Intensive and Critical Care Nursing最新文献

{"title":"Comparative analysis of fully automated vs. conventional ventilation in postoperative cardiac surgery patients: Impact on alarms, interventions, and nurse acceptance","authors":"Lisan M.A.A. van Haren ,&nbsp;Daphne L.J. Nabben ,&nbsp;Carla Kloeze ,&nbsp;Michiel A.C. Dekker ,&nbsp;Tineke J.C. De Vries ,&nbsp;Laura A. Buiteman-Kruizinga ,&nbsp;Ary Serpa Neto ,&nbsp;Tobias van Leijsen ,&nbsp;Frederique Paulus ,&nbsp;David M.P. van Meenen ,&nbsp;Leon Montenij ,&nbsp;Erik H.M. Korsten ,&nbsp;Alexander J.G.H. Bindels ,&nbsp;Arthur R. Bouwman ,&nbsp;Marcus J. Schultz ,&nbsp;Ashley J.R. De Bie Dekker","doi":"10.1016/j.iccn.2025.103963","DOIUrl":"10.1016/j.iccn.2025.103963","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the number of alarms, interventions and nurses’ acceptance of automated ventilation with INTELLiVENT-ASV versus conventional ventilation strategy in patients receiving postoperative ventilation after cardiac surgery.</div></div><div><h3>Methods</h3><div>This preplanned secondary analysis of the ‘POSITiVE’ randomized clinical trial compared INTELLiVENT-ASV (automated ventilation) with conventional ventilation in postoperative cardiac surgery patients. The number of critical alarms and manual ventilator interventions were compared during the first three hours of ventilation or until extubation. Nurses’ acceptance was assessed using a Technology Acceptance Model 2-based questionnaire and a user acceptance score from 1 to 10.</div></div><div><h3>Results</h3><div>POSITiVE randomized 220 patients (109 to automated and 111 to conventional ventilation). The average number of critical alarms per monitoring hour was similar between the automated and conventional group (5.6 vs 5.7; p = 0.823). The automated group required fewer manual interventions per monitoring hour for both ventilation control (0.7 vs 1.9; p &lt; 0.001) and alarm management (2.0 vs 2.8; p &lt; 0.001). The automated ventilation mode scored higher for perceived usefulness (2.6 vs 2.1; p &lt; 0.001) and user acceptance (8.0 vs 7.0; p &lt; 0.001), but similar for perceived ease of use.</div></div><div><h3>Conclusions</h3><div>Automated ventilation for postoperative cardiac surgery patients had similar alarm frequencies as conventional ventilation, but reduced the number of interventions and showed higher nurses’ acceptance, indicating its potential to optimize patient care and reduce nurses’ workload.</div></div><div><h3>Implications for Clinical Practice</h3><div>Our findings suggest that automated ventilation modes like INTELLiVENT-ASV can reduce the frequency of manual interventions and improve nurses’ acceptance, which may help alleviate nurses’ workload for postoperative cardiac surgery patients.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 103963"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378446","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":"Potential issues related to perceived stress and health literacy on family satisfaction among family members of critically ill patients - Letter on Padilla-Fortunatti et al.","authors":"Kuaile Zhao ,&nbsp;Juan Wang ,&nbsp;Zhe Zhang ,&nbsp;Qiang Li ,&nbsp;Hongling Zhang","doi":"10.1016/j.iccn.2025.103966","DOIUrl":"10.1016/j.iccn.2025.103966","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 103966"},"PeriodicalIF":4.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378444","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":"Navigating the shadows of the post-ICU survival journey","authors":"Francesca Trotta,&nbsp;Davide Bartoli,&nbsp;Gianluca Pucciarelli","doi":"10.1016/j.iccn.2025.103968","DOIUrl":"10.1016/j.iccn.2025.103968","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103968"},"PeriodicalIF":4.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143376891","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":"Communication with the critically ill patient: A nexus between patient needs, communication partner skills and the ICU environment","authors":"Amy Freeman-Sanderson ,&nbsp;Laura Istanboulian ,&nbsp;Louise Rose","doi":"10.1016/j.iccn.2025.103962","DOIUrl":"10.1016/j.iccn.2025.103962","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"88 ","pages":"Article 103962"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family involvement in the intensive care unit, moving to decision-making and family participation","authors":"Boukje M. Dijkstra ,&nbsp;Lisette Schoonhoven ,&nbsp;Lilian C.M. Vloet","doi":"10.1016/j.iccn.2025.103964","DOIUrl":"10.1016/j.iccn.2025.103964","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103964"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a gender-specific perspective in critical care: An expert report from the 2024 iWIN International Meeting","authors":"Francesca Rubulotta ,&nbsp;Jordi Rello ,&nbsp;Annamaria Moretti ,&nbsp;Luciana Mascia ,&nbsp;on behalf of the iWIN network","doi":"10.1016/j.iccn.2025.103946","DOIUrl":"10.1016/j.iccn.2025.103946","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103946"},"PeriodicalIF":4.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143287317","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":"Understanding the use of sedation boluses in the intensive care unit: A mixed methods study","authors":"Christian Vincelette ,&nbsp;François Martin Carrier ,&nbsp;Charles Bilodeau ,&nbsp;Michaël Chassé","doi":"10.1016/j.iccn.2025.103958","DOIUrl":"10.1016/j.iccn.2025.103958","url":null,"abstract":"<div><h3>Background</h3><div>To better understand the impact of sedations in the intensive care unit (ICU), an accurate understanding of the clinical practices surrounding sedation bolus use is essential.</div></div><div><h3>Objectives</h3><div>Our primary objectives were to describe how sedation boluses are administered, and to compare observed and nurse-reported practices.</div></div><div><h3>Methods</h3><div>We conducted a mixed methods study comprising 150 quantitative observations in a large university-affiliated ICU and 10 semi-structured interviews with nurses recruited in the same ICU and from others in the Province of Quebec (Canada).</div></div><div><h3>Results</h3><div>During 150 observations, nurses administered 197 boluses. Nurses mostly administered boluses with a volumetric pump (76 %, 95 %CI 69–81 %). In interviews, all nurses expressed favoring volumetric pumps to administer boluses. Nurses documented bolus use in 58 % of observations (58 %, 95 %CI 50–66 %). Propofol and fentanyl were the most frequently used drugs, and all nurses reported that they were the “classic“ bolus drugs. The median cumulative propofol and opioid bolus doses given by nurses were respectively 30 mg (95 %CI 25–30), and 50 µg in fentanyl-equivalent (95 %CI 50–50). We observed that nursing or medical interventions were the most common trigger for bolus use (63 %, 95 %CI 55–71 %), and these were among the main reason for bolus use reported in interviews (n = 9, 90 %). Increasing norepinephrine was observed (19 %, 95 %CI 13–26 %) and reported by all nurses as the most frequent interventions after boluses.</div></div><div><h3>Conclusions</h3><div>Nurses favor volumetric pumps to administer boluses and propofol and fentanyl were the most used drugs. Documentation of boluses was suboptimal. Sedation boluses often led to norepinephrine titration.</div></div><div><h3>Implications for clinical practice</h3><div>Sedation boluses administered to patients with continuous infusions of sedations often led to norepinephrine titration, suggesting that they may have implications for patient safety and outcomes. Merging electronic health records entries and volumetric pump data logs or data feeds may be essential to properly capture the exposure of ICU patients to sedation.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103958"},"PeriodicalIF":4.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143287318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of structured family auditory stimulation on preventing ICU delirium among patients with unplanned admissions: A randomized controlled study","authors":"Yajun Ma ,&nbsp;Yuping Zhang ,&nbsp;Nianqi Cui ,&nbsp;Zhiting Guo ,&nbsp;Jingfen Jin","doi":"10.1016/j.iccn.2025.103944","DOIUrl":"10.1016/j.iccn.2025.103944","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the effect of a structured family auditory stimulation on preventing ICU delirium among patients with unplanned admissions.</div></div><div><h3>Design</h3><div>A three-arm parallel, single-blinded, randomized controlled trial was designed.</div></div><div><h3>Research methodology</h3><div>Patients were randomly assigned to one of three groups: structured family auditory stimulation (Group A), unstructured family auditory stimulation (Group B), and usual care (Group C). The primary outcome was delirium incidence, and secondary outcomes included delirium severity, delirium duration, delirium-free days, delirium subtypes, time to first delirium, the family anxiety and depression levels.</div></div><div><h3>Results</h3><div>A total of 213 patients were randomly assigned to three groups. There were no significant differences in demographic or clinical characteristics among the three groups. For the primary outcome, fewer patients developed delirium in Group A than in Group B and Group C (22.5 % vs. 26.8 % vs. 49.3 %, <em>P =</em> 0.001). For secondary outcomes, Group A had lower delirium severity scores than the other groups did (3.1 ± 0.4 vs. 4.0 ± 0.3 vs. 5.1 ± 0.3, <em>P</em> &lt; 0.001). Patients in Group A had shorter delirium durations (2.0 vs. 3.0 vs.4.0 days, <em>P</em> &lt; 0.001) and longer delirium-free days (3.0 vs. 2.0 vs. 1.0 days, <em>P</em> &lt; 0.001) than those in Group B and Group C. The time to first delirium was 3.0, 2.0, and 2.0 days, respectively (<em>P</em> &lt; 0.001). The SAS scores of the families in the three groups were 47.1 ± 5.7, 48.9 ± 5.5, and 56.5 ± 7.5 (<em>P</em> &lt; 0.001) and the SDS scores were 38.2 ± 5.8, 38.3 ± 5.7, and 42.7 ± 7.2 (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The results revealed that structured family auditory stimulation could reduce delirium incidence, decrease its severity, shorten the duration of delirium, increase delirium-free days, and prolong the time to first delirium among ICU patients with unplanned admission. Additionally, it could alleviate families’ anxiety and depression levels.</div></div><div><h3>Implications for clinical practice</h3><div>Structured family auditory stimulation prevents ICU delirium by maintaining the patients’ cognitive function and promoting early recovery, showing significant clinical potential in ICU delirium.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 103944"},"PeriodicalIF":4.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132146","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":"Waiting to be discharged from intensive care units: Key factors shaping patient and family experiences","authors":"Yingyan Chen ,&nbsp;Jacqueline Peet ,&nbsp;Lauren Murray ,&nbsp;Mahesh Ramanan ,&nbsp;Kylie Jacobs ,&nbsp;Jane Brailsford ,&nbsp;Amelia Osmond ,&nbsp;Moreblessing Kajevu ,&nbsp;Peter Garrett ,&nbsp;Alexis Tabah ,&nbsp;Carol Mock ,&nbsp;Frances Fengzhi Lin","doi":"10.1016/j.iccn.2025.103961","DOIUrl":"10.1016/j.iccn.2025.103961","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the factors that facilitate and hinder intensive care unit (ICU) discharge processes related to patients and their family members.</div></div><div><h3>Methods</h3><div>This was a qualitative exploratory study conducted in three regional adult ICUs in Queensland, Australia. Data were collected through semi-structured interviews with patients and their family members (or patient representatives) in addition to daily reflections based on direct observation. A deductive content analysis was undertaken using the Structure, Process, and Outcomes framework, followed by an inductive approach to generate themes.</div></div><div><h3>Results</h3><div>A total of 16 participants participated in interviews, involving 14 patients, one family member, and one patient representative. Four themes included a desire to be involved, being kept informed, uncertainty in waiting, and the discharge rush. Participants spoke about the desire to be involved in their care and discharge transition. There was a prevailing tension among patients about being kept informed. Although participants remarked that staff communication was reassuring, supportive, and comforting, they noted that timelines for discharge were often unclear, causing hesitation in the discharge process and minimal information before a sudden transfer. Uncertainty in waiting was frequently mentioned by the participants and also reflected in the daily reflections. This uncertainty led to consequences, such as discharge against medical advice and after-hours discharge rush.</div></div><div><h3>Conclusion</h3><div>The findings of this study support existing literature that underlines the importance of patient and family involvement in care, effective communication, and coordination during the discharge processes. After-hours discharge rush should be avoided for the safety of the patients and others on the wards.</div></div><div><h3>Implications for clinical practice</h3><div>Gaining an understanding of patient and family perspectives on the ICU discharge processes can guide clinicians in developing strategies to improve the continuity and quality of care and therefore enhance patient safety during ICU discharge.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103961"},"PeriodicalIF":4.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A triangular approach for Configuring the ventilator in Acute Respiratory Distress Syndrome","authors":"Farshid Rahimi-Bashar ,&nbsp;Alberto Lucchini ,&nbsp;Vinciya Pandian ,&nbsp;Hay Baggen ,&nbsp;Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2025.103965","DOIUrl":"10.1016/j.iccn.2025.103965","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103965"},"PeriodicalIF":4.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367072","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}