ABSTRACT
This study aimed to evaluate the effectiveness of nurse-led interventions for the prevention of mental health disorders after intensive care unit discharge through a systematic review of the literature. The searches were conducted in the MEDLINE (via PubMed), CINAHL, PsycINFO, and Cochrane Library databases for studies pertaining to such interventions. Two independent reviewers analyzed the studies, extracted data, and assessed the quality of the evidence. Six eligible articles were identified, all of which were regarding post-traumatic stress disorder after intensive care unit discharge. Some of the interventions were conducted during the admission and some after the discharge. One study found that multimedia education during admission improved anxiety and depression one week after discharge. The remaining five studies concluded that nurse-led interventions did not prevent mental health disorders three months to one year after intensive care unit discharge. Our review revealed a paucity of research into the effectiveness of nurse-led interventions for the prevention of mental health disorders after intensive care unit discharge. The timing and the content of these interventions, and the adequate training of nurses, appear to be key factors. Therefore, multidisciplinary interventions are likely to be more effective than those led by nurses alone.
ABSTRACT
Gastrointestinal endoscopic treatments have increased in Japan. Respiratory depression is as an unexpected development during sedation. This study aimed to clarify the sedation-related difficulties encountered by nurses involved in endoscopic treatment. Participants were five nurses who had worked for more than a year in the endoscopy department of a gastrointestinal endoscopy specialist guidance facility in Sapporo. Semistructured interviews were conducted. The number of recording units obtained was 129, which were divided into 12 categories and subdivided into 42 subcategories. The nursing practice difficulties related to sedation in endoscopic treatment were classified into two major categories: "difficulties in nursing practice" and "system difficulties." All of the "difficulty in nursing practice" items were role-fulfilling difficulties involved in protecting patient safety and reducing anxiety and discomfort. Four of these items reflected difficulties related particularly to the role of the nurse in charge of the sedated patient in the endoscopy room. To reduce the difficulties encountered by nurses, a treatment environment system must be devised to ensure patient safety and improve the education support system for nurses with regard to sedation.