Nursing in Critical Care最新文献

Background: Families of chronically critically ill (CCI) children admitted to paediatric critical care (PCC) experience significant and long-lasting psychological distress. Structured family-centred care consultations, using a family system approach, have shown promise in mitigating these effects. Though most studies in PCC are single-component or lack methodological rigour. There is a need for complex, multi-component interventions that address the evolving needs of families in PCC.

Aim: To assess the feasibility of a co-developed complex multi-component family-centred intervention to support families of CCI children on the PCC ward before effectiveness testing in a future clinical trial.

Study design: This single-centre pilot feasibility study used a descriptive observational design guided by Bowen's feasibility framework. The intervention consisted of structured family consultations delivered by trained healthcare professionals, supported by interprofessional handovers. Quantitative data were collected at multiple time points using validated instruments to assess feasibility and limited efficacy outcomes.

Results: Of 802 patients screened, 55 were eligible and 19 families enrolled (34.5%) representing 19 children and 27 parents. All allocated parents completed the intervention. Parents reported clinically meaningful reductions in acute stress, anxiety and depression from admission to follow-up. Family functioning improved across most domains, and no parent met the threshold for PTSD at follow-up. Satisfaction scores remained high throughout.

Conclusions: This study demonstrates the clinical feasibility of a multi-component family-centred intervention for parents of children hospitalised in paediatric critical care. Findings suggest a protective effect on parental mental health and improved family functioning, supporting progression to a full-scale effectiveness trial.

Relevance to clinical practice: The OCTO-Plus intervention offers a structured, family-centred approach to support parents of CCI children in PCC. Its integration into clinical practice may enhance emotional regulation, communication and resilience, ultimately improving long-term outcomes for families.

Background: Missed nursing care (MNC) is widespread in intensive care units (ICUs), severely threatening patient safety and nursing quality. It has become a key research topic in both national and international studies.

Aims: To identify the status quo of MNC in the ICU and explore nurses' real experiences of encountering MNC.

Study design: Using the scoping review methodology as the framework, we searched Web of Science, PubMed, CINAHL, Cochrane Library, Embase, Wanfang, SinoMed, CNKI and VIP databases until April 25, 2025 and used the topic analysis method and the social-ecological model to classify the included studies.

Results: A total of 1038 studies were retrieved, and 14 were included. The review found that the factors influencing MNC in ICUs were synthesised into four interrelated categories: intrapersonal, interpersonal, institutional, community and public policy levels; nurses' real experiences were synthesised into two themes: emotional burden and adaptive growth.

Conclusions: MNC in the ICU is determined by multiple factors, threatening care quality and patient safety. Meanwhile, as both contributors to and bearers of MNC, nurses face an emotional burden and achieve adaptive growth after experiencing MNC. Identifying the multidimensional factors of MNC and nurses' real experiences in the ICU supports managers in strategy-making, optimises staffing and informs care-process improvements and quality enhancement.

Relevance to clinical practice: It is recommended that clinical managers formulate MNC management norms based on the multidimensional influencing factors and dual emotional experiences of nurses' MNC experiences and take relevant measures to improve the environment of medical institutions, optimise human resources and pay attention to nurses' real experiences.

Trial registration: The review protocol was registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/AEDFP).

Background: Methicillin-resistant staphylococci (MRS) pose a great health threat to hospital-associated infections. Healthcare workers (HCWs) are known as sources, vectors and victims for MRS.

Aim: This study aimed to identify non-hand hygiene factors associated with the higher prevalence of MRS colonisation among ICU HCWs compared to those in non-ICU settings.

Study design: Samples were collected from HCWs, patients and environment sites of a community hospital in Tianjin. 16s rRNA sequencing was used to identify the species of bacteria, and the disc diffusion method was used to explore the antimicrobial susceptibility profile of staphylococci. The mecA gene and SCCmec types were determined by PCR.

Results: Two hundred and eighty staphylococcal isolates were recovered and 186 isolates were identified as MRS. The prevalence of MRS carriage among HCWs, patients, and environmental dissemination in the ICU was significantly elevated compared to that in the non-ICU setting (p<0.05). Moreover, HCWs of the ICU had a higher hand hygiene compliance (p<0.05) and rates of correct answers in comparison with non-ICU HCW regarding the hand hygiene knowledge (p<0.05).

Conclusions: In this study, the MRS carriage among HCWs in the ICU was significantly higher than that of HCWs in the non-ICU in the same hospital who followed the same hand hygiene rules. The high-level MRS colonisation among patients and the transmission of MRS in the environment may be risk factors for the higher carriage level of MRS in HCWs.

Relevance to clinical practice: Clinicians should consider eradicating the environmental contamination of MRS and decolonisation of MRS in patients.

Background: Assessing sleep quality in detail is of critical importance, as sleep disturbances in myocardial infarction survivors not only impair quality of life but may also influence recurrence risk and overall prognosis.

Aim: This study was planned to evaluate the sleep quality of patients with Myocardial Infarction hospitalized in the intensive care unit.

Study design: An explanatory sequential mixed methods design was used. In the quantitative phase, a cross-sectional design was utilized, while the qualitative phase was conducted using a descriptive approach. The study's quantitative and qualitative components were carried out with patients hospitalized in the intensive care unit between June 01 and October 01, 2023. The Patient Information Form, Richard Campbell Sleep Questionnaire, and Semi-structured Interview Form were data collection tools. Descriptive statistics, normality tests, and the Mann-Whitney U test were used to analyze the quantitative data, and the Cronbach's alpha coefficient was calculated to determine the scale's reliability. In the qualitative phase, content analysis was employed. Reported according to STROBE and COREQ.

Results: The median Richard Campbell Sleep Questionnaire score was 66.6 (IQR = 25.83-78.33). The quantitative analyses did not reveal any statistically significant associations. Three main themes were identified in the qualitative section. These themes are "poor sleep quality", "normal sleep quality", and "good sleep quality".

Conclusions: The qualitative phase of the study shed light on the 'why' behind the quantitative findings. Overall, patients with poor sleep quality were influenced by multiple factors, those with normal sleep quality focused on specific needs, and good sleepers reported consistently high sleep quality both in the Intensive Care Unit and daily life.

Relevance to clinical practice: For quality sleep in intensive care units, nurses should provide noise control, increase patients' privacy, and make arrangements to enable them to maintain their sleep habits.