Intensive and Critical Care Nursing最新文献

{"title":"Dietary fiber in critical illness: Friend or foe?","authors":"Emma Ridley","doi":"10.1016/j.iccn.2024.103759","DOIUrl":"10.1016/j.iccn.2024.103759","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473935","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":"Registered nurses’ experiences of caring for patients with hypoactive delirium after cardiac surgery − A qualitative study","authors":"Ann Hallberg Kristensen ,&nbsp;Carolin Nymark ,&nbsp;Malin Stenman ,&nbsp;Anna Falk","doi":"10.1016/j.iccn.2024.103757","DOIUrl":"10.1016/j.iccn.2024.103757","url":null,"abstract":"<div><h3>Objectives</h3><p>Delirium is a common post-cardiac surgery complication that presents as acute changes in mental abilities with confused thinking and a lack of awareness of the surroundings. Delirium symptoms present in hyperactive- and hypoactive forms. Hypoactive delirium is often overlooked. Although nursing interventions are important in preventing and treating hypoactive delirium, studies focusing on nurses’ experiences of hypoactive delirium are scarce. This study describes registered nurses’ experiences of caring for patients with hypoactive delirium after cardiac surgery.</p></div><div><h3>Research methodology/design</h3><p>This was a qualitative descriptive study with an inductive approach. Data was collected through focus group interviews with 12 registered nurses with experience in caring for cardiac surgery patients with hypoactive delirium. The study complied with the Consolidated Criteria for Reporting Qualitative Research.</p></div><div><h3>Setting</h3><p>A cardiac surgery department at a Swedish University Hospital.</p></div><div><h3>Findings</h3><p>The analysis resulted in one main category; “<em>Navigating the complexities of care when caring for patients with hypoactive delirium”</em> and three sub-categories: “<em>Challenges, “Nursing interventions”</em> and “<em>Promoting a team approach”.</em></p></div><div><h3>Conclusion</h3><p>Delirium assessment and nursing interventions are perceived as essential yet demanding. when caring for patients with hypoactive delirium. Nursing interventions like maintaining the circadian rhythm and offering emotional support need to be prioritised by the nurses, in line with the autonomy of the registered nurse’s profession. Moreover, the team around the patient is crucial for detecting and treating hypoactive delirium, and it is important to involve other professionals as well as the patient’s relatives. Future research is needed to develop assessment instruments that more accurately capture hypoactive delirium in the postoperative setting.</p></div><div><h3>Implications for clinical practice</h3><p>Despite the use of screening tools, nurses still experience challenges in detecting the symptoms of hypoactive delirium, indicating a need for more clinically effective screening tools for hypoactive delirium. Nursing interventions are emphasised in the care of patients with hypoactive delirium.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0964339724001423/pdfft?md5=87254206c8644792de3f7fea91cfbf67&pid=1-s2.0-S0964339724001423-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473945","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":"Prevalence and risk factors for in-hospital mortality of adult patients on veno-arterial extracorporeal membrane oxygenation for cardiogenic shock and cardiac arrest: A systematic review and meta-analysis","authors":"Youn-Jung Son ,&nbsp;So Hyun Park ,&nbsp;Youngeon Lee ,&nbsp;Hyeon-Ju Lee","doi":"10.1016/j.iccn.2024.103756","DOIUrl":"10.1016/j.iccn.2024.103756","url":null,"abstract":"<div><h3>Objectives</h3><p>To synthesize quantitative research findings on the prevalence and risk factors for in-hospital mortality of patients on veno-arterial extracorporeal membrane oxygenation (VA-ECMO).</p></div><div><h3>Methods</h3><p>A comprehensive search was conducted for the period from May 2008 to December 2023 by searching the five electronic databases of PubMed, CINAHL, Web of Science, EMBASE, and Cochrane library. The quality of included studies was assessed using the Newcastle–Ottawa scale. The <em>meta</em>-analysis estimated the pooled odds ratio or standard mean difference and 95% confidence intervals.</p></div><div><h3>Results</h3><p>A total of twenty-five studies with 10,409 patients were included in the analysis. The overall in-hospital mortality of patients on VA-ECMO was 56.7 %. In the subgroup analysis, in-hospital mortality of VA-ECMO for cardiogenic shock and cardiac arrest was 49.2 % and 75.2 %, respectively. The number of significant factors associated with an increased risk of in-hospital mortality in the pre-ECMO period (age, body weight, creatinine, chronic kidney disease, pH, and lactic acid) was greater than that in the intra- and post-ECMO periods. Renal replacement, bleeding, and lower limb ischemia were the most significant risk factors for in-hospital mortality in patients receiving VA-ECMO.</p></div><div><h3>Conclusion</h3><p>Early detection of the identified risk factors can contribute to reducing in-hospital mortality in patients on VA-ECMO. Intensive care unit nurses should provide timely and appropriate care before, during, and after VA-ECMO.</p></div><div><h3>Implications for Clinical Practice</h3><p>Intensive care unit nurses should be knowledgeable about factors associated with the in-hospital mortality of patients on VA-ECMO to improve outcomes. The present findings may contribute to developing guidelines for reducing in-hospital mortality among patients considering ECMO.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473946","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":"Perme ICU Physical Therapy Competency: Development of an ICU Knowledge and Skills Assessment Tool","authors":"Christiane S. Perme ,&nbsp;Monica S. Damasceno ,&nbsp;Rohini Chandrashekar ,&nbsp;Jiaqiong Xu ,&nbsp;Iqbal Ratnani ,&nbsp;Faisal Masud ,&nbsp;Esther C. Wilches-Luna","doi":"10.1016/j.iccn.2024.103750","DOIUrl":"10.1016/j.iccn.2024.103750","url":null,"abstract":"<div><h3>Background</h3><p>Physical therapy for patients in the ICU is advanced practice demanding specialized knowledge and skills. However, ICU physical therapy competency standards lack uniformity or defined processes.</p></div><div><h3>Objectives</h3><p>To describe the development process of the Perme ICU Physical Therapy Competency and to assess its face and content validity.</p></div><div><h3>Methods</h3><p>Quantitative research study for the content validation of the Perme ICU Physical Therapy Competency using a panel of experts. The face validity assessment consisted of two informal surveys and discussions with clinicians representing various disciplines in ICU.</p></div><div><h3>Main Outcome Measures</h3><p>A content validation survey included analysis of sufficiency, clarity, coherence, and relevance for items in the Perme ICU Physical Therapy Competency. For the quantitative analysis of content validity, the item-level content validity index (I-CVI) was used. Scale-level content validity index based on the universal agreement method (S-CVI/UA) was calculated as the proportion of items on the scale that achieve a relevance scale of 3 or 4 by all experts. Scale-level content validity index was calculated based on the average method (S-CVI/Ave).</p></div><div><h3>Results</h3><p>The sufficiency, clarity, coherence, and relevance of the Perme ICU Physical Therapy Competency items presented S-CVI/Ave greater than 80 % (97 %, 97 %, 99 %, 95 %, respectively).</p></div><div><h3>Conclusion</h3><p>This study establishes that the Perme ICU Physical Therapy Competency has a satisfactory level of face and content validity.</p></div><div><h3>Implications for clinical practice</h3><p>The Perme ICU Physical Therapy Competency, with its solid framework, is a valuable assessment tool applicable for integration in any ICU competency program. It can be utilized as a self-assessment tool by individual therapists or in collaboration with mentors and evaluators to evaluate knowledge and skills effectively. This innovative tool not only enhances clinical practice but also presents an opportunity for advancing the physical therapy profession within the ICU setting.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0964339724001356/pdfft?md5=6acee3adb810a7ddb2df510996476d81&pid=1-s2.0-S0964339724001356-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461325","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":"Written communication and the ICU team experience (WRITE): A pre-post intervention study","authors":"Jane J. Lee ,&nbsp;Shubha Mathur ,&nbsp;James Gerhart ,&nbsp;Crystal M. Glover ,&nbsp;Ethan Ritz ,&nbsp;Santosh Basapur ,&nbsp;Jared A. Greenberg","doi":"10.1016/j.iccn.2024.103753","DOIUrl":"10.1016/j.iccn.2024.103753","url":null,"abstract":"<div><h3>Objective</h3><p>Families of critically ill patients may benefit from receiving a written update of patient care each day. Our objective was to develop a system to facilitate care provider creation of written updates and to determine the effect of implementing this process on the care provider experience.</p></div><div><h3>Design</h3><p>The experiences of ICU care providers (nurses, advanced practice providers, and physicians) were measured monthly during a 3-month pre-intervention and a 3-month intervention period. During the intervention period, written updates were sent to families each day and posted in the electronic medical record. Study investigators assisted by editing and distributing the written communication to families.</p></div><div><h3>Setting</h3><p>An urban academic medical center in the United States.</p></div><div><h3>Main outcome measures</h3><p>Nurse-Physician Collaboration Scale (NPCS) and Maslach Burnout Inventory (MBI).</p></div><div><h3>Results</h3><p>Over the 3-month intervention period, care providers created written communication for families of 152 patients (average 5 ICU days per family). NPCS scores among the 65 participating care providers were significantly lower, indicating greater collaboration during the intervention vs. pre-intervention period: 49.9 (95 % CI 46.4–53.6) vs. 55.4 (95 % CI 51.5–59.3), p = 0.002. MBI scores were similar during the intervention vs. pre-intervention periods. A subset of care providers participated in individual interviews. Care providers reported that the process of creating written communication was acceptable and had clear benefits for both families and the medical team.</p></div><div><h3>Conclusions</h3><p>Use of written communication as a supplement to verbal communication improves collaboration among ICU care providers without affecting symptoms of burnout.</p></div><div><h3>Implications for practice</h3><p>We created a system to facilitate written communication with ICU families that was acceptable to care providers and improved aspects of their experience. In the future, use of written communication can be enhanced with refinements to the process that reduce the time spent creating written updates while highlighting the benefits to families and care providers.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461324","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":"Exploring the relationship between spiritual care and patient advocacy of nurses from generations X, Y and Z working in intensive care clinics: A cross-sectional study","authors":"Özge Uçar,&nbsp;Sevim Çelik,&nbsp;Elif Karahan,&nbsp;Sibel Altıntaş,&nbsp;Meryem Yücel","doi":"10.1016/j.iccn.2024.103754","DOIUrl":"10.1016/j.iccn.2024.103754","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the relationship between spiritual care and patient advocacy across three generations of nurses working in intensive care units.</p></div><div><h3>Design</h3><p>Cross-sectional survey.</p></div><div><h3>Methods</h3><p>Data collection took place from July to August 2022 with 120 nurses in Turkey. Data collection tools included the Spiritual Caregiving Competency Scale, the Spirituality and Spiritual Care Assessment Scale, and the Patient Advocacy Scale for Nurses. Data on nurses’ demographics were evaluated using descriptive statistical methods (number, percentage, mean, standard deviation). Independent sample <em>t</em>-test, one-way ANOVA, Pearson correlation, and linear multiple regression analysis were used to evaluate the relationships between variables, with results reported as 95% confidence intervals (CI).</p></div><div><h3>Results</h3><p>More than half of the nurses were from Generation Y (39.2 %) and Generation Z (42.5 %). Generation Z’s mean patient advocacy score (156.96 ± 23.16) was statistically significantly higher than Generation X’s (139.32 ± 34.26). We determined that the spiritual competence scale communication sub-dimension score of Generation Y nurses working between 1–10 years was higher than that of Generation Z nurses. Additionally, as the patient advocacy scores of all generations increased, so did spiritual competence scores.</p></div><div><h3>Conclusion</h3><p>The study found differences in patient advocacy and spiritual care competencies between generations. Thus, we recommend organizing courses, seminars, and in-service training on patient advocacy and spiritual care for intensive care nurses.</p></div><div><h3>Implications for clinical practice</h3><p>This study estimates nurses’ spiritual care competencies and patient advocacy levels from different generations and sheds light on the literature to eliminate differences in care between generations in nursing practices that evolve and change over time. It is recommended that courses, seminars, in-service training, spiritual activities, and interactive meetings be organized to encourage the participation of intensive care nurses to minimize the differences in spiritual care and patient advocacy among all generations of intensive care nurses.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452475","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":"Prophylactic dressings to prevent sacral pressure injuries in adult patients admitted to intensive care units: A three-arm feasibility randomized controlled trial","authors":"Sharon Latimer ,&nbsp;Rachel M. Walker ,&nbsp;Wendy Chaboyer ,&nbsp;Lukman Thalib ,&nbsp;Fiona Coyer ,&nbsp;Jodie L. Deakin ,&nbsp;Brigid M. Gillespie","doi":"10.1016/j.iccn.2024.103746","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103746","url":null,"abstract":"<div><h3>Background</h3><p>Pressure injuries in intensive care patients are a safety issue. Specialized foam sacral prophylactic dressings prevent pressure injuries with several products available for clinicians to choose from.</p></div><div><h3>Objectives</h3><p>Assess the feasibility of conducting a multisite trial to test the effectiveness of two dressings versus usual care in preventing sacral pressure injuries in intensive care patients.</p></div><div><h3>Methods</h3><p>Using a three-arm pilot randomized trial design, adult intensive care unit patients at risk for pressure injuries were randomly allocated to the Mepilex® Sacrum dressing, the Allevyn™ Life Sacrum dressing or the control group. Daily pressure injury data were collected including a de-identified sacral photograph, which the blinded outcome assessor used to determine the study end point: a new sacral pressure injury. Pre-determined feasibility criteria were measured in terms of eligibility, recruitment, retention, intervention fidelity and missing data.</p></div><div><h3>Results</h3><p>From May-September 2021, we screened 602 intensive care unit adult patients for eligibility with 93 % (n = 558) excluded. Forty-four (7 %) were eligible, and all were recruited and randomized (100 %). After receipt of the intervention two participants withdrew from the study. Our final sample of 42 participants were randomly allocated to the Mepilex® (n = 12), Allevyn™ (n = 14) or control (n = 16) group. The interventions were delivered as intended and there were 11 (6 %) cases of missing outcome data. Five participants (12 %) developed a sacral pressure injury, four of whom received a sacral dressing.</p></div><div><h3>Conclusions</h3><p>A larger trial is feasible with minor refinement to the length of stay eligibility criterion.</p></div><div><h3>Implications for practice</h3><p>Prophylactic sacral dressings are recommended for pressure injury prevention. Determining the feasibility of a larger trial to test the effectiveness of two dressings versus usual care in preventing sacral pressure injuries in intensive care patients can provide evidence to aid clinicians, policy makers and managers make value-based care decisions.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0964339724001319/pdfft?md5=724a061e04a1d0eedeaec639000d7cec&pid=1-s2.0-S0964339724001319-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141424430","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":"Is it time to monitor the unmonitored?","authors":"Niels Van Regenmortel,&nbsp;Manu L.N.G. Malbrain,&nbsp;Xavier Monnet","doi":"10.1016/j.iccn.2024.103751","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103751","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141424454","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":"Modified frailty index effectively predicts adverse outcomes in sepsis patients in the intensive care unit","authors":"Xinya Li ,&nbsp;Yonglan Tang ,&nbsp;Xingwen Deng ,&nbsp;Fuling Zhou ,&nbsp;Xiaxuan Huang ,&nbsp;Zihong Bai ,&nbsp;Xin Liang ,&nbsp;Yu Wang ,&nbsp;Jun Lyu","doi":"10.1016/j.iccn.2024.103749","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103749","url":null,"abstract":"<div><h3>Background</h3><p>Frailty and sepsis have a significant impact on patient prognosis. However, research into the relationship between frailty and sepsis in the general adult population remains inadequate. This paper aims to investigate the association between frailty and adverse outcomes in this population.</p></div><div><h3>Method</h3><p>This retrospective analysis investigated sepsis patients who were initially admitted to the intensive care unit (ICU). The Modified Frailty Index (MFI) was derived by tracking patients’ International Classification of Diseases (ICD) codes during their hospitalization. Patients were classified into two groups based on their MFI scores: a frail group (MFI ≥ 3) and a non-frail group (MFI = 0–2). The key outcomes were mortality rates at 90 and 180 days, with secondary outcomes including the incidence of delirium and pressure injury.</p></div><div><h3>Result</h3><p>Of the 21,338 patients who were recruited for this study (median age about 68 years, 41.8 % female), 5,507 were classified as frail and 15,831 were classified as non-frail. Frail patients were significantly more likely to have delirium (48.9 % vs. 36.1 %, p &lt; 0.001) and pressure injury (60.5 % vs. 51.4 %, p &lt; 0.001). After controlling for confounding variables, the multifactorial Cox proportional hazard regression analyses revealed a significantly elevated mortality rate at 90 days (adjusted HR: 1.58, 95 % CI: 1.24–2.02, p &lt; 0.001) and 180 days (adjusted HR: 1.47, 95 % CI: 1.18, 1.83, p &lt; 0.001) in the frail group compared to their non-frail counterparts.</p></div><div><h3>Conclusions</h3><p>Frailty independently predisposes adult sepsis patients in the ICU to adverse outcomes. Future investigations should concentrate on evaluating frailty and developing targeted interventions to improve patient prognosis.</p></div><div><h3>Implication for clinical practice</h3><p>The MFI provides a simple clinical assessment tool that can be integrated into electronic medical records for immediate calculation. This simplifies the assessment process and plays a key role in predicting patient outcomes.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141424431","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":"Implementation of a routine post-shift debriefing program in ICU aiming at quality-of-care improvement: A primary analysis of feasibility and impacts","authors":"Anne-Françoise Rousseau ,&nbsp;Michael Fontana ,&nbsp;Stéphanie Georis ,&nbsp;Bernard Lambermont ,&nbsp;Jonathan Cavalleri ,&nbsp;Marc Pirotte ,&nbsp;Gaëlle Tronconi ,&nbsp;Méryl Paquay ,&nbsp;Benoit Misset","doi":"10.1016/j.iccn.2024.103752","DOIUrl":"https://doi.org/10.1016/j.iccn.2024.103752","url":null,"abstract":"<div><h3>Objectives</h3><p>This report describes the implementation of a clinical debriefing (CD) program in intensive care units (ICU) and analyses its feasibility and its impact on staff well-being.</p></div><div><h3>Design</h3><p>Observational study.</p></div><div><h3>Setting</h3><p>From April to September 2023, post-shift CDs were run once a week in 2 out of 7 units in our department, using an adapted version of the DISCOVER-PHASE tool. CD sessions were performed face-to-face with volunteer members of the multidisciplinary ICU team.</p></div><div><h3>Main outcome measures</h3><p>After 6 months, a survey assessing the satisfaction of the debriefed teams was conducted. The impact of CD on staff well-being was assessed using three validated questionnaires (Maslach Burnout Inventory, Ways of Coping Checklist, Professional Quality of Life Scale) administered in the 7 units before and after the CD period.</p></div><div><h3>Results</h3><p>A total of 44 CDs were performed, lasting 15 (4–35) min. There were 6 (1–9) attendees per CD, mainly nurses (64.6%). Discussions focused mainly on basic problems related to dysfunctional material, communication and organization inside the team. The two debriefed teams were satisfied of the program and gave 9, 8 and 8 out of 10 on a visual analogical scale for the climate of confidence of the DC, their organisation, and their ability to improve working conditions and quality of care, respectively. Subscores at the three questionnaires assessing staff well-being before and after the CD period were similar, whether teams experienced CD or not.</p></div><div><h3>Conclusions</h3><p>Implementing of post-shift debriefings in our ICU was feasible and well accepted. More prolonged programs are probably needed to demonstrate benefits on staff well-being.</p></div><div><h3>Implications for clinical practice</h3><p>This report offers elements that other teams can use to successfully conduct post-shift debriefings and to plan future research on longer-term programs.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141424432","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}