROM AUTHOR]

Background: Intensive care units are critical environments where various alarm systems play a pivotal role in patient monitoring and safety. Alarm fatigue can lead to slower response times and missed alarms, compromising patient safety and increasing stress and burnout among intensive care unit nurses. Understanding how intensive care unit nurses respond to and manage these alarms is crucial in evaluating their impact on patient care and nursing well-being. Methods: This descriptive qualitative study explored the experiences of intensive care unit nurses in alarm management. Conducted in the medical and surgical intensive care units of a Northern Taiwan medical center, the study involved 15 nurses. Semi-structured interviews were utilized to investigate the working experiences of ICU nurses in alarm management and to identify their coping strategies for dealing with the constant inundation of medical device alarms. The interviews were transcribed, and content analysis was applied to identify key themes in the responses. Results: The study revealed five main themes in intensive care unit nurses' strategies for managing alarms: (1) Mastering alarm signals and acting; (2) Team monitoring for life preservation; (3) Enhancing senses and distinguishing carefully; (4) Learning from the lessons of incidents for vigilant reflection; and (5) Detach alarms' influence on daily life. These coping strategies are effective in alarm management, safeguarding patients' lives, enhancing the serenity of the clinical environment, and mitigating the physical and mental exhaustion caused by alarm fatigue. Conclusions: Intensive Care Unit nurses develop various coping strategies to manage medical device alarms, based on their experience. These strategies are crucial in maintaining patient safety and reducing nurse alarm fatigue. They can also be used for nursing education and clinical training. [ABSTRACT FROM AUTHOR]

Introduction: Critical care nurses are crucial in managing critical patients, facing challenges with advanced technology, alarms, ventilators, and multiple laboratory investigations. They must effectively communicate and manage patients on mechanical ventilation (MV), a lifesaving intervention for those needing oxygenation and ventilation support to ensure patient satisfaction. Materials and Methods: The study employed a quasi-experimental design with 80 mechanically ventilated patients selected through purposive sampling. Data were collected using demographic and clinical pro forma and a predesigned four-point Likert satisfaction scale comprised 14 items. The intervention group utilized a communication board, while the conventional group received routine care. The aim was to evaluate satisfaction levels in both groups, followed by a posttest on the 5th day using the same instrument. Results: The pretest revealed mean satisfaction scores of 32.47 ± 6.48 and 33.95 ± 6.41 for the intervention and conventional groups, respectively, with a mean difference of 1.47, considered statistically nonsignificant (t 78 = 1.023, P = 0.310). Conversely, posttest scores showed 37.85 ± 8.23 and 34.32 ± 6.18 for the intervention and conventional groups, respectively, with a mean difference of 3.53, indicating statistical significance (t 78 = 2.164, P = 0.034). Hence, the communication board intervention significantly enhanced satisfaction scores among mechanically ventilated patients, underscoring its positive impact on nursing care in terms of patients' satisfaction. Conclusion: Effective communication is crucial in intensive care unit patient care, especially for those unable to speak due to MV. Utilizing communication boards significantly enhances patient satisfaction, highlighting the need for ongoing innovation in critical care nursing. [ABSTRACT FROM AUTHOR]

Background: One of the most vital forms of the affected patient safety is pressure ulcers (PUs), which can be a critical health problem that every day impacts sufferers and healthcare structures. This study aimed to explore the level of nurse's knowledge and perceived barriers regarding PUs prevention among critically ill patients. Methods: This cross-sectional study was conducted among 100 nurses who working in the critical care units (CCUs) at tertiary teaching hospitals in Baghdad City, the study extended from April to June 2024 to assess the nurses' knowledge level using the knowledge perceived barriers on the prevention of PUs questionnaire. The data were analyzed using descriptive and inferential statistics (SPSS version 26). Results: The age of the participants included in this study ranged between 18 and 27 years with a mean age of (28.61 ± 6.603) years and females accounted 55% of total study participants. The highest group of the study population has finished their bachelor's degree (74%). Moreover, less than half of the study population (43%) had <5 years of experience in CCU. Conclusions: Nurses' knowledge on the prevention of PU in CCUs is satisfactory in this study and moderately has a high level of perceived barriers toward PU prevention. Several barriers perceived to affect patients' quality of care regarding proper prevention of PUs were identified by Iraqi CCUs. The findings of this study suggest that several barriers need to be resolved if proper prevention of PUs is to be guaranteed in CCUs. [ABSTRACT FROM AUTHOR]

Aim: Guided by Benner's framework, From Novice to Expert, this study aimed to identify (1) critical soft skills to be evaluated in nurses and (2) levels of nursing behaviour indicating achievement of soft skills to provide a framework for developing a soft skills rubric. Background/Introduction: Nurse shortages are often attributable to high turnover rates among nurses. To improve this situation, healthcare facilities implement transition programmes and continuing education with a primary focus on developing and maintaining nurses' knowledge and performance (hard skills). However, balancing hard and soft skills (beliefs, values and attitudes) is key to nurses' quality of care and ultimately to their retention. Despite the importance of soft skills, their intangible nature creates problems in evaluating nurses' attainment of these skills and in providing constructive feedback to help them set concrete goals for improving their practice. Methods: This qualitative descriptive study described critical soft skills in the nursing context. A purposeful sampling strategy was used to enrol 13 clinical nurse educators from multiple hospital units; each had more than 2 years of clinical nurse educator experience and had completed preceptor training. One‐to‐one interviews with these individuals were audio recorded, transcribed and subjected to direct content analysis using NVivo 12. The study follows the Consolidated criteria for reporting qualitative research (COREQ) guidelines for qualitative studies. Findings: Five main competencies, comprising 20 subcompetencies, were identified: personal growth, effective interactions, professionalism, teamwork and the caring role. For each subcompetency, four skill levels were delineated using clinical indicators. Conclusion: This study's findings can enhance understanding of clinical nurse educators' perceptions regarding soft skills required of nurses. Implications for the profession and/or patient care: The soft skills identified can be incorporated into a rubric to be used by clinical nurse educators to evaluate and guide nurses' professional development and contribute to improving quality of care. No patient or public contribution is required for this study. [ABSTRACT FROM AUTHOR]