Intensive and Critical Care Nursing最新文献

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Muscle strength trajectories and prognostic implications in critically ill patients – Letter on Wu et al.

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-25 DOI: 10.1016/j.iccn.2025.103979

Jiamin Sheng, Chunyu Li

引用次数: 0

Resourceful recovery: Personalised rehabilitation strategies for modern ICU

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-25 DOI: 10.1016/j.iccn.2025.103974

Samuel Dean, Owen Gustafson, David McWilliams

引用次数: 0

The impact of physical restraints on mental health and quality of life in ICU patients – Letter on Francken et al.

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-25 DOI: 10.1016/j.iccn.2025.103978

Jiamin Sheng, Chunyu Li

引用次数: 0

Risk factors for mucosal membrane pressure injury in the intensive care unit: Future perspectives – Response to Rahimi-Bashar et al. 重症监护室粘膜压力损伤的风险因素：未来展望 - 对 Rahimi-Bashar 等人的回应

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-25 DOI: 10.1016/j.iccn.2025.103973

Guanjie Chen, Xiaoqing Li, Jianfeng Xie

引用次数: 0

Exploring ‘family’ in paediatric intensive care family-centred-care research: A concept analysis 探索儿科重症监护以家庭为中心的护理研究中的 "家庭"：概念分析

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-25 DOI: 10.1016/j.iccn.2025.103972

Ashleigh E. Butler , Elizabeth Bichard , Kate Masterson , Jessica Appleyard , Efa Apriyanti , Nega Degefa Megersa , Claire Collins , Stephen McKeever , Joseph C. Manning , Sarah E. Seaton

Objectives

Family-Centred Care (FCC) is a cornerstone of Paediatric Intensive Care Unit (PICU) care. While FCC is well defined, debate exists as to how ‘family’ is or should be defined. FCC research commonly focuses on parents, particularly mothers. To ensure PICU research represents all family members’ voices, understanding how family is currently used and understood within PICU research is required. Therefore, this systematic concept analysis explored the concept of ‘family’ within PICU FCC research.

Methods

Following Rodgers’ Evolutionary Concept Analysis method, a systematic search of Cumulative Index of Nursing and Allied Health Literature, OVID Medline, Allied and Complementary Medicine Database, PsycINFO, and Nursing and Allied Health Database (ProQuest) was conducted in November 2023. All citations underwent two stage screening based on a pre-developed protocol. Data related to attributes, antecedents, and consequences were extracted and analysed using open coding.

Results

Twenty-four articles were included. Attributes of ‘family’ in PICU FCC research included: Family characteristics; Recognition of adversity and vulnerability, and Evolving expectations of family. Antecedents included: A child in PICU; (Child)- and Family-Centred Care; and Hospital culture and environment. Consequences included impacts on delivery of care in PICU; and impact on PICU research.

Conclusions

Despite addressing a range of important issues, FCC research in PICUs lacks a clear definition and operationalisation of the concept of ‘family’. This impacts on subsequent care and research design. Addressing this gap is key to developing an inclusive FCC culture in PICU research.

Implications for clinical practice

A historically narrow definition of family means that most PICU family support is aimed at parents. To meet the needs of a changing society, clinical support services should consider extended family, including grandparents and siblings. More broadly, PICUs should challenge the definition and operationalisation of “family centred care” to ensure families are properly supported during a PICU admission.

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引用次数: 0

Prevalence of chronic pain and its risk factors until one year after intensive care unit discharge. A single-center prospective observational study

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-13 DOI: 10.1016/j.iccn.2025.103969

Baptiste Mottet, Cléor Cayla, Tiphaine Bernard, Maxime Léger, Maëva Campfort, Sigismond Lasocki

Purpose

To investigate the prevalence and risk factors for long-term pain following an ICU stay.

Materials and methods

This prospective, single-center study included patients who stayed in the ICU for ≥3 days and could complete a questionnaire. The primary aim was to assess chronic pain incidence at 3 months and up to 1 year post-discharge and identify associated risk factors. Follow-up involved 3 phone interviews at 3, 6, and 12 months, utilizing the Brief Pain Inventory (BPI) and the Patient Health Questionnaire-2 (PHQ-2).

Results

Among the 150 included patients (mean age 66 ± 17 years; 66 % male; median SAPS II 39), 71(47 %) reported pain at discharge. At 3 months, 39 % of 114 respondents had pain, and 35 % of 103 patients at one year. Significant factors for pain at 3 months included urgent surgical admission (p = 0.029), axial-skeleton bone fractures (p = 0.035), days with significant pain in ICU (p = 0.004), and opioid exposure (p = 0.014 for duration, p = 0.038 for dose). Axial skeleton fractures were independently associated with pain at 1 year (OR 5.18, p = 0.023).

Conclusions

Around one-third of ICU patients experience pain one year post-discharge, with axial-skeleton bone fractures being a significant risk factor for chronic pain.

Implications for clinical practice

Management of pain and optimal opioids dose during ICU stay are crucial to limit chronic pain after ICU discharge. Special attention should be given to patients with axial-skeleton fracture.

{"title":"Prevalence of chronic pain and its risk factors until one year after intensive care unit discharge. A single-center prospective observational study","authors":"Baptiste Mottet, Cléor Cayla, Tiphaine Bernard, Maxime Léger, Maëva Campfort, Sigismond Lasocki","doi":"10.1016/j.iccn.2025.103969","DOIUrl":"10.1016/j.iccn.2025.103969","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the prevalence and risk factors for long-term pain following an ICU stay.</div></div><div><h3>Materials and methods</h3><div>This prospective, single-center study included patients who stayed in the ICU for ≥3 days and could complete a questionnaire. The primary aim was to assess chronic pain incidence at 3 months and up to 1 year post-discharge and identify associated risk factors. Follow-up involved 3 phone interviews at 3, 6, and 12 months, utilizing the Brief Pain Inventory (BPI) and the Patient Health Questionnaire-2 (PHQ-2).</div></div><div><h3>Results</h3><div>Among the 150 included patients (mean age 66 ± 17 years; 66 % male; median SAPS II 39), 71(47 %) reported pain at discharge. At 3 months, 39 % of 114 respondents had pain, and 35 % of 103 patients at one year. Significant factors for pain at 3 months included urgent surgical admission (p = 0.029), axial-skeleton bone fractures (p = 0.035), days with significant pain in ICU (p = 0.004), and opioid exposure (p = 0.014 for duration, p = 0.038 for dose). Axial skeleton fractures were independently associated with pain at 1 year (OR 5.18, p = 0.023).</div></div><div><h3>Conclusions</h3><div>Around one-third of ICU patients experience pain one year post-discharge, with axial-skeleton bone fractures being a significant risk factor for chronic pain.</div></div><div><h3>Implications for clinical practice</h3><div>Management of pain and optimal opioids dose during ICU stay are crucial to limit chronic pain after ICU discharge. Special attention should be given to patients with axial-skeleton fracture.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 103969"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394984","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}

引用次数: 0

Intensive care nurses’ provision of culturally sensitive care through communication at the end-of-life - Letter on Berdida and Grande

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-13 DOI: 10.1016/j.iccn.2025.103971

Laura A. Brooks , Elizabeth Manias , Bodil Rasmussen , Melissa J. Bloomer

引用次数: 0

Evidence-based practice enhances patient outcomes: Early pressure ulcer detection with biocapacitance technology among critically ill patients

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-13 DOI: 10.1016/j.iccn.2025.103950

Magda Mohamed Bayoumi , Leena Mohamed Khonji , Naseem Saeed Abdulla Ali , Marwan Kamal Altheeb , Nafeesa Abdulla Mohammed , Zohour Ibrahim Rashwan

Background

In pressure ulcers (PUs), significant tissue damage often develops beneath the skin before any visual or tactile symptoms manifest. The breakthrough technology of the SEM Scanner identifies localized micro-edema that forms at tissue depths of several millimeters up to 4 cm. This empowers critical care nurses to implement proactive preventive measures.

Purpose

To compare the effectiveness of the SEM scanner and Modified Cubbin and Jackson (MCJ) Scale risk assessment tool in predicting PU among immobile patients in Intensive Care Unit (ICU).

Methods

A descriptive comparative, longitudinal study was carried out in ICU of Government Hospitals in Bahrain. Two independent raters blindly evaluated risk of PU against MCJ Scale, and a trained critical care nurse used SEM scanner.

Results

SEM scanner demonstrated a true positive rate of 51.6 % in predicting PU development (Δ ≥ 0.6), significantly higher than the 29.7 % prediction rate of MCJ Scale (p < 0.001(. Furthermore, 28.1 % of patients developed PUs that were not predicted by MCJ (false negatives), compared to only 6.2 % with SEM scanner. The sensitivity of SEM scanner was 89.2 %, compared to 48.6 % of MCJ. The area under the curve was 0.880 for the SEM scanner versus 0.739 for MCJ. SEM scanner identified PU risk earlier than MCJ in 188 readings (35.1 %), with an average of 3.07 ± 2.93 days.

Conclusions

The SEM scanner was effective in detecting PUs three days earlier than MCJ. The SEM canner also reported more true positives of PU and more sensitivity than MCJ scale.

Implications for Clinical Practice

Investing in advanced technology by integrating a reliable, evidence-based tool such as the SEM scanner into routine ICU care protocols, along with staff training, is crucial to guide clinical decision-making, reduce the variability in skin assessment, which ultimately reduces the incidence and severity of Hospital-Acquired PUs, and enhance patient outcomes.

{"title":"Evidence-based practice enhances patient outcomes: Early pressure ulcer detection with biocapacitance technology among critically ill patients","authors":"Magda Mohamed Bayoumi , Leena Mohamed Khonji , Naseem Saeed Abdulla Ali , Marwan Kamal Altheeb , Nafeesa Abdulla Mohammed , Zohour Ibrahim Rashwan","doi":"10.1016/j.iccn.2025.103950","DOIUrl":"10.1016/j.iccn.2025.103950","url":null,"abstract":"<div><h3>Background</h3><div>In pressure ulcers (PUs), significant tissue damage often develops beneath the skin before any visual or tactile symptoms manifest. The breakthrough technology of the SEM Scanner identifies localized micro-edema that forms at tissue depths of several millimeters up to 4 cm. This empowers critical care nurses to implement proactive preventive measures.</div></div><div><h3>Purpose</h3><div>To compare the effectiveness of the SEM scanner and Modified Cubbin and Jackson (MCJ) Scale risk assessment tool in predicting PU among immobile patients in Intensive Care Unit (ICU).</div></div><div><h3>Methods</h3><div>A descriptive comparative, longitudinal study was carried out in ICU of Government Hospitals in Bahrain. Two independent raters blindly evaluated risk of PU against MCJ Scale, and a trained critical care nurse used SEM scanner.</div></div><div><h3>Results</h3><div>SEM scanner demonstrated a true positive rate of 51.6 % in predicting PU development (Δ ≥ 0.6), significantly higher than the 29.7 % prediction rate of MCJ Scale (<em>p</em> < 0.001(. Furthermore, 28.1 % of patients developed PUs that were not predicted by MCJ (false negatives), compared to only 6.2 % with SEM scanner. The sensitivity of SEM scanner was 89.2 %, compared to 48.6 % of MCJ. The area under the curve was 0.880 for the SEM scanner versus 0.739 for MCJ. SEM scanner identified PU risk earlier than MCJ in 188 readings (35.1 %), with an average of 3.07 ± 2.93 days.</div></div><div><h3>Conclusions</h3><div>The SEM scanner was effective in detecting PUs three days earlier than MCJ. The SEM canner also reported more true positives of PU and more sensitivity than MCJ scale.</div></div><div><h3>Implications for Clinical Practice</h3><div>Investing in advanced technology by integrating a reliable, evidence-based tool such as the SEM scanner into routine ICU care protocols, along with staff training, is crucial to guide clinical decision-making, reduce the variability in skin assessment, which ultimately reduces the incidence and severity of Hospital-Acquired PUs, and enhance patient outcomes.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 103950"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394983","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}

引用次数: 0

Navigating between the familiar and the unfamiliar: A qualitative study exploring critical care nurses’ clinical practice during early rehabilitation in the ICU

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-12 DOI: 10.1016/j.iccn.2025.103960

Karina Knutsen, Rita Solbakken, Britt Normann

Background

Critical care nurses provide bedside care around the clock, which offers a unique opportunity to integrate rehabilitative activities into routine care. How nurses perform such activities is underinvestigated.

Aim

To explore how competencies related to early rehabilitation emerged in the clinical practice of critical care nurses, and to explore their reflections on this aspect of their clinical practice.

Study design and methods

A qualitative study with a phenomenological-hermeneutic approach was conducted in two Norwegian ICUs from January 2022 to January 2023. Observations and video recordings of eight nurse-patient dyads were conducted, followed by post-observation nurse interviews. Data were analysed using Heath and Luff’s video analysis and Malterud’s systematic text condensation, with additional insights drawn from Benner’s work on clinical knowledge.

Findings

Three categories emerged: 1) range in clinical assessments, displaying adequate assessments and actions related to major organ systems but lacking attention towards the assessment and facilitation of movement; 2) nurses’ and physiotherapists’ cooperation in terms of roles and responsibilities, revealing established roles within their professions and sparse sharing of situated considerations; and 3) grounding the patient, how the nurses used a verbal and attentive approach that appeared to ground their patients in the present, potentially enhancing participation.

Conclusions

Nurses were familiar with essential assessments and interventions connected to major organ systems, both independently and with physiotherapists, as well as in verbal communication. However, they were less familiar with assessing and facilitating movements, sharing professional knowledge, and using bodily communication skills.

Implications

This study highlights competencies that can be further explored and developed in CCNs clinical practice and education to improve care for critically ill patients. Future research should further investigate CCNs’ roles in early rehabilitation and identify independent nursing interventions, especially where resources and multidisciplinary support are limited.

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引用次数: 0

Advancing nasogastric tube placement safety: A call for standardizing the verification workflow based on patient-related and contextual factors

IF 4.9 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-02-11 DOI: 10.1016/j.iccn.2025.103970

Tim Torsy, Harm Van Noort, Paul Rood

引用次数: 0

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