Pub Date : 2026-04-01Epub Date: 2026-02-02DOI: 10.1016/j.enfi.2025.500588
Marta Raurell-Torredà RN, PhD , Ignacio Zaragoza-García RN, PhD , Francisco Javier Sánchez-Chillón RN, MSN , Martin Torralba-Melero RN, MSN , Oscar Arrogante RN, PhD , María Jesús Frade Mera RN, PhD , Elena Maestre RN, MSN , Mariona Farrés-Tarafa RN, PhD
Introduction
Post Intensive Care Syndrome (PICS) can be prevented by applying the components of the ABCDE bundle (mainly pain management, sedation, delirium and early mobilization).
Objective
To design and validate the simulation-based SIMUPICS course to train knowledge and skills related to the application of the ABCDE bundle.
Methods
Descriptive study of metric characteristics. Analysis of the face and content validity of the course with experts from the working groups of the Spanish Society of Intensive Care Nurses and Coronary Units (SEEIUC). Pilot test with at least 30 intensive care unit (ICU) nurses to assess applicability of the course in ICUs.
Results
Two Delphi rounds were carried out until 85% of the items were agreed as optimal and an Aiken V between 0.82 and 1. The nurses who participated in the pilot test (n = 38) considered that the simulation received had helped them to identify key actions in the prevention of post-ICU syndrome (5 [4-5]) with a Likert scale from 1 totally disagree to 5 totally agree, and that the structure of the course (stations, duration, dynamics) facilitated practical learning (5 [4-5]).
Conclusions
The SIMUPICS course, validated by nursing experts in analgesia, delirium and mobilization practices, is useful for training skills and knowledge related to the ABCDE bundle. Its design based on clinical simulation makes it a suitable strategy for the continuing education of health professionals, both in situ in the ICU itself and in simulation centers.
{"title":"SIMUPICS: curso basado en simulación para la prevención del síndrome post-UCI","authors":"Marta Raurell-Torredà RN, PhD , Ignacio Zaragoza-García RN, PhD , Francisco Javier Sánchez-Chillón RN, MSN , Martin Torralba-Melero RN, MSN , Oscar Arrogante RN, PhD , María Jesús Frade Mera RN, PhD , Elena Maestre RN, MSN , Mariona Farrés-Tarafa RN, PhD","doi":"10.1016/j.enfi.2025.500588","DOIUrl":"10.1016/j.enfi.2025.500588","url":null,"abstract":"<div><h3>Introduction</h3><div>Post Intensive Care Syndrome (PICS) can be prevented by applying the components of the ABCDE bundle (mainly pain management, sedation, delirium and early mobilization).</div></div><div><h3>Objective</h3><div>To design and validate the simulation-based SIMUPICS course to train knowledge and skills related to the application of the ABCDE bundle.</div></div><div><h3>Methods</h3><div>Descriptive study of metric characteristics. Analysis of the face and content validity of the course with experts from the working groups of the Spanish Society of Intensive Care Nurses and Coronary Units (SEEIUC). Pilot test with at least 30 intensive care unit (ICU) nurses to assess applicability of the course in ICUs.</div></div><div><h3>Results</h3><div>Two Delphi rounds were carried out until 85% of the items were agreed as optimal and an Aiken V between 0.82 and 1. The nurses who participated in the pilot test (n<!--> <!-->=<!--> <!-->38) considered that the simulation received had helped them to identify key actions in the prevention of post-ICU syndrome (5 [4-5]) with a Likert scale from 1 totally disagree to 5 totally agree, and that the structure of the course (stations, duration, dynamics) facilitated practical learning (5 [4-5]).</div></div><div><h3>Conclusions</h3><div>The SIMUPICS course, validated by nursing experts in analgesia, delirium and mobilization practices, is useful for training skills and knowledge related to the ABCDE bundle. Its design based on clinical simulation makes it a suitable strategy for the continuing education of health professionals, both in situ in the ICU itself and in simulation centers.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500588"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-15DOI: 10.1016/j.enfi.2025.500586
Marta Rodríguez-Navarro MD, Montserrat Pujol-Jover MD, Maria Lourdes Ausin-Garcia MD, Beatriz Soria-Navarro MD, Roser Riera-Mas RN
Aims
The primary objective was to identify the factors associated with the success rate of intraosseous (IO) access placement in patients attended by a Pediatric and Neonatal Transport (PNT) unit.
Methods
We conducted a retrospective descriptive study between January 2021 and September 2025, including all pediatric and neonatal patients (0-16 years) who required intraosseous (IO) access during care provided by the TPN team. Demographic, clinical, and procedural data were collected. Descriptive statistics were used, and associations with the primary outcome (successful IO access placement) were assessed using the Chi-square test for categorical variables (age group, operator, needle type, and anatomical site) and the Mann–Whitney U test for numerical variables (weight and age).
Results
Sixty IO access attempts were analyzed in 45 patients. The overall success rate was 88.3% (n = 53). Anatomical site was significantly associated with successful placement (P=.01), with the proximal tibia being the most frequently used and effective site, followed by femur and humerus. No association was found with patient age, needle size, or the provider performing the procedure. Complications occurred in 15.1% of cases, all due to extravasation, with a higher incidence in younger and lower-weight patients.
Conclusions
The IO access is an effective alternative to vascular access in critically ill pediatric and neonatal patients. Placement success is significantly influenced by anatomical site. Neonates show a tendency toward lower success rates and higher incidence of extravasation.
{"title":"Acceso vascular intraóseo en transporte pediátrico y neonatal especializado. Estudio descriptivo","authors":"Marta Rodríguez-Navarro MD, Montserrat Pujol-Jover MD, Maria Lourdes Ausin-Garcia MD, Beatriz Soria-Navarro MD, Roser Riera-Mas RN","doi":"10.1016/j.enfi.2025.500586","DOIUrl":"10.1016/j.enfi.2025.500586","url":null,"abstract":"<div><h3>Aims</h3><div>The primary objective was to identify the factors associated with the success rate of intraosseous (IO) access placement in patients attended by a Pediatric and Neonatal Transport (PNT) unit.</div></div><div><h3>Methods</h3><div>We conducted a retrospective descriptive study between January 2021 and September 2025, including all pediatric and neonatal patients (0-16 years) who required intraosseous (IO) access during care provided by the TPN team. Demographic, clinical, and procedural data were collected. Descriptive statistics were used, and associations with the primary outcome (successful IO access placement) were assessed using the Chi-square test for categorical variables (age group, operator, needle type, and anatomical site) and the Mann–Whitney U test for numerical variables (weight and age).</div></div><div><h3>Results</h3><div>Sixty IO access attempts were analyzed in 45 patients. The overall success rate was 88.3% (n<!--> <!-->=<!--> <!-->53). Anatomical site was significantly associated with successful placement (<em>P</em>=.01), with the proximal tibia being the most frequently used and effective site, followed by femur and humerus. No association was found with patient age, needle size, or the provider performing the procedure. Complications occurred in 15.1% of cases, all due to extravasation, with a higher incidence in younger and lower-weight patients.</div></div><div><h3>Conclusions</h3><div>The IO access is an effective alternative to vascular access in critically ill pediatric and neonatal patients. Placement success is significantly influenced by anatomical site. Neonates show a tendency toward lower success rates and higher incidence of extravasation.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500586"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-02-04DOI: 10.1016/j.enfi.2026.500590
Thayanne Chaves RN , Ariel Pereira da Silva , Isabella Rosmino , João Paulo Victorino RN, CCNS, PhD , Talita Rodrigues PT , Daniel Santos PhD , Vagner Pires de Campos Junior PT
Evaluation
A 63-year-old female Jehovah's Witness with familial idiopathic pulmonary fibrosis underwent elective bilateral lung transplantation at a private quaternary hospital in southeastern Brazil. Intraoperatively, Cell Saver technology was used to minimize blood loss. Postoperatively, she developed severe anemia (Hb <7 g/dL), primary graft dysfunction (grade 2), and septic shock. Due to her religious beliefs, she refused allogeneic blood transfusion, creating unique challenges for the intensive care team.
Diagnosis
Nursing diagnoses included risk of ineffective tissue perfusion related to severe anemia and transfusion refusal; impaired gas exchange secondary to graft dysfunction; risk of infection and sepsis due to immunosuppression; and potential spiritual distress associated with religious restrictions in the context of critical illness.
Planning
The care plan focused on pharmacological stimulation of erythropoiesis, continuous hemodynamic and respiratory monitoring, renal replacement therapy, infection control, and individualized rehabilitation strategies. Ethical principles – particularly autonomy – guided all shared decision-making and documentation.
Discussion
Despite comprehensive interdisciplinary interventions, the patient developed progressive clinical deterioration and died. This case emphasizes the importance of structured nursing care, integration of bioethical principles, and institutional preparedness in managing complex postoperative scenarios when transfusion is not an option. It highlights the nurse's central role in coordinating technical, psychosocial, and spiritual care needs, ensuring that patient-centered values remain at the core of critical care.
{"title":"Integrated and structured care in lung transplantation for a Jehovah's Witness patient","authors":"Thayanne Chaves RN , Ariel Pereira da Silva , Isabella Rosmino , João Paulo Victorino RN, CCNS, PhD , Talita Rodrigues PT , Daniel Santos PhD , Vagner Pires de Campos Junior PT","doi":"10.1016/j.enfi.2026.500590","DOIUrl":"10.1016/j.enfi.2026.500590","url":null,"abstract":"<div><h3>Evaluation</h3><div>A 63-year-old female Jehovah's Witness with familial idiopathic pulmonary fibrosis underwent elective bilateral lung transplantation at a private quaternary hospital in southeastern Brazil. Intraoperatively, Cell Saver technology was used to minimize blood loss. Postoperatively, she developed severe anemia (Hb <7<!--> <!-->g/dL), primary graft dysfunction (grade 2), and septic shock. Due to her religious beliefs, she refused allogeneic blood transfusion, creating unique challenges for the intensive care team.</div></div><div><h3>Diagnosis</h3><div>Nursing diagnoses included risk of ineffective tissue perfusion related to severe anemia and transfusion refusal; impaired gas exchange secondary to graft dysfunction; risk of infection and sepsis due to immunosuppression; and potential spiritual distress associated with religious restrictions in the context of critical illness.</div></div><div><h3>Planning</h3><div>The care plan focused on pharmacological stimulation of erythropoiesis, continuous hemodynamic and respiratory monitoring, renal replacement therapy, infection control, and individualized rehabilitation strategies. Ethical principles – particularly autonomy – guided all shared decision-making and documentation.</div></div><div><h3>Discussion</h3><div>Despite comprehensive interdisciplinary interventions, the patient developed progressive clinical deterioration and died. This case emphasizes the importance of structured nursing care, integration of bioethical principles, and institutional preparedness in managing complex postoperative scenarios when transfusion is not an option. It highlights the nurse's central role in coordinating technical, psychosocial, and spiritual care needs, ensuring that patient-centered values remain at the core of critical care.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500590"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-29DOI: 10.1016/j.enfi.2025.500584
Elena Moreta-Gil RN , Cristina Rivera-Picón PhD , Rosa Conty-Serrano PhD , Begoña Polonio-López PhD , José L. Martín-Conty PhD , Francisco Martín-Rodríguez PhD , Ancor Sanz-García PhD
Introduction
Triage, and in particular scales, are a tool that allows patients with clinical risk to be managed for early, effective and efficient care.
Objective
To identify the most precise and specific prehospital score for the detection of clinical worsening risk in COVID-19 patients.
Methods
The protocol followed for the integrative review was the PRISMA method 2020. A literature search was performed in five databases: Scopus, Cochrane Library, Pubmed, Embase, Prospero and Lit-covid-NIH-NLM. Based on 19 keywords, 5 inclusion and 5 exclusion points. Finally, 22 articles were selected.
Results
Twenty-two studies were identified that addressed effective outcomes for early measures such as telephone triage, web, protocols or tools such as scales. We compared the functionality of 12 scales in patients with COVID-19, showing that the most important variables for this early assessment of clinical worsening were systolic blood pressure, temperature, oxygen saturation and the need for oxygen supplementation. The best predictive value for clinical deterioration and mortality was obtained by NEWS score, with sensitivities and specificities ranging from 77 to 88%.
Conclusions
Prehospital scales are still under development, with few research studies and a relative confidence in their statistical values. Nonetheless, it has been observed that the scale that best fit the COVID-19 was NEWS with an optimal prediction for patients. This could pave the way for its use under other relevant clinical scenarios, such as acute respiratory infections, exacerbations of chronic diseases or future health emergencies.
{"title":"Prehospital early warning scores for predicting clinical deterioration of COVID-19 patients: An integrative review","authors":"Elena Moreta-Gil RN , Cristina Rivera-Picón PhD , Rosa Conty-Serrano PhD , Begoña Polonio-López PhD , José L. Martín-Conty PhD , Francisco Martín-Rodríguez PhD , Ancor Sanz-García PhD","doi":"10.1016/j.enfi.2025.500584","DOIUrl":"10.1016/j.enfi.2025.500584","url":null,"abstract":"<div><h3>Introduction</h3><div>Triage, and in particular scales, are a tool that allows patients with clinical risk to be managed for early, effective and efficient care.</div></div><div><h3>Objective</h3><div>To identify the most precise and specific prehospital score for the detection of clinical worsening risk in COVID-19 patients.</div></div><div><h3>Methods</h3><div>The protocol followed for the integrative review was the PRISMA method 2020. A literature search was performed in five databases: Scopus, Cochrane Library, Pubmed, Embase, Prospero and Lit-covid-NIH-NLM. Based on 19 keywords, 5 inclusion and 5 exclusion points. Finally, 22 articles were selected.</div></div><div><h3>Results</h3><div>Twenty-two studies were identified that addressed effective outcomes for early measures such as telephone triage, web, protocols or tools such as scales. We compared the functionality of 12 scales in patients with COVID-19, showing that the most important variables for this early assessment of clinical worsening were systolic blood pressure, temperature, oxygen saturation and the need for oxygen supplementation. The best predictive value for clinical deterioration and mortality was obtained by NEWS score, with sensitivities and specificities ranging from 77 to 88%.</div></div><div><h3>Conclusions</h3><div>Prehospital scales are still under development, with few research studies and a relative confidence in their statistical values. Nonetheless, it has been observed that the scale that best fit the COVID-19 was NEWS with an optimal prediction for patients. This could pave the way for its use under other relevant clinical scenarios, such as acute respiratory infections, exacerbations of chronic diseases or future health emergencies.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500584"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-02-11DOI: 10.1016/j.enfi.2026.500589
Marc Pañero-Moreno RN, MSc , Cristina Carbonell-Sabate RN , Rut Conesa-González RN , Laura Risco-Patiño RN , Eva Maria Guix-Comellas RN, MSN, PhD , Alberto Villamor-Ordozgoiti RN, MSN, PhD , Tània Cordón-Arnau RN
Introduction
Glycemic control in critically ill patients is essential to prevent complications. This study evaluates the use of continuous glucose monitoring (CGM) in a 58-year-old patient with acute myocardial infarction, complicated by intraventricular communication and progression to cardiogenic shock, admitted to the intensive care unit (ICU).
Methods
The patient received advanced hemodynamic support with extracorporeal membrane oxygenation, intra-aortic balloon pump, and continuous renal replacement therapy. A Dexcom G7 sensor was used for 10.5 days to monitor glucose levels. Accuracy (Mean Absolute Relative Difference [MARD]) and clinical reliability (Clarke Error Grid) were analyzed, along with the impact on glycemic control and nursing workload.
Results
The CGM system showed preliminarily high accuracy, with a MARD of 7.12%, and 100% of values fell within zones A and B of the Clarke Error Grid. During 98.00% of the monitored time, glucose remained within the target range (70-180 mg/dL), with a mean of 138 mg/dL and no hypoglycaemic episodes. A 27.62% reduction in point-of-care glucose (POC-G) measurements was observed, and the need for capillary glucose testing was eliminated.
Discussion
This case aligns with findings from other authors, demonstrating that CGM in critically ill patients requiring advanced hemodynamic support is accurate, reduces invasive procedures and nursing workload, and improves glycemic control. Larger clinical trials are needed to validate its routine use in the ICU.
Conclusions
CGM in patients with advanced hemodynamic support shows high accuracy and effectiveness, reducing invasiveness and nursing burden, and positioning itself as a promising tool for glycemic management in intensive care, but more clinical trials are needed.
{"title":"Monitorización continua de glucosa en un paciente crítico con oxigenación por membrana extracorpórea (ECMO), balón de contrapulsación intraaórtico y terapia de reemplazo renal continua: caso clínico","authors":"Marc Pañero-Moreno RN, MSc , Cristina Carbonell-Sabate RN , Rut Conesa-González RN , Laura Risco-Patiño RN , Eva Maria Guix-Comellas RN, MSN, PhD , Alberto Villamor-Ordozgoiti RN, MSN, PhD , Tània Cordón-Arnau RN","doi":"10.1016/j.enfi.2026.500589","DOIUrl":"10.1016/j.enfi.2026.500589","url":null,"abstract":"<div><h3>Introduction</h3><div>Glycemic control in critically ill patients is essential to prevent complications. This study evaluates the use of continuous glucose monitoring (CGM) in a 58-year-old patient with acute myocardial infarction, complicated by intraventricular communication and progression to cardiogenic shock, admitted to the intensive care unit (ICU).</div></div><div><h3>Methods</h3><div>The patient received advanced hemodynamic support with extracorporeal membrane oxygenation, intra-aortic balloon pump, and continuous renal replacement therapy. A Dexcom G7 sensor was used for 10.5<!--> <!-->days to monitor glucose levels. Accuracy (Mean Absolute Relative Difference [MARD]) and clinical reliability (Clarke Error Grid) were analyzed, along with the impact on glycemic control and nursing workload.</div></div><div><h3>Results</h3><div>The CGM system showed preliminarily high accuracy, with a MARD of 7.12%, and 100% of values fell within zones<!--> <!-->A and<!--> <!-->B of the Clarke Error Grid. During 98.00% of the monitored time, glucose remained within the target range (70-180<!--> <!-->mg/dL), with a mean of 138<!--> <!-->mg/dL and no hypoglycaemic episodes. A 27.62% reduction in point-of-care glucose (POC-G) measurements was observed, and the need for capillary glucose testing was eliminated.</div></div><div><h3>Discussion</h3><div>This case aligns with findings from other authors, demonstrating that CGM in critically ill patients requiring advanced hemodynamic support is accurate, reduces invasive procedures and nursing workload, and improves glycemic control. Larger clinical trials are needed to validate its routine use in the ICU.</div></div><div><h3>Conclusions</h3><div>CGM in patients with advanced hemodynamic support shows high accuracy and effectiveness, reducing invasiveness and nursing burden, and positioning itself as a promising tool for glycemic management in intensive care, but more clinical trials are needed.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500589"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-13DOI: 10.1016/j.enfi.2025.500585
Hernando Parra-Reyes RN, MSc, Alejandra Mendoza-Monsalve RN, MSc, Faride Astrid Sarabia-Herrera RN, Adriana Camila Rincon-Ascanio RN, Edgar Fabian Manrique-Hernandez MD, MSc, Alexandra Hurtado-Ortiz Msc, Maricel Licht-Ardila RN, MSc
Introduction
Caring for neonatal intensive care unit patients requires precise, individualized, and compassionate care. Roy's Adaptation Model and Swanson's Theory of Caring provide complementary frameworks for addressing physiological and emotional needs. Integrated with the Nursing Care Process (NCP) and standardized languages (NANDA-I, NIC, NOC), these models support systematic, evidence-based, and family-centered neonatal nursing care. The objective was to describe the most frequently identified nursing diagnoses, interventions, and outcomes in NICU patients, guided by the theoretical perspectives of Callista Roy and Kristen Swanson.
Methods
A cross-sectional observational study was conducted using nursing records from a NICU in Colombia (September 2023–February 2024). The NCP was implemented based on Roy's Adaptation Model and Swanson's Theory of Caring. Records including all five NCP phases were analyzed. Diagnoses, interventions, and outcomes were classified using NANDA-I, NIC, and NOC taxonomies, respectively. Variables were grouped by gestational age (<32, 32–34, >34 weeks) and summarized using descriptive statistics.
Results
Among 180 neonates, median gestational age: 31.2 weeks (IQR: 28–36.1); birth weight: 1420–g (IQR: 1040–2290), 73.3% delivered by cesarean section. Frequent diagnoses included impaired gas exchange (27.2%) and ineffective breathing pattern (15.6%). Main interventions were airway management (15.0%) and oxygen therapy (12.2%). Oxygen desaturation (51.1%) was the most common focal stimulus.
Conclusion
Integrating Roy's Adaptation Model and Swanson's Theory of Caring into the NCP framed a structured and family-centered approach to neonatal care standardized taxonomies facilitated decision-making, highlighting the role of nursing judgment in addressing physiological and emotional needs in preterm infants.
{"title":"Descriptive cross-sectional analysis of nursing diagnoses, interventions, and outcomes in neonatal intensive care based on Roy's and Swanson's models","authors":"Hernando Parra-Reyes RN, MSc, Alejandra Mendoza-Monsalve RN, MSc, Faride Astrid Sarabia-Herrera RN, Adriana Camila Rincon-Ascanio RN, Edgar Fabian Manrique-Hernandez MD, MSc, Alexandra Hurtado-Ortiz Msc, Maricel Licht-Ardila RN, MSc","doi":"10.1016/j.enfi.2025.500585","DOIUrl":"10.1016/j.enfi.2025.500585","url":null,"abstract":"<div><h3>Introduction</h3><div>Caring for neonatal intensive care unit patients requires precise, individualized, and compassionate care. Roy's Adaptation Model and Swanson's Theory of Caring provide complementary frameworks for addressing physiological and emotional needs. Integrated with the Nursing Care Process (NCP) and standardized languages (NANDA-I, NIC, NOC), these models support systematic, evidence-based, and family-centered neonatal nursing care. The objective was to describe the most frequently identified nursing diagnoses, interventions, and outcomes in NICU patients, guided by the theoretical perspectives of Callista Roy and Kristen Swanson.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted using nursing records from a NICU in Colombia (September 2023–February 2024). The NCP was implemented based on Roy's Adaptation Model and Swanson's Theory of Caring. Records including all five NCP phases were analyzed. Diagnoses, interventions, and outcomes were classified using NANDA-I, NIC, and NOC taxonomies, respectively. Variables were grouped by gestational age (<32, 32–34, >34 weeks) and summarized using descriptive statistics.</div></div><div><h3>Results</h3><div>Among 180 neonates, median gestational age: 31.2 weeks (IQR: 28–36.1); birth weight: 1420–g (IQR: 1040–2290), 73.3% delivered by cesarean section. Frequent diagnoses included impaired gas exchange (27.2%) and ineffective breathing pattern (15.6%). Main interventions were airway management (15.0%) and oxygen therapy (12.2%). Oxygen desaturation (51.1%) was the most common focal stimulus.</div></div><div><h3>Conclusion</h3><div>Integrating Roy's Adaptation Model and Swanson's Theory of Caring into the NCP framed a structured and family-centered approach to neonatal care standardized taxonomies facilitated decision-making, highlighting the role of nursing judgment in addressing physiological and emotional needs in preterm infants.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500585"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To analyze the agreement between NU-DESC and CAM-ICU scales in detecting hyperactive and hypoactive delirium in adult patients at a tertiary hospital, testing the alternative hypothesis (HA) of significant concordance.
Method
Cross-sectional study of 105 patients (18-85 years) under moderate sedation and ventilatory weaning, assessed with NU-DESC and CAM-ICU at three time points after staff training. Concordance was evaluated using the Kappa index.
Results
Mean age: 45 years (52% male, 48% female). Initial agreement: Kappa = 0.758 (good, p < 0.001); second measurement: Kappa = 0.448 (moderate, p < 0.001); third measurement: Kappa = 0.848 (very good, p < 0.001). Variability reflects differences in sensitivity across delirium phases.
Discussion
NU-DESC was optimal for initial screening (speed), while CAM-ICU showed higher accuracy in advanced stages. Their combined use captures dynamic delirium manifestations.
Conclusion
HA was confirmed, proving that integrating NU-DESC and CAM-ICU enhances delirium detection and management in critically ill patients, adapting to their evolving clinical needs.
{"title":"Concordancia entre NU-DESC y CAM-ICU para detectar el delirio en entornos hospitalarios de alta complejidad","authors":"César Flores-Galicia RN, MSN , Gandhy Ponce-Gomez RN, MSN, PhD , Alejandra Valencia-Cruz MSc, PhD","doi":"10.1016/j.enfi.2025.500587","DOIUrl":"10.1016/j.enfi.2025.500587","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the agreement between NU-DESC and CAM-ICU scales in detecting hyperactive and hypoactive delirium in adult patients at a tertiary hospital, testing the alternative hypothesis (HA) of significant concordance.</div></div><div><h3>Method</h3><div>Cross-sectional study of 105 patients (18-85 years) under moderate sedation and ventilatory weaning, assessed with NU-DESC and CAM-ICU at three time points after staff training. Concordance was evaluated using the Kappa index.</div></div><div><h3>Results</h3><div>Mean age: 45 years (52% male, 48% female). Initial agreement: Kappa<!--> <!-->=<!--> <!-->0.758 (good, p<!--> <!--><<!--> <!-->0.001); second measurement: Kappa<!--> <!-->=<!--> <!-->0.448 (moderate, p<!--> <!--><<!--> <!-->0.001); third measurement: Kappa<!--> <!-->=<!--> <!-->0.848 (very good, p<!--> <!--><<!--> <!-->0.001). Variability reflects differences in sensitivity across delirium phases.</div></div><div><h3>Discussion</h3><div>NU-DESC was optimal for initial screening (speed), while CAM-ICU showed higher accuracy in advanced stages. Their combined use captures dynamic delirium manifestations.</div></div><div><h3>Conclusion</h3><div>HA was confirmed, proving that integrating NU-DESC and CAM-ICU enhances delirium detection and management in critically ill patients, adapting to their evolving clinical needs.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500587"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A premature birth involves stress derived from the context of the NICU where the baby is cared for. In addition, the separation between mother and father/couple and child involves an interruption of the biological process of breastfeeding. The experiences lived in this process between mother and father/couple are unequal, which entails different care needs to be covered by the health professional through informative and educational activities.
Objective
To explore the experiences of mothers and fathers/couple breastfeeding PTNB during their stay in the NICU.
Design and methods
A qualitative phenomenological study was carried out. The population studied were mothers and fathers/couple of PTNB in a neonatal unit who were breastfeeding. Using purposive convenience sampling and the principle of information saturation, the participants were 5 mothers and 4 fathers. Semi-structured interviews were conducted and organized into the following thematic areas: knowledge, environment, feelings, coping strategies and challenges.
Results
The mothers’ and fathers’/couples’ experiences are grouped into four themes: previous lack of knowledge about the breastfeeding process, BF as a personal challenge, barriers and facilitators during the process of breastfeeding a PTNB, and the feelings of the families.
Conclusions
From the perceptions and feelings reported by breastfeeding mothers and fathers/couples of PTNB, changes can be made to improve nursing care in the NICU. Improving early expressing within the first hour, developing specific protocols for breastfeeding in PTNB and updated training for nursing staff are aspects that emerge from the study and could help to priorities and meet the expressed needs for breastfeeding support in the NICU.
{"title":"Experiencias percibidas por las madres y padres sobre la lactancia materna de un recién nacido prematuro en una unidad de cuidados intensivos neonatales","authors":"Èlia Santiveri-Camacho RN, MSc , Alejandro Bosch-Alcaraz RN, PNP, MSc, PhD , Mariela Patricia Aguayo-González RN, MSc, PhD , M. Ángeles Saz-Roy RN, PNP, MSc, PhD","doi":"10.1016/j.enfi.2025.500571","DOIUrl":"10.1016/j.enfi.2025.500571","url":null,"abstract":"<div><h3>Introduction</h3><div>A premature birth involves stress derived from the context of the NICU where the baby is cared for. In addition, the separation between mother and father/couple and child involves an interruption of the biological process of breastfeeding. The experiences lived in this process between mother and father/couple are unequal, which entails different care needs to be covered by the health professional through informative and educational activities.</div></div><div><h3>Objective</h3><div>To explore the experiences of mothers and fathers/couple breastfeeding PTNB during their stay in the NICU.</div></div><div><h3>Design and methods</h3><div>A qualitative phenomenological study was carried out. The population studied were mothers and fathers/couple of PTNB in a neonatal unit who were breastfeeding. Using purposive convenience sampling and the principle of information saturation, the participants were 5 mothers and 4 fathers. Semi-structured interviews were conducted and organized into the following thematic areas: knowledge, environment, feelings, coping strategies and challenges.</div></div><div><h3>Results</h3><div>The mothers’ and fathers’/couples’ experiences are grouped into four themes: previous lack of knowledge about the breastfeeding process, BF as a personal challenge, barriers and facilitators during the process of breastfeeding a PTNB, and the feelings of the families.</div></div><div><h3>Conclusions</h3><div>From the perceptions and feelings reported by breastfeeding mothers and fathers/couples of PTNB, changes can be made to improve nursing care in the NICU. Improving early expressing within the first hour, developing specific protocols for breastfeeding in PTNB and updated training for nursing staff are aspects that emerge from the study and could help to priorities and meet the expressed needs for breastfeeding support in the NICU.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500571"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To identify the risk factors and the main preventive measures in scientific literature related to the development of corneal injury in critically ill patients.
Methods
This is a scoping review, with a protocol previously registered on the Open Science Framework platform. The study was guided by the methodological guidelines of the Joanna Briggs Institute and followed the PRISMA-ScR framework. The research question was developed based on the PCC strategy. The search was conducted in the LILACS, PubMed, and SciELO databases, and in the gray literature via the CAPES Periodicals portal, with no language or time restrictions. The following descriptors were used: Corneal Injuries, Patient Care, Nursing, and Intensive Care Units. Two independent reviewers, with a third reviewer involved in case of disagreements, performed Screening and selection of studies. The steps followed the methodological recommendations for scoping reviews, aiming to map evidence on risk factors and preventive measures for corneal injuries in patients hospitalized in intensive care units.
Results
The studies analyzed indicate that the main risk factors for the development of ophthalmological injuries are higher among critically ill patients on mechanical ventilation, those under sedation and those with a decreased level of consciousness. Simple, effective nursing interventions are essential to the prevention of corneal injuries, contributing to the maintenance of ocular integrity of the patient.
Conclusion
Increasing the knowledge and training of nurses concerning ophthalmological care can contribute to greater awareness of the relevance of corneal injuries in critically ill patients, which is a crucial aspect of nursing care.
{"title":"Risk factors and preventive measures for corneal injury in the intensive care unit: Scoping review","authors":"Felicialle Pereira-da-Silva RN, PhD , Joana Estefanny de França-Oliveira RN , Raphael Alves da-Silva RN , Emanuela Batista Ferreira-e-Pereira RN, PhD , Maria Eduarda Ximenes-do-Rego RN , Yure Rodrigues-Silva RN , Beatriz Mendonça Morais-Alves RN , Camilla Ribeiro Lima-de-Farias RN, PhD , Isabel Cristina Ramos Vieira-Santos RN, PhD","doi":"10.1016/j.enfi.2025.500580","DOIUrl":"10.1016/j.enfi.2025.500580","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the risk factors and the main preventive measures in scientific literature related to the development of corneal injury in critically ill patients.</div></div><div><h3>Methods</h3><div>This is a scoping review, with a protocol previously registered on the Open Science Framework platform. The study was guided by the methodological guidelines of the Joanna Briggs Institute and followed the PRISMA-ScR framework. The research question was developed based on the PCC strategy. The search was conducted in the LILACS, PubMed, and SciELO databases, and in the gray literature via the CAPES Periodicals portal, with no language or time restrictions. The following descriptors were used: Corneal Injuries, Patient Care, Nursing, and Intensive Care Units. Two independent reviewers, with a third reviewer involved in case of disagreements, performed Screening and selection of studies. The steps followed the methodological recommendations for scoping reviews, aiming to map evidence on risk factors and preventive measures for corneal injuries in patients hospitalized in intensive care units.</div></div><div><h3>Results</h3><div>The studies analyzed indicate that the main risk factors for the development of ophthalmological injuries are higher among critically ill patients on mechanical ventilation, those under sedation and those with a decreased level of consciousness. Simple, effective nursing interventions are essential to the prevention of corneal injuries, contributing to the maintenance of ocular integrity of the patient.</div></div><div><h3>Conclusion</h3><div>Increasing the knowledge and training of nurses concerning ophthalmological care can contribute to greater awareness of the relevance of corneal injuries in critically ill patients, which is a crucial aspect of nursing care.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500580"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-09DOI: 10.1016/j.enfi.2025.500572
Roberto Gonçalves-Mendes MSN , André Pinto-Novo PhD , Manuel Lourenço-Nunes PhD , Miguel Castelo-Branco PhD
Background
Admission to intensive care can be accompanied by significant adverse effects for patients, which last beyond their stay in the unit. Early mobilisation is part of a set of a bundle to minimise these effects and is now unanimously considered to be safe and beneficial. It is therefore important to understand how it is being implemented in practice and what its real benefits are.
Aim/Objective
To characterise mobility in the ICU and correlate the level of mobility at discharge from the ICU with the results of post-intensive care, namely: length of stay after intensive care and hospital mortality.
Methods
This was an observational, retrospective study carried out in the Intensive Care Department of a Local Health Unit located in the Portuguese countryside. A quantitative research methodology was used.
Results
Of the 244 patients included in the sample, 54.5% achieved orthostatism during the ICU stay and 36.5% achieved deambulation. The average length of stay between leaving the ICU and hospital discharge was 8.0 ± 7.5 days. Patients who remained at bed rest at discharge had longer hospital stays than patients who were ambulating (p = 0.014); and patients who performed activities in bed also had longer hospital stays than those who were orthostatic or ambulating (p = 0.026 and 0.002 respectively). Post-ICU mortality was 5.7%, and there was a strong correlation with mobility on discharge from the ICU (p < 0.001), with less mobile patients having a higher mortality rate than expected (odds ratio = 5.13).
Conclusions
The mobility levels founded in this study are in line with international reality. Patients who achieve higher levels of mobility during their stay in intensive care have shorter hospital stays and lower mortality.
{"title":"Effect of mobility at ICU discharge on mortality and length of post-ICU stay: A retrospective analysis","authors":"Roberto Gonçalves-Mendes MSN , André Pinto-Novo PhD , Manuel Lourenço-Nunes PhD , Miguel Castelo-Branco PhD","doi":"10.1016/j.enfi.2025.500572","DOIUrl":"10.1016/j.enfi.2025.500572","url":null,"abstract":"<div><h3>Background</h3><div>Admission to intensive care can be accompanied by significant adverse effects for patients, which last beyond their stay in the unit. Early mobilisation is part of a set of a bundle to minimise these effects and is now unanimously considered to be safe and beneficial. It is therefore important to understand how it is being implemented in practice and what its real benefits are.</div></div><div><h3>Aim/Objective</h3><div>To characterise mobility in the ICU and correlate the level of mobility at discharge from the ICU with the results of post-intensive care, namely: length of stay after intensive care and hospital mortality.</div></div><div><h3>Methods</h3><div>This was an observational, retrospective study carried out in the Intensive Care Department of a Local Health Unit located in the Portuguese countryside. A quantitative research methodology was used.</div></div><div><h3>Results</h3><div>Of the 244 patients included in the sample, 54.5% achieved orthostatism during the ICU stay and 36.5% achieved deambulation. The average length of stay between leaving the ICU and hospital discharge was 8.0<!--> <!-->±<!--> <!-->7.5 days. Patients who remained at bed rest at discharge had longer hospital stays than patients who were ambulating (<em>p</em> <!-->=<!--> <!-->0.014); and patients who performed activities in bed also had longer hospital stays than those who were orthostatic or ambulating (<em>p</em> <!-->=<!--> <!-->0.026 and 0.002 respectively). Post-ICU mortality was 5.7%, and there was a strong correlation with mobility on discharge from the ICU (<em>p</em> <!--><<!--> <!-->0.001), with less mobile patients having a higher mortality rate than expected (odds ratio<!--> <!-->=<!--> <!-->5.13).</div></div><div><h3>Conclusions</h3><div>The mobility levels founded in this study are in line with international reality. Patients who achieve higher levels of mobility during their stay in intensive care have shorter hospital stays and lower mortality.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500572"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号