Intensive and Critical Care Nursing最新文献

{"title":"Feasibility of implementing a multi-component intervention of environmental control in mechanically ventilated ICU patients to improve sleep: A pilot randomized controlled trial","authors":"Vanessa Oviedo ,&nbsp;Leyla Alegría ,&nbsp;Douglas Leonard ,&nbsp;Rodrigo Cádiz ,&nbsp;Pablo Brockmann ,&nbsp;Paula Repetto ,&nbsp;Mario Henríquez ,&nbsp;Gonzalo Labarca ,&nbsp;Margarita Carrasco ,&nbsp;Ana Moya ,&nbsp;Idalid Rojas ,&nbsp;Macarena Amthauer ,&nbsp;Hugo Vidal ,&nbsp;María Paz Carrera ,&nbsp;Jan Bakker","doi":"10.1016/j.iccn.2026.104349","DOIUrl":"10.1016/j.iccn.2026.104349","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the feasibility of implementing a multi-component intervention in the ICU to promote sleep in critically ill patients.</div></div><div><h3>Trial design</h3><div>A prospective, two-parallel-group, unblinded, pilot randomized controlled trial.</div></div><div><h3>Methods</h3><div>Adult patients ventilated for at least 48 h with no or superficial sedation in the past 24 h were recruited. They were randomized to receive a multi-component ICU environmental control intervention (dynamic light therapy, auditory masking, and rationalization of nighttime care) or standard care. A family member of each participant consented to the study.</div></div><div><h3>Main outcome measures</h3><div>The primary outcomes were the feasibility of enrolling and retaining participants and the fidelity of the intervention. Secondary outcomes were sleep quantity (assessed by polysomnography and actigraphy) and sleep quality (assessed by Richards-Campbell Sleep Questionnaire), the prevalence of delirium at day three post-randomization, and neuropsychological impairment at six months post-ICU discharge.</div></div><div><h3>Setting</h3><div>An intensive care unit in a tertiary care teaching hospital in Santiago, Chile.</div></div><div><h3>Results</h3><div>122 patients were screened; 17 were randomized, 9 to intervention and 8 to control. 78% (7) and 100% (8) stayed in ICU until day three. All 8 in the intervention group received the full intervention until ICU discharge. The enrollment rate was 94%. The 6-month follow-up rate was 35%, as some patients died. All participants who completed the study nights expressed very high satisfaction.</div></div><div><h3>Conclusions</h3><div>This pilot study demonstrates the feasibility and acceptability of the intervention and informs methodological refinements for a future trial.</div></div><div><h3>Implications for clinical practice</h3><div>Implementing a multi-component environmental control intervention in intensive care units could improve short- and long-term outcomes in ventilated patients; however, further high-quality efficacy trials are required.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104349"},"PeriodicalIF":4.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and family-centered interdisciplinary rounds and patient satisfaction: A controlled intervention study","authors":"Brigitte S. Cypress,&nbsp;Rida Gharzeddine","doi":"10.1016/j.iccn.2026.104347","DOIUrl":"10.1016/j.iccn.2026.104347","url":null,"abstract":"<div><h3>Objectives</h3><div>Interdisciplinary rounds are a core component of care delivery in intensive care units (ICUs), supporting communication, coordination, and shared decision-making. Although patient- and family-centered interdisciplinary rounds (PFCC-IR) are recommended, evidence linking PFCC-IR to patients’ satisfaction with nursing care remains limited, as prior research has focused largely on family perceptions. This study evaluated the effect of family engagement during ICU interdisciplinary rounds on patient satisfaction with nursing care.</div></div><div><h3>Methods</h3><div>A quasi-experimental, two-group pre–post design was conducted in adult ICUs. Patients in the intervention group had a family member participate in interdisciplinary rounds, whereas control patients received standard care without family involvement. Using convenience sampling, 150 patients were enrolled (75 per group). Satisfaction was measured pre- and post-intervention using the <em>Patient Satisfaction with Nursing Care Quality Questionnaire</em>, which demonstrated high internal consistency. Linear mixed-effects regression examined group differences over time, adjusting for age, gender, marital status, and number of rounds attended.</div></div><div><h3>Results</h3><div>Participants had a mean age of 63.4 years; 41% were male, and 41% were married. Satisfaction scores changed minimally in the control group (mean difference = 0.76, p = 0.20). In contrast, the intervention group demonstrated significant improvement following family engagement during rounds (mean difference = –47.4, p &lt; 0.001). Linear mixed-effects analysis confirmed a significant treatment effect (time × group interaction = –47.43, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Engaging family members during ICU interdisciplinary rounds was associated with significantly improved patient satisfaction with nursing care. These findings support the Society for Critical Care Medicine’s clinical practice guidelines recommending that families be offered the option to be present and engaged during ICU rounds.</div></div><div><h3>Implications for Practice</h3><div>Integrating structured family participation into ICU interdisciplinary rounds is a feasible, nursing-led strategy to enhance communication and patient-centered care. Institutions should implement clear policies and workflows to support family engagement.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104347"},"PeriodicalIF":4.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent relatives’ experiences and perceptions of everyday life when a family member is critically ill and admitted to an ICU and in the aftermath: A qualitative study","authors":"Mathilde Elsa Christensen ,&nbsp;Gro Frivold ,&nbsp;Gudrun Elin Rohde","doi":"10.1016/j.iccn.2026.104333","DOIUrl":"10.1016/j.iccn.2026.104333","url":null,"abstract":"<div><h3>Aims</h3><div>This study explored the experiences and perceptions of adolescents who were relatives of intensive care unit (ICU) patients, focusing on their everyday lives during and after the ICU stay.</div></div><div><h3>Design</h3><div>Inductive descriptive qualitative study.</div></div><div><h3>Methods</h3><div>Semi-structured, in-depth interviews were conducted and analysed using reflexive thematic analysis (RTA).</div></div><div><h3>Findings</h3><div>Sixteen adolescents as relatives of ICU patients in Norway were included. Three themes were identified: <em>Navigating adolescence independently during critical illness, Relational bonds and A new everyday life.</em> Eight sub-themes identified: <em>Feeling isolated, need for support from knowledgeable adults, striving for normalcy, avoid being a burden, loyalty to their family, adaptation in roles and changed relations, experiencing mental and physical challenges and existential experiences.</em></div></div><div><h3>Conclusions</h3><div>Adolescent relatives of critically ill patients experienced substantial uncertainty and distress, with their attention persistently focused on the critically ill family member. Their lives were significantly altered, resulting in unpredictability. Some adolescents reported personal growth in the aftermath. The adolescents expressed a need for a structured support programme.</div></div><div><h3>Implications for clinical practice</h3><div>The adolescents experienced substantial disruption in their everyday lives and often lacked systematic support when a family member was admitted to an ICU. The findings suggest that health care professionals (HCPs), both in the ICU and school health service, should collaborate to offer targeted support to adolescents who are relatives of ICU patients.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104333"},"PeriodicalIF":4.7,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A matter of perspective: How divergent professional logics shape perceptions of appropriate care in the ICU","authors":"Anna-Henrikje Seidlein","doi":"10.1016/j.iccn.2026.104339","DOIUrl":"10.1016/j.iccn.2026.104339","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"94 ","pages":"Article 104339"},"PeriodicalIF":4.7,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticipatory guidance for parents following paediatric intensive care: a scoping review and environmental scan of recovery-focused resources","authors":"Leigh Dunn ,&nbsp;Suzanne Williams ,&nbsp;Debbie Long","doi":"10.1016/j.iccn.2025.104332","DOIUrl":"10.1016/j.iccn.2025.104332","url":null,"abstract":"<div><h3>Objectives</h3><div>To map and critically appraise anticipatory guidance interventions and resources for parents following PICU discharge, examine how they address recovery challenges, and identify gaps to inform parent-centred resource development.</div></div><div><h3>Methods</h3><div>Database search across EBSCO (MEDLINE, CINAHL, PsychINFO), Embase, Scopus, Web of Science, and Cochrane Library for studies published January 2000-June 2025. Environmental scan via targeted and Google searches. Five tools assessed delivery, understandability, actionability, quality, and readability.</div></div><div><h3>Results</h3><div>Of 1752 records, four studies and nine digital resources met inclusion criteria (n = 271 parents). Formats included phone calls, brochures, in-person conversations, plus websites, webpages, downloadable content, and videos, from university children’s hospitals (n = 10), and organisations (n = 3) across the US (n = 9), UK (n = 3), and Australia (n = 1). Three key findings emerged: (1) support for how parents’ access, understand, and use information was inconsistent; (2) resources prioritised functional (reading/comprehension), over interactive (communication, application) or critical health literacy (evaluation, advocacy); (3) system-level health literacy strategies were limited.</div></div><div><h3>Conclusion</h3><div>There is an urgent need to strengthen anticipatory guidance by embedding health literacy principles across design and delivery. This includes addressing organisational barriers to access and equity through co-design, plain language, and culturally responsive approaches. Beyond information provision, a deliberate focus on capability building can empower parents as active partners in care, ultimately improving outcomes for children and families.</div></div><div><h3>Implications for clinical practice</h3><div>Anticipatory guidance following PICU discharge must move beyond information provision toward capacity building that supports parents to apply, evaluate, and act on information. Embedding health literacy principles − plain language, readability testing, co-design, and cultural responsiveness − into resource development is critical to ensure accessibility and equity. Clinician education and integration into routine workflows are equally important to optimise resource impact. A universal precautions approach offers a practical strategy for health services to ensure all families, regardless of literacy level, receive clear, actionable, and supportive guidance.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104332"},"PeriodicalIF":4.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral distress: The unmeasured catalyst in preventing catheter-associated bloodstream infections in neonatal ICUs − Letter on Berdida et al.","authors":"Peiyan Lin,&nbsp;Yuliu Huang","doi":"10.1016/j.iccn.2026.104341","DOIUrl":"10.1016/j.iccn.2026.104341","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"94 ","pages":"Article 104341"},"PeriodicalIF":4.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early enteral nutritional support and clinical outcomes in critically ill children: A scoping review","authors":"Marina Maffeo ,&nbsp;Gabriele Caggianelli ,&nbsp;Emanuele Buccione ,&nbsp;Valentina Vanzi ,&nbsp;Daniele Ciofi ,&nbsp;Mirco Gregorini ,&nbsp;Maurizio Zega ,&nbsp;Jacopo Fiorini","doi":"10.1016/j.iccn.2026.104336","DOIUrl":"10.1016/j.iccn.2026.104336","url":null,"abstract":"<div><h3>Background and aims</h3><div>Pediatric malnutrition, is defined as an imbalance between nutrient intake and requirements leading to cumulative energy, protein, or micronutrient deficits, is highly prevalent among critically ill children and negatively affects growth and recovery. Early enteral nutrition (EEN) is increasingly recognized as a key strategy to prevent or address malnutrition in pediatric intensive care units (PICUs). Although emerging evidence suggests that EEN improves clinical outcomes, uncertainty persists regarding its feasibility and impact in this population. This scoping review aimed to map existing evidence on the use of EEN in critically ill children, evaluate its effects on key clinical outcomes including mechanical ventilation duration, length of stay, and infection risk; and identify barriers and facilitators to its implementation in pediatric intensive care settings.</div></div><div><h3>Methods</h3><div>A scoping review was conducted following Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Searches were performed in PubMed, Embase, Scopus, CINAHL, and the Cochrane Library. Studies were eligible if they involved children aged 1 month to 18 years and initiated enteral nutrition within 48 h of PICU admission. Keywords included child, critical illness, enteral nutrition, intensive care units, and pediatrics. Studies in English or Italian were included without date restrictions.</div></div><div><h3>Results</h3><div>Sixteen thousand seven hundred ninety-nine records were identified; 15,556 were screened after duplicates were removed, and 14 studies met inclusion criteria (USA n = 6; Asia n = 4; Africa n = 3; Europe n = 1). Most were cohort studies, with one randomized trial. EEN was consistently associated with shorter mechanical ventilation duration (5.86 ± 3.63 vs 11.96 ± 9.17 days, p = 0.002), reduced PICU and hospital length of stay (4 vs 11.5 days, p &lt; 0.001), and lower infection rates (16.7 % vs 41.1 %, p = 0.001). Barriers to EEN included hemodynamic instability, gastrointestinal intolerance, and procedural interruptions, while facilitators included multidisciplinary teamwork, nurse-led feeding protocols, and standardized nutritional guidelines.</div></div><div><h3>Conclusion</h3><div>EEN initiated within 24–48 h was generally associated with favorable clinical outcomes; however, evidence on feasibility and safety remains limited and heterogeneous. Strengthening nursing autonomy and implementing standardized feeding pathways may enhance timely nutrition delivery and support recovery in pediatric intensive care.</div></div><div><h3>Implications for clinical practice</h3><div>Pediatric intensive care nurses play a pivotal role in initiating and monitoring EEN. Empowering nurses through evidence-based feeding protocols and multidisciplinary education can promote timely nutrition delivery and improve recovery in critically ill children.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104336"},"PeriodicalIF":4.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes, characteristics and improvement strategies for delayed interventions during paediatric deterioration: A mixed methods systematic review","authors":"Shannon Cresham Fox ,&nbsp;Takawira C. Marufu ,&nbsp;Emma Popejoy ,&nbsp;Nicola Taylor ,&nbsp;Damien Roland ,&nbsp;Joseph C. Manning","doi":"10.1016/j.iccn.2025.104330","DOIUrl":"10.1016/j.iccn.2025.104330","url":null,"abstract":"<div><h3>Background</h3><div>Children are susceptible to deterioration due to compensatory mechanisms. Timely recognition and intervention are strongly associated with improved clinical outcomes, whereas delays elevate mortality risk. Failure to rescue (FtR), the inability to prevent death following deterioration, represents a critical safety concern, yet contributory factors and contextual characteristics remain inadequately synthesised.</div></div><div><h3>Aim</h3><div>Identify and evaluate causes, characteristics and improvement strategies associated with delayed intervention during paediatric clinical deterioration in hospitalised children.</div></div><div><h3>Methods</h3><div>A mixed-methods systematic review of five databases was conducted including studies on hospitalised children (0–18 years) reporting outcomes related to FtR (e.g. mortality), published after 2000. Rigour was ensured through PROSPERO registration (CRD420250651864) and appraisal checklists. Data were analysed using a convergent segregated approach.</div></div><div><h3>Results</h3><div>Fifty-two studies included 820,000 hospitalised children and 4.4 million clinical events were synthesised. Qualitative and quantitative findings resulted in three themes: recognition, escalation and response, with qualitative findings presenting insight into barriers associated with each stage (including unclear escalation pathways and training gaps). Whilst quantitative findings reported prevalence of delayed recognition, escalation and response with pervasive organisational factors contributing to delays (e.g. staffing). Younger children and children with medical complexity (CMC) were at increased risk, and global majority populations were disproportionately affected. Integrated synthesis showed delays stem from individual, organisational, and systemic factors, while experienced nurses play a critical role in timely intervention.</div></div><div><h3>Conclusion</h3><div>Individual, organisational and systemic factors contribute to delayed intervention. CMC and global majority populations were disproportionately affected. Findings highlight critical points of delay. Reporting participant characteristics (e.g. ethnicity, medical complexity) is essential to understand their impact upon deterioration pathways.</div></div><div><h3>Implications for clinical practice</h3><div>Nurses are pivotal in recognising and responding to deterioration, and should recognise high-risk groups. Awareness should translate into advocacy for early intervention.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104330"},"PeriodicalIF":4.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of complementary therapies on chronic obstructive pulmonary disease patient outcomes treated with noninvasive ventilation: A systematic review","authors":"Dilara Ülke Çelik,&nbsp;Meral Gün","doi":"10.1016/j.iccn.2026.104340","DOIUrl":"10.1016/j.iccn.2026.104340","url":null,"abstract":"<div><h3>Background</h3><div>COPD patients receiving noninvasive ventilation (NIV) face many physiological and psychosocial problems. The impact of complementary therapies on NIV adherence and symptom management in COPD patients is not sufficiently addressed.</div></div><div><h3>Objective</h3><div>This systematic review was conducted to examine the effectiveness of complementary therapies used in COPD patients receiving NIV on clinical symptoms and health outcomes.</div></div><div><h3>Methods</h3><div>A systematic review was designed based on PRISMA-P (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols) criteria. The literature search was conducted in the “PubMed, Cochrane, Scopus, Web of Science, Google Scholar” databases. Studies were selected by determining inclusion and exclusion criteria according to the PICOT method. Studies were evaluated using the Joanna Briggs Institute (JBI) critical assessment lists.</div></div><div><h3>Results</h3><div>Five randomized controlled trials were included in the systematic review, which included a total of 338 COPD patients receiving NIV. Most studies have found that complementary therapies significantly reduce anxiety and dyspnea levels. Significant improvements were observed in physical capacity and quality of life.</div></div><div><h3>Conclusions</h3><div>Complementary therapies may offer potential benefits for clinical symptoms and health outcomes in patients receiving NIV, including anxiety, dyspnea, physical capacity and quality of life. However, the findings are limited by substantial heterogeneity and methodological shortcomings among the included studies. Well-designed, controlled clinical trials are needed to provide more definitive evidence regarding the effects of complementary therapies in this population.</div></div><div><h3>Implications for Clinical Practice</h3><div>The current evidence remains insufficient to support the routine incorporation of complementary therapies into critical care practice for patients with COPD receiving NIV. Further high-quality studies are required to guide nursing practice and support the integration of complementary therapies into holistic care.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104340"},"PeriodicalIF":4.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex cases and coordination: Reports from organ donation specialists in Canada","authors":"Amina Silva ,&nbsp;Ken Lotherington ,&nbsp;Sonny Dhanani ,&nbsp;Julia Luvizutto ,&nbsp;Vanessa Silva e Silva","doi":"10.1016/j.iccn.2026.104335","DOIUrl":"10.1016/j.iccn.2026.104335","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore Organ and Tissue Donation Coordinator nurses’ experiences and perceptions of their most challenging and complex cases, with a focus on emotional, ethical, and procedural factors.</div></div><div><h3>Methods</h3><div>Qualitative descriptive study where data were collected using a semi-structured interview guide and analyzed using a thematic analysis approach.</div></div><div><h3>Findings</h3><div>29 coordinators were interviewed from April 2022 to February 2023 across all Canadian provinces. Most coordinators have been in their role for 6.9 years, and have experience in critical care. Two overarching themes captured the complexity of coordinators’ experiences: (1) Donation Type, encompassing donation after death determination by circulatory criteria and specific donor circumstances, and (2) Pediatric versus Adult Contexts, highlighting contrasts in family, patient, recipient, and team dynamics. Donation after death determination by circulation criteria cases were characterized by procedural pressure due to sensitivity. In contrast, specific donor types, such as patients undergoing medical assistance in dying, intensified emotional and ethical strain through personal connections with donors. Pediatric cases further amplified emotional complexity, extending family interactions and deepening the search for meaning in care.</div></div><div><h3>Conclusion</h3><div>Our findings highlighted that coordinators face significant challenges in complex organ and tissue donation cases and there is a current need for targeted interventions to psychologically enhance support systems and improve the coordination of deceased organ donation.</div></div><div><h3>Implications for clinical practice</h3><div>Understanding the multifaceted challenges coordinators encounter in complex donation contexts in critical care can inform future training development, psychosocial support, and interdisciplinary communication strategies, thereby improving the overall quality of care provided during donation processes.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"93 ","pages":"Article 104335"},"PeriodicalIF":4.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}