Australian Critical Care最新文献

{"title":"‘White lies and safety nets’: The perceptions of nurses on the use of early warning systems and the development of higher-order thinking skills","authors":"Deb Massey RN, PhD ,&nbsp;Tracy Flenady RN, PhD ,&nbsp;Amy-Louise Byrne RN, PhD ,&nbsp;Justine Connor RN, MPhil ,&nbsp;Danielle Le Lagadec RN, PhD","doi":"10.1016/j.aucc.2024.04.007","DOIUrl":"10.1016/j.aucc.2024.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Algorithmic tools such as early warning systems (EWSs) have been embedded into clinical practice globally to facilitate the early recognition of patient deterioration and to guide the escalation of care. Concerns have been raised that the mandated use of these EWS tools may impact the development of nurses' higher-order thinking. However, the relationship between EWS tools and the development of higher-order thinking is poorly understood.</div></div><div><h3>Objectives</h3><div>This paper provides the qualitative results of a larger study that sought to explore the impact of EWS tools on the development of nurses' higher-order thinking. The objective of this component of the study was to ascertain the thoughts and perceptions of nurses on the use of EWSs and how this related to the development of higher-order thinking skills.</div></div><div><h3>Methods</h3><div>A mixed-method, concurrent study design was used to explore the concept of the development of nurses' higher-order thinking in the context of EWS tools. The qualitative responses from a Qualtrics survey were thematically analysed and presented.</div></div><div><h3>Findings</h3><div>Two major themes were uncovered: <em>White Lies</em> and <em>Safety Nets</em>. Our analysis of the data suggested that some nurses amend their documentation practice to accommodate the EWS’s escalation process, uncovering a view that the tool did not account for clinical reasoning. Parallel to this, some nurses found that these systems supported clinical decision-making and helped to build confidence, thus acting as a safety net for their practice.</div></div><div><h3>Conclusion</h3><div>Reliance on EWSs can both hinder and/or support the development of higher-order thinking. Early warning systems are useful tools in ensuring patient safety but should be used in conjunction with nurses' higher-order thinking.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101062"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible fibreoptic bronchoscopy is beneficial in children on extracorporeal membrane oxygenation support","authors":"Pravin Babhalgaonkar MBBS ,&nbsp;Gareth Forster FRACP ,&nbsp;Ian B. Masters FRACP ,&nbsp;Emma Haisz RN ,&nbsp;Adrian Mattke FCICM ,&nbsp;Sarfaraz Rahiman FCICM","doi":"10.1016/j.aucc.2024.05.008","DOIUrl":"10.1016/j.aucc.2024.05.008","url":null,"abstract":"<div><h3>Background</h3><div>Flexible fibreoptic bronchoscopy<span><span> (FFB) has the potential to enhance diagnostic capabilities and improve pulmonary function in children on </span>extracorporeal membrane oxygenation (ECMO).</span></div></div><div><h3>Objectives</h3><div>The objective of this study was to evaluate the benefits (clinical, radiological, and microbiological) of FFB and assess associated complications in children on ECMO.</div></div><div><h3>Methods</h3><div>We conducted a single-centre retrospective observational cohort study in a tertiary paediatric intensive care unit. All FFB episodes performed during the study period on children aged 0–18 years on ECMO were included.</div></div><div><h3>Results</h3><div>Out of the 155 children who received ECMO, 36 (23%) underwent a total of 92 episodes of FFB. FFB provided anatomical and pathological information in 53% (19/36) of cases and proved beneficial in clearing the airways in 62% (54/87) of the episodes.</div><div><span>Overall, patients exhibited transient increases in ECMO and mechanical ventilation<span> support 1 h post FFB in 14% (13/92) and 9.7% (9/92) episodes, respectively. At 6 h, the mean fraction of inspired oxygen on the mechanical ventilator was lower (0.46 [±0.21] vs 0.53 [±0.21] </span></span><em>p</em><span> &lt; 0.01), with no change in mean airway pressure. Similarly, compared to pre-FFB, the fraction of inspired oxygen on the mechanical ventilator on ECMO was lower at 6 h and 24 h (0.65 [±0.25] vs 0.71 [±0.23] </span><em>p</em> &lt; 0.01 and 0.006, respectively), with no significant change in the sweep gas flow and ECMO flow.</div><div>The radiological imaging indicated improved or stable findings in 91% (83/91) of FFB episodes. FFB contributed to the identification of new and previously unknown microbiological information in 75% (27/36) of the patients. The incidence of major complications was 7.6%. Minor self-resolving bleeding occurred in 25% (23/92) episodes, and major bleeding occurred in two episodes, with a total of 10 episodes needing blood product transfusion.</div></div><div><h3>Conclusions</h3><div>FFB is a valuable adjunct in managing children with severe respiratory failure on ECMO, offering clinical benefits with a low rate of major complications. Further studies should aim to develop a consensus approach encompassing criteria and clinical management around FFB in patients on ECMO.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101071"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk prediction models for intensive care unit–acquired weakness in critically ill patients: A systematic review","authors":"Yue Zhou RN, BSN,&nbsp;YuJian Sun RN, BSN,&nbsp;YuFan Pan RN, BSN,&nbsp;Yu Dai RN, BSN,&nbsp;Yi Xiao RN, BSN,&nbsp;YuFeng Yu BSN","doi":"10.1016/j.aucc.2024.05.003","DOIUrl":"10.1016/j.aucc.2024.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Intensive care unit<span> (ICU)-acquired weakness (ICU-AW) is a critical complication that significantly worsens patient prognosis. It is widely thought that risk prediction models can be harnessed to guide preventive interventions. While the number of ICU-AW risk prediction models is increasing, the quality and applicability of these models in clinical practice remain unclear.</span></div></div><div><h3>Objective</h3><div>The objective of this study was to systematically review published studies on risk prediction models for ICU-AW.</div></div><div><h3>Methods</h3><div>We searched electronic databases (PubMed, Web of Science, The Cochrane Library<span>, Embase<span>, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), China Science and Technology Periodical Database (VIP), and Wanfang Database) from inception to October 2023 for studies on ICU-AW risk prediction models. Two independent researchers screened the literature, extracted data, and assessed the risk of bias and applicability of the included studies.</span></span></div></div><div><h3>Results</h3><div><span>A total of 2709 articles were identified. After screening, 25 articles were selected, encompassing 25 risk prediction models. The area under the curve for these models ranged from 0.681 to 0.926. Evaluation of bias risk indicated that all included models exhibited a high risk of bias, with three models demonstrating poor applicability. The top five predictors among these models were </span>mechanical ventilation<span> duration, age, Acute Physiology and Chronic Health Evaluation II score, blood lactate levels, and the length of ICU stay. The combined area under the curve of the ten validation models was 0.83 (95% confidence interval: 0.77–0.88), indicating a strong discriminative ability.</span></div></div><div><h3>Conclusions</h3><div>Overall, ICU-AW risk prediction models demonstrate promising discriminative ability. However, further optimisation is needed to address limitations, including data source heterogeneity, potential biases in study design, and the need for robust statistical validation. Future efforts should prioritise external validation of existing models or the development of high-quality predictive models with superior performance.</div></div><div><h3>Registration</h3><div>The protocol for this study is registered with the International Prospective Register of Systematic Reviews (registration number: CRD42023453187).</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101066"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practices for defining, detecting, and diagnosing postoperative atrial fibrillation after coronary revascularization surgery – A scoping review","authors":"Megan Higgs RN, MN ,&nbsp;Julee McDonagh RN, PhD ,&nbsp;Jenny Sim RN, PhD","doi":"10.1016/j.aucc.2024.06.006","DOIUrl":"10.1016/j.aucc.2024.06.006","url":null,"abstract":"<div><h3>Objectives</h3><div>This scoping review was undertaken to understand the degree of variation in clinical practices associated with postoperative atrial fibrillation (POAF), following coronary revascularization surgery by collating and synthesising key concepts from current published literature.</div></div><div><h3>Review methods and data sources</h3><div>This scoping review was conducted following the framework outlined by Askey and O'Malley. Reporting of this scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.</div><div>Initial searches were completed in September 2020 and updated in January 2023. Comprehensive searches to identify relevant published literature were carried out within CINAHL, MEDLINE, and ProQuest databases. All searches were limited to full-text papers published in English with human adult participants. Deductive content analysis using NVivo software was performed to synthesise the data.</div></div><div><h3>Results</h3><div>A total of 692 studies were identified during the database searches. After the deletion of duplicates and the application of the inclusion and exclusion criteria, 73 studies were included in the scoping review. The included studies were published between 2001 and 2022 and included a total of 24,833 participants. Forty-six studies included a definition of POAF, with four of these citing a peak-body definition. A total of 24 included studies reported on electrocardiogram diagnostic criteria for POAF, with 13/24 [54%] describing these characteristics within their definition. The time-based diagnostic criteria ranged from a minimum duration of greater than 30 seconds to greater than 1 hour. The most frequently reported minimum-time thresholds were ≥30 seconds, reported in 12 of 51 (24%) studies and ≥5 min, reported in 13 of 51 (25%) studies.</div></div><div><h3>Conclusions</h3><div>There is a lack of consistency in clinical practice for defining, detecting, and diagnosing POAF, following coronary revascularization surgery. Consensus and standardisation of clinical practices are urgently needed.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101083"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N95 respirator seal integrity following extended-use by healthcare workers in the intensive care unit: A cohort study","authors":"Samuel J. Reade MBChB, MRes,&nbsp;Ahmad Bassam MBBS, BMedSci,&nbsp;Wisam Al-Bassam FCICM, MBChB,&nbsp;Umesh Kadam MD, MRCP UK, FCICM","doi":"10.1016/j.aucc.2024.07.080","DOIUrl":"10.1016/j.aucc.2024.07.080","url":null,"abstract":"<div><h3>Aim/objectives</h3><div>Fit testing of N95/FFP2 respirators is universally recommended before exposure to airborne infectious diseases such as COVID-19. Respirator supply shortage in the COVID-19 pandemic encouraged extended-use for up to 4 h, despite uncertainty about seal integrity over time. The aim of our study was to assess N95 seal integrity after at least 2 h of continuous clinical use in the intensive care unit (ICU). We hypothesised that seal integrity would deteriorate over time, with variability between respirator shapes.</div></div><div><h3>Methods</h3><div>A prospective cohort study of healthcare workers in a metropolitan ICU setting in Australia between April 2021 and August 2022. Following consent and screening, participants underwent qualitative fit testing in the ICU, and fit tests were repeated following a continuous period of at least 2-h usage. The primary outcome was N95 fit-test failure rate measured by qualitative fit testing of &gt;2 h compared to baseline. Secondary outcomes evaluated effects of respirator shape, demographic characteristics, and duration of respirator use on respirator fit after 2 h use.</div></div><div><h3>Results</h3><div>Fifty-one participants were recruited and consented. Six participants were excluded; four failed baseline fit test, one could not taste saccharin, and one did not complete 2 h of usage. Fourteen of 45 participants (∼31%) failed the extended-use fit test (median duration: 2 h 10 min [interquartile range: 2:07–2:20]). Fit-test rates differed between respirator shapes; three-piece flat-fold respirators had lower failure rates (6/32; 19%) than duckbill-shaped respirators (6/11; 55%) p = 0.046. No other demographic characteristic or respirator shape was significantly associated with increased failure rate.</div></div><div><h3>Conclusions</h3><div>Following 2 h of use, approximately 30% of participants failed repeat fit testing, suggesting incomplete respiratory protection. Three-piece flat-fold respirators outperformed duckbill respirators. Extended use of respirators, even without respirator reuse, may put healthcare workers at risk of inadequate respiratory protection, in particular when using duckbill-shaped respirators.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101099"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilator-tube holder for mobilising patients with a tracheostomy: A pilot usability study (TrachVest)","authors":"Paul Twose MSc, BSc ,&nbsp;Susan Peirce PhD, MSc, BSc ,&nbsp;John Maisey BSc ,&nbsp;Laura Jones MSc, BSc ,&nbsp;Jason Nunn BSc","doi":"10.1016/j.aucc.2024.05.014","DOIUrl":"10.1016/j.aucc.2024.05.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients in intensive care may have a tracheostomy and be dependent on a respiratory ventilator while yet conscious and able to mobilise. Early rehabilitation is known to be key to patient recovery. However, for these patients, therapy staff members are required to manage the ventilator tubing in addition to other patient-connected equipment whilst focussing on patient mobility and progress. A technical garment (TrachVest) was designed to hold the ventilator tubing securely during these therapeutic mobilisations.</div></div><div><h3>Methods</h3><div>We conducted a mixed-methods study to evaluate the use of this garment in an intensive care unit setting. The aim was to determine potential effects on patient safety, its potential benefits, and usability. Research methods included direct observations, user questionnaires (quantitative and qualitative), and staff focus groups.</div></div><div><h3>Results</h3><div>A total of 14 therapy sessions with the garment were observed, involving nine patients and 10 staff. Eleven staff members participated in two focus groups, including two previously involved in the therapy sessions. Therapy sessions consisted of a range of activities including sitting on the edge of the bed, transferring from bed to chair (including use of hoists), and mobilising with walking aids. Overall, staff members felt that the garment was easy to use and would likely improve patient safety during mobilisations. The main benefits were staff reassurance, allowing them to focus on therapy, and in potentially reducing the number of staff members needed for particular activities. Patient characteristics were found to be influential on the perceived utility, and TrachVest may have greater benefit for patients who have greater physical function (e.g., able to actively participate in rehabilitation) and can mobilise at least from bed to chair. Experience of using the TrachVest and of patient capabilities was thought to be key to knowing when it would be most useful.</div></div><div><h3>Conclusion</h3><div>Within this pilot usability study, participants, both staff and patients, reported that the TrachVest garment designed to support ventilator tubing during rehabilitation to be highly useable and beneficial to supporting rehabilitation in this patient group.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101077"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory processing sensitivity and compassion fatigue in intensive care unit nurses: A chain mediation model","authors":"Jiaqi Shi MM ,&nbsp;Xinmei Cao BS ,&nbsp;Zhi Chen MM ,&nbsp;Xinyue Pang BS ,&nbsp;Danwen Zhuang RN ,&nbsp;Guohua Zhang PhD ,&nbsp;Lijie Mao MM","doi":"10.1016/j.aucc.2024.06.010","DOIUrl":"10.1016/j.aucc.2024.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Compassion among intensive care unit (ICU) nurses is an essential component of humanistic care in the ICU However, the enormous pressures of the job and the lack of social support have led to persistently severe compassion fatigue. Sensory processing sensitivity, as a personality trait for individuals to perceive external factors, has underlying significance for compassion fatigue.</div></div><div><h3>Aims</h3><div>This study aims to investigate the internal and external environmental factors and the underlying mechanisms that influence the impact of sensory processing sensitivity among ICU nurses on the development of compassion fatigue.</div></div><div><h3>Study design</h3><div>A cross-sectional descriptive study was conducted with 290 nurses from various hospitals in five cities in China.</div></div><div><h3>Method</h3><div>A self-designed demographic questionnaire, the Chinese version of the Professional Quality of Life Scale, the Chinese version of the Highly Sensitive Person Scale, the Chinese version of the Perceived Social Support Scale, and the Chinese version of the Perceived Stress Scale were used to survey 290 ICU nurses. The mediating roles of perceived social support and perceived stress between sensory processing sensitivity and compassion fatigue were tested.</div></div><div><h3>Results</h3><div>The research results indicate that the total effect of sensory processing sensitivity on compassion fatigue is significant (0.245 [0.093, 1.160]), whereas the direct effect of sensory processing sensitivity on compassion fatigue is not significant (−0.43 [-0.402, 0.247]). Perceived social support and perceived stress exhibit serial mediating effects between sensory processing sensitivity and compassion fatigue (−0.065 [-0.142, -0.013]).</div></div><div><h3>Conclusion</h3><div>Our results revealed, for the first time, the underlying mechanism between sensory processing sensitivity and compassion fatigue among ICU nurses. Providing necessary stress-relief condition and abundant social support are important measures for nursing managers to reduce compassion fatigue and improve the quality of critical care humanistic nursing services.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101089"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Comparison of different eye care methods to prevent dry eye and corneal ulcer in older critically ill patients: A randomised controlled trial","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101140"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review on the effect of telehealth communication with intensive care unit families on patient and family outcomes","authors":"Claire Crossfield MNP, RN ,&nbsp;Guncag Ozavci PhD, MBA, MSc, BPharm ,&nbsp;Robin Digby PhD, RN ,&nbsp;Tracey Bucknall PhD, RN, FAAN","doi":"10.1016/j.aucc.2024.06.013","DOIUrl":"10.1016/j.aucc.2024.06.013","url":null,"abstract":"<div><h3>Background</h3><div>During the Covid-19 pandemic, family visitation to intensive care was severely restricted. In response, family communication moved to remote-only options. The effect on patients and families of this communication change is poorly understood.</div></div><div><h3>Objective</h3><div>The aim of this review was to synthesise the available research on remote-only communication interventions and their effect on patient and family outcomes within the intensive care environment.</div></div><div><h3>Review method used</h3><div>A systematic review of relevant studies was undertaken.</div></div><div><h3>Data sources</h3><div>Databases included CINAHL, APA PsychINFO, MEDLINE, and Ovid Embase.</div></div><div><h3>Review methods</h3><div>Databases were searched with a date restriction of June 1st, 2011, to June 1st, 2023. Two independent reviewers assessed each study using the Mixed Methods Appraisal Tool, version 2 of the Cochrane risk-of-bias tool for randomised controlled trials, and the Risk Of Bias In Nonrandomised Studies of Interventions tool for methodological quality and risk of bias. Of the 2292 articles screened, 10 studies met the inclusion criteria.</div></div><div><h3>Results</h3><div>Ten studies were included (n = 3861). Methodological quality was mostly poor, with one study evaluated as high on Mixed Methods Appraisal Tool quality criteria. Two themes were derived from the literature: (i) patient and family satisfaction; and (ii) patient and family psychological distress symptoms. Five studies reported patient and family satisfaction, with four studies finding statistically significant improvement following the communication intervention. However, only one of the five studies specifically evaluated the satisfaction with the communication intervention. Nine studies reported patient and family psychological distress symptoms, using 12 measurement tools. A variable effect of interventions was found within this theme.</div></div><div><h3>Conclusions</h3><div>This review identified important gaps in the research examining remote-only family communication interventions in intensive care. Inconsistent delivery of remote-only communication interventions, biased research methods, and variable outcome measurement tools impacted the reliability and validity of current evidence. Further research on remote-only communication interventions and the effect on families is recommended.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101094"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Live music in the intensive care unit—A mixed-methods pilot study exploring the experience and impact of live music played for the adult intensive care patient","authors":"Linette Thorn RN, CCRN, MScN ,&nbsp;Margrethe Langer Bro PhD ,&nbsp;Trine Højfeldt Lund RN, CCRN ,&nbsp;Pia Dreyer RN, PhD","doi":"10.1016/j.aucc.2024.07.077","DOIUrl":"10.1016/j.aucc.2024.07.077","url":null,"abstract":"<div><h3>Background</h3><div>Evidence for music's beneficial effect on physical and mental disorders is mounting. Intensive care unit (ICU) patients experience multiple uncomfortable symptoms, which may be alleviated using a music-based intervention. Few studies have examined the experience and the physical impact of patient-tailored live music offered by trained health musicians in an adult ICU.</div></div><div><h3>Aims</h3><div>This study aimed to explore the experience of live music in adult patients admitted to an ICU, focusing on its effects on relaxation, stress, and pain.</div></div><div><h3>Study design</h3><div>A pilot study with a convergent mixed-methods design. A total of 27 intensive care patients at a Danish University Hospital were offered patient-tailored live music by trained musicians in a single-session design. We performed participant observation and conducted patient interviews using an observational and semistructured interview guide. These data were supported by quantitative pre-post measurements of heart rate, respiration rate, mean arterial blood pressure, subjective pain experience, and heart-rate variability. The study was conducted from February 2020 to December 2021.</div></div><div><h3>Findings</h3><div>Using a Ricoeur-inspired analysis of observations and interviews, we elicited four themes: <em>‘A break where you can swim away and relax’, ‘The living presence makes the play unique’, ‘Happy memories of the past and longing for home’</em>, and <em>‘An intense and meaningful experience’</em>. The quantitative analysis showed a significant decrease in heart rate (4.33 bpm, p &lt; 0.02), respiration rate (2.93, p &lt; 0.001), and blood pressure (3.30, p &lt; 0.05) and a significant increase in heart-rate variation (−0.22, p &lt; 0.01). Seven patients reported pain reduction after the music intervention, corresponding to a 24% reduction.</div></div><div><h3>Conclusion</h3><div>Live music contributes to meaningful moments by bringing elements of everyday life into the ICU and may promote relaxation and reduce stress and pain.</div></div><div><h3>Relevance to clinical practice</h3><div>Our findings indicate that live music is a nonpharmacological experience that creates meaningful moments for critically ill patients.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101092"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}