Pub Date : 2025-09-18DOI: 10.1016/j.enfi.2025.500564
Francisco Javier Mesa-Mesa RN, Francisco Manuel Cornejo-Gil RN, Jose Antonio Márquez-García RN
Introduction
ICUs are one of the services where serious infections are treated, so the use of anti-infective drugs, especially those administered intravenously, is daily. The nursing staff is in charge of preparing, diluting and administering these medications.
Objectives
This study aims to compare the coincidences between the data obtained through human consultation of the technical data sheets of anti-infective drugs for intravenous use in ICUs with those obtained through the same search with an AI tool.
Method
A search was carried out for 8 parameters in the technical specifications of 55 drugs. Subsequently, to deepen the theoretical framework, we conducted a bibliographic search, selected the articles that met our inclusion criteria and synthesized the data. Finally, we used ChatGPT to perform an analysis of the parameters that we had previously searched humanly.
Results
After an exhaustive comparison of the findings attained both through human search and through the use of AI (ChatGPT), the coincidence of most of them was a fact.
Conclusion
As a conclusion of the study, it must be said that the evidences gathered by using AI (ChatGPT) were not as deep as those obtained when human analysis was carried out. Anyway, this information was valid enough when preparing the drugs. Therefore, AI (ChatGPT) can be considered a complementary tool in this field.
{"title":"Comparación de 2 métodos de obtención de información de fármacos antiinfecciosos de uso en la UCI: revisión humana de fichas técnicas y uso de inteligencia artificial. Estudio cualitativo","authors":"Francisco Javier Mesa-Mesa RN, Francisco Manuel Cornejo-Gil RN, Jose Antonio Márquez-García RN","doi":"10.1016/j.enfi.2025.500564","DOIUrl":"10.1016/j.enfi.2025.500564","url":null,"abstract":"<div><h3>Introduction</h3><div>ICUs are one of the services where serious infections are treated, so the use of anti-infective drugs, especially those administered intravenously, is daily. The nursing staff is in charge of preparing, diluting and administering these medications.</div></div><div><h3>Objectives</h3><div>This study aims to compare the coincidences between the data obtained through human consultation of the technical data sheets of anti-infective drugs for intravenous use in ICUs with those obtained through the same search with an AI tool.</div></div><div><h3>Method</h3><div>A search was carried out for 8 parameters in the technical specifications of 55 drugs. Subsequently, to deepen the theoretical framework, we conducted a bibliographic search, selected the articles that met our inclusion criteria and synthesized the data. Finally, we used ChatGPT to perform an analysis of the parameters that we had previously searched humanly.</div></div><div><h3>Results</h3><div>After an exhaustive comparison of the findings attained both through human search and through the use of AI (ChatGPT), the coincidence of most of them was a fact.</div></div><div><h3>Conclusion</h3><div>As a conclusion of the study, it must be said that the evidences gathered by using AI (ChatGPT) were not as deep as those obtained when human analysis was carried out. Anyway, this information was valid enough when preparing the drugs. Therefore, AI (ChatGPT) can be considered a complementary tool in this field.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500564"},"PeriodicalIF":1.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104682","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}
The birth of a premature child represents a sudden and difficult change in family dynamics, where parents experience a disruption in their roles as their child is admitted to a neonatal intensive care unit, where the care they can provide is limited and the outcome is uncertain. The high levels of stress they experience modifies their relationship with their child, impacting their child's later emotional and developmental growth.
Objectives
To assess which factors related to parents and premature infants may significantly influence parental stress levels, family dynamics, and caregiver burden, and to understand how these factors affect them.
Method
Longitudinal study conducted in the Neonatology Department of the Central University Hospital of Asturias (HUCA), a tertiary-level neonatal care hospital, during the year 2023.
Results
Stress levels were found to increase significantly (p = 0.001) from admission (M = 37.5 points, 95% CI: 36.6-38.7) to 3 months post-discharge (M = 41.6 points, 95% CI: 40.2-43.1), and were higher in families with a medium-high socioeconomic level (at admission: OR = 3.4; 95% CI: 1.1-10.8 [p = 0.026], and at discharge: OR = 5; 95% CI: 1.5-16.3 [p = 0.006]). Family dysfunction was observed in cases of twin pregnancies (at discharge: OR = 3.3; 95% CI: 1.1-10.1; p = 0.029), and in more than half of the cases, caregiver burden was not observed (79.1% at discharge and 77.6% at 3 months post-discharge).
Conclusions
Support and guidance from the multidisciplinary team responsible for premature newborns in neonatal intensive care units is crucial, as well as the implementation of early interventions that help reduce parental stress and promote the proper development of their child.
{"title":"Efecto de la prematuridad en el estrés parental y la dinámica familiar","authors":"Belén Blanco García RN, MSD , Ruben Martín-Payo PhD , Gonzalo Solís Sánchez MD, PhD","doi":"10.1016/j.enfi.2025.500568","DOIUrl":"10.1016/j.enfi.2025.500568","url":null,"abstract":"<div><h3>Introduction</h3><div>The birth of a premature child represents a sudden and difficult change in family dynamics, where parents experience a disruption in their roles as their child is admitted to a neonatal intensive care unit, where the care they can provide is limited and the outcome is uncertain. The high levels of stress they experience modifies their relationship with their child, impacting their child's later emotional and developmental growth.</div></div><div><h3>Objectives</h3><div>To assess which factors related to parents and premature infants may significantly influence parental stress levels, family dynamics, and caregiver burden, and to understand how these factors affect them.</div></div><div><h3>Method</h3><div>Longitudinal study conducted in the Neonatology Department of the Central University Hospital of Asturias (HUCA), a tertiary-level neonatal care hospital, during the year 2023.</div></div><div><h3>Results</h3><div>Stress levels were found to increase significantly (p<!--> <!-->=<!--> <!-->0.001) from admission (M<!--> <!-->=<!--> <!-->37.5 points, 95% <span>C</span>I: 36.6-38.7) to 3 months post-discharge (M<!--> <!-->=<!--> <!-->41.6 points, 95% CI: 40.2-43.1), and were higher in families with a medium-high socioeconomic level (at admission: OR<!--> <!-->=<!--> <!-->3.4; 95% CI: 1.1-10.8 [p<!--> <!-->=<!--> <!-->0.026], and at discharge: OR<!--> <!-->=<!--> <!-->5; 95% CI: 1.5-16.3 [p<!--> <!-->=<!--> <!-->0.006]). Family dysfunction was observed in cases of twin pregnancies (at discharge: OR<!--> <!-->=<!--> <!-->3.3; 95% CI: 1.1-10.1; p<!--> <!-->=<!--> <!-->0.029), and in more than half of the cases, caregiver burden was not observed (79.1% at discharge and 77.6% at 3 months post-discharge).</div></div><div><h3>Conclusions</h3><div>Support and guidance from the multidisciplinary team responsible for premature newborns in neonatal intensive care units is crucial, as well as the implementation of early interventions that help reduce parental stress and promote the proper development of their child.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500568"},"PeriodicalIF":1.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018978","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 relationship between high-fidelity clinical simulation and levels of anxiety, stress and self-perceived competence in masters level nursing students.
Methods
We conducted a quasi-experimental pre–post study from June 2021 to December 2022 at the Faculty of Nursing. 190 Masters students took part in the study. Students were alphabetically divided into four sections of about 20 students and these sections were in turn divided into subgroups of three to four people. Seven clinical scenarios were designed, coinciding with frequent problems in critically ill children and each group of students was assigned one of them. Before and after resolving clinical scenarios students assessed their level of anxiety using the State-Trait Anxiety Inventory (STAI), the Self-Confidence in Learning Scale (SCLS), stress and the Nursing Student Satisfaction.
Results
The overall median score for anxiety was 8 (5–10) pre-CS versus 5 (3–7) post-CS, with a statistically significant relationship (p < 0.001). As for stress, we observed scores of 3.0 (2–4) points pre-CS vs. 2.0 (1–3) post-CS, also with statistical significance (p < 0.001). An overall self-confidence in learning score of 25.0 (22–28) points was obtained. Previous experience in CS was independently related to a lower level of stress after performing the CS, and the older the age, the higher the level of self-confidence in learning.
Conclusion
When designing scenarios that focus on the attention of critically ill pediatric patients, professionals should consider the relevant sociodemographic and professional variables in order to reduce anxiety and stress.
{"title":"Association between pediatric simulation-based education and anxiety, stress, self-confidence in learning, and satisfaction in master nursing students","authors":"M.ª Ángeles Saz-Roy PhD, PNP, RN, MSc , Núria Herranz-Rubia PNP, RN, MSc , Marta Tamame-San Antonio PNP, RN, MSc , Elvira García-Carulla PNP, RN , Miguel Ángel Hidalgo-Blanco PhD, RN, MSc , José Antonio Sarria-Guerrero PhD, RN, MSc , Esther Crespo-Mirasol PhD, RN, MSc , Alejandro Bosch-Alcaraz PhD, PNP, RN, MSc","doi":"10.1016/j.enfi.2025.500566","DOIUrl":"10.1016/j.enfi.2025.500566","url":null,"abstract":"<div><h3>Aim</h3><div>To analyze the relationship between high-fidelity clinical simulation and levels of anxiety, stress and self-perceived competence in masters level nursing students.</div></div><div><h3>Methods</h3><div>We conducted a quasi-experimental pre–post study from June 2021 to December 2022 at the Faculty of Nursing. 190 Masters students took part in the study. Students were alphabetically divided into four sections of about 20 students and these sections were in turn divided into subgroups of three to four people. Seven clinical scenarios were designed, coinciding with frequent problems in critically ill children and each group of students was assigned one of them. Before and after resolving clinical scenarios students assessed their level of anxiety using the State-Trait Anxiety Inventory (STAI), the Self-Confidence in Learning Scale (SCLS), stress and the Nursing Student Satisfaction.</div></div><div><h3>Results</h3><div>The overall median score for anxiety was 8 (5–10) pre-CS versus 5 (3–7) post-CS, with a statistically significant relationship (<em>p</em> <!--><<!--> <!-->0.001). As for stress, we observed scores of 3.0 (2–4) points pre-CS vs. 2.0 (1–3) post-CS, also with statistical significance (<em>p</em> <!--><<!--> <!-->0.001). An overall self-confidence in learning score of 25.0 (22–28) points was obtained. Previous experience in CS was independently related to a lower level of stress after performing the CS, and the older the age, the higher the level of self-confidence in learning.</div></div><div><h3>Conclusion</h3><div>When designing scenarios that focus on the attention of critically ill pediatric patients, professionals should consider the relevant sociodemographic and professional variables in order to reduce anxiety and stress.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500566"},"PeriodicalIF":1.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917880","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}
Simulation is a pedagogical methodology that promotes the development of technical, scientific, communicational, relational, and leadership skills without compromising people's safety. This study aimed to analyze the association between Advanced Cardiovascular Life Support simulation practice and Internal Medical Emergency Teams nurses’ self-perceived competence and assess changes in their self-perception before, immediately after, and three months post-training.
Methods
A prospective cohort study with intervention, consisting of Advanced Cardiovascular Life Support simulation practice and assessment, was carried out before the course, immediately after the course, and three months after the course regarding self-perception of nurse's skills. The sample consists of 26 nurses. The simulation practices were conducted in teams of 4–6 nurses per instructor, and nurses were randomly assigned to the simulated practice teams.
Results
Non-parametric analysis was carried out using the Wilcoxon test. Significance was measured. There was a trend of improvement in Advanced Cardiovascular Life Support skills perception, particularly immediately after the course and continued over time. The simulation training was effective and essential to improve the professionals’ skills and perception of their performance, and it lasted for three months to improve the professionals’ skills and performance perceptions.
Conclusions
Self-perception skills seem to influence comfort and confidence in acting, and it is possible to affirm that simulated practices contributed to improving nurse's self-assessment of their ability to act.
{"title":"Advanced Cardiovascular Life Support simulated practice in nursing: A prospective cohort study","authors":"Sónia Ferreira-Sousa RN , Ana Silva-Poeira PhD , Guida Silva-Amaral PhD","doi":"10.1016/j.enfi.2025.500567","DOIUrl":"10.1016/j.enfi.2025.500567","url":null,"abstract":"<div><h3>Background</h3><div>Simulation is a pedagogical methodology that promotes the development of technical, scientific, communicational, relational, and leadership skills without compromising people's safety. This study aimed to analyze the association between Advanced Cardiovascular Life Support simulation practice and Internal Medical Emergency Teams nurses’ self-perceived competence and assess changes in their self-perception before, immediately after, and three months post-training.</div></div><div><h3>Methods</h3><div>A prospective cohort study with intervention, consisting of Advanced Cardiovascular Life Support simulation practice and assessment, was carried out before the course, immediately after the course, and three months after the course regarding self-perception of nurse's skills. The sample consists of 26 nurses. The simulation practices were conducted in teams of 4–6 nurses per instructor, and nurses were randomly assigned to the simulated practice teams.</div></div><div><h3>Results</h3><div>Non-parametric analysis was carried out using the Wilcoxon test. Significance was measured. There was a trend of improvement in Advanced Cardiovascular Life Support skills perception, particularly immediately after the course and continued over time. The simulation training was effective and essential to improve the professionals’ skills and perception of their performance, and it lasted for three months to improve the professionals’ skills and performance perceptions.</div></div><div><h3>Conclusions</h3><div>Self-perception skills seem to influence comfort and confidence in acting, and it is possible to affirm that simulated practices contributed to improving nurse's self-assessment of their ability to act.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500567"},"PeriodicalIF":1.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913357","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}
Despite ethical principles and standards of care aiming to ensure proper pain management, inadequate pain treatment is common.
Aim
To explore ICU nurses’ beliefs, attitudes, and ethical perspectives regarding pain management in non-communicative critically ill patients, focusing on applying the bioethical principles of beneficence, non-maleficence, autonomy, and justice.
Methods
This qualitative study used descriptive phenomenology. We conducted semi-structured interviews with 11 nurses with ≥3 years’ ICU experience selected through purposive sampling. Thematic and content elements were combined for the analysis. Our hospital's ethics committee approved the study, and all participants provided written informed consent.
Findings
Nurses’ beliefs, attitudes, and ethical perspectives regarding pain management in non-communicative patients into 15 categories. Inequities in managing communicative and non-communicative patients arose mainly from professionals’ inadequate sensitivity, challenges of managing non-communicative patients, and personal beliefs. Nurses reported significant ethical dilemmas in managing pain of non-communicative patients, highlighting challenges in adequately applying principles of beneficence, non-maleficence, and justice. Findings indicate pain is often under-assessed and undertreated, partly due to misconceptions, high workload, and variability in pain assessment tools. Participants also expressed autonomy is frequently overlooked, as decisions are often made without patient or family input. Institutional factors like insufficient time and heavy workload, were identified as barriers to equitable pain management, limiting the consistent application of bioethical principles.
Conclusions
Results underscore the need for standardized ICU pain assessment protocols incorporating validated non-verbal tools, alongside ongoing ethical decision-making training and pain management. Better institutional support, including clearer guidelines and improved resource allocation, could help ICU nurses deliver more consistent, ethical, and patient-centered care, addressing bioethical principles of justice, beneficence, non-maleficence, and autonomy.
{"title":"Nurses’ perceptions of pain management in non-communicative critically ill patients: A phenomenological study","authors":"Gemma Robleda RN, MSc, PhD , Marta Benet PT, MPH, PhD , Helena Cebrià-Fondevila MD , Xavier Robleda-Font BA, MSc , Olga Canet-Vélez RN, MSc, PhD , Josep-Eladi Baños MD, PhD","doi":"10.1016/j.enfi.2025.500560","DOIUrl":"10.1016/j.enfi.2025.500560","url":null,"abstract":"<div><h3>Background</h3><div>Despite ethical principles and standards of care aiming to ensure proper pain management, inadequate pain treatment is common.</div></div><div><h3>Aim</h3><div>To explore ICU nurses’ beliefs, attitudes, and ethical perspectives regarding pain management in non-communicative critically ill patients, focusing on applying the bioethical principles of beneficence, non-maleficence, autonomy, and justice.</div></div><div><h3>Methods</h3><div>This qualitative study used descriptive phenomenology. We conducted semi-structured interviews with 11 nurses with ≥3 years’ ICU experience selected through purposive sampling. Thematic and content elements were combined for the analysis. Our hospital's ethics committee approved the study, and all participants provided written informed consent.</div></div><div><h3>Findings</h3><div>Nurses’ beliefs, attitudes, and ethical perspectives regarding pain management in non-communicative patients into 15 categories. Inequities in managing communicative and non-communicative patients arose mainly from professionals’ inadequate sensitivity, challenges of managing non-communicative patients, and personal beliefs. Nurses reported significant ethical dilemmas in managing pain of non-communicative patients, highlighting challenges in adequately applying principles of beneficence, non-maleficence, and justice. Findings indicate pain is often under-assessed and undertreated, partly due to misconceptions, high workload, and variability in pain assessment tools. Participants also expressed autonomy is frequently overlooked, as decisions are often made without patient or family input. Institutional factors like insufficient time and heavy workload, were identified as barriers to equitable pain management, limiting the consistent application of bioethical principles.</div></div><div><h3>Conclusions</h3><div>Results underscore the need for standardized ICU pain assessment protocols incorporating validated non-verbal tools, alongside ongoing ethical decision-making training and pain management. Better institutional support, including clearer guidelines and improved resource allocation, could help ICU nurses deliver more consistent, ethical, and patient-centered care, addressing bioethical principles of justice, beneficence, non-maleficence, and autonomy.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500560"},"PeriodicalIF":1.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536049","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 : 2025-07-01DOI: 10.1016/j.enfi.2025.500559
Paula Samanta-Pereira RN , Ana Carolina-Monteiro MSc , Matilde Fernandes MSc
{"title":"A commentary on “Development of burnout and moral distress in intensive care nurses: An integrative literature review” (Salas-Bergüés et al., 2024)","authors":"Paula Samanta-Pereira RN , Ana Carolina-Monteiro MSc , Matilde Fernandes MSc","doi":"10.1016/j.enfi.2025.500559","DOIUrl":"10.1016/j.enfi.2025.500559","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500559"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536221","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 : 2025-06-27DOI: 10.1016/j.enfi.2025.500561
María Dolores Saiz-Vinuesa RN, MSc, PhD candidate , Eloina Rodriguez-Moreno RN , Francisca Calero-Yánez RN, MSc, PhD candidate , Ana María Piqueras-Carrión TCAE , Carmen Carrilero-López RN , Isabel Murcia-Sáez MD, PhD , María Pilar Córcoles-Jimenez RN, MSc, PhD , Milagros Molina-Alarcón Psy, PhD
Introduction
Enteral nutrition (EN) is a common nutritional support in intensive care units (ICU). The administration method can be continuous (CEN)or intermittent (IEN), but there are controversies and a lack of evidence on which method is more effective in achieving good nutritional status while minimizing complications.
Objectives
To evaluate the safety (no increase in complications) IEN versus CEN during administration of EN with a gastric feeding tube (GFT) in ICU patients.
Methods
Randomized, open clinical trial. Registered in Clinical Trials. Population: Adults >18 years admitted to ICU, with GFT, indication of EN, signed consent. Exclusion: insulin-dependent diabetic. Intervention: Control (CEN): continuous administration via infusion pump; Experimental (IEN): the total amount divided into 4 doses, administered q 6 h via infusion pump, for 1 hour each dose. Outcome variables: complications (gastrointestinal, respiratory, metabolic), achievement of caloric goal (CG) Others: demographic data, nutritional status, severity (APACHE), EN type, mechanical ventilation (MV), duration of EN, causes of interruption. Statistical analysis: SPSS. Intention-to-treat analysis. Measures of central tendency and dispersión (standard deviation or interquartile range: IQR), absolute and relative frequencies. Bivariate analysis: Chi-cuadrado, t-Student and U-Mann-Whitney.Ethical aspects: CEIm approval.
Results
Forty patients (18 CEN/22 IEN), 70% (28) men, age 62.65 DE: 13.27 years (95% CI: 58.40-66.90), BMI: 27.93 (IQR: 4.6), APACHE II: 18.85 DE: 5.83 (95% CI: 16.98-20.72), MV: 11.5 days (IQR: 13). 17.5% (7) diabetic. The CEN and IEN groups were homogeneous for all variables except APACHE (CEN 21.22 vs. IEN 16.91; P=.018). CG was achieved by 82.5% (33) (88.9 CEN vs.77.3% IEN; P=.33), time to achieve it (36 hours CEN vs. 34 h IEN; P=.28). Complications: vomiting: 20% (8) patients (4 per group; P=.75). Diarrhea: (16.7% CEN vs. 22.7% IEN; P=.63). Bronchial aspiration and GRV > 500 cc 1 case in IEN. Median interruptions (2.5 [IQR: 2] CEN vs. 1 [IQR: 2] IEN; P=.005).
Discussion
The results are similar to other studies. CG was achieved in a high percentage, with no differences between groups. The use of INE shows feweer interruptions, which may lead to better compliance with caloric guidelines without increasing complications, maintaining physiological guidelines.
Conclusion
IEN in ICU patients shows no differences in terms of complications, compared to CEN, nor less effectiveness in achieving the CG. A larger sample is needed to identify the advantages and complications of each method.
肠内营养（EN）是重症监护病房（ICU）常见的营养支持。给药方法可以是连续给药（CEN）或间歇给药（IEN），但关于哪种给药方法更有效地达到良好的营养状态，同时最大限度地减少并发症，存在争议和缺乏证据。目的评价EN与CEN在ICU患者胃饲管（GFT）下的安全性（无并发症增加）。方法随机、开放临床试验。临床试验注册。人群：18岁成人，ICU， GFT， EN指征，已签署同意。排除：胰岛素依赖型糖尿病。干预：控制（CEN）：通过输液泵持续给药；实验（IEN）：总剂量分为4剂，每6 h通过泵给药，每1 h给药。结局变量：并发症（胃肠道、呼吸、代谢）、热量目标（CG）的实现其他：人口统计数据、营养状况、严重程度（APACHE）、EN类型、机械通气（MV）、EN持续时间、中断原因。统计分析：SPSS。意向处理分析。集中趋势和dispersión（标准差或四分位数间距：IQR）、绝对频率和相对频率的度量。双变量分析：Chi-cuadrado， t-Student和U-Mann-Whitney。伦理方面：CEIm批准。结果40例患者（18例CEN/22例IEN），男性占70%（28例），年龄62.65岁，DE: 13.27岁（95% CI: 58.40-66.90）， BMI: 27.93 (IQR: 4.6), APACHE II: 18.85 DE: 5.83 (95% CI: 16.98-20.72), MV: 11.5天（IQR: 13）。17.5%（7人）患有糖尿病。除APACHE外，CEN组和IEN组在所有变量上均均匀(CEN 21.22 vs. IEN 16.91；P = .018)。CG达到82.5%（33例）(CEN为88.9，IEN为77.3%；P= 0.33)，实现时间(36小时CEN vs. 34小时IEN；P =陈霞)。并发症：呕吐：20%(8)例（每组4例）；P =炮)。腹泻：CEN占16.7%，IEN占22.7%；P =点)。支气管吸入与GRV >；500cc 1例IEN。中位中断(2.5 [IQR: 2] CEN vs. 1 [IQR: 2] IEN；P = .005)。讨论结果与其他研究相似。CG达到了很高的百分比，组间无差异。INE的使用显示更少的中断，这可能导致更好地遵守热量指南，而不会增加并发症，维持生理指南。结论与CEN相比，ien在ICU患者的并发症方面没有差异，在实现CG方面的效果也不差。需要更大的样本来确定每种方法的优点和复杂性。
{"title":"Seguridad de la nutrición enteral intermitente frente a la continua en los pacientes críticos. Ensayo clínico aleatorizado","authors":"María Dolores Saiz-Vinuesa RN, MSc, PhD candidate , Eloina Rodriguez-Moreno RN , Francisca Calero-Yánez RN, MSc, PhD candidate , Ana María Piqueras-Carrión TCAE , Carmen Carrilero-López RN , Isabel Murcia-Sáez MD, PhD , María Pilar Córcoles-Jimenez RN, MSc, PhD , Milagros Molina-Alarcón Psy, PhD","doi":"10.1016/j.enfi.2025.500561","DOIUrl":"10.1016/j.enfi.2025.500561","url":null,"abstract":"<div><h3>Introduction</h3><div>Enteral nutrition (EN) is a common nutritional support in intensive care units (ICU). The administration method can be continuous (CEN)or intermittent (IEN), but there are controversies and a lack of evidence on which method is more effective in achieving good nutritional status while minimizing complications.</div></div><div><h3>Objectives</h3><div>To evaluate the safety (no increase in complications) IEN versus CEN during administration of EN with a gastric feeding tube (GFT) in ICU patients.</div></div><div><h3>Methods</h3><div>Randomized, open clinical trial. Registered in Clinical Trials. Population: Adults<!--> <!-->>18 years admitted to ICU, with GFT, indication of EN, signed consent. Exclusion: insulin-dependent diabetic. Intervention: Control (CEN): continuous administration via infusion pump; Experimental (IEN): the total amount divided into 4 doses, administered q 6<!--> <!-->h via infusion pump, for 1 hour each dose. Outcome variables: complications (gastrointestinal, respiratory, metabolic), achievement of caloric goal (CG) Others: demographic data, nutritional status, severity (APACHE), EN type, mechanical ventilation (MV), duration of EN, causes of interruption. Statistical analysis: SPSS. Intention-to-treat analysis. Measures of central tendency and dispersión (standard deviation or interquartile range: IQR), absolute and relative frequencies. Bivariate analysis: Chi-cuadrado, t-Student and U-Mann-Whitney.Ethical aspects: CEIm approval.</div></div><div><h3>Results</h3><div>Forty patients (18 CEN/22 IEN), 70% (28) men, age 62.65 DE: 13.27 years (95% CI: 58.40-66.90), BMI: 27.93 (IQR: 4.6), APACHE II: 18.85 DE: 5.83 (95% CI: 16.98-20.72), MV: 11.5<!--> <!-->days (IQR: 13). 17.5% (7) diabetic. The CEN and IEN groups were homogeneous for all variables except APACHE (CEN 21.22 vs. IEN 16.91; <em>P</em>=.018). CG was achieved by 82.5% (33) (88.9 CEN vs.77.3% IEN; <em>P</em>=.33), time to achieve it (36<!--> <!-->hours CEN vs. 34<!--> <!-->h IEN; <em>P</em>=.28). Complications: vomiting: 20% (8) patients (4 per group; <em>P</em>=.75). Diarrhea: (16.7% CEN vs. 22.7% IEN; <em>P</em>=.63). Bronchial aspiration and GRV<!--> <!-->><!--> <!-->500<!--> <!-->cc 1 case in IEN. Median interruptions (2.5 [IQR: 2] CEN vs. 1 [IQR: 2] IEN; <em>P</em>=.005).</div></div><div><h3>Discussion</h3><div>The results are similar to other studies. CG was achieved in a high percentage, with no differences between groups. The use of INE shows feweer interruptions, which may lead to better compliance with caloric guidelines without increasing complications, maintaining physiological guidelines.</div></div><div><h3>Conclusion</h3><div>IEN in ICU patients shows no differences in terms of complications, compared to CEN, nor less effectiveness in achieving the CG. A larger sample is needed to identify the advantages and complications of each method.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500561"},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489931","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 : 2025-06-20DOI: 10.1016/j.enfi.2025.500562
Kholood E. Al-Nbabteh MSN , Rezan Bani Bkar MSN , Ayman M. Al-Qaaneh PhD , Eqbal M. Alfarajat PhD , Sonia Kraishan MSN
Background
Sleep is an essential component of daily living, yet sleep disturbances are prevalent among nurses in critical care settings. Poor sleep quality is linked to adverse outcomes, including diminished cognitive and physical performance, mood disorders, and an increased risk of chronic diseases. This study aimed to evaluate the sleep quality of critical care nurses in Jordanian public hospitals and identify the associated factors.
Methods
A cross-sectional study was conducted in two major hospitals affiliated with Jordan's Ministry of Health. A convenience sample of 172 critical care nurses completed the Pittsburgh Sleep Quality Index (PSQI), the National Aeronautics and Space Administration Task Load Index (NASA-TLX), and the Depression Anxiety Stress Scale (DASS). Data were analyzed using multiple regression analysis in SPSS version 28.
Results
A total of 82.6% of nurses reported poor sleep quality, with an average global PSQI score of 10.87 ± 3.19. Workload (B = 2.844, p < 0.001) and anxiety (B = 1.087, p < 0.001) were the most significant predictors of poor sleep quality. Marital status (B = 1.466, p = 0.017) and working shifts (B = 1.826, p = 0.022) were also significantly associated with poor sleep quality.
Conclusion
Poor sleep quality level was found among the majority of critical care nurses, highlighting the need of implementing immediate interventions; including routine assessment of nurses sleep quality, ongoing support and counseling. Policymakers should prioritize initiatives such as workload management, disciplined shift scheduling, and stress reduction programs to improve nurses’ well-being. Implementing these procedures may reduce fatigue-related medical errors and increase patient safety.
睡眠是日常生活的重要组成部分，但睡眠障碍在重症护理环境中的护士中很普遍。睡眠质量差与不良后果有关，包括认知和身体表现下降、情绪障碍以及患慢性病的风险增加。本研究旨在评估约旦公立医院重症护理护士的睡眠质量，并确定相关因素。方法在约旦卫生部所属的两大医院进行横断面研究。方便抽样172名重症护理护士完成匹兹堡睡眠质量指数（PSQI）、美国国家航空航天局任务负荷指数（NASA-TLX）和抑郁焦虑压力量表（DASS）。数据分析采用SPSS 28版多元回归分析。结果82.6%的护士睡眠质量较差，整体PSQI平均得分为10.87±3.19。工作量(B = 2.844, p <；0.001)和焦虑(B = 1.087, p <；0.001)是睡眠质量差的最显著预测因子。婚姻状况（B = 1.466, p = 0.017）和工作班次（B = 1.826, p = 0.022）也与睡眠质量差显著相关。结论大多数重症护士睡眠质量水平较差，需要立即采取干预措施；包括对护士睡眠质量的常规评估，持续的支持和咨询。政策制定者应优先考虑工作量管理、有纪律的轮班安排和减压计划等举措，以改善护士的福祉。实施这些程序可以减少与疲劳有关的医疗差错，提高患者安全。
{"title":"Sleep quality and associated factors among critical care nurses in Jordan: A cross-sectional study","authors":"Kholood E. Al-Nbabteh MSN , Rezan Bani Bkar MSN , Ayman M. Al-Qaaneh PhD , Eqbal M. Alfarajat PhD , Sonia Kraishan MSN","doi":"10.1016/j.enfi.2025.500562","DOIUrl":"10.1016/j.enfi.2025.500562","url":null,"abstract":"<div><h3>Background</h3><div>Sleep is an essential component of daily living, yet sleep disturbances are prevalent among nurses in critical care settings. Poor sleep quality is linked to adverse outcomes, including diminished cognitive and physical performance, mood disorders, and an increased risk of chronic diseases. This study aimed to evaluate the sleep quality of critical care nurses in Jordanian public hospitals and identify the associated factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in two major hospitals affiliated with Jordan's Ministry of Health. A convenience sample of 172 critical care nurses completed the Pittsburgh Sleep Quality Index (PSQI), the National Aeronautics and Space Administration Task Load Index (NASA-TLX), and the Depression Anxiety Stress Scale (DASS). Data were analyzed using multiple regression analysis in SPSS version 28.</div></div><div><h3>Results</h3><div>A total of 82.6% of nurses reported poor sleep quality, with an average global PSQI score of 10.87<!--> <!-->±<!--> <!-->3.19. Workload (<em>B</em> <!-->=<!--> <!-->2.844, <em>p</em> <!--><<!--> <!-->0.001) and anxiety (<em>B</em> <!-->=<!--> <!-->1.087, <em>p</em> <!--><<!--> <!-->0.001) were the most significant predictors of poor sleep quality. Marital status (<em>B</em> <!-->=<!--> <!-->1.466, <em>p</em> <!-->=<!--> <!-->0.017) and working shifts (<em>B</em> <!-->=<!--> <!-->1.826, <em>p</em> <!-->=<!--> <!-->0.022) were also significantly associated with poor sleep quality.</div></div><div><h3>Conclusion</h3><div>Poor sleep quality level was found among the majority of critical care nurses, highlighting the need of implementing immediate interventions; including routine assessment of nurses sleep quality, ongoing support and counseling. Policymakers should prioritize initiatives such as workload management, disciplined shift scheduling, and stress reduction programs to improve nurses’ well-being. Implementing these procedures may reduce fatigue-related medical errors and increase patient safety.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500562"},"PeriodicalIF":1.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322394","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 : 2025-06-20DOI: 10.1016/j.enfi.2025.500558
Susana Arias-Rivera RN, MSN , Marta Raurell-Torredà RN, PhD , María Nieves Moro-Tejedor RN, PhD , Israel John Thuissard-Vasallo PhD , Cristina Andreu-Vázquez MVD, MsC, PhD , Fernando Frutos-Vivar MD, PhD , grupo CFS-Es-UCI
Introduction
Frailty scales, developed to assess elderly patients, are being implemented in critically ill patients. One of the most widely used is Clinical Frailty Scale, wrecently adapted to Spanish (CFS-Spain).
Objective
To evaluate the validity and sensitivity to change of the CFS-España in a cohort of critically ill patients aged ≥18 years.
Methodology
A prospective, multicenter, observational, metric-based study was conducted between January-2020 and July-2024. Adult patients with ICU stays >48 hours were included. Follow-up was performed during the stay and up to one year after discharge. Variables: frailty, sociodemographic characteristics, quality of life, comorbidities, severity (SAPS3), ICU outcome variables, length of stay, and discharge destination. Statistical analysis: exploratory, bivariate regression to assess the relationship between frailty and the recorded variables; multivariate regression of significant variables in bivariate. Spearman correlation of CFS-Spain with quantitative variables. Comparison of means with Student's t-test for sensitivity to change.
Results
A total of 493 patients were included, 17.4% of whom were frail (CFS-Spain = 5-9). Age, being female, and being dependent increased the risk of frailty, as did previous hospitalizations, comorbidities, poorer physical quality of life, low academic level, and low annual income. Frailty predicts muscle weakness, hypoglycemia, the need for extrarenal blood pressure, invasive mechanical ventilation, vasoactive drugs, cardiopulmonary resuscitation, or limitation of life-sustaining treatment, and is associated with mortality. Frailty was not associated with mental quality of life, SAPS3, SOFA or ICU/hospital stay. The greatest change observed was between admission and 3 months after discharge. The effect size for changes in CFS-Es between admission, midpoints, and discharge was high (d = 0.832).
Conclusions
The CFS-Spain shows good convergent validity with age, women, dependency, poorer physical quality of life, days of previous hospitalization, academic level and low annual income. Good predictive validity for the level of vital support in ICU, mortality and destination at hospital discharge.
{"title":"Validez y sensibilidad al cambio de la Clinical Frailty Scale-España en pacientes ingresados en cuidados intensivos","authors":"Susana Arias-Rivera RN, MSN , Marta Raurell-Torredà RN, PhD , María Nieves Moro-Tejedor RN, PhD , Israel John Thuissard-Vasallo PhD , Cristina Andreu-Vázquez MVD, MsC, PhD , Fernando Frutos-Vivar MD, PhD , grupo CFS-Es-UCI","doi":"10.1016/j.enfi.2025.500558","DOIUrl":"10.1016/j.enfi.2025.500558","url":null,"abstract":"<div><h3>Introduction</h3><div>Frailty scales, developed to assess elderly patients, are being implemented in critically ill patients. One of the most widely used is Clinical Frailty Scale, wrecently adapted to Spanish (CFS-Spain).</div></div><div><h3>Objective</h3><div>To evaluate the validity and sensitivity to change of the CFS-España in a cohort of critically ill patients aged ≥18 years.</div></div><div><h3>Methodology</h3><div>A prospective, multicenter, observational, metric-based study was conducted between January-2020 and July-2024. Adult patients with ICU stays<!--> <!-->>48<!--> <!-->hours were included. Follow-up was performed during the stay and up to one year after discharge. Variables: frailty, sociodemographic characteristics, quality of life, comorbidities, severity (SAPS3), ICU outcome variables, length of stay, and discharge destination. Statistical analysis: exploratory, bivariate regression to assess the relationship between frailty and the recorded variables; multivariate regression of significant variables in bivariate. Spearman correlation of CFS-Spain with quantitative variables. Comparison of means with Student's t-test for sensitivity to change.</div></div><div><h3>Results</h3><div>A total of 493 patients were included, 17.4% of whom were frail (CFS-Spain<!--> <!-->=<!--> <!-->5-9). Age, being female, and being dependent increased the risk of frailty, as did previous hospitalizations, comorbidities, poorer physical quality of life, low academic level, and low annual income. Frailty predicts muscle weakness, hypoglycemia, the need for extrarenal blood pressure, invasive mechanical ventilation, vasoactive drugs, cardiopulmonary resuscitation, or limitation of life-sustaining treatment, and is associated with mortality. Frailty was not associated with mental quality of life, SAPS3, SOFA or ICU/hospital stay. The greatest change observed was between admission and 3 months after discharge. The effect size for changes in CFS-Es between admission, midpoints, and discharge was high (<em>d</em> <!-->=<!--> <!-->0.832).</div></div><div><h3>Conclusions</h3><div>The CFS-Spain shows good convergent validity with age, women, dependency, poorer physical quality of life, days of previous hospitalization, academic level and low annual income. Good predictive validity for the level of vital support in ICU, mortality and destination at hospital discharge.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500558"},"PeriodicalIF":1.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330788","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 : 2025-06-20DOI: 10.1016/j.enfi.2025.500557
Mónica Padilla-Lamadrid RN, MSN , Ana Pardo-Fernández RN, MSN , Raquel Torres-Luna RN, MSc , Alberto García-Gómez RN, MSN , Julia de Villarreal-Arracò RN, MSN , Elena García-González RN, MSN , Laura Frade-Pardo RN, MSN , Pedro Piqueras-Rodríguez RN, MSN , Eva del Ara Muñoz-Granda RN
Background
Pediatric critical care has undergone important changes in the last decades. In order to adapt pediatric care to the patient-family binomial and guarantee its quality, the evaluation of the needs perceived by family members during hospital stay is becoming increasingly relevant.
Objective
To determine the perception of the needs of the relatives of patients admitted to the pediatric critical care units (PCCU) in a tertiary level hospital.
Methods
Cross-sectional descriptive observational quantitative study was run through the distribution of the modified version of the Critical Care Family Needs Inventory. Population: Parents or legal caregivers of patients admitted to 2 PCCUs with >48 h stay between September 2023 and January 2024. Descriptive analysis, Mann-Whitney U and Kruskal-Wallis tests were performed.
Results
Eighty-four questionnaires were completed. The median total score on the questionnaire was 15.00, corresponding to a high perception of fulfillment of needs. The subscale with the highest degree of compliance of the needs was «Patient care» (3.00), followed by «Information and communication» (3.00) and «Family care» (4.50); the subscale «Possible perceived improvements» (4.50) was the one with the worst results. Statistically significant differences were found when comparing the total score between units (P = 0.046) and according to the type of room (P = 0.016) and the educational level of the relatives (P = 0.049). No significant differences were found during the analysis of the remaining variables.
Conclusions
The findings suggest that the hospital environment, specifically type of room, have a significant impact on the perception of family members’ needs fulfillment. It is considered essential to adapt pediatric critical care units in order to suit today's family-centered care approach.
{"title":"Percepción de necesidades de los familiares de pacientes en unidades de cuidados críticos pediátricos","authors":"Mónica Padilla-Lamadrid RN, MSN , Ana Pardo-Fernández RN, MSN , Raquel Torres-Luna RN, MSc , Alberto García-Gómez RN, MSN , Julia de Villarreal-Arracò RN, MSN , Elena García-González RN, MSN , Laura Frade-Pardo RN, MSN , Pedro Piqueras-Rodríguez RN, MSN , Eva del Ara Muñoz-Granda RN","doi":"10.1016/j.enfi.2025.500557","DOIUrl":"10.1016/j.enfi.2025.500557","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric critical care has undergone important changes in the last decades. In order to adapt pediatric care to the patient-family binomial and guarantee its quality, the evaluation of the needs perceived by family members during hospital stay is becoming increasingly relevant.</div></div><div><h3>Objective</h3><div>To determine the perception of the needs of the relatives of patients admitted to the pediatric critical care units (PCCU) in a tertiary level hospital.</div></div><div><h3>Methods</h3><div>Cross-sectional descriptive observational quantitative study was run through the distribution of the modified version of the Critical Care Family Needs Inventory. <em>Population:</em> Parents or legal caregivers of patients admitted to 2<!--> <!-->PCCUs with<!--> <!-->>48<!--> <!-->h stay between September 2023 and January 2024. Descriptive analysis, Mann-Whitney U and Kruskal-Wallis tests were performed.</div></div><div><h3>Results</h3><div>Eighty-four questionnaires were completed. The median total score on the questionnaire was 15.00, corresponding to a high perception of fulfillment of needs. The subscale with the highest degree of compliance of the needs was «Patient care» (3.00), followed by «Information and communication» (3.00) and «Family care» (4.50); the subscale «Possible perceived improvements» (4.50) was the one with the worst results. Statistically significant differences were found when comparing the total score between units (<em>P</em> <!-->=<!--> <!-->0.046) and according to the type of room (<em>P</em> <!-->=<!--> <!-->0.016) and the educational level of the relatives (<em>P</em> <!-->=<!--> <!-->0.049). No significant differences were found during the analysis of the remaining variables.</div></div><div><h3>Conclusions</h3><div>The findings suggest that the hospital environment, specifically type of room, have a significant impact on the perception of family members’ needs fulfillment. It is considered essential to adapt pediatric critical care units in order to suit today's family-centered care approach.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500557"},"PeriodicalIF":1.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330032","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