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Lung collapse during postural repositioning in a mechanically ventilated patient, could it have been avoided? A case report 机械通气患者体位复位时肺塌陷是否可以避免?病例报告
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2025-12-11 DOI: 10.1016/j.enfi.2025.500583
María Dolores Rodríguez-Huerta RN, MSc , Ana Díez-Fernández RN, MSc, PhD , María Jesús Rodríguez-Alonso RN , María Martín-Rodríguez RN , Mario Fernández-Izquierdo RN

Objective

To analyse through a clinical case the need for comprehensive management of bronchial secretions by nurses, with a proactive and preventive character to improve mechanically ventilated patients’ safety.

Clinical case presentation

A 76-year-old man under invasive mechanical ventilation admitted to the ICU due to pulmonary infection, who presented subtotal left lung collapse during routine postural changes. Trying to recover the left lung ventilation, the patient was repositioned, an endotracheal suctioning and two recruitment manoeuvres were made without any ventilation improvement. The previous level of left ventilation was not achieved until secretions were completely eliminated after three more suctioning manoeuvres.

Discussion and implications for practice

Critically ill patient care is complex, requiring general basic attention and monitoring, including the assessment of the risks that certain interventions and nursing care may entail for each individual patient. Both, postural repositioning and endotracheal suctioning constitutes tow integral parts of routine care for all mechanically ventilated patients. This case shows how the presence of deep secretions during postural repositioning can greatly affect the respiratory function, with no significant immediate or short-term changes observed on routine monitoring, as electrical impedance monitoring is not standard practice, so the changes described in this case would not have been observed in short term.

Conclusions

The implementation of a nursing integral care protocol for the management of secretions in mechanically ventilated patients, could be very useful in preventing adverse events, ineffective multiple endotracheal suctioning, which are not free of potential complications, and in reducing the need for deep airway clearance by fibrobronchoscopy.
目的通过一例临床病例分析护士对支气管分泌物进行综合管理的必要性,以积极预防的态度提高机械通气患者的安全性。一名76岁男性患者在有创机械通气下因肺部感染入住ICU,在常规体位改变时出现左肺大部萎陷。试图恢复左肺通气,患者重新定位,气管内吸痰和两次复吸手法,没有任何通气改善。在三次以上的抽吸操作后分泌物完全消除后,才达到先前的左侧通气水平。危重病人护理是复杂的,需要一般的基本关注和监测,包括评估某些干预措施和护理可能给每个病人带来的风险。体位复位和气管内吸引是所有机械通气患者常规护理的两个组成部分。本病例显示体位重定位过程中深层分泌物的存在如何极大地影响呼吸功能,常规监测没有观察到明显的即时或短期变化,因为电阻抗监测不是标准做法,因此本病例中描述的变化不会在短期内观察到。结论机械通气患者分泌物管理的护理整体护理方案的实施,对于预防不良事件、无效的多次气管内吸引(可能存在的并发症)和减少纤维支气管镜下深度气道清除率的需要是非常有用的。
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引用次数: 0
Experiencia de cuidado de cuidadores y niños entre 12 y 17 años brindado por personal de salud durante la hospitalización en cuidado intensivo pediátrico 医护人员在儿科重症监护住院期间对护理人员和12 - 17岁儿童的护理经验
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2025-12-09 DOI: 10.1016/j.enfi.2025.500582
Herly Ruth Alvarado-Romero RN, MSc , Carlos Yecid Bernal-Cárdenas RN, PhD , Diana Norella Córdoba-Rojas RN, MSc , Alba Deyanira Quiñonez-López MD , Camila Yesenia Ruiz-Matore RN , Paola Torres-Giraldo RN, MSN

Introduction

Caring for children hospitalized in Pediatric Intensive Care Units is a complex and multidimensional process. This process includes specialized care, as well as emotional and psychological support for both patients and their caregivers. These caregivers play an essential role in the hospitalization experience, facing a range of emotions due to the severity of the children's illness and the connotations of being hospitalized.

Objective

Describe the caregiving experience of caregivers and children between the ages of 12 and 17 provided by healthcare personnel during hospitalization in the unit at an institution in Bogotá in 2023.

Methodology

Qualitative study with a phenomenological design, using in-depth semi-structured interviews with caregivers and children hospitalized in an Intensive Care Unit in Bogotá in 2023.

Results

Twenty-seven interviews were conducted to achieve data saturation. Most of the caregivers were women. The predominant socioeconomic status was 3 and the educational level was high school. Four categories and thirteen subcategories were identified: Environment and dynamics, interaction with healthcare personnel, recognition of healthcare personnel, and feelings and experience upon admission to the unit.

Conclusion

Nurses working in Pediatric Intensive Care Units play a fundamental role, as they are in constant contact with children and their caregivers, who often experience high levels of anxiety and fear due to the seriousness of the environment. To provide comprehensive and humanized care, it is essential that these professionals have specific scientific knowledge about children's health, as well as disciplinary skills to guide their interventions. In this way, they contribute to the child's recovery and the creation of a more humane care environment, even in a highly technical context.
儿童重症监护病房住院儿童的护理是一个复杂和多维的过程。这一过程包括专门护理,以及对患者及其护理人员的情感和心理支持。这些护理人员在住院经历中发挥着至关重要的作用,他们面临着由于儿童疾病的严重程度和住院的内涵而产生的一系列情绪。目的描述2023年波哥大一家机构住院期间护理人员和12至17岁儿童的护理经验。方法:采用现象学设计的定性研究,对2023年波哥大重症监护室的护理人员和住院儿童进行了深入的半结构化访谈。结果共进行了27次访谈,达到数据饱和。大多数看护人都是女性。社会经济地位为3,文化程度为高中。确定了四个类别和十三个子类别:环境和动态,与医护人员的互动,对医护人员的认可,以及入院时的感受和体验。结论儿科重症监护室的护士工作起着至关重要的作用,因为他们经常与儿童及其照顾者接触,由于环境的严重性,他们经常经历高度的焦虑和恐惧。为了提供全面和人性化的护理,这些专业人员必须具备有关儿童健康的具体科学知识,以及指导其干预措施的学科技能。这样,它们有助于儿童的康复和创造一个更人道的照料环境,即使在高度技术性的环境中也是如此。
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引用次数: 0
Clinical judgment and self-efficacy of nurses in sepsis management: The use of clinical simulation 护士在脓毒症管理中的临床判断和自我效能:临床模拟的应用
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2025-12-11 DOI: 10.1016/j.enfi.2025.500577
Lilian Regina-de-Carvalho RN, MSc, PhD , Ursula Marcondes-Westin RN, MSc, PhD , Renata Elizabete-Pagotti-da-Fonseca RN, MSc, PhD , Rafael Bressani-Lino RN, MSc, PhD , João Paulo Victorino RN , Silvia Helena-Zem-Mascarenhas RN, PhD

Introduction

Sepsis has high mortality and demands prompt intervention. Nurses are key in its management, but knowledge gaps persist. Enhancing clinical judgment and self-efficacy is crucial, and clinical simulation offers a safe, effective strategy for developing these skills, supporting education in healthcare.

Objective

To evaluate the responses related to self-efficacy and clinical judgment of nurses in the management of sepsis through high-fidelity clinical simulation.

Methods

A quasi-experimental, pre- and post-test study design was adopted. Self-efficacy, clinical judgment, and knowledge were considered dependent variables, while time and participant role (scenario participant/observer) were treated as covariates. The sample consisted of 28 nurses. Data were transcribed into Microsoft Excel® spreadsheets and analyzed using SAS version 9.4 software.

Results

After the debriefing session, the mean scores for knowledge, clinical judgment, and self-efficacy increased compared to baseline. Knowledge scores improved from a mean of 9.71 (SD = 2.02) to 12.75 (SD = 1.24). Clinical judgment scores increased from 31.75 (SD = 4.88) to 36.5 (SD = 5.5), and self-efficacy rose from 4.05 (SD = 0.44) to 4.19 (SD = 0.55). Statistically significant differences were found in clinical judgment (p < 0.0001) and knowledge (p < 0.0001) across time points. Participants who actively engaged in the simulation had significantly higher post-simulation clinical judgment (mean = 39.5 vs. 34.83; p = 0.0252) and self-efficacy scores (mean = 4.51 vs. 4.01; p = 0.0269) compared to observers. However, there was no significant difference in post-test knowledge scores between the groups (p = 0.6012). A strong correlation was identified between self-efficacy and clinical judgment. These findings support the effectiveness of simulation-based education in enhancing both clinical judgment and self-efficacy among nurses.

Conclusions

High-fidelity clinical simulation contributed to the development of nurses’ clinical judgment, self-efficacy, and knowledge regarding sepsis management.
败血症死亡率高,需要及时干预。护士是其管理的关键,但知识差距仍然存在。增强临床判断和自我效能是至关重要的,临床模拟为发展这些技能提供了一种安全、有效的策略,支持医疗保健教育。目的通过高保真临床模拟,评价护士在脓毒症处理过程中自我效能感和临床判断的反应。方法采用准实验、测试前和测试后的研究设计。自我效能、临床判断和知识作为因变量,时间和参与者角色(情景参与者/观察者)作为协变量。样本包括28名护士。将数据转录到Microsoft Excel®电子表格中,使用SAS version 9.4软件进行分析。结果报告后,知识、临床判断和自我效能的平均得分较基线有所提高。知识得分从平均9.71分(SD = 2.02)提高到12.75分(SD = 1.24)。临床判断评分从31.75分(SD = 4.88)提高到36.5分(SD = 5.5),自我效能从4.05分(SD = 0.44)提高到4.19分(SD = 0.55)。不同时间点的临床判断(p < 0.0001)和知识(p < 0.0001)差异有统计学意义。积极参与模拟的受试者在模拟后的临床判断(平均= 39.5 vs. 34.83, p = 0.0252)和自我效能评分(平均= 4.51 vs. 4.01, p = 0.0269)均显著高于观察者。但两组间测验后知识得分差异无统计学意义(p = 0.6012)。自我效能感与临床判断之间存在很强的相关性。这些发现支持了模拟教育在提高护士临床判断和自我效能方面的有效性。结论高保真度临床模拟有助于提高护士的临床判断、自我效能感和脓毒症管理知识。
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引用次数: 0
Relación entre estrés percibido, apoyo social percibido y satisfacción familiar en familiares de una unidad de cuidados intensivos adulto 成人重症监护家庭成员感知压力、感知社会支持和家庭满意度之间的关系
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2025-11-19 DOI: 10.1016/j.enfi.2025.500573
Valentina Nilo-González RN, MSN, Noelia Rojas-Silva RN, MSN, Cristóbal Padilla-Fortunatti RN, MSN, PhD

Introduction

In intensive care units (ICU), stress experienced by family members can negatively impact their family satisfaction. The literature describes social support as a stress neutralizer. However, evidence regarding the influence of stress and social support on family satisfaction in ICU is limited.

Objective

To explore the relationship between perceived stress, social support, and family satisfaction in family members of ICU patients.

Methods

Descriptive correlational study conducted in an ICU of a private hospital in Santiago, Chile. Family members of patients with a stay of ≥48 hours were included. Family participants completed three questionnaires to assess perceived stress, perceived social support, and family satisfaction. Sociodemographic and clinical data were also collected from the patients. The association between perceived stress, perceived social support, and family satisfaction was explored using Spearman's rho correlations.

Results

Fifty family members were included, 70% of whom were women. Perceived stress was (r = –.41; P<.05), satisfaction with patient and family care (r = –.39; P<.01), and satisfaction with communication (r = –.34; P=.02), while with satisfaction with decision making, the association was not significant (P>.05). No significant association was observed between social support and family satisfaction (P>.05).

Conclusions

Findings of this study add to the evidence on the negative impact of stress on family satisfaction and its dimensions in family members of ICU patients. Further studies are needed to explore the role of social support in family members of ICU patients and its possible influence on family satisfaction.
在重症监护病房(ICU),家庭成员所经历的压力会对其家庭满意度产生负面影响。文献将社会支持描述为压力中和剂。然而,关于压力和社会支持对ICU家庭满意度影响的证据有限。目的探讨ICU患者家属感知压力、社会支持和家庭满意度之间的关系。方法在智利圣地亚哥一家私立医院的ICU进行描述性相关研究。住院时间≥48小时的患者家属纳入研究对象。家庭参与者完成了三份问卷来评估感知压力、感知社会支持和家庭满意度。还收集了患者的社会人口学和临床数据。感知压力、感知社会支持和家庭满意度之间的关系采用Spearman的rho相关关系进行了探讨。结果共纳入50名家庭成员,其中70%为女性。感知压力(r = - 0.41; P< 0.05)、对病人和家属护理的满意度(r = - 0.39; P< 0.01)和对沟通的满意度(r = - 0.34; P= 0.02),而对决策的满意度,相关性不显著(P> 0.05)。社会支持与家庭满意度之间无显著关联(P> 0.05)。结论本研究结果进一步证实了压力对ICU患者家庭成员家庭满意度及其维度的负面影响。社会支持在ICU患者家庭成员中的作用及其对家庭满意度的影响有待进一步研究。
{"title":"Relación entre estrés percibido, apoyo social percibido y satisfacción familiar en familiares de una unidad de cuidados intensivos adulto","authors":"Valentina Nilo-González RN, MSN,&nbsp;Noelia Rojas-Silva RN, MSN,&nbsp;Cristóbal Padilla-Fortunatti RN, MSN, PhD","doi":"10.1016/j.enfi.2025.500573","DOIUrl":"10.1016/j.enfi.2025.500573","url":null,"abstract":"<div><h3>Introduction</h3><div>In intensive care units (ICU), stress experienced by family members can negatively impact their family satisfaction. The literature describes social support as a stress neutralizer. However, evidence regarding the influence of stress and social support on family satisfaction in ICU is limited.</div></div><div><h3>Objective</h3><div>To explore the relationship between perceived stress, social support, and family satisfaction in family members of ICU patients.</div></div><div><h3>Methods</h3><div>Descriptive correlational study conducted in an ICU of a private hospital in Santiago, Chile. Family members of patients with a stay of ≥48<!--> <!-->hours were included. Family participants completed three questionnaires to assess perceived stress, perceived social support, and family satisfaction. Sociodemographic and clinical data were also collected from the patients. The association between perceived stress, perceived social support, and family satisfaction was explored using Spearman's rho correlations.</div></div><div><h3>Results</h3><div>Fifty family members were included, 70% of whom were women. Perceived stress was (<em>r</em> <!-->=<!--> <!-->–.41; <em>P</em>&lt;.05), satisfaction with patient and family care (<em>r</em> <!-->=<!--> <!-->–.39; <em>P</em>&lt;.01), and satisfaction with communication (<em>r</em> <!-->=<!--> <!-->–.34; <em>P</em>=.02), while with satisfaction with decision making, the association was not significant (<em>P</em>&gt;.05). No significant association was observed between social support and family satisfaction (<em>P</em>&gt;.05).</div></div><div><h3>Conclusions</h3><div>Findings of this study add to the evidence on the negative impact of stress on family satisfaction and its dimensions in family members of ICU patients. Further studies are needed to explore the role of social support in family members of ICU patients and its possible influence on family satisfaction.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500573"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546702","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}
引用次数: 0
Associations between ICU nursing care and functional outcomes in survivors of critical COVID-19: Longitudinal study 重症COVID-19幸存者ICU护理与功能结局的关系:纵向研究
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2025-12-02 DOI: 10.1016/j.enfi.2025.500579
Raví P. Pereira RN, MSN , Vanessa F. Bonatto RN, MSN , Luísa B. Santana RN , Isis M. Severo RN, PhD , Michele D. Santarem RN, PhD , Augusto Savi PT, PhD , Cassiano Teixeira MD, PhD , Karina de O. Azzolin RN, PhD

Introduction

The evaluation of long-term functional disabilities and factors associated with decline following COVID-19-related critical illness in low- and middle-income countries remains underexplored in current literature. Addressing this gap is essential for healthcare professionals, particularly nurses, to develop targeted interventions aimed at reducing the risk of functional decline after critical illness during pandemics.

Objectives

To analyze ICU nursing care factors associated with functional outcomes in survivors of critical illness due to COVID-19, six months after ICU discharge.

Methods

A prospective longitudinal study was conducted. Adults (≥18 years) discharged from the ICU after viral pneumonia, confirmed by RT-PCR for SARS-CoV-2, with a minimum ICU stay of 72 h, were included. Follow-up was conducted via telephone interviews at one, three, and six months to collect sociodemographic data and assess functional status using the Barthel Index. Data were analyzed using Generalized Estimating Equations.

Results

The study included 400 participants (mean age: 52.41 ± 13.680 years; median ICU stay: 15.0 days, IQR: 8.0–26.0). Functional decline was observed in 43% of patients at one month, 28.4% at three months, and 20.4% at six months. Delirium and skin ulcers during ICU stay were modifiable factors associated with post-critical care functional disability.

Conclusions

Exploring targeted nursing interventions, such as delirium and pressure ulcer prevention, is essential to promote recovery and prevent long-term disability after critical illness.
目前的文献中,对低收入和中等收入国家covid -19相关危重疾病后长期功能残疾和衰退相关因素的评估仍未得到充分探讨。解决这一差距对于卫生保健专业人员,特别是护士,制定有针对性的干预措施,以减少大流行期间重症后功能下降的风险至关重要。目的分析COVID-19危重症患者出院后6个月ICU护理因素与功能结局的关系。方法采用前瞻性纵向研究。纳入经RT-PCR确诊为SARS-CoV-2的病毒性肺炎后出院的成人(≥18岁),至少在ICU住院72小时。随访时间为1个月、3个月和6个月,通过电话访谈收集社会人口统计数据,并使用Barthel指数评估功能状态。使用广义估计方程对数据进行分析。结果共纳入400例患者,平均年龄52.41±13.680岁,中位ICU住院时间15.0天,IQR: 8.0 ~ 26.0。43%的患者在1个月时出现功能下降,28.4%在3个月时,20.4%在6个月时。重症监护期间谵妄和皮肤溃疡是重症监护后功能障碍的可改变因素。结论探索有针对性的护理干预措施,如预防谵妄和压疮,是促进重症患者康复和预防长期残疾的必要措施。
{"title":"Associations between ICU nursing care and functional outcomes in survivors of critical COVID-19: Longitudinal study","authors":"Raví P. Pereira RN, MSN ,&nbsp;Vanessa F. Bonatto RN, MSN ,&nbsp;Luísa B. Santana RN ,&nbsp;Isis M. Severo RN, PhD ,&nbsp;Michele D. Santarem RN, PhD ,&nbsp;Augusto Savi PT, PhD ,&nbsp;Cassiano Teixeira MD, PhD ,&nbsp;Karina de O. Azzolin RN, PhD","doi":"10.1016/j.enfi.2025.500579","DOIUrl":"10.1016/j.enfi.2025.500579","url":null,"abstract":"<div><h3>Introduction</h3><div>The evaluation of long-term functional disabilities and factors associated with decline following COVID-19-related critical illness in low- and middle-income countries remains underexplored in current literature. Addressing this gap is essential for healthcare professionals, particularly nurses, to develop targeted interventions aimed at reducing the risk of functional decline after critical illness during pandemics.</div></div><div><h3>Objectives</h3><div>To analyze ICU nursing care factors associated with functional outcomes in survivors of critical illness due to COVID-19, six months after ICU discharge.</div></div><div><h3>Methods</h3><div>A prospective longitudinal study was conducted. Adults (≥18 years) discharged from the ICU after viral pneumonia, confirmed by RT-PCR for SARS-CoV-2, with a minimum ICU stay of 72<!--> <!-->h, were included. Follow-up was conducted via telephone interviews at one, three, and six months to collect sociodemographic data and assess functional status using the Barthel Index. Data were analyzed using Generalized Estimating Equations.</div></div><div><h3>Results</h3><div>The study included 400 participants (mean age: 52.41<!--> <!-->±<!--> <!-->13.680 years; median ICU stay: 15.0 days, IQR: 8.0–26.0). Functional decline was observed in 43% of patients at one month, 28.4% at three months, and 20.4% at six months. Delirium and skin ulcers during ICU stay were modifiable factors associated with post-critical care functional disability.</div></div><div><h3>Conclusions</h3><div>Exploring targeted nursing interventions, such as delirium and pressure ulcer prevention, is essential to promote recovery and prevent long-term disability after critical illness.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500579"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691377","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}
引用次数: 0
¿Podemos reducir los errores de medicación en urgencias? Una mirada interprofesional hacia una práctica segura 我们能在紧急情况下减少用药错误吗?跨专业人士对安全实践的看法
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2026-02-13 DOI: 10.1016/j.enfi.2026.500594
Mariam Hijazi-Vega BPharm , Juan Luque-Galán MD, MsC , Rocío Vázquez-Sánchez BPharm, PhD , Javier Sánchez Rubio-Ferrández BPharm, PhD , Ana Isabel Sacristán-Vaquerizo RN , Francisco José Salas-Álvarez del Valle MD, MsC , Teresa Molina-García BPharm
{"title":"¿Podemos reducir los errores de medicación en urgencias? Una mirada interprofesional hacia una práctica segura","authors":"Mariam Hijazi-Vega BPharm ,&nbsp;Juan Luque-Galán MD, MsC ,&nbsp;Rocío Vázquez-Sánchez BPharm, PhD ,&nbsp;Javier Sánchez Rubio-Ferrández BPharm, PhD ,&nbsp;Ana Isabel Sacristán-Vaquerizo RN ,&nbsp;Francisco José Salas-Álvarez del Valle MD, MsC ,&nbsp;Teresa Molina-García BPharm","doi":"10.1016/j.enfi.2026.500594","DOIUrl":"10.1016/j.enfi.2026.500594","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500594"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188185","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}
引用次数: 0
Management of the environment and patient care using extracorporeal membrane oxygenation: A scoping review 使用体外膜氧合的环境管理和患者护理:范围综述
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2026-01-30 DOI: 10.1016/j.enfi.2025.500581
Camila Medeiros-dos-Santos-de-Cerqueira MsC , Christiany Moçali-Gonzalez MsC , Marluci Andrade-Conceição-Stipp PhD , Aurean Deca-Junior PhD , Graciele Oroski-Paes PhD

Introduction

The use of strategies planned for the environment and care of adult patients undergoing extracorporeal membrane oxygenation allows for better assistance from the multidisciplinary team to this individual in the Intensive Care Unit.

Objective

The objective is to map strategies for planning the environment and care of adult patients in extracorporeal membrane oxygenation in intensive care.

Methodology

This scoping review follows the Joanna Briggs Institute methodology and adheres to the extension PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Eligible studies included those that answered the guiding question: “what are the strategies for planning the environment and care of adult patients undergoing extracorporeal membrane oxygenation in intensive care?”, no time or language restriction. The search and selection were carried out by two double-blind researchers between February and April 2024, using Rayyan software for data extraction and analysis. The collection took place in 10 databases, with selection of articles and gray literature.

Results

Six thousand nine hundred ninety-six sources of evidence were identified, of which 39 composed the final sample. The strategies cited by the publications were: management of the environment (family preparation; team preparation; ethical issues; human and material resources); and care management (monitoring; systematization of nursing care; nutritional management; early mobilization).

Conclusions

The complexity of ECMO management was highlighted, reinforcing the need for adequate infrastructure, a multidisciplinary team and more robust studies, especially in underdeveloped countries, to improve practical application and clinical outcomes.
为接受体外膜氧合的成人患者的环境和护理计划的策略的使用允许多学科团队更好地帮助重症监护病房的个体。目的探讨重症监护成人患者体外膜氧合环境与护理的规划策略。方法:该范围审查遵循Joanna Briggs研究所的方法,并遵循扩展PRISMA-ScR(范围审查的系统审查和元分析首选报告项目扩展)。符合条件的研究包括那些回答指导性问题的研究:“在重症监护中进行体外膜氧合的成年患者的环境和护理规划策略是什么?”,没有时间和语言的限制。搜寻和选择由两名双盲研究人员在2024年2月至4月期间进行,使用Rayyan软件进行数据提取和分析。该收集在10个数据库中进行,其中包括精选的文章和灰色文献。结果共鉴定出证据来源66996份,其中39份构成最终样本。这些出版物引用的战略是:环境管理(家庭准备;团队准备;道德问题;人力和物质资源);护理管理(监测;系统化护理;营养管理;早期动员)。结论ECMO管理的复杂性突出,强调了对足够的基础设施,多学科团队和更强大的研究的需求,特别是在不发达国家,以改善实际应用和临床结果。
{"title":"Management of the environment and patient care using extracorporeal membrane oxygenation: A scoping review","authors":"Camila Medeiros-dos-Santos-de-Cerqueira MsC ,&nbsp;Christiany Moçali-Gonzalez MsC ,&nbsp;Marluci Andrade-Conceição-Stipp PhD ,&nbsp;Aurean Deca-Junior PhD ,&nbsp;Graciele Oroski-Paes PhD","doi":"10.1016/j.enfi.2025.500581","DOIUrl":"10.1016/j.enfi.2025.500581","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of strategies planned for the environment and care of adult patients undergoing extracorporeal membrane oxygenation allows for better assistance from the multidisciplinary team to this individual in the Intensive Care Unit.</div></div><div><h3>Objective</h3><div>The objective is to map strategies for planning the environment and care of adult patients in extracorporeal membrane oxygenation in intensive care.</div></div><div><h3>Methodology</h3><div>This scoping review follows the Joanna Briggs Institute methodology and adheres to the extension PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Eligible studies included those that answered the guiding question: “what are the strategies for planning the environment and care of adult patients undergoing extracorporeal membrane oxygenation in intensive care?”, no time or language restriction. The search and selection were carried out by two double-blind researchers between February and April 2024, using Rayyan software for data extraction and analysis. The collection took place in 10 databases, with selection of articles and gray literature.</div></div><div><h3>Results</h3><div>Six thousand nine hundred ninety-six sources of evidence were identified, of which 39 composed the final sample. The strategies cited by the publications were: management of the environment (family preparation; team preparation; ethical issues; human and material resources); and care management (monitoring; systematization of nursing care; nutritional management; early mobilization).</div></div><div><h3>Conclusions</h3><div>The complexity of ECMO management was highlighted, reinforcing the need for adequate infrastructure, a multidisciplinary team and more robust studies, especially in underdeveloped countries, to improve practical application and clinical outcomes.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500581"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076782","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}
引用次数: 0
Occurrence of adverse events with arterial catheters and their contributing factors: A cross-sectional study 动脉导管不良事件的发生及其影响因素:一项横断面研究
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2025-11-28 DOI: 10.1016/j.enfi.2025.500575
Patriny Marcelle Mariano-Gomes , Adriana Ouverney-Braz RN, PhD , Graciele Oroski-Paes RN, PhD

Introduction

The insertion of an arterial line is one of the most important invasive procedures in intensive care, but it may still pose risks to patients.

Objectives

To determine the prevalence and analyze the association of contributing factors with the occurrence of adverse events related to the use of arterial catheters.

Method

Cross-sectional, retrospective, analytical and quantitative study. The sample included all reports of adverse events involving arterial catheters over the past five years. The hospital's electronic and physical medical records were used to supplement the patients’ clinical data. Descriptive and inferential analysis was carried out using frequency calculations and association tests, including Chi-square and Fisher's exact test. A significance level of up to 10% (p-value < 0.1) was used for all analyses. The study adhered to the STROBE Checklist guidelines (a checklist of items recommended for reports of cross-sectional studies).

Results

Between 2019 and 2023, 3104 arterial catheters were inserted in the hospital's intensive care units. 39 reports of adverse events with these catheters were included, with an occurrence rate of 1.25% (95% confidence interval). The most prevalent incident was inadvertent loss (41%), followed by pseudoaneurysm and/or hematoma formation (25.6%), and obstruction (20.51%). Human resources (p-value 0.069), need for sedation (p-value 0.011) and insertion site (p-value 0.074) were factors that were associated with accidental device loss. Factors related to the patient (p-value 0.079) and the puncture method (p-value 0.079) were related to the formation of pseudoaneurysms and hematomas. Human resources (p-value 0.001), the use of vasoactive amines (p-value 0.032) and the insertion site (p-value 0.012) were associated with system obstruction.

Conclusion

The results elucidated potential weaknesses that could compromise the safety of critically ill patients using blood pressure monitoring, such as the method of puncture, circuit management and the clinical characteristics of the patients. In addition to the negative impact on patients and costs, litigation can also result from failures in healthcare safety.
动脉线的插入是重症监护中最重要的侵入性手术之一,但它仍然可能给患者带来风险。目的了解动脉导管使用不良事件发生率,分析影响因素与不良事件发生的关系。方法横断面、回顾性、分析定量研究。样本包括过去五年中所有涉及动脉导管不良事件的报告。利用医院的电子病历和实物病历来补充患者的临床资料。使用频率计算和关联检验(包括卡方检验和Fisher精确检验)进行描述性和推断性分析。所有分析均采用高达10%的显著性水平(p值<; 0.1)。该研究遵循STROBE清单指南(一份推荐用于横断面研究报告的项目清单)。结果2019年至2023年,该院重症监护室共插入动脉导管3104根。纳入39例不良事件报告,发生率为1.25%(95%可信区间)。最常见的事故是意外丢失(41%),其次是假性动脉瘤和/或血肿形成(25.6%)和梗阻(20.51%)。人力资源(p值为0.069)、镇静需求(p值为0.011)和插入位置(p值为0.074)是与意外器械丢失相关的因素。假性动脉瘤和血肿的形成与患者相关因素(p值为0.079)和穿刺方法相关因素(p值为0.079)有关。人力资源(p值0.001)、血管活性胺的使用(p值0.032)和插入部位(p值0.012)与系统阻塞有关。结论分析了危重患者血压监测在穿刺方法、回路管理及患者临床特点等方面存在的可能危及危重患者安全的薄弱环节。除了对患者和成本的负面影响外,医疗安全方面的失败也可能导致诉讼。
{"title":"Occurrence of adverse events with arterial catheters and their contributing factors: A cross-sectional study","authors":"Patriny Marcelle Mariano-Gomes ,&nbsp;Adriana Ouverney-Braz RN, PhD ,&nbsp;Graciele Oroski-Paes RN, PhD","doi":"10.1016/j.enfi.2025.500575","DOIUrl":"10.1016/j.enfi.2025.500575","url":null,"abstract":"<div><h3>Introduction</h3><div>The insertion of an arterial line is one of the most important invasive procedures in intensive care, but it may still pose risks to patients.</div></div><div><h3>Objectives</h3><div>To determine the prevalence and analyze the association of contributing factors with the occurrence of adverse events related to the use of arterial catheters.</div></div><div><h3>Method</h3><div>Cross-sectional, retrospective, analytical and quantitative study. The sample included all reports of adverse events involving arterial catheters over the past five years. The hospital's electronic and physical medical records were used to supplement the patients’ clinical data. Descriptive and inferential analysis was carried out using frequency calculations and association tests, including Chi-square and Fisher's exact test. A significance level of up to 10% (<em>p</em>-value<!--> <!-->&lt;<!--> <!-->0.1) was used for all analyses. The study adhered to the STROBE Checklist guidelines (a checklist of items recommended for reports of cross-sectional studies).</div></div><div><h3>Results</h3><div>Between 2019 and 2023, 3104 arterial catheters were inserted in the hospital's intensive care units. 39 reports of adverse events with these catheters were included, with an occurrence rate of 1.25% (95% confidence interval). The most prevalent incident was inadvertent loss (41%), followed by pseudoaneurysm and/or hematoma formation (25.6%), and obstruction (20.51%). Human resources (<em>p</em>-value 0.069), need for sedation (<em>p</em>-value 0.011) and insertion site (<em>p</em>-value 0.074) were factors that were associated with accidental device loss. Factors related to the patient (<em>p</em>-value 0.079) and the puncture method (<em>p</em>-value 0.079) were related to the formation of pseudoaneurysms and hematomas. Human resources (<em>p</em>-value 0.001), the use of vasoactive amines (<em>p</em>-value 0.032) and the insertion site (<em>p</em>-value 0.012) were associated with system obstruction.</div></div><div><h3>Conclusion</h3><div>The results elucidated potential weaknesses that could compromise the safety of critically ill patients using blood pressure monitoring, such as the method of puncture, circuit management and the clinical characteristics of the patients. In addition to the negative impact on patients and costs, litigation can also result from failures in healthcare safety.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 1","pages":"Article 500575"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624815","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}
引用次数: 0
Exploring patients’ experiences in intensive care units (ICU): A cross-sectional study in Pakistan 探索重症监护病房(ICU)患者的经验:巴基斯坦的横断面研究
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2025-12-17 DOI: 10.1016/j.enfi.2025.500578
Tawseef Ahmad MS, Pharm-D , Sirima Sitaruno Pharm-D, BCPS , Sutthiporn Pattharachayakul Pharm-D, BCPS , Faiz Ullah Khan Pharm-D, PhD , Muhammad Kiddeer Pharm-D, M.Phil. , Shujaat Ali Khan Pharm-D, PhD

Background

Intensive care unit (ICU) stays are often traumatic, impacting patients psychologically, physically, and emotionally. However, patient experiences in ICU settings remain underexplored, particularly in developing countries like Pakistan.

Objective

This study aimed to assess the experiences of ICU patients in a tertiary care hospital in Pakistan, with a focus on psychological distress, emotional responses, and perceived quality of care.

Methods

A descriptive cross-sectional study was conducted at Ayub Teaching Hospital, Abbottabad. A total of 102 post-ICU patients meeting the inclusion criteria were interviewed within 72 hours of transfer to medical wards. Data were collected using the validated Intensive Care Experience Questionnaire (ICEQ), and analyzed to evaluate patient perceptions and associated factors.

Results

Of the participants, 93.13% expressed relief upon discharge from the ICU, while 42.15% reported experiencing blurred memories during their stay. Despite this, 77.45% expressed satisfaction with the care received. Notably, only 23.52% of patients felt involved in decision-making processes regarding their care, indicating a communication gap. Statistical analysis revealed a significant negative correlation between patient age and satisfaction with care (r = −0.199, p < 0.05), suggesting older patients experienced reduced satisfaction. Gender also negatively correlated with memory of experience (r = −0.236, p < 0.05) and satisfaction with care (r = −0.208, p < 0.05), with women reporting more negative experiences. Length of ICU stay was significantly associated with reduced environmental awareness (r = −0.230, p < 0.001).

Conclusion

The findings highlight significant psychological and emotional challenges faced by ICU patients in Pakistan. Enhanced patient-centered communication, psychological support, and greater involvement in care decisions are critical to improving ICU experiences. Nursing staff play a pivotal role in creating a supportive and therapeutic ICU environment that fosters trust and improves patient outcomes.
重症监护病房(ICU)的住院往往是创伤性的,对患者的心理、身体和情感都有影响。然而,ICU环境中的患者体验仍未得到充分探索,特别是在巴基斯坦等发展中国家。目的本研究旨在评估巴基斯坦一家三级护理医院ICU患者的经历,重点关注心理困扰、情绪反应和感知护理质量。方法在阿伯塔巴德Ayub教学医院进行描述性横断面研究。102名符合纳入标准的icu后患者在转至内科病房后72小时内接受了访谈。使用经过验证的重症监护体验问卷(ICEQ)收集数据,并分析以评估患者的感知和相关因素。结果:93.13%的患者在出院时感到宽慰,42.15%的患者在住院期间记忆模糊。尽管如此,77.45%的人对所得到的护理表示满意。值得注意的是,只有23.52%的患者感觉自己参与了有关其护理的决策过程,这表明存在沟通差距。统计分析显示,患者年龄与护理满意度呈显著负相关(r = - 0.199, p < 0.05),表明老年患者满意度降低。性别与经验记忆(r = - 0.236, p < 0.05)和护理满意度(r = - 0.208, p < 0.05)也呈负相关,女性报告的负面经历更多。ICU住院时间与环境意识降低显著相关(r = - 0.230, p < 0.001)。结论本研究结果突出了巴基斯坦ICU患者面临的重大心理和情绪挑战。加强以患者为中心的沟通、心理支持和更多地参与护理决策对改善ICU体验至关重要。护理人员在创造支持性和治疗性ICU环境中发挥关键作用,促进信任并改善患者预后。
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引用次数: 0
Prevalence, characteristics, and associated factors of dyskalemia in Moroccan intensive care units over a 28-month period: A cross-sectional correlational study 摩洛哥重症监护病房28个月期间钾血症的患病率、特征和相关因素:一项横断面相关性研究
IF 1 Q3 NURSING Pub Date : 2026-01-01 Epub Date: 2025-12-09 DOI: 10.1016/j.enfi.2025.500570
Kamal Takhdat RAN, PhD , Salma El Hamdou REN, BSN , Houda El Bannaoui REN, BSN , Ahmed Rhassane El Adib MD

Introduction

Dyskalemia disturbs electrophysiological homeostasis and even cause several life-threatening conditions. Improved understanding of dyskalemia risk factors is clinically relevant for prompt and effective dyskalemia treatment. This study aims to analyze dyskalemia prevalence and risk factors in two adult medical and surgical intensive care units (ICUs) in a Moroccan university hospital.

Methods

A retrospective cross-sectional study was conducted from January 1st 2022 to April 30, 2024. A total of 1274 patients’ medical records were examined, yielding for 549 dyskalemic patients. Single-factor and multi-factor logistic regression analyses were conducted to investigate associations between dyskalemia and the risk factors related to patients’ characteristics, comorbidities, and therapeutic agents.

Results

The prevalence of dyskalemia was found at 43%, with a dyskalemic patients’ mean age of 48.3 (±18.6). Over 62% of them developed dyskalemia during ICU stay. Multivariable analyses showed that the risk of hypokalemia was associated to female gender, diabetic ketoacidosis, anticancer drugs, heparin (LMWH), and insulin. However, the risk of hyperkalemia was associated with male gender, chronic kidney failure, metabolic acidosis, burns, blood transfusion, and propofol as a sedative agent.

Conclusion

Several associated factors of the risk of dyskalemia were identified. Critical care nurses should pay particular attention to high-risk patients of dyskalemia and be proactive in identifying early signs of dyskalemia in order to achieve targeted risk assessment, improve early diagnosis, and management of the patients’ conditions.
钾血症扰乱电生理稳态,甚至引起一些危及生命的疾病。提高对血钾障碍危险因素的认识,对及时有效地治疗血钾障碍具有临床意义。本研究旨在分析血钾异常的患病率和危险因素在两个成人内科和外科重症监护病房(icu)在摩洛哥大学医院。方法于2022年1月1日至2024年4月30日进行回顾性横断面研究。共检查了1274例患者的医疗记录,其中549例为钾血症患者。进行单因素和多因素logistic回归分析,以调查血钾异常与患者特征、合并症和治疗药物相关的危险因素之间的关系。结果血钾异常的患病率为43%,患者平均年龄为48.3岁(±18.6岁)。超过62%的患者在ICU期间出现血钾异常。多变量分析显示,低钾血症的风险与女性、糖尿病酮症酸中毒、抗癌药物、肝素(LMWH)和胰岛素有关。然而,高钾血症的风险与男性、慢性肾衰竭、代谢性酸中毒、烧伤、输血和异丙酚作为镇静剂有关。结论确定了血钾异常危险的几个相关因素。重症监护护士应特别关注钾血症高危患者,积极识别钾血症的早期体征,以实现有针对性的风险评估,提高患者的早期诊断和病情管理。
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引用次数: 0
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Enfermeria Intensiva
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