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Aim: To investigate the incidence of post-intensive care unit (ICU) depression and its risk factors among critical care survivors., Methods: The study data were extracted from the database of the National Health Insurance Service of Korea. We retrospectively analyzed data from 161,977 adult patients who were admitted to the ICU for more than 24 hr from January 1, 2012 to December 31, 2014 and survived for more than 1 year after discharge. Risk factors for newly diagnosed depression (Code F32) were analyzed using multiple logistic regression analysis., Results: The incidence of post-ICU depression was 18.5%. The major risk factors were enteral nutrition (odds ratio [OR] = 2.28, 95% confidence interval [CI] = 2.19-2.36), cerebrovascular disease (OR = 1.59, 95% CI = 1.54-1.64), and hemi/paraplegia (OR = 1.48, 95% CI = 1.41-1.56). It was observed that cardiopulmonary resuscitation (OR = 0.55, 95% CI = 0.50-0.61) and myocardial infarction (OR = 0.75, 95% CI = 0.71-0.79) lowered depression., Conclusions: The incidence of post-ICU depression was high and influenced by ICU treatment and physical impairments. Healthcare providers must pay attention to the psychological changes in survivors with major risk factors in the recovery process., (© 2019 Japan Academy of Nursing Science.)

Purpose: We aimed to classify nonpharmacological interventions used for preventing delirium in the intensive care unit (ICU), and estimate their effect size., Materials and Methods: In this systematic review and meta-analysis, the literature was searched and studies were selected based on the PRISMA flow chart. Data sources included MEDLINE, Cochrane, CINHAHL, PsyInfo, and EMBASE. We used Cochrane's Effective Practice and Organisation of Care (EPOC) criteria in study design and quality assessment of the meta-analysis., Results: This systematic review and meta-analysis included 35 and 15 studies, respectively. Studies were grouped into nine intervention types: multicomponent (16 studies), physical environment (9), daily interruption of sedation (2), exercise (2), patient education (2), automatic warning system (1), cerebral hemodynamics improving (1), family participation (1), and sedation reducing protocol (1). The effect size of preventive nonpharmacological interventions had an odds ratio (OR) of 0.66 (95% confidence interval [CI], 0.50-0.86) for delirium occurrence, and an OR of 0.31 (95% CI, 0.10-0.94) for delirium duration. Although relevant studies by interventions were lacking, a partial subgroup analysis by intervention was performed., Conclusions: Nonpharmacological interventions were effective in reducing the duration and occurrence of delirium. Consistent application and development of nonpharmacological interventions for use in the ICU are important., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Purpose: The purpose of the study was to analyze the nursing activities related to continuous renal replacement therapy (CRRT) in the intensive care units (ICU). Methods: We developed a list of 31 CRRT related nursing activities based on literature review and reviewed by expert group. A total of 109 direct time measurement records by 43 ICU nurses were collected and analyzed in terms of total time per shift, frequency, standard time, difficulty and performance levels of each CRRT nursing activity. Results: The mean time for CRRT nursing activity was 85.60 minutes per 8 hour shift. Nurses have spent average 9.46±6.98 minutes in a shift for "waste fluid bag change" activity. In addition, "check catheter location" was the most time consuming single activity. The most difficult activity was "counseling-answer" and the most competent one was "dialysis solutions change". Conclusion: The CRRT nursing activities accounted for a significant portion of total nursing workload. Practical allocation of nursing staff for CRRT patient along with development of a new nursing cost system need to be considered. Continuous nursing educational and training programs on CRRT should be developed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the experience of horizontal violence in intensive care unit (ICU) nurses. Methods: This is a methodological triangulation study consists of quantitative and qualitative research methods. A total of 134 ICU nurses from 5 hospitals participated in a survey on nurse to nurse horizontal violence, and the qualitative data were collected through 3 focus group interviews. Results: 94.0% of the participants have experienced horizontal violence within the past 6 months. The question with the highest mean score was "dominating senior nurses mood", and the question with the lowest mean score was "physical assaults". The qualitative data analysis revealed 17 themes on the backgrounds, types, and influence of horizontal violence. Conclusion: The survey result shows that the problem of horizontal violence in ICU nurses is serious, and the focus group interview extracts additional types of horizontal violence such as "scolding in a wrong way", "pressing to resign", "leaving out in the cold", and "burning". Further research needs to be done to build a multidimensional model of horizontal violence in the nursing workplace. [ABSTRACT FROM AUTHOR]