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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]

Background Aim Study Design Methods Results Conclusion Relevance to Clinical Practice Frailty, a geriatric syndrome characterized by decreased resilience, is a known risk factor for mortality in critical care settings and can significantly impact a patient's perception of their own health and prognosis.To explore the relationship between frailty and fear of death in geriatric patients admitted to critical care units.A convergent parallel mixed methods design was applied.Data were collected from 247 geriatric patients in critical care units from March 2023 to February 2024. Quantitative data included clinical frailty score and death anxiety questionnaire. Qualitative data were gathered through semi‐structured interviews with a subset of 34 participants. Quantitative analysis involved descriptive statistics, correlation analysis and multiple linear regression. Qualitative data were analysed thematically using Braun and Clarke's approach.Quantitative analysis revealed a positive significant correlation between frailty and death anxiety (r = 0.19, p = 0.003). Additionally, regression analysis identified age (B = 0.69, 95% CI [0.22, 1.15], p = 0.004), lack of social support (B = 2.88, 95% CI [0.28, 5.47], p = 0.030), lower income (B = −5.33, 95% CI [−9.03, −1.63], p = 0.005) and higher frailty scores (B = 0.83, 95% CI [0.10, 1.56], p = 0.025) as significant predictors of increased death anxiety. Qualitative findings yielded four key themes: the impact of frailty on perception of mortality, the psychological and emotional dimensions of fear of death, the role of the critical care unit environment on fear of death and coping mechanisms and support.Frailty in geriatric critically ill patients heightened death anxiety due to physical decline, existential worries and the overwhelming critical care environment.This study can help nurses provide more personalized care to geriatric patients by addressing both their physical frailty and psychological needs related to fear of death. This, in turn, can improve the quality of care and enhance patient satisfaction. [ABSTRACT FROM AUTHOR]

Background Aim Study Design Results Conclusions Relevance to Clinical Practice Re‐deployment of medical, nursing and Allied Health Professional workforce became a more prevalent feature in filling workforce gaps during the Covid‐19 pandemic; however, very little evidence exists surrounding the impact of this re‐deployment of registered nursing workforce. Prior to the Covid‐19 pandemic and subsequently in an attempt to address nursing shortages across paediatric ward areas, there is a growing trend to utilize registered nursing staff more flexibly to meet the demands of the whole organization.The aim of this study was to explore the incidence impact of re‐deployment to cover workforce shortages in the registered paediatric critical care nursing workforce.This is a cross‐sectional electronic survey of paediatric critical care nurses registered with the Paediatric Critical Care Society as nursing members (n = 688). Anonymous quantitative and qualitative data were collected between January and March 2023. Quantitative data were analysed using descriptive statistics and qualitative data were analysed thematically.There were 225 participant responses representing 21 of the 26 paediatric critical care units within the United Kingdom. This represents a response rate of 33%. The frequency of re‐deployment ranged from zero to two occurrences per month (n = 195; 87%). Thirty percent (n = 67) of respondents felt that re‐deployment to other wards to cover staffing shortfalls impacted the safety of care delivered to the patients. Five themes were identified: Quality of Care, Wellbeing, Teamwork, Training and Support and Leadership.This study demonstrates the significant impact that re‐deployment has on the paediatric critical care nurse population. With retention of experienced critical care nurses at crisis point, it is essential that we identify factors that contribute to this poor retention and address these factors accordingly. Re‐deployment is a significant factor.This study has provided a greater understanding of the impact of re‐deploying paediatric critical care to cover workforce shortages throughout acute hospital settings. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Design Methods Results Conclusions Relevance to Clinical Practice Reporting Method To determine nursing costs for intensive care unit (ICU) patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), assess the correlation with diagnosis‐related group (DRG) payments and identify cost determinants.Prospective, descriptive and quantitative study.From January to December 2022, we selected ICU patients with AECOPD and used time‐driven activity‐based costing method to calculate the overall nursing costs. We examined the cost recovery rate, correlations between nursing costs and DRG Relative Weight, and factors influencing nursing costs using nonparametric tests, Spearman's rank correlation and quantile regression.The median nursing charge was US$1001.88, the median nursing cost was US$678.51, and the average cost recovery rate was 68.39%. Nursing costs correlated with the DRG Relative Weight but not with payments. Length of stay, oxygen therapy mode and noninvasive ventilator use days impacted costs.Nursing costs exceeded charges, with a moderate cost recovery rate. DRG payments do not fully reflect nursing cost variations.Our findings indicate the need to enhance the reimbursement system for nursing costs and to manage ICU nursing expenses by addressing the determinants of these costs.The authors adhered to the EQUATOR network guidelines STROBE to report observational cross‐sectional studies. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To ascertain the current evidence about the support, education and learning needs of experienced registered nurses who are transitioning their work to intensive care nursing as a new context.A scoping review was conducted using established frameworks from JBI, Arksey and O'Malley.A search was conducted in CINHAL and MEDLINE (April 2023). Two researchers independently screened the records, extracted and cross‐checked the data. The results were consolidated narratively in answer to the review questions. The PRISMA‐ScR checklist was used to guide reporting.Eight articles (seven research, one evaluation) were included. The data were widely heterogenous. Evidence pays more attention to education experiences and needs during transition than to mechanisms used informally to engender socialisation of experienced registered nurses into the intensive care team. Key education strategies include orientation, skill and knowledge development, self‐directed learning, preceptorship and mentorship, situated clinical nurse education and expertise sharing from the wider intensive care team. Four papers related to the COVID‐19 pandemic reported education related to patient surges; three papers described team or buddy nursing as an educational strategy. Several articles reported that learning needs and experiences evolve as transition occurs, and intensive care is a specialised learning environment where required skills and knowledge are domain specific. Reality shock can be encountered, education needs can be influenced by prior experience and social connection with and support from the team can make a difference.This review has identified the current state of evidence regarding the support education and learning needs of experienced registered nurses who are transitioning to work in intensive care. The evidence is limited and very heterogeneous. Findings highlight several areas of evidence paucity and some basis for further research. Given the importance of this group to the intensive care workforce, it will be imperative to invest in future research.Attending to the specific learning and support needs of experienced registered nurses who are making transitions to work in intensive care may impact their experiences of transition shock and quality of learning and may make some differences to recruitment and retention of staff.By consolidating the evidence, this scoping review highlights important support, education and learning needs of experienced nurses who are transitioning to intensive care. Insight arising from the review will assist experienced nurses, and those working in education and management, as they seek to engage with and support registered nurses who are making transitions to this context of work. There are genuine gaps in research evidence which will require the investment of nursing researchers internationally.Preferred Reporting Items for Systematic Reviews and Meta‐Analyse extension for Scoping Reviews (PRISMA‐ScR).No patient or public contribution. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession Impact Reporting Method Patient or Public Contribution To explore the perspectives of nurse educators, clinical nurse educators and nurse specialists with regard to supporting the deployed registered nurses in Australian intensive care units during the COVID‐19 pandemic surge.A qualitative‐descriptive study design was used.Intensive care nurse educators, clinical nurse educators and nurse specialists who had been involved with the preparation and support of nurses for deployment to intensive care units for COVID‐19 surge were purposively recruited from around Australia. Data were collected through 18 semi‐structured interviews and examined using thematic framework analysis of NVivo software.Participants described a number of challenges related to surge deployment including the varied skill sets and inadequate preparation for deployed staff, lack of a clear scope of practice and their general reluctance to deploy to intensive care units. Mixed communication from hospital managers about the mandatory or voluntary nature of deployments and the plans for return of nurses to their usual place of work were also considered problematic. Conversely, factors that supported effective deployment included consistently deploying the same staff, scope of practice guides, task cards and colour coding to identify the experience of nurses. The burden of the pandemic, including variable waves of surge, infection control complexities and fear of caring for patients with COVID‐19, influenced the participants' experiences and perspectives. Additionally, there was a significant personal toll for participants because of the increased load of supervising deployed staff and concerns related to accountability for nursing care, and personal and patient safety.The deployment of nursing staff to intensive care units to support increased patient numbers is necessary during surge events. Having clarity about what role those nurses perform within intensive care units is essential in order to design training and support strategies that prepare them adequately so as not to place undue burden on an already strained intensive care nursing workforce.The toll of the COVID pandemic on ICU nurses was immense. This was further compounded by inadequate preparation and the strain of supporting deployed nurses in surged intensive care units.This research outlines the lessons learned from deploying nurses into surged intensive care units in the Australian setting. Supporting deployed nurses places a significant burden on the intensive care team; this is heavier when there is uncertainty about the scope of deployed staff and accountability for patient safety. These findings contribute to the body of evidence that will assist in for planning more effective deployment strategies for future intensive care surge events.Reporting complied with the COREQ criteria for qualitative research.There was no patient or public contribution. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methodology Results Conclusion and Recommendation Relevance to Clinical Practice Patient or Public Contribution Compassion forms the basis for nursing practice and is an essential component of patient‐centered care. It is vital, essential and of great significance to relieve patient's suffering and have a positive impact on the quality of care provided by a nurse. In the context of Tanzania, knowledge on learning and giving compassionate nursing care to patients remained unresearched.To explore nurse's perspectives on how they learn and give compassionate nursing care to patients in ICUs in Tanzania.A qualitative descriptive study design using in‐depth interviews was conducted amongst eleven (11) ICU nurses of two hospitals in Dodoma region. Audio‐recording and notetaking were used to collect data. Data from the audio records were transcribed verbatim and subjected to inductive thematic analysis using manifest codding approach with a semantic focus. We report this paper according to COREQ checklist.Three themes emerged from data that summarised the nurses' perspectives on learning and giving compassionate care to patients in ICUs. These themes included (i) Sources and learning of compassionate nursing care (ii) Practicing compassionate nursing care and (iii) impact of compassionate nursing care. Overall, nurses in this setting expressed compassion to as a combination of empathy, ethical view, duty to care and readiness to go extra mile to address patients needs defined their unique view of compassion.Emphasis of compassionate nursing care in formal training curricula, role modelling on compassion in clinical settings and motivation of nurses in critical care settings may facilitate provision of compassionate nursing care amongst patients in ICUs.The findings of the present study underscore the nurse's perspectives on compassionate nursing care and what motivates and prevents them to provide compassionate care to patients.No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim: The study aims to develop a protocol for the combined use of swaddling, facilitated tucking, expressed breast milk and sucrose administration methods in the orogastric tube (OGT) insertion procedure and evaluate its effectiveness. Methods: The randomized controlled trial was conducted in the Neonatal Intensive Care Unit between 15 February 2022 and 15 September 2022, with 175 preterms. Preterms at 32–34 gestational weeks were randomly allocated to five groups: routine care, swaddling + expressed breast milk, swaddling + sucrose, facilitated tucking + expressed breast milk and facilitated tucking + sucrose groups. The data were collected using the Preterm Descriptive Information Form, the Physiological Measurement Form, the COMFORTneo scale and the Premature Infant Pain Profile (PIPP). Results: The facilitated tucking + expressed breast milk method was found to be more effective than the routine care (pdistress < 0.001; ppain = 0.031) and swaddling + expressed breast milk (pdistress = 0.004; ppain = 0.015) methods in reducing the estimated distress and PIPP pain level of preterms during the procedure. Two minutes after the procedure, the facilitated tucking + expressed breast milk method was more effective than the routine care (p < 0.001), swaddling + expressed breast milk (p = 0.011) and swaddling + sucrose (p = 0.002) methods in reducing the comfort level score. Conclusions: The facilitated tucking + expressed breast milk method is effective in reducing pain and distress and providing comfort during the OGT procedure. Clinical Trials ID: NCT05180058. Summary statement: What is already known about this topic? As there is a paucity of evidence‐based literature on the management of OGT, which is a painful procedure, the management of this pain becomes even more crucial, especially in preterms whose development and complication mechanisms are not completed.There are conflicting results in the literature regarding the effectiveness of expressed breast milk and sucrose, so this study is believed to serve as a research topic for further studies. What this paper adds? The highest mean heart rate, the lowest oxygen saturation, the highest estimate of pain and distress level and the highest comfort and pain score averages of the neonates were found during the procedure, indicating that the OGT procedure is painful.The facilitated tucking + expressed breast milk method was effective in decreasing the estimate of distress and the pain level of newborns during the procedure, decreasing the estimate of pain and distress values 1 min after the procedure and decreasing the comfort level score 2 min after the procedure. The implications of this paper: This study, comparing the effectiveness of using expressed breast milk and sucrose in combination with swaddling and facilitated tucking and developing an application protocol, provides an easy‐to‐use nursing practice for preterm pain management.The protocol was developed for combined swaddling, facilitated tucking, expressed breast milk and sucrose administration, and its effectiveness was evaluated.The facilitated tucking + expressed breast milk method may help nurses as a supportive method in pain management. [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]

The article discusses the 39th Annual British Association of Critical Care Nurses (BACCN) Conference, held on 2–3 September 2024 in Aberdeen, Scotland, emphasizing its inclusive atmosphere and commitment to empowering critical care nurses. Topics discussed include diversity, equity, and inclusion in nursing; advocacy and professional development; and innovative projects and collaborations to improve patient outcomes.

Background Aim Study Design Results Conclusion Relevance for Clinical Practice Family‐led interventions have been identified as effective in many areas of care including the management of delirium. However, because of the heterogeneity and ambiguity of family‐led interventions, they are not consistently applied within intensive care units. A user‐friendly digital intervention may therefore support consistent family integration into delirium management.To explore the feasibility and acceptability of a family member's voice reorientation intervention for delirium prevention and management in an adult intensive care unit.Parallel, convergent mixed‐methods pilot study was conducted in a general adult intensive care unit in the United Kingdom. Thirty participants (15 patients and 15 family members) were enrolled in the study. For the qualitative component, 17 participants (three patients, six family members and eight nurses) contributed to the evaluation.The median frequency of the family member's voice reorientation intervention was 2.3 times per day (range 3.3), and the median Richmond Agitation‐Sedation Scale score was −1 (range 2.5). Qualitative data revealed seven themes: acceptance of the intervention, communication, delirium awareness, reactions to the intervention, cognitive state, perception of the intensive care unit and psychological well‐being.Nurses can involve family members in person‐centred care within the intensive care unit. Results from this study indicate that the family member's voice reorientation programme is feasible and acceptable and may be an effective strategy for providing ongoing orientation, reassurance and comfort to critically ill adult patients to prevent or manage delirium. A larger study is needed to evaluate its impact on delirium.The family member's voice reorientation intervention offers critical care nurses a feasible, family‐centred approach to support delirium care in the intensive care unit. Integrating this non‐invasive tool into practice may enable nurses to enhance patient outcomes, reduce anxiety and strengthen collaboration between patients, families and health care professionals. [ABSTRACT FROM AUTHOR]

Objective Malnutrition in intensive care unit patients significantly affects recovery and increases morbidity and mortality. Adequate nutritional support is essential, but nutritional care is often overlooked, and intensive care nurses play a key role in nutritional management. This study aimed to assess the knowledge levels, attitudes, and perceived quality of nutritional care among intensive care nurses to identify gaps in clinical practice. Methods This cross-sectional study was conducted with 147 intensive care nurses working at Isparta City Hospital. Data were collected using an information form and a validated scale evaluating the importance of nutritional assessment, knowledge of nutritional care, and perceived quality of care. Descriptive statistics, t-tests, ANOVA, Pearson's correlation, and multiple linear regression analyses were used to analyze the data. Results The mean score for the importance of nutritional assessment was 23.39±2.92, knowledge level was 25.24±5.38, and perceived quality of care was 37.53±4.82. A significant relationship was found between positive attitudes toward nutritional care and perceived quality of care (p<0.001). Attitude toward nutritional care significantly predicted perceived quality of care (Adj. R²=0.216, p<0.001). Nurses with higher levels of knowledge also perceived better quality of care. Conclusion Intensive care nurses generally have positive attitudes toward nutritional care, but knowledge gaps and perceived quality of care need improvement. Further studies should explore the effectiveness of different educational strategies in improving nutritional management in intensive care units. Keywords:Nutritional assessment, intensive care units, nurses, attitude, quality of care: [ABSTRACT FROM AUTHOR]

Nurses require optimal competency to deliver safe and high‐quality care to patients with delirium. However, the factors influencing delirium care core competency remain unclear. This study aims to investigate the factors influencing core competency in delirium care among nurses. This study was conducted as a descriptive correlational study following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. A convenience sample of 202 Korean nurses from 15 hospitals completed a structured, web‐based, self‐administered questionnaire. The survey covered general characteristics, delirium care knowledge, moral sensitivity, barriers to delirium care, and core competency in delirium care. Multiple regression analysis identified the factors affecting core competency in delirium care. Results showed that barriers to delirium care, moral sensitivity, academic qualifications, and clinical ladder level were significant factors, accounting for 18.1% of the variance in delirium care core competency. To improve delirium care among nurses, using individual, team, and organizational approaches to address perceived barriers and moral sensitivity is crucial. Competency‐based training programs and administrative support are crucial for enhancing the competency of nurses who are novices and those with associate degrees. [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]

Background: Patients with cardiogenic shock have a 25% to 50% mortality rate despite the introduction of mechanical circulatory devices and coordinated medical treatment. The use of shock teams has improved outcomes for these patients. Local Problem: A cardiovascular hospital with a multidisciplinary shock team had inconsistency and delays in recognition and diagnosis of patients with cardiogenic shock. Methods: A nurse-led, preintervention-postintervention quality improvement project was performed in April and May 2021 and in April and May 2022 within a cardiovascular hospital in north Texas. The 2 nursing staff interventions regarding shock team activation were education and shock alert implementation. Time from first signs to diagnosis (for inpatients) and time from initial transfer request to acceptance (for transferring patients) were measured. Descriptive and statistical analyses were conducted using R, version 4.0.0 (R Foundation for Statistical Computing). Results: The mean (SD) time to diagnosis of cardiogenic shock decreased significantly from 17.98 (28.39) hours in the preintervention group (n = 25) to 8.15 (12.26) hours in the postintervention group (n = 45; P =.045). For patients with cardiogenic shock transferring from referring hospitals, the median (IQR) time to acceptance was 1.55 (0.08-3.18) hours in the preintervention group and 0.35 (0.00-0.72) hours in the postintervention group (P <.001). Conclusions: Nursing staff interventions regarding shock team activation significantly improved the time of diagnosis and acceptance of patients with cardiogenic shock in a cardiovascular hospital, enhancing the overall quality of care provided to these patients. [ABSTRACT FROM AUTHOR]

Background: The intensive care unit environment exposes nurses to high-stress situations that potentially affect their mental and physical health. Resilience is a protective factor that can enhance the well-being of intensive care unit nurses. Objective: To investigate the current evidence regarding resilience in intensive care unit nurses and identify factors that promote resilience. Methods: A comprehensive literature search was undertaken for primary research conducted between January 1990 and December 2022. The updated framework of Whittemore and Knafl was used as a guide. Studies were critically appraised for methodological quality by using the Johns Hopkins Nursing evidence-based practice appraisal tool. Results: Twelve studies were included; most used quantitative methods to measure resilience. The findings indicate that intensive care unit nurses exhibit various levels of resilience, the literature contains inconsistencies about factors affecting resilience, and resilience protects nurses against negative psychological outcomes. Discussion: Nurses' resilience levels should be regularly assessed to identify areas for improvement and gauge the impact of resilience interventions. By continuously monitoring and adapting support strategies on the basis of resilience changes over time, organizations can meet the needs of intensive care unit nurses. Conclusion: More research is needed to comprehend the factors that impact resilience and devise interventions to boost resilience in intensive care nurses. [ABSTRACT FROM AUTHOR]

The author calls for comprehensive training and support to fight workplace violence in the critical care setting. Topics discussed include the role of nurses in enhancing their safety and of their patients, the U.S. Occupational Safety and Health Administration's proposed standard requiring health care employers to develop programs for workplace violence prevention, and evidence-based approaches to violence assessment at the bedside.

Empathy is one of the important components in the patient–nurse relationship. The aim of the study was to explain the culture of empathic care in intensive care unit (ICU) nurses. The present focused ethnographic study was conducted in the cardiac surgery ICU in Tehran. Three methods of observation, interview, and review of existing documents were used to collect data. From data analysis, three cultural models, "Predominance of task-based care over emotion-based care," "Empathy and lack of empathy, two ends of the spectrum of the nurse–patient relationship," and "Empathy, an interactive and reciprocal process," were extracted. The results showed that empathy creates a caring environment where nurses not only understand their patients but also relate to them, and both are affected by it. Policymakers should consider removing barriers as a means of empowering nurses to provide empathic care. [ABSTRACT FROM AUTHOR]

Objective: Care burden threatens the physical, psychological, emotional, and functional health of caregivers. Caring for patients with delirium leads to stress, increased emotional load and workload in nurses. The strain of care for delirium index (SCDI) was developed to measure the subjective burden of nurse’s experience in the care of patients with delirium. The aim of this study is to examine the Turkish validity and reliability of the “The SCDI". Material and Methods: This study was conducted in a methodological and cross-sectional type. The sample consisted of 102 nurses working in the intensive care unit for at least 6 months. Results: The goodness-fit indices obtained in the confirmatory factor analysis were at an acceptable level. In the explanatory factor analysis of the scale, factor loads were found to be between 0.343 and 0.865. Item-to- total correlation coefficients ranged from 0.298 to 0.627 and above 0.20 for each item. Conclusion: Reliability refers to consistency between independent measurements of the same thing. In this study, Cronbach’s alpha coefficient and item-total correlations were used to measure reliability. In this study, the Cronbach’s alpha coefficient was 0.89. Therefore, SCDI has been accepted as a highly reliable measurement tool. In the reliability analysis of the original index, the Cronbach’s alpha coefficient was found to be 0.88. The Turkish version of the SCDI is a valid and reliable scale to evaluate the care difficulty of nurses caring for patients with delirium. [ABSTRACT FROM AUTHOR]

Mental illnesses are the leading causes of disability worldwide. Psychotic disorders occur in about 3% of people in the general population during their lifetimes. Patients experiencing acute psychosis need a medical provider who is capable of differentiating among medical, drug-induced, and psychiatric causes of the presentation to initiate the most appropriate management plan. This article focuses on the role of the acute care NP in medical clearance evaluations and initial management of adult patients experiencing acute psychosis in acute care settings. [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]

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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]

Introduction: This is a phenomenologically designed qualitative study conducted to explore and conceptualize the problems experienced by intensive care nurses caring for patients undergoing continuous renal replacement therapy. Methods: Face‐to‐face, semi‐structured interviews were conducted with the participants. The interviews were transcribed verbatim, then thematic analysis was conducted. Results: The study was conducted 12 intensive care nurses. As a result, 3 main and 6 sub‐themes were identified. The themes identified were changing routines, uncertainty in terms of patient benefit, and need for adaptation. Conclusion: It was found that nurses experienced challenges in providing care to patients undergoing continuous renal replacement therapy, spent more effort to prevent complications, and lacked information on the subject. It is recommended to consider institutional and individual actions to meet the educational needs of nurses for implementing continuous renal replacement therapy. [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.)

ABSTRACT Aim Design Methods Results Conclusions Impact Implications for the Profession Reporting Method Patient or Public Contribution Trial Registration The Intensive Care Unit Randomised Trial Comparing Two Approaches to Oxygen Therapy Trial (ICU‐ROX) compared conservative oxygen therapy with usual care in mechanically ventilated adults in Australian and New Zealand intensive care units. Dissemination focused on publication and presentation, with no targeted approach.The current study aimed to investigate whether health practitioners from intensive care units that participated in ICU‐ROX were more likely to report they knew the trial results and had read the publication than those from intensive care units that did not participate; explore whether there was a difference between doctors' and nurses' knowledge of the ICU‐ROX results and whether they read the publication. Survey using a self‐administered, quantitative design, developed for this study.Convenience sample of 197 Australian and New Zealand intensive care specialist doctors and nurses.There was no difference in the knowledge of the study results between respondents from intensive care units that participated in ICU‐ROX compared to those that did not. Nurses were significantly less likely to have knowledge of the trial results or have read the publication than doctors. The commonest way for doctors and nurses to get the results was by word of mouth at work.Participation in ICU‐ROX did not make a difference to knowledge of the findings. While the dissemination of trial results was extensive, it failed to adequately reach nurses, who play an important role in administering oxygen in intensive care.This study has provided further evidence that nurses working in intensive care were unlikely to read the research results of an important study about oxygen management. Researchers, unit management and nurse leaders need to ensure dissemination methods that will reach nurses are used for research findings. This study followed the STROBE reporting guidelines for observational studies.No patient or public contribution.This study is a substudy of a trial that was prospectively registered before the first participant was recruited: ACTRN12615000957594 [ABSTRACT FROM AUTHOR]

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]

ABSTRACT Aims Design Methods Results Conclusion Implications for the Profession Impact Reporting Method Patient or Public Contribution To elucidate the meaning of moral distress in nurses caring for critically ill neonates.Qualitative study using Husserl's descriptive phenomenology.Between April and December 2022, unstructured interviews were conducted with 11 nurses with at least 3 years of neonatal intensive care unit experience in Japan. They were asked to recall experiences of moral distress and to speak freely about their thoughts and feelings at the time. The analysis followed Colaizzi's seven‐step method.Three themes (‘organisational constraints’, ‘regret’ and ‘unshared experiences’) and seven subtheme clusters were extracted from the nurses' narratives of moral distress, which was the basis of trauma. Subtheme clusters included ‘wavering beliefs’, ‘guilt associated with the death of a child’, ‘powerlessness at being unable to help one's family’ and ‘mismatch with the perceptions and feelings of the family’.Nurses experience various morally distressing events, but these are processed only as personal problems and give rise to feelings of self‐negation. Therefore, trauma can develop as a result of experiences related to decision‐making and the child's best interests. There is a need to improve nurses' moral resilience and ensure their psychological safety to alleviate moral distress.This study clarifies nurses' roles within the neonatal intensive care unit, potentially helping them to handle life‐and‐death issues and cope with feelings of moral distress.This study elucidated the meanings of powerlessness underlying the moral distress experienced by neonatal intensive care unit nurses. These results will contribute to releasing suppressed feelings and thoughts and alleviating unavoidable moral distress in this setting.This study was performed in accordance with the COREQ guidelines.Nurses with experience in neonatal intensive care unit nursing participated as interviewees. They also verified the credibility of survey results and ensured analytical rigour. [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]

ABSTRACT Aim Background Evaluation Key issues Conclusions Implications for clinical practice To identify factors protecting and hindering the well‐being of critical care nurses during the COVID‐19 pandemic.The unique work challenges of critical care nurses can undermine their professional and mental well‐being; as evidenced by the prevailing literature on burnout, compassion fatigue, and moral distress. The COVID‐19 pandemic has seen these professionals on the front lines and has raised many questions about professional well‐being. Identifying the factors that protect and hinder the well‐being of critical care nurses would help to develop the strategies necessary to reduce worrying phenomena associated with professional malaise.A systematic review was conducted using electronic databases including PubMed, CINAHL, Scopus, Cochrane, PsycINFO, and Web on Science.After full text analysis, 25 papers were included in the current systematic review. Factors influencing the well‐being of critical care nurses have been grouped into “Protective” and “Hindering.”This review shows that critical care nurses’ well‐being is influenced by factors like personal resilience and supportive work environments, which enhance their experience. Challenges include sociodemographic issues and the COVID‐19 pandemic's impact. Addressing these factors is crucial for their well‐being and the effectiveness of healthcare systems.The well‐being of nurses is intricately linked to the quality and security of patient care, ultimately influencing clinical outcomes. This review delves deeply into the multifaceted factors that affect the professional well‐being of critical care nurses during the COVID‐19 pandemic. Recognizing these elements is critical for directing health policy toward the development of initiatives that bolster healthcare workers’ welfare. Prioritizing the professional well‐being of nurses is imperative, as it is fundamental in mitigating the increasing inclination towards job turnover, a challenge that is profoundly impacting the healthcare sector. [ABSTRACT FROM AUTHOR]

Background Aim Study Design Results Conclusions Relevance to Clinical Practice Retinopathy is frequently seen in the neonatal intensive care unit (NICU), and its examination is a painful procedure for infants.This randomized active‐controlled trial aimed to investigate the impact of multisensory stimulation (MSS) on neonatal pain during retinopathy of prematurity (ROP) examinations, in comparison with a white noise (WN) and control group receiving standard care.Conducted as a three‐arm, randomized controlled trial, the study was implemented in the NICU of a local university hospital. Recruitment spanned from July 2023 to November 2023, with preterm infants (gestational age < 37 weeks) randomly assigned to either a MSS, WN or a control group. MSS components included visual, auditory, tactile, olfactory and gustatory stimuli, all designed to create a synergistic, comforting environment for the infant during the procedure. Procedural pain, heart rate and oxygen saturation were assessed at various stages before and after ROP examinations.Analysis of 90 participants revealed that the MSS group exhibited lower Premature Infant Pain Profile (PIPP) scores than the WN and control groups (mean difference: −2.12, 95% confidence interval [CI]: −2.62 to −1.62; odds ratio [OR]: 0.004, 95% CI [0.001, 0.012], p < 0.001). Additionally, heart rates were significantly lower in the MSS group (mean difference: −15.3 beats/min, 95% CI: −20.5 to −10.1; OR: 0.025, 95% CI [0.008, 0.073], p < .001) and oxygen saturation levels were higher (mean difference: 3.2%, 95% CI: 1.8% to 4.6%; OR: 1.12, 95% CI [1.05, 1.20], p < .001) than in the other groups.MSS emerges as a favourable, safe and non‐pharmacological intervention for pain management in ROP and similar procedures.Multisensory stimulation can be effectively integrated into the routine care provided by critical care nurses during retinopathy of prematurity examinations in preterm infants. This non‐pharmacological intervention offers a practical approach for critical care nurses to reduce procedural pain and improve physiological stability in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background Aims Study Design Results Conclusions Relevance to Clinical Practice Endotracheal tube suctioning is an effective measure to ensure airway patency during mechanical ventilation; however, inappropriate suction pressure often leads to many adverse effects.This study aimed to investigate safe and effective suction pressures and intracatheter pressure ranges during artificial airway open suctioning procedures.In this double‐blind randomized controlled trial, 438 patients receiving mechanical ventilation in China were divided into nine groups according to their sputum viscosity grades and suction pressure. A random sampling method was used to select one of the three pressure groups (low‐, medium‐ and high‐pressure groups). Registered intensive care unit (ICU) nurses performed open suction manoeuvres of the artificial airway based on the pressures set by the researchers. Two teaching supervisors observed and recorded the sputum viscosity, suction pressure, minimum intracatheter pressure, maximum intracatheter pressure, heart rate, mean arterial pressure, pulse oxygen saturation, airway mucosal bleeding and sputum sound improvement score.This study finally included 438 patients. The results showed that the safe and effective suction pressures were 80–120 mmHg for grade I sputum viscosity, 150 mmHg for grade II sputum viscosity and 200 mmHg for grade III sputum viscosity in open suction procedures for ICU patients. These pressure values were associated with the lowest changes in heart rate, mean arterial pressure and pulse oxygen saturation; the lowest incidence of airway mucosal bleeding; and the highest sputum sound improvement score.In an open suction procedure, accurate setting of safe and effective suction pressure for sputum of different viscosity grades can not only achieve the suction effect but also have minimal impact on the vital signs and airway mucosal bleeding of patients.The findings can guide critical care nurses to accurately select safe and effective initial suction pressure values rather than use general ranges when performing artificial airway open suctioning procedures. [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]

Simulation training in healthcare settings has become a valuable training tool. It provides an ideal formative assessment for interdisciplinary teaching. It provides a high fidelity and highly immersive environment where healthcare staff and students can practice developing their skills in a safe and controlled manner. Simulation training allows staff to practice skills that better prepare them for clinical emergencies, therefore possibly optimising clinical care. While the benefits of simulation education are well understood, establishing a programme for use by critical care staff is complex. Complexities include the highly specialised scenarios that are not typically encountered in non-critical care areas, as well as the need for advanced monitoring equipment, ventilation equipment etc. These 12 tips are intended to assist healthcare educators in navigating the complexities in the establishment of a critical care simulation programme, providing advice on selecting target audiences, learning outcomes, creating a critical care simulation environment and recommendations on evaluation and development of the programme. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) patients admitted to intensive care units (ICUs) exhibit varying survival outcomes due to the unique challenges in managing AD patients. Stratifying patient mortality risk and understanding the criticality of nursing care are important to improve the clinical outcomes of AD patients. This study aimed to leverage machine learning (ML) and electronic health records (EHRs) only consisting of demographics, disease history, and routine lab tests, with a focus on nursing care, to facilitate the optimization of nursing practices for AD patients. We utilized Medical Information Mart for Intensive Care III, an open-source EHR dataset, and AD patients were identified based on the International Classification of Diseases, Ninth Revision codes. From a cohort of 453 patients, a total of 60 features, encompassing demographics, laboratory tests, disease history, and number of nursing events, were extracted. ML models, including XGBoost, random forest, logistic regression, and multi-layer perceptron, were trained to predict the 30-day mortality risk. In addition, the influence of nursing care was analyzed in terms of feature importance using values calculated from both the inherent XGBoost module and the SHapley Additive exPlanations (SHAP) library. XGBoost emerged as the lead model with a high accuracy of 0.730, area under the curve (AUC) of 0.750, sensitivity of 0.688, and specificity of 0.740. Feature importance analyses using inherent XGBoost module or SHAP both indicated the number of nursing care within 14 days post-admission as an important denominator for 30-day mortality risk. When nursing care events were excluded as a feature, stratifying patient mortality risk was also possible but the model's AUC of receiver operating characteristic curve was reduced to 0.68. Nursing care plays a pivotal role in the survival outcomes of AD patients in ICUs. ML models can be effectively employed to predict mortality risks and underscore the importance of specific features, including nursing care, in patient outcomes. Early identification of high-risk AD patients can aid in prioritizing intensive nursing care, potentially improving survival rates. [ABSTRACT FROM AUTHOR]

Background: Burnout is frequent among intensive care unit (ICU) healthcare professionals and may result in medical errors and absenteeism. The COVID‐19 pandemic caused additional strain during working hours and also affected off‐duty life. The aims of this study were to survey burnout levels among ICU healthcare professionals during the first year of COVID‐19, describe those who reported burnout, and analyse demographic and work‐related factors associated with burnout. Methods: This was a national prospective longitudinal cohort study of 484 nurses, physicians and leaders working in intensive care units with COVID‐19 patients in Norway. Burnout was measured at 6‐ and 12‐month follow‐up, after a registration of baseline data during the first months of the COVID epidemic. The Copenhagen Burnout Inventory (CBI), was used (range 0–100), burnout caseness defined as CBI ≥50. Bi‐ and multivariable logistic regression analyses were performed to examine baseline demographic variables and work‐related factors associated with burnout caseness at 12 months. Results: At 6 months, the median CBI score was 17, increasing to 21 at 12 months (p =.037), with nurses accounting for most of the increase. Thirty‐two per cent had an increase in score of more than 5, whereas 25% had a decrease of more than 5. Ten per cent reported caseness of burnout at 6 months and 14% at 12 months (n.s.). The participants with burnout caseness were of significantly lower age, had fewer years of experience, reported more previous anxiety and/or depression, more moral distress, less perceived hospital recognition, and more fear of infection in the bivariate analyses. Burnout was the single standing most reported type of psychological distress, and 24 out of 41 (59%) with burnout caseness also reported caseness of anxiety, depression and/or post‐traumatic stress disorder (PTSD) symptoms. Multivariate analysis showed statistically significant associations of burnout caseness with fewer years of professional experience (p =.041) and borderline significance of perceived support by leader (p =.049). Conclusion: In Norway, a minority of ICU nurses, physicians and leaders reported burnout 1 year into the pandemic. A majority of those with burnout reported anxiety, depression and/or PTSD symptoms combined. Burnout was associated with less years of professional experience. [ABSTRACT FROM AUTHOR]

Background: The pandemic profoundly stressed practicing nurses and could have thereby affected trends in nursing-sensitive quality indicators (NSIs), measures that detect changes in patient health status directly affected by nursing care. Objectives: The aim of the study was to determine if NSIs have worsened in response to the pandemic and then returned to prepandemic levels using data from 2019 through 2022. Methods:We conducted a cross-sectional descriptive study of annual trends, examining unit data from the National Database of Nursing Quality Indicators (NDNQI) from 2019 through 2022 for five indicators: rates of falls, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), hospital-acquired pressure injuries (HAPI), and ventilator-associated events (VAE). The NDNQI is the largest repository of nursing quality indicators, which are derived from patient-level events, reported at the nursing unit level, and submitted quarterly by over 2,000 member hospitals. Adult medical-surgical or critical care inpatient nursing units with complete data for the 4 years were included, with samples ranging from456 to 5,818 nursing units in 2,346 hospitals. Analysis of variance was conducted by comparing the 2019 rates to each subsequent year. Results: In decreasing order of prevalence, the mean prepandemic rates were 6.58 VAE per 1,000 ventilator days (critical care only), 2.41 HAPI per 1,000 device days, 2.20 falls per 1,000 patient days, 0.96 CAUTI per 1,000 catheter days, and 0.68 CLABSI per 1,000 central line days for medical-surgical and critical care units combined. The rates for all five nurse-sensitive indicators increased significantly beginning in 2020 and have begun to decline but have not returned to baseline by 2022. The maximum rate was observed in 2020 for falls and 2021 for the remaining indicators. These increases to the maximum ranged from a 12% increase in CAUTI to 49% for CLABSI. Discussion: NSIs increased during the pandemic and are now returning to baseline. The pandemic underscored the importance of nursing practice. The pandemic's enduring negative effects on the nursing workforce must be addressed to preserve patient safety. [ABSTRACT FROM AUTHOR]

The article highlights the comprehensive focus of the sixth issue of the periodical which addresses critical topics pertinent to nurses in this field. Topics include respiratory care, delirium, and the well-being of patients and families, reflecting a wide range of evidence-based studies and reviews aimed at improving practice and outcomes in critical care settings.

Background: The visit restrictions imposed as a result of COVID‐19 precluded the entrance of the patient's family into the confines of the intensive care unit. Aim: This study evaluated the experiences of intensive care nurses (ICNs) regarding COVID‐19 visit restrictions and their opinions on these restrictions. Study Design: From May 2023 to July 2023, semi‐structured interviews with 15 ICNs from intensive care units in a tertiary public hospital in Türkiye were conducted. Data were analysed using qualitative content analysis with an inductive approach. Reporting of the study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: The analysis revealed two main themes, 'widespread negative impacts of visit restrictions' and 'adaptive strategies to the visitation ban', and seven sub‐themes supporting the main themes. Nurses perceived that the visit restrictions imposed during the COVID‐19 pandemic had a severe negative effect on patients, their relatives, themselves and the care environment. They also did not support visit restriction in future pandemics. Conclusions: The COVID‐19 visitation policy weakened the involvement of family members in patient care and created serious challenges in the intensive care setting. The study revealed an urgent need for patient‐centred, family‐sensitive and consistently applied protocols in future pandemics. Relevance to Clinical Practice: In future pandemics, strategies such as the benefit–benefit ratio of the visit, the provision and use of adequate personal protective equipment, and vaccination requirements should be considered in visiting decisions of patients hospitalized because of infection. Participation of nurses responsible for patient care in decisions regarding visitor practices should be supported. [ABSTRACT FROM AUTHOR]

Background: Compassion and moral intelligence occupy a very significant place in ensuring quality in health care services, increasing patient satisfaction, reducing side effects, increasing patient safety and accelerating the healing process. Aim: This study was conducted to determine the relationship between moral intelligence and compassion fatigue in nurses working in intensive care units. Study Design: In this descriptive and cross‐sectional study, 180 nurses working in intensive care units of a hospital comprised the population of the study. Of them, 114 who agreed to participate in the study were included in the study sample. The Personal Information Form, Yakut Moral Intelligence Scale (YMIS) and Compassion Fatigue‐Short Scale were used as data collection tools. The scales and forms used in the study were created on Google Form. Nurses were visited in intensive care units, and the forms were given to them. Then the participating nurses filled in the forms. Results: Of the nurses participating in the study, 69.3% were women and 65.4% had a bachelor's degree. The analysis of the correlation between the scores obtained from the sub‐dimensions of the YMIS by the nurses participating in the study demonstrated that there was a negative, low‐level significant relationship between the self‐control and kindness sub‐dimensions of the YMIS. As the nurses' compassion fatigue levels increased, their self‐control and kindness levels decreased. Conclusions: It can be said that as compassion fatigue levels increase in nurses, their moral intelligence levels decrease. Therefore, diagnosing compassion fatigue in nurses and taking precautions to prevent them from suffering from fatigue are of significant importance. Relevance to Clinical Practice: By determining the healthy intelligence and compensation spending levels of health workers, organizing maid training will increase the service and care provided. [ABSTRACT FROM AUTHOR]

Background: During the COVID‐19 pandemic, intensive care units (ICUs) were under heavy pressure, with a significantly increased number of severely ill patients. Hospitals introduced restrictions, and families could not visit their ill and dying family members. Patients were cared for without privacy, and several died in shared patient rooms, leaving the intensive care nurse to protect the patient's need for loving care in a vulnerable situation at the end of life. Aim: This study aimed to investigate how piloting and watch over were revealed in end‐of‐life care for patients with COVID‐19 in intensive care COVID‐19. Study Design: A qualitative study was conducted with an abductive approach was conducted. Data were collected via semi‐structured interviews to cover the research area while allowing the informant to talk freely about the topic; 11 informants were interviewed. Results: The findings are presented based on four categories: The road to the decision, End‐of‐life care, Farewell of close family members and Closure. Each category and subcategory reveal how piloting and watch over were addressed in the end‐of‐life care of patients with COVID‐19 in the ICU during the pandemic. Overall findings indicated that workload and organization of care directly affect the quality of care given, the acceptance of privacy and the possibility of dignified end‐of‐life care. Conclusions: Workload directly affects the quality of care, risking dehumanization of the patient. Visiting restrictions hindered supporting family members through the various piloting phases. Visiting restrictions also forced the ICU nurses to take on the role of the relative in watching over the patient. Relevance to Clinical Practice: Collaboration with family members is essential for the intensive care nurse to be able to provide a person‐centred and dignified end‐of‐life care. [ABSTRACT FROM AUTHOR]