Intensive and Critical Care Nursing最新文献

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Patients need undisturbed sleep to heal: fight noise with noise? 患者需要不受干扰的睡眠来治愈：以噪音对抗噪音？

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-24 DOI: 10.1016/j.iccn.2025.104267

Mathias Basner, Makayla Cordoza

引用次数: 0

Refining the understanding of ICU Nurses’ attitudes toward family involvement: Key methodological, conceptual, contextual, and statistical considerations - Letter on Verkaik et al. 完善对ICU护士对家庭参与态度的理解：关键的方法、概念、背景和统计考虑- Verkaik等人的信。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-24 DOI: 10.1016/j.iccn.2025.104197

Fatemeh Bahramnezhad , Farshid Rahimi-Bashar , Amir Vahedian-Azimi

引用次数: 0

Beds we make, futures we shape: A life cycle and cost analysis of reusable and disposable linen in the ICU 我们做的床，我们塑造的未来：ICU可重复使用和一次性床单的生命周期和成本分析。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-24 DOI: 10.1016/j.iccn.2025.104290

Kylie Feely , Stacey Matthews , Forbes McGain , Mariana Ibarra , Michelle Pinan , Catherine O’Shea , Scott McAlister , Edward Quilas , Rochelle Wynne

Objectives

The aim of this study was to quantify and compare the environmental impact and cost associated with transitioning from disposable under pads (blueys) and bed protectors (pinkies) to reusable linen products in the intensive care unit (ICU).

Methods

A process-based life cycle assessment (LCA) was employed to evaluate carbon emissions and cost across the manufacturing, transportation, laundering, landfill, and disposal stages of disposable versus reusable linen. The analysis compared data from the pre (April 2022 – March 2023) and post-implementation (April 2023 – March 2024) phases of adopting reusable linen in a single centre metropolitan ICU in Melbourne, Australia.

Results

The introduction of reusable linens to replace single use products resulted in a 50 % reduction in total carbon emissions, decreasing from 7,206 kg CO₂ equivalent (CO₂e) to 3,605 kg CO₂e. The intervention avoided approximately 3.6 tonnes of CO₂e emissions and 2.2 tonnes of landfill waste, despite a 3 % ($1,005) increase in overall costs driven mainly by reusable pinkies. Reusable blueys required more frequent use to achieve CO₂e emissions parity with single use variants due to their higher initial carbon footprint, while pinkies reached parity earlier in their lifecycle.

Conclusions

These data underscore the environmental advantages of adopting reusable medical products in healthcare settings, and highlights both environmental impact and financial considerations.

Implications for clinical practice

The findings support wider implementation of reusable products in healthcare to advance sustainability goals while maintaining patient care standards. Exploration is required of long-term trends when reusables are introduced, and studies in other socioeconomic settings, on the overall financial and environmental outcomes.

目的：本研究的目的是量化和比较重症监护室（ICU）从一次性衬垫（蓝色）和床护（粉红色）过渡到可重复使用的亚麻制品所带来的环境影响和成本。方法：采用基于过程的生命周期评估（LCA）来评估一次性亚麻与可重复使用亚麻在制造、运输、洗涤、填埋和处理阶段的碳排放和成本。该分析比较了澳大利亚墨尔本单一中心大都会ICU采用可重复使用亚麻的前（2022年4月至2023年3月）和实施后（2023年4月至2024年3月）阶段的数据。结果：引入可重复使用的亚麻布来取代一次性产品，导致总碳排放量减少了50%，从7,206千克二氧化碳当量（CO2e）减少到3,605千克二氧化碳当量。干预措施避免了大约3.6吨的二氧化碳排放和2.2吨的垃圾填埋，尽管主要由可重复使用的小拇指推动的总成本增加了3%（1,005美元）。由于可重复使用的蓝蓝蓝蓝的初始碳足迹较高，因此需要更频繁的使用才能达到与一次性使用蓝蓝蓝相同的二氧化碳排放量，而小白蓝蓝在其生命周期的早期就达到了这一水平。结论：这些数据强调了在医疗机构中采用可重复使用的医疗产品的环境优势，并强调了环境影响和财务考虑。对临床实践的启示：研究结果支持在医疗保健中更广泛地实施可重复使用的产品，以推进可持续性目标，同时保持患者护理标准。需要探索引入可重复使用材料时的长期趋势，并在其他社会经济环境中研究总体财务和环境结果。

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引用次数: 0

Retention and morale in the ICU: interprofessional team members’ perspectives on interprofessional staffing in adult ICUs ICU的保留和士气：跨专业团队成员对成人ICU跨专业人员配置的看法。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-24 DOI: 10.1016/j.iccn.2025.104255

Kathleen E. Fitzpatrick Rosenbaum , Nathan C. Wright , Shelli L. Feder , Olga Yakusheva , Deena Kelly Costa

Objective

To explore how interprofessional team staffing—comprised of registered nurses, physicians, and respiratory therapists—is perceived to impact team members and patient care in the ICU.

Methods

Using previously collected interview data from a study focused on optimal interprofessional teams in adult ICUs from a single academic medical center, we used thematic analysis to examine how team staffing influenced team members and patient care; we paid particular attention to perspectives on patient safety, team member well-being, and retention.

Results

Using data from 14 interviews (7 registered nurses, 4 physicians, 3 respiratory therapists) we identified five themes: (1) patient assignments were linked to patient safety: “sometimes it can get a little dicey”; (2) continuity of care helps, “but let’s get real… you need breaks”; (3) when staffing is inadequate – “you can’t provide the type of care you want” – interprofessional team members feel demoralized; (4) retention was both a cause and a result of inadequate interprofessional staffing; and (5) team support is critical: “we are like a unified front…we band together”. Staffing was described as cyclical, dynamic, and interconnected.

Conclusions

Interprofessional team members described ICU staffing as complex and may influence patient safety, continuity of care, team member well-being, and retention. Focusing on how to improve ICU interprofessional team staffing may have the potential to improve both team and patient outcomes.

Implications for clinical practice

Given current workforce dynamics for ICU nurses and their colleagues, the ICU interprofessional team might benefit from understanding how interprofessional team staffing aids in well-being, retention, and patient safety. These study findings can inform future research and quality improvement programs to explore opportunities to enhance interprofessional team collaboration to promote excellence of care of critically ill patients.

目的：探讨由注册护士、内科医生和呼吸治疗师组成的跨专业团队人员对ICU团队成员和患者护理的影响。方法：使用先前收集的访谈数据，这些访谈数据来自于一项针对单个学术医疗中心成人重症监护病房最佳跨专业团队的研究，我们使用主题分析来研究团队人员配置如何影响团队成员和患者护理；我们特别关注患者安全、团队成员福利和保留的观点。结果：使用14个访谈（7名注册护士、4名医生、3名呼吸治疗师）的数据，我们确定了五个主题：(1)患者分配与患者安全相关：“有时可能会变得有点冒险”；(2)持续的护理有帮助，“但让我们面对现实吧……你需要休息”；(3)当人员配置不足时——“你不能提供你想要的那种护理”——跨专业团队成员感到士气低落；(4)留任既是跨专业人员配备不足的原因，也是结果；(5)团队支持至关重要：“我们就像一个统一战线……我们团结在一起”。人员配置被描述为周期性的、动态的和相互关联的。结论：跨专业团队成员描述ICU人员配置复杂，可能影响患者安全、护理连续性、团队成员福祉和保留。关注如何改善ICU跨专业团队的人员配置可能有潜力改善团队和患者的结果。对临床实践的启示：考虑到当前ICU护士及其同事的劳动力动态，ICU跨专业团队可能会从了解跨专业团队人员配置如何有助于健康、保留和患者安全中受益。这些研究结果可以为未来的研究和质量改进计划提供信息，以探索加强跨专业团队合作的机会，以促进重症患者的卓越护理。

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引用次数: 0

Strengthening the parental role: parents’ experiences of family presence during invasive procedures in pediatric and neonatal intensive care units 强化父母角色：父母在儿科和新生儿重症监护病房侵入性手术期间的家庭存在经验。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-24 DOI: 10.1016/j.iccn.2025.104279

Laia Ventura Expósito , Esperanza Zuriguel-Pérez , Jesús Corrionero Alegre , Antonia Arreciado Marañón

Introduction

The presence of family members during invasive procedures in neonatal and pediatric intensive care units is limited, despite its emotional benefits. Exploring parents’ experiences in these contexts can help us move toward more family-centered models of care.

Objective

(I) To explore the experiences of parents of pediatric and neonatal patients admitted to intensive care units regarding being present during invasive procedures; (II) Understand the needs, limitations, and suggestions for improvement expressed by parents regarding their presence during invasive procedures.

Methods

Qualitative phenomenological study based on in-depth interviews with parents of pediatric patients admitted to an intensive care unit. The thematic analysis followed the approach of Braun and Clarke, and the COREQ guidelines were respected.

Results

22 parents participated in the study. Two major themes emerged from the analysis: (1) The influence of family presence during invasive procedures, and (2) Parents’ needs. Participants viewed being present as essential to fulfilling their role as caregivers, providing comfort to their children, and strengthening emotional bonds. They endorsed being present, despite the emotional burden entailed. They identified the following key needs: receiving clear information, having emotional support, having the freedom to decide whether to be present, and having a private and safe environment.

Conclusions

Parents view being present during procedures as a right and a way of exercising their parental role. It promotes the emotional well-being of the child and strengthens their relationship with professionals.

Implications for Clinical Practice

The presence of family members should be encouraged through specific training for staff and support personnel. Safe environments must be created, and teams must foster a sensitive approach toward the active role of parents in caregiving.

在新生儿和儿科重症监护病房的侵入性手术中，家庭成员的存在是有限的，尽管它在情感上有好处。探索父母在这些情况下的经历可以帮助我们走向更加以家庭为中心的护理模式。目的：(1)探讨重症监护病房儿科和新生儿患者家长在有创手术过程中的在场体验；（II）了解家长对其介入侵入性手术的需求、限制和改进建议。方法：质性现象学研究基于深度访谈儿科患者的家长入住重症监护室。主题分析遵循Braun和Clarke的方法，并遵循COREQ指南。结果：22名家长参与了本研究。分析中出现了两个主要主题：(1)侵入性手术过程中家庭在场的影响；(2)父母的需求。参与者认为，作为照顾者、为孩子提供安慰和加强情感纽带，在场是必不可少的。他们同意出席，尽管会带来情感上的负担。他们确定了以下关键需求：获得清晰的信息，有情感支持，有决定是否出席的自由，以及有一个私人和安全的环境。结论：父母认为在手术过程中在场是一种权利，也是行使父母角色的一种方式。它促进了孩子的情感健康，并加强了他们与专业人士的关系。对临床实践的启示：应通过对工作人员和辅助人员的专门培训，鼓励家庭成员在场。必须创造安全的环境，团队必须培养一种敏感的方法，让父母在照顾中发挥积极作用。

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引用次数: 0

Endotracheal suctioning: moving from standard to individualised procedure in mechanically ventilated patients – Response to Ji and Zhang 气管内吸引：机械通气患者从标准程序到个体化程序的转变——对Ji和Zhang的反应。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-24 DOI: 10.1016/j.iccn.2025.104285

Alberto Lucchini, Marco Giani, Emanuele Rezoagli

引用次数: 0

Optimising alarm models without losing clinical relevance: Letter on Fang et al. 在不失去临床相关性的情况下优化报警模型：Letter on Fang等人。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-24 DOI: 10.1016/j.iccn.2025.104260

Nutan Prakash Makasare , H.K. Komala , Devraj Singh Chouhan

引用次数: 0

Authorship integrity and artificial intelligence 作者完整性和人工智能。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-24 DOI: 10.1016/j.iccn.2025.104283

Amir Vahedian-Azimi, Masoud Arabfard, Stijn Blot (Editor-in-Chief, Intensive and Critical Care Nursing)

引用次数: 0

Effects of mindfulness-based stress reduction on ICU nurses’ resilience and well-being 正念减压对ICU护士心理弹性和幸福感的影响。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-23 DOI: 10.1016/j.iccn.2025.104258

Merve Bat Tonkuş , Hülya Bilgin

Objectives

This study investigated the effects of a Mindfulness-Based Stress Reduction (MBSR) on the resilience and well-being of intensive care unit (ICU) nurses.

Methods

This randomized study was conducted with a control group design and repeated measures. A total of 44 nurses participated in the study, (22 intervention and 22 control groups). Data were collected using an information form and scales measuring psychological resilience and psychological well-being. The intervention group participated in an 8-week online MBSR program. Each session lasted 90 min. The control group received a minimal intervention consisting of a single 90-minute information session on mindfulness.

Results

The MBSR intervention improved the nurses’ resilience scores (p < 0.05). Comparison of psychological well-being scores revealed significant differences in the intervention group by time and in the control group.

Conclusions

MBSR is a useful intervention to improve the psychological resilience and well-being of intensive care nurses. It is recommended to perform MBSR at regular intervals to improve the quality of ICU care and reduce the risk of professional burnout by strengthening the coping skills of ICU nurses.

Implications for clinical practice

MBSR increases ICU nurses’ resilience and well-being by reducing stress, improving emotional regulation, and promoting a supportive work environment, which has significant clinical potential for critical care.

目的：本研究探讨正念减压（MBSR）对重症监护病房（ICU）护士心理弹性和幸福感的影响。方法：采用随机对照设计，重复测量。共44名护士参与研究，其中干预组22名，对照组22名。数据收集使用信息表和量表测量心理弹性和心理健康。干预组参加了为期8周的在线正念减压课程。每节课持续90分钟。对照组接受了一个最小的干预，包括一个90分钟的关于正念的信息会议。结果：正念减压干预提高了护士的心理弹性得分(p)。结论：正念减压干预对提高重症监护护士的心理弹性和幸福感是有效的干预。建议定期进行正念减压，通过加强ICU护士的应对技能，提高ICU护理质量，降低职业倦怠风险。对临床实践的启示：正念减压疗法通过减轻压力、改善情绪调节和促进支持性工作环境，提高了ICU护士的复原力和幸福感，在危重病护理中具有重要的临床潜力。

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引用次数: 0

Effectiveness of intermittent pneumatic compression cushion in preventing sacrococcygeal intraoperative acquired pressure injuries during cardiac surgery: a randomized controlled trial 间歇气动压缩垫预防心脏手术中骶尾骨术后获得性压力损伤的有效性：一项随机对照试验。

IF 4.7 2区医学 Q1 NURSING

Intensive and Critical Care Nursing

Pub Date : 2025-11-22 DOI: 10.1016/j.iccn.2025.104278

Yan Zhang , Wei Gao , Yi Zhang , Yuyan Lin , Na Chen , Caixia Sun , Yaoyao Hu , Huijun Chen , Min Xu , Weijian Wang

Background

Intraoperative Acquired Pressure Injury (IAPI) is a common complications in cardiac surgery, with reported incidence rates of 14.3–30%. Conventional pressure redistribution methods have limited effectiveness during lengthy procedures. This study evaluated the efficacy of intermittent pneumatic compression (IPC) cushions in preventing sacrococcygeal IAPI in cardiac surgery patients and developed a predictive nomogram for risk assessment.

Methods

In this prospective, single-center randomized controlled trial, patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were randomized to receive either IPC cushion (n = 94) or standard gel pad (n = 95). The primary outcome was the incidence of sacrococcygeal IAPI. Secondary outcomes included intraoperative changes in regional tissue oxygen saturation (rSO₂) and postoperative skin temperature differentials (ΔT). Risk factors were identified through logistic regression analysis, and a predictive nomogram was constructed and validated.

Results

The IAPI incidence was significantly lower in the IPC group compared to the control group (3.19 % vs. 18.95 %, P = 0.001). The IPC group demonstrated higher sacrococcygeal rSO₂ values during CPB and rewarming phases (P < 0.05). Postoperative sacrococcygeal ΔT was significantly lower in the IPC group [0.0 (–0.1, 0.1) vs 0.3 (–0.3, 0.5); P = 0.001]. Multivariate logistic regression identified lower preoperative sacrococcygeal rSO₂ (OR = 0.94, 95 % CI: 0.90–0.98), absence of IPC intervention (OR = 0.06, 95 % CI: 0.01–0.28), and diabetes mellitus (OR = 7.98, 95 % CI: 2.20–29.01) as independent risk factors for IAPI. The nomogram demonstrated excellent discrimination (AUC = 0.857, 95 % CI: 0.776–0.937) and calibration (χ² = 1.09, P = 0.997).

Conclusion

IPC cushions effectively reduce IAPI incidence during cardiac surgery by improving sacrococcygeal tissue perfusion. Skin temperature differentials correlate with IAPI risk and may serve as early indicators for prevention. The validated predictive nomogram offers a practical tool for risk assessment and targeted preventive strategies in clinical practice.

Implications for clinical practice

This study introduced an innovative application of IPC for preventing intraoperative IAPI in cardiac surgery patients, demonstrating its effectiveness in lowering the incidence of IAPI.

背景：术中获得性压力损伤（IAPI）是心脏手术中常见的并发症，据报道发病率为14.3-30%。在漫长的过程中，传统的压力再分配方法的有效性有限。本研究评估了间歇气动压缩（IPC）缓冲垫预防心脏手术患者骶尾骨IAPI的效果，并开发了一种用于风险评估的预测图。方法：在这项前瞻性、单中心随机对照试验中，接受心脏手术合并体外循环（CPB）的患者被随机分为IPC缓冲垫（n = 94）和标准凝胶垫（n = 95）。主要观察指标为骶尾骨IAPI的发生率。次要结果包括术中局部组织氧饱和度（rSO2）和术后皮肤温差的变化（ΔT）。通过logistic回归分析识别危险因素，构建预测模态图并进行验证。结果：IPC组IAPI发生率明显低于对照组（3.19% vs. 18.95%, P = 0.001）。IPC组在CPB和复温阶段的骶尾骨rSO2值较高（P < 2 (OR = 0.94, 95% CI: 0.90-0.98)），缺乏IPC干预（OR = 0.06, 95% CI: 0.01-0.28）和糖尿病（OR = 7.98, 95% CI: 2.20-29.01）是IAPI的独立危险因素。模态图具有良好的鉴别性（AUC = 0.857, 95% CI: 0.776 ~ 0.937）和校准性（χ2 = 1.09, P = 0.997）。结论：IPC缓冲垫通过改善骶尾骨组织灌注，有效降低心脏手术中IAPI的发生率。皮肤温差与IAPI风险相关，可作为预防的早期指标。经过验证的预测图为临床实践中的风险评估和有针对性的预防策略提供了实用的工具。临床意义：本研究介绍了IPC在心脏手术患者术中预防IAPI的创新应用，证明了其在降低IAPI发生率方面的有效性。

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