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1.
Semin Neurol ; 44(3): 357-361, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38788764

RESUMEN

Highly educated and skilled nursing care is critical to improving patient outcomes in general and in specialties like neurocritical care. Nursing interventions reflect nursing knowledge, critical thinking, and decision-making and is generally rooted in the nursing process. Nursing interventions are also a key focus of research to better understand how nursing care influences patient outcomes. This review describes the literature regarding nursing interventions in key neurocritical diagnoses and contextualizes it within the broader discussion about the nursing process and nursing interventions research. Publications about nursing interventions in neurocritical care emphasize key themes, including managing neurophysiologic parameters, providing psychosocial support, managing the environmental milieu, and interventions to prevent complications. Further study of how to best support nurses in collecting and interpreting data to form nursing interventions is needed, as is understanding the benefits and limitations of the nursing process in low- and middle-income countries.


Asunto(s)
Cuidados Críticos , Humanos , Cuidados Críticos/métodos , Enfermedades del Sistema Nervioso/enfermería , Enfermedades del Sistema Nervioso/terapia , Enfermería de Cuidados Críticos/normas
2.
Crit Care ; 28(1): 181, 2024 05 28.
Artículo en Inglés | MEDLINE | ID: mdl-38807236

RESUMEN

PURPOSE: Triggers have been developed internationally to identify intensive care patients with palliative care needs. Due to their work, nurses are close to the patient and their perspective should therefore be included. In this study, potential triggers were first identified and then a questionnaire was developed to analyse their acceptance among German intensive care nurses. METHODS: For the qualitative part of this mixed methods study, focus groups were conducted with intensive care nurses from different disciplines (surgery, neurosurgery, internal medicine), which were selected by convenience. Data were analysed using the "content-structuring content analysis" according to Kuckartz. For the quantitative study part, the thus identified triggers formed the basis for questionnaire items. The questionnaire was tested for comprehensibility in cognitive pretests and for feasibility in a pilot survey. RESULTS: In the qualitative part six focus groups were conducted at four university hospitals. From the data four main categories (prognosis, interprofessional cooperation, relatives, patients) with three to 15 subcategories each could be identified. The nurses described situations requiring palliative care consults that related to the severity of the disease, the therapeutic course, communication within the team and between team and patient/relatives, and typical characteristics of patients and relatives. In addition, a professional conflict between nurses and physicians emerged. The questionnaire, which was developed after six cognitive interviews, consists of 32 items plus one open question. The pilot had a response rate of 76.7% (23/30), whereby 30 triggers were accepted with an agreement of ≥ 50%. CONCLUSION: Intensive care nurses see various triggers, with interprofessional collaboration and the patient's prognosis playing a major role. The questionnaire can be used for further surveys, e.g. interprofessional triggers could be developed.


Asunto(s)
Grupos Focales , Cuidados Paliativos , Humanos , Cuidados Paliativos/métodos , Cuidados Paliativos/psicología , Grupos Focales/métodos , Encuestas y Cuestionarios , Femenino , Masculino , Adulto , Persona de Mediana Edad , Unidades de Cuidados Intensivos/organización & administración , Unidades de Cuidados Intensivos/estadística & datos numéricos , Actitud del Personal de Salud , Investigación Cualitativa , Alemania , Enfermeras y Enfermeros/psicología , Enfermeras y Enfermeros/estadística & datos numéricos , Cuidados Críticos/métodos , Cuidados Críticos/psicología , Enfermería de Cuidados Críticos/métodos , Enfermería de Cuidados Críticos/normas , Enfermería de Cuidados Críticos/estadística & datos numéricos
3.
Acta Anaesthesiol Scand ; 68(10): 1426-1435, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39056218

RESUMEN

BACKGROUND: Burnout is frequent among intensive care unit (ICU) healthcare professionals and may result in medical errors and absenteeism. The COVID-19 pandemic caused additional strain during working hours and also affected off-duty life. The aims of this study were to survey burnout levels among ICU healthcare professionals during the first year of COVID-19, describe those who reported burnout, and analyse demographic and work-related factors associated with burnout. METHODS: This was a national prospective longitudinal cohort study of 484 nurses, physicians and leaders working in intensive care units with COVID-19 patients in Norway. Burnout was measured at 6- and 12-month follow-up, after a registration of baseline data during the first months of the COVID epidemic. The Copenhagen Burnout Inventory (CBI), was used (range 0-100), burnout caseness defined as CBI ≥50. Bi- and multivariable logistic regression analyses were performed to examine baseline demographic variables and work-related factors associated with burnout caseness at 12 months. RESULTS: At 6 months, the median CBI score was 17, increasing to 21 at 12 months (p = .037), with nurses accounting for most of the increase. Thirty-two per cent had an increase in score of more than 5, whereas 25% had a decrease of more than 5. Ten per cent reported caseness of burnout at 6 months and 14% at 12 months (n.s.). The participants with burnout caseness were of significantly lower age, had fewer years of experience, reported more previous anxiety and/or depression, more moral distress, less perceived hospital recognition, and more fear of infection in the bivariate analyses. Burnout was the single standing most reported type of psychological distress, and 24 out of 41 (59%) with burnout caseness also reported caseness of anxiety, depression and/or post-traumatic stress disorder (PTSD) symptoms. Multivariate analysis showed statistically significant associations of burnout caseness with fewer years of professional experience (p = .041) and borderline significance of perceived support by leader (p = .049). CONCLUSION: In Norway, a minority of ICU nurses, physicians and leaders reported burnout 1 year into the pandemic. A majority of those with burnout reported anxiety, depression and/or PTSD symptoms combined. Burnout was associated with less years of professional experience.


Asunto(s)
Agotamiento Profesional , COVID-19 , Unidades de Cuidados Intensivos , Médicos , Humanos , COVID-19/epidemiología , COVID-19/psicología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Masculino , Estudios Longitudinales , Femenino , Adulto , Médicos/psicología , Persona de Mediana Edad , Estudios Prospectivos , Noruega/epidemiología , Liderazgo , Pandemias , Enfermeras y Enfermeros/psicología , Estudios de Cohortes , Encuestas y Cuestionarios , Enfermería de Cuidados Críticos , Cuidados Críticos/psicología
4.
BMC Health Serv Res ; 24(1): 653, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38773420

RESUMEN

BACKGROUND: Implicit absenteeism is very common among nurses. Poor perceived social support of intensive care unit nurses has a negative impact on their mental and physical health. There is evidence that lack of occupational coping self-efficacy can promote implicit absenteeism; however, the relationship between lack of occupational coping self-efficacy in perceived social support and implicit absenteeism of intensive care unit nurses is unclear. Therefore, this study aimed to evaluate the role of perceived social support between lack of occupational coping self-efficacy and implicit absenteeism of intensive care unit nurses, and to provide reliable evidence to the management of clinical nurses. METHODS: A cross-sectional study of 517 intensive care unit nurses in 10 tertiary hospitals in Sichuan province, China was conducted, of which 474 were valid questionnaires with a valid recovery rate of 91.6%. The survey tools included the Chinese version of Implicit Absenteeism Scale, the Chinese version of Perceived Social Support Scale, the Chinese version of Occupational Coping Self-Efficacy Scale and the Sociodemographic characteristics. Descriptive analysis and Pearson correlation analysis were performed using SPSS version 22.0, while the mediating effects were performed using AMOS version 24.0. RESULTS: The average of intensive care unit nurses had a total implicit absenteeism score of (16.87 ± 3.98), in this study, the median of intensive care unit nurses' implicit absenteeism score was 17, there were 210 intensive care unit nurses with low implicit absenteeism (44.3%) and 264 ICU nurses with high implicit absenteeism (55.7%). A total perceived social support score of (62.87 ± 11.61), and a total lack of occupational coping self-efficacy score of (22.78 ± 5.98). The results of Pearson correlation analysis showed that implicit absenteeism was negatively correlated with perceived social support (r = -0.260, P < 0.001) and positively correlated with lack of occupational coping self-efficacy (r = 0.414, P < 0.001). In addition, we found that perceived social support plays a mediating role in lack of occupational coping self-efficacy and implicit absenteeism [ß = 0.049, 95% CI of (0.002, 0.101)]. CONCLUSIONS: Intensive care unit nurses had a high level of implicit absenteeism with a moderate level of perceived social support and lack of occupational coping self-efficacy. Nursing managers should pay attention to the nurses those who were within low levels of social support and negative coping strategies, and take measures to reduce intensive care unit nurses' professional stress, minimize implicit absenteeism.


Asunto(s)
Absentismo , Adaptación Psicológica , Unidades de Cuidados Intensivos , Autoeficacia , Apoyo Social , Humanos , Estudios Transversales , Femenino , Masculino , Adulto , China , Encuestas y Cuestionarios , Personal de Enfermería en Hospital/psicología , Persona de Mediana Edad , Enfermería de Cuidados Críticos
5.
Contact Dermatitis ; 91(1): 30-37, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38702937

RESUMEN

BACKGROUND: Healthcare workers are at high risk of developing occupational hand dermatitis (HD) due to their frequent exposure to wet-work and use of gloves. Complaints of HD may interfere with work and cause loss of work productivity, or sick leave, and may have impact on job pleasure and performing daily activities. The prevalence of HD among intensive care unit (ICU) nurses is unknown. OBJECTIVES: To investigate the point prevalence and the 1-year prevalence of HD among ICU nurses, and to determine the impact of HD on work and daily activities. METHOD: A questionnaire-based cross-sectional study was performed among ICU nurses. Participants were recruited in the Amsterdam University Medical Centre. A symptom-based questionnaire was used to determine HD and atopic predisposition, and an additional questionnaire was used concerning the influence of HD. ICU nurses with an atopic predisposition or symptoms suiting HD were invited for the hand dermatitis consultation hour (HDCH). Data were analysed with logistic regression. RESULTS: A total of 184 ICU nurses were included. The point prevalence of HD was 9.8% (95% CI: 5.9-15.0) and the 1-year prevalence was 26.6% (95% CI: 20.4-33.6). Sick leave was reported by 0.5%. HD seemed to have more impact on job pleasure than on work productivity. CONCLUSION: The high prevalence rate of HD resulting from our study highlights the need for the prevention of occupational HD among healthcare workers.


Asunto(s)
Dermatitis Profesional , Dermatosis de la Mano , Humanos , Dermatitis Profesional/epidemiología , Dermatitis Profesional/etiología , Dermatosis de la Mano/epidemiología , Femenino , Prevalencia , Estudios Transversales , Adulto , Masculino , Persona de Mediana Edad , Unidades de Cuidados Intensivos/estadística & datos numéricos , Países Bajos/epidemiología , Ausencia por Enfermedad/estadística & datos numéricos , Personal de Enfermería en Hospital/estadística & datos numéricos , Encuestas y Cuestionarios , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Enfermería de Cuidados Críticos
6.
Neurocrit Care ; 41(2): 568-575, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38570410

RESUMEN

BACKGROUND: Nurses are vital partners in the development of pediatric neurocritical care (PNCC) programs. Nursing expertise is acknowledged to be an integral component of high-quality specialty patient care in the field, but little guidance exists regarding educational requirements to build that expertise. We sought to obtain expert consensus from nursing professionals and physicians on curricular priorities for specialized PNCC nursing education in pediatric centers across the United States. METHODS: We used a modified Delphi study technique surveying a multidisciplinary expert panel of nursing professionals and physicians. Online surveys were distributed to 44 panelists over three rounds to achieve consensus on curricular topics deemed essential for PNCC nursing education. During each round, panelists were asked to rate topics as essential or not essential, as well as given opportunities to provide feedback and suggest changes. Feedback was shared anonymously to the panelist group throughout the process. RESULTS: From 70 initial individual topics, the consensus process yielded 19 refined topics that were confirmed to be essential for a PNCC nursing curriculum by the expert panel. Discrepancies existed regarding how universally to recommend topics of advanced neuromonitoring, such as brain tissue oxygenation; specialized neurological assessments, such as the serial neurological assessment in pediatrics or National Institutes of Health Stroke Scale; and some disease-based populations. Panelists remarked that not all centers see specific diseases, and not all centers currently employ advanced neuromonitoring technologies and skills. CONCLUSIONS: We report 19 widely accepted curricular priorities that can serve as a standard educational base for PNCC nursing. Developing education for nurses in PNCC will complement PNCC programs with targeted nursing expertise that extends comprehensive specialty care to the bedside. Further work is necessary to effectively execute educational certification programs, implement nursing standards in the field, and evaluate the impact of nursing expertise on patient care and outcomes.


Asunto(s)
Curriculum , Técnica Delphi , Humanos , Estados Unidos , Cuidados Críticos/normas , Educación en Enfermería/normas , Consenso , Enfermería de Cuidados Críticos/educación , Enfermería de Cuidados Críticos/normas , Enfermería Pediátrica/educación , Enfermería Pediátrica/normas , Niño
7.
Pain Manag Nurs ; 25(3): e250-e255, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38458848

RESUMEN

AIM: To determine the knowledge and attitudes of adult intensive care nurses regarding pain. METHOD: This descriptive and cross-sectional study was conducted with 196 nurses working in the intensive care units of a tertiary university hospital between June 2022 and September 2022. Data were collected by face-to-face interview method, and the "Personal Information Form" and "Nurses' Knowledge and Attitude Scale Regarding Pain" were used as data collection tools. RESULTS: About 71.8% of the nurses were between the ages of 18 and 30, 58.5% were women, 54.9% had a bachelor's degree, and 55.1% had been working in intensive care for 0-5 years. The nurses' total knowledge and attitude score levels were 11.8% inadequate, 64.1% moderate, and 24.1% good. A statistically significant relationship was found between age, gender, receiving training on pain in the institution, satisfaction level with the unit in which one works, frequency of pain assessment and indicators taken into consideration when evaluating pain severity, and the total scale score average (p < 0.05). CONCLUSIONS: The average pain knowledge and attitude scores of intensive care nurses are at a good level. Results can be further improved with planned training on pain.


Asunto(s)
Enfermería de Cuidados Críticos , Conocimientos, Actitudes y Práctica en Salud , Unidades de Cuidados Intensivos , Humanos , Femenino , Adulto , Masculino , Estudios Transversales , Enfermería de Cuidados Críticos/métodos , Enfermería de Cuidados Críticos/normas , Encuestas y Cuestionarios , Unidades de Cuidados Intensivos/organización & administración , Persona de Mediana Edad , Adolescente , Manejo del Dolor/métodos , Manejo del Dolor/normas , Manejo del Dolor/psicología , Manejo del Dolor/estadística & datos numéricos , Competencia Clínica/normas , Competencia Clínica/estadística & datos numéricos , Dimensión del Dolor/métodos , Enfermeras y Enfermeros/psicología , Enfermeras y Enfermeros/estadística & datos numéricos
8.
Pain Manag Nurs ; 25(5): 494-500, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38897824

RESUMEN

OBJECTIVES: This study, which uses a randomized controlled design, aimed to determine the effect of foot reflexology on stress, fatigue, and low back pain (LBP) in intensive care unit (ICU) nurses. METHODS: The study was conducted with intensive care unit nurses at two hospitals in a city between September 2022 and April 2023. The study sample consisted of 42 nurses, 21 of whom had low back pain for at least 3 months and 21 of whom were controls. In the study, foot reflexology was applied to the intervention group for 20 minutes (10 minutes on each foot) once a week for 4 weeks. There was no intervention applied to the control group. Data were collected using the Personal Information Form, the Perceived Stress Scale (PSS), the Fatigue Severity Scale (FSS), and the Visual Analog Scale (VAS). FINDINGS: Based on the change in the mean scores of the scale in the intervention and control groups over time, a statistically significant decrease was found between the pre-test (before foot reflexology) and post-test mean scores of the LBP-VAS (from 6.33 to 2.24, respectively) and the Fatigue Severity Scale (from 4.81 to 3.60, respectively) in the intervention group. Although there was no statistically significant difference between the perceived stress scale pre-test and post-test scores, it was found that there was a decrease in favor of the intervention group. CONCLUSION: Foot reflexology appears to offer promise as an effective method for ICU nurses to reduce lower back pain and fatigue.


Asunto(s)
Fatiga , Pie , Unidades de Cuidados Intensivos , Dolor de la Región Lumbar , Humanos , Dolor de la Región Lumbar/terapia , Dolor de la Región Lumbar/psicología , Femenino , Adulto , Unidades de Cuidados Intensivos/organización & administración , Masculino , Pie/fisiopatología , Fatiga/psicología , Persona de Mediana Edad , Masaje/métodos , Masaje/normas , Estrés Psicológico/complicaciones , Estrés Psicológico/psicología , Enfermeras y Enfermeros/estadística & datos numéricos , Enfermeras y Enfermeros/psicología , Enfermería de Cuidados Críticos/métodos , Enfermería de Cuidados Críticos/normas , Dimensión del Dolor/métodos
9.
J Adv Nurs ; 80(11): 4629-4638, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38318983

RESUMEN

AIMS: Globally, the nursing shortage is a growing concern. Much of the research on retention of nurses focuses on the experience of those who left positions. In this study, we set out to listen to critical care nurses (CCRNs) who have chosen to remain in their positions to understand the factors retaining them in critical care. DESIGN: This interpretive descriptive study was guided by the following research question: 'what factors influence CCRN's decision to continue to work in critical care?' METHODS: Digitally recorded interviews and a focus group were conducted between July 2022 and January 2023 using a semi-structured, strengths-based interview guide with CCRNs from three critical care units at a tertiary hospital in a city in a central Canadian province. Transcribed interviews were analysed using open, axial and selective coding and constant comparative analysis. RESULTS: Twenty-two CCRNs participated in interviews and three in a focus group. The theme of Respect, demonstrated through the interconnected concepts of Working to Full Scope, Team, Rotations and Compensation was identified. Working to Full Scope was described as providing nursing care aligned with how each nurse envisions what nursing is. Being part of a Team led by strong nurse leaders that provides opportunities and supports the sharing of their perspectives was also found. Respect was also found to be demonstrated through Rotations that recognize that work is one part of these nurses' lives. Compensation that reflects the increased education, knowledge and skills required in critical care was the final concept of Respect. CONCLUSION: Organizations should focus their efforts across the identified concepts to demonstrate Respect for CCRNs and retain them. IMPLICATIONS FOR PRACTICE: The findings of this study provide ways to support the retention of CCRNs. IMPACT: This research will have an impact on nursing leaders by providing tangible ways to retain CCRNs. REPORTING METHOD: Reporting of this work was guided by the Standards for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.


Asunto(s)
Enfermería de Cuidados Críticos , Grupos Focales , Personal de Enfermería en Hospital , Investigación Cualitativa , Humanos , Femenino , Masculino , Adulto , Personal de Enfermería en Hospital/psicología , Persona de Mediana Edad , Reorganización del Personal/estadística & datos numéricos , Actitud del Personal de Salud , Canadá , Cuidados Críticos
10.
J Adv Nurs ; 80(11): 4616-4628, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38318643

RESUMEN

AIM: To investigate the potential challenges experienced by cardiac intensive care unit (ICU) nurses in the first out-of-bed patient mobilization after open-heart surgery and propose solutions. DESIGN: A qualitative study design using the descriptive phenomenological approach. METHODS: Individual face-to-face interviews were conducted via a widely used videoconferencing program between 28 July and 22 October 2022, in the tertiary cardiac ICU of a university hospital. Nurses who had at least 1 year of cardiac ICU experience and actively participating in patient care were included. The COREQ criteria and checklist were followed in this investigation and the data were analysed by using the ATLAS.ti 8.0. FINDINGS: Nurses reported that they experience challenges when mobilizing patients, such as patients' fear, reluctance or resistance; nurses having insufficient experience, strength or lack of team members. Despite these challenges, they highlighted some positive outcomes of mobilization, such as feeling happy, reinforced team communication and nurse-patient relationship. The nurses also suggested some facilitators, such as patient motivation and an explanation of the process. CONCLUSION: Nurses experience various patient-related and nurse-related challenges during the first out-of-bed mobilization of the patient after open-heart surgery. It is recommended that healthcare institutions should implement effective strategies to address the staffing shortages and to support nurse motivation to ensure adequate nursing care. IMPACT: This study provides valuable insights into the existing literature by examining the potential challenges and strategies of the first out-of-bed patient mobilization in the cardiac ICU. It shows that patient education and organizational adaptations are effective ways to overcome the challenges. It also suggests that motivating and informing patients before the mobilization can make the process easier. Moreover, it reveals that successful patient mobilization makes nurses happy, improves team communication and strengthens nurse-patient relationship. PATIENT AND PUBLIC INVOLVEMENT AND ENGAGEMENT: No patient or public contribution.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Enfermería de Cuidados Críticos , Investigación Cualitativa , Humanos , Masculino , Femenino , Procedimientos Quirúrgicos Cardíacos/psicología , Procedimientos Quirúrgicos Cardíacos/enfermería , Persona de Mediana Edad , Adulto , Personal de Enfermería en Hospital/psicología , Relaciones Enfermero-Paciente , Ambulación Precoz/enfermería , Unidades de Cuidados Intensivos , Actitud del Personal de Salud
11.
BMC Med Educ ; 24(1): 442, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38658914

RESUMEN

INTRODUCTION: Nurses in intensive care units (ICUs) face high stress and anxiety, impacting their well-being and productivity. Addressing this, this study evaluated the impact of resilience training via a mHealth application based on micro-learning on ICU nurses' stress and anxiety levels. MATERIALS AND METHODS: This study, a single-blind randomized controlled trial conducted in 2022-23, involved sixty ICU nurses from two Tehran hospitals. Nurses were chosen through purposive sampling and divided into intervention and control groups by simple randomization. The intervention group was taught resilience via an educational mHealth application based on micro-learning, with data collected using the anxiety and stress subscales of DASS-21. RESULTS: Before the intervention, there were no significant differences in stress and anxiety scores between the intervention and control groups (P > 0.05). Upon utilizing the mHealth application, the intervention group exhibited significant reductions in stress, from 10.77 ± 3.33 to 9.00 ± 1.66 (P = 0.001), and in anxiety, from 9.43 ± 3.35 to 7.93 ± 0.98 (P < 0.001). In contrast, the control group experienced a slight increase in stress levels, from 10.10 ± 2.19 to 10.73 ± 2.15 (P = 0.002), and in anxiety levels, from 9.10 ± 1.63 to 10.23 ± 1.65 (P < 0.0001). CONCLUSIONS: The micro-learning-based mHealth application for resilience training significantly reduced ICU nurses' stress and anxiety, recommending its adoption as an innovative educational method. TRIAL REGISTRATION: The study has been registered in the Iranian Registry of Clinical Trials (No. IRCT20221225056916N1, Date: 04/29/2023).


Asunto(s)
Unidades de Cuidados Intensivos , Resiliencia Psicológica , Telemedicina , Humanos , Femenino , Adulto , Masculino , Método Simple Ciego , Irán , Ansiedad , Enfermería de Cuidados Críticos/educación , Personal de Enfermería en Hospital/educación , Personal de Enfermería en Hospital/psicología , Estrés Psicológico , Estrés Laboral/prevención & control
12.
J Clin Nurs ; 33(10): 3831-3843, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38708852

RESUMEN

AIM: To analyse the qualitative evidence on the role of critical care nurses in rapid response teams. DESIGN: Qualitative systematic review. METHODS: This qualitative systematic review employed Bettany-Saltikov and McSherry's guidelines and is reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist. Two pairs of blinded researchers screened the articles. The data were synthesised using a thematic analysis approach. DATA SOURCES: A systematic literature search was conducted using the CINAHL, Embase and MEDLINE databases. RESULTS: Seven studies were included, and three main roles were identified: (1) balancing between confidence and fear in clinical encounters, (2) facilitating collaboration and (3) managing challenging power dynamics in decision-making. CONCLUSION: Critical care nurses possess extensive knowledge and skills in providing critical care to patients experiencing deterioration on general wards. They play a vital role in facilitating collaboration between team members and ward staff. Furthermore, within the rapid response team, critical care nurses assume leadership responsibilities by overseeing the comprehensive coordination of patient care and actively engaging in the decision-making process concerning patient care. IMPLICATIONS FOR THE PROFESSION: Highlighting the central role of critical care nurses in rapid response teams as well such a team's benefits in healthcare organisations can promote applications for funding to support further quality assurance of rapid response teams and thus enhance patient safety. IMPACT: Health care organisations can assure the quality of rapid response team by providing economical resources and training. The education providers should facilitate and standardise curriculum for critical care nursing students to achieve necessary knowledge and skills as members in rapid response teams. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.


Asunto(s)
Enfermería de Cuidados Críticos , Equipo Hospitalario de Respuesta Rápida , Rol de la Enfermera , Humanos , Enfermería de Cuidados Críticos/organización & administración , Equipo Hospitalario de Respuesta Rápida/organización & administración , Investigación Cualitativa
13.
J Clin Nurs ; 33(11): 4445-4454, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39107902

RESUMEN

AIM: To explore and describe acute care nurses' decisions to recognise and respond to improvement in patients' clinical states as they occurred in the real-world clinical environment. DESIGN: A descriptive study. METHODS: Nine medical and eleven surgical nurses in a large Australian metropolitan hospital were individually observed during nurse-patient interactions and followed up in interview to describe their reasoning and clinical judgements behind observed decisions. Verbal description of observations and interviews were recorded and transcribed. Reflexive thematic analysis was used to analyse the data. RESULTS: The three themes constructed from the data were as follows: nurses checking in; nurses reaching judgements about improvements; and nurses deciding on the best person to respond. Acute care nurses made targeted assessment decisions based on predicted safety risks related to improvement in clinical states. Subjective and objective cues were used to assess for and make judgements about patient improvement. Acute care nurses' judgment of patient safety and a desire to promote patient centred care guided their decisions to select the appropriate person to manage improvement. CONCLUSIONS: The outcomes of this research have demonstrated that the proven safety benefits of acute care nurses' decision making in response to deterioration extend to improvement in patients' clinical states. In response to improvement, acute care nurses' decisions protect patients from harm and promote recovery. IMPLICATIONS FOR PATIENT CARE: Early recognition and response to improvement enable acute care nurses to protect patients from risks of unnecessary treatment and promote recovery. IMPACT: This study makes explicit nurses' essential safety role in recognising and responding to improvement in patients' clinical states. Healthcare policy and education must reflect the equal importance of assessment for and management of deterioration and improvement to ensure patients are protected and provided with safe care.


Asunto(s)
Investigación Cualitativa , Humanos , Femenino , Adulto , Australia , Personal de Enfermería en Hospital/psicología , Masculino , Relaciones Enfermero-Paciente , Persona de Mediana Edad , Seguridad del Paciente/normas , Toma de Decisiones , Mejoramiento de la Calidad , Enfermería de Cuidados Críticos/normas , Enfermería de Cuidados Críticos/métodos
14.
J Clin Nurs ; 33(3): 1195-1208, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38258507

RESUMEN

AIM(S): To explore intensive care nurses' (ICN) perceptions of simulation-based learning (SBL). DESIGN: A systematic review and meta-synthesis. METHODS: The review followed the PRISMA guidelines for reporting a systematic review. A systematic search strategy was developed using a modified PICo framework. A comprehensive search was conducted in July 2023 in CINAHL, OVID Embase, Medline complete, Web of Science, ERIC and Scopus databases for articles published in English between 2013 and 2023. Data were extracted using the Joanna Briggs Institute QARI Data Extraction, with data synthesis guided by Braun and Clark's thematic analysis approach. Quality appraisal was assessed using the CASP tool. RESULTS: Eleven studies providing qualitative data were included for analysis. Analysis and meta-synthesis led to the construction of two themes: The learning experience and professional growth through collaboration. CONCLUSION: The review highlights the balance needed in finding the appropriate simulation approach, with the right level of fidelity, conducted at appropriately regular intervals, incorporating the correct makeup of professional team members, conducted in the right environment and facilitated by a skilled facilitator, to ensure best outcomes and return on investment for ICN's education. IMPLICATIONS FOR PRACTICE: These findings are a valuable resource for educators and organisations considering simulation-based learning initiatives in the intensive care setting. NO PATIENT OR PUBLIC CONTRIBUTION: This review involved analysis of existing literature and as such no unique patient or public involvement occurred. REPORTING METHOD: The systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting guidelines.


Asunto(s)
Enfermería de Cuidados Críticos , Entrenamiento Simulado , Humanos , Entrenamiento Simulado/métodos , Enfermería de Cuidados Críticos/educación , Personal de Enfermería en Hospital/psicología , Personal de Enfermería en Hospital/educación , Actitud del Personal de Salud , Femenino , Adulto , Masculino
15.
J Clin Nurs ; 33(8): 3188-3198, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38348543

RESUMEN

OBJECTIVE: To design, develop and validate a new tool, called NEUMOBACT, to evaluate critical care nurses' knowledge and skills in ventilator-associated pneumonia (VAP) and catheter-related bacteraemia (CRB) prevention through simulation scenarios involving central venous catheter (CVC), endotracheal suctioning (ETS) and mechanically ventilated patient care (PC) stations. BACKGROUND: Simulation-based training is an excellent way for nurses to learn prevention measures in VAP and CRB. DESIGN: Descriptive metric study to develop NEUMOBACT and analyse its content and face validity that followed the COSMIN Study Design checklist for patient-reported outcome measurement instruments. METHODS: The first version was developed with the content of training modules in use at the time (NEUMOBACT-1). Delphi rounds were used to assess item relevance with experts in VAP and CRB prevention measures, resulting in NEUMOBACT-2. Experts in simulation methods then assessed feasibility, resulting in NEUMOBACT-3. Finally, a pilot test was conducted among 30 intensive care unit (ICU) nurses to assess the applicability of the evaluation tool in clinical practice. RESULTS: Seven national experts in VAP and CRB prevention and seven national simulation experts participated in the analysis to assess the relevance and feasibility of each item, respectively. After two Delphi rounds with infection experts, four Delphi rounds with simulation experts, and pilot testing with 30 ICU nurses, the NEUMOBACT-FINAL tool consisted of 17, 26 and 21 items, respectively, for CVC, ETS and PC. CONCLUSION: NEUMOBACT-FINAL is useful and valid for assessing ICU nurses' knowledge and skills in VAP and CRB prevention, acquired through simulation. RELEVANCE FOR CLINICAL PRACTICE: Our validated and clinically tested tool could facilitate the transfer of ICU nurses' knowledge and skills learning in VAP and CRB prevention to critically ill patients, decreasing infection rates and, therefore, improving patient safety. PATIENT OR PUBLIC CONTRIBUTION: Experts participated in the Delphi rounds and nurses in the pilot test.


Asunto(s)
Lista de Verificación , Enfermería de Cuidados Críticos , Neumonía Asociada al Ventilador , Humanos , Enfermería de Cuidados Críticos/normas , Enfermería de Cuidados Críticos/educación , Enfermería de Cuidados Críticos/métodos , Neumonía Asociada al Ventilador/prevención & control , Neumonía Asociada al Ventilador/enfermería , Técnica Delphi , Competencia Clínica/estadística & datos numéricos , Competencia Clínica/normas , Femenino , Entrenamiento Simulado/métodos , Masculino , Adulto , Control de Infecciones/métodos , Control de Infecciones/normas , Infecciones Relacionadas con Catéteres/prevención & control , Infecciones Relacionadas con Catéteres/enfermería , Personal de Enfermería en Hospital/educación , Unidades de Cuidados Intensivos
16.
J Clin Nurs ; 33(9): 3468-3476, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38590046

RESUMEN

BACKGROUND: In society, people live in a social reality where multiculturalism is an increasingly relevant and prevalent topic in their contexts. Facing this, caring for multicultural patients in an emergency service or intensive care unit setting requires a high level of cultural competence due to the complexity, vulnerability of the patient, rapid changes in hemodynamic status, involvement of the family, their informational needs. OBJECTIVE: To map the strategies for nursing care of critically ill multicultural patients. METHOD: A Scoping Review was conducted following the Joanna Briggs Institute's recommendations, with the research question: What are the strategies for nursing care of critically ill multicultural patients? The study was guided by PRISMA. The research was conducted through the EBSCOHost platform, SciELO, Portugal's Open Access Scientific Repository, the Virtual Health Library and a search in grey literature. This was achieved by combining the descriptors DECS/MESH: cultural competence; critical care; emergency room; intensive care; and natural words: cultural care; nurs* interventions; nurs* strategies; within the time frame from 2012 to 2024. The study screening was performed by three independent reviewers through the reading of titles, abstracts and full texts, applying exclusion criteria. The study results were then subjected to content analysis, from which categories emerged. RESULTS: The selected articles highlight various strategies that contribute to the improvement of nursing care for critically ill multicultural patients, focusing on care practice and cultural diversity training for both nurses and nursing students. CONCLUSION: Nurses with cultural competence possess more knowledge and strategies to provide tailored care for multicultural critically ill patients, thereby enhancing the quality of care delivered and contributing to the humanization of healthcare. RELEVANCE TO CLINICAL PRACTICE: Nurses need to have knowledge of existing strategies for caring for multicultural critically ill patients. PATIENT OR PUBLIC CONTRIBUTION: No direct patient or public contribution to the review.


Asunto(s)
Enfermedad Crítica , Diversidad Cultural , Humanos , Enfermedad Crítica/enfermería , Enfermería de Cuidados Críticos/normas , Masculino , Femenino , Competencia Cultural , Adulto , Asistencia Sanitaria Culturalmente Competente
17.
J Clin Nurs ; 33(10): 4005-4013, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38308404

RESUMEN

AIMS AND OBJECTIVES: This study aims to determine the relationship between perceptions of nursing presence and intensive care experiences in adult intensive care unit patients'. BACKGROUND: Intensive care units (ICUs) are settings where patients have many negative emotions and experiences, which affect both treatment and post-discharge outcomes. The holistic presence of nurses may help patients turn their negative emotions and experiences into positive ones. DESIGN: A descriptive-correlational design was used and reported according to the STROBE checklist. METHODS: The sample consisted of 182 participants. Data were collected using a personal information form, the Glasgow Coma Scale (GCS), the Intensive Care Experience Scale (ICES), and the Presence of Nursing Scale (PONS). RESULTS: A strong positive correlation existed between total ICES and PONS scores (r = 0.889, p < 0.001). There was a strong positive correlation between PONS total score and ICES subscales (awareness of surroundings (r = 0.751, p < 0.001), frightening experiences (r = 0.770, p < 0.001), recall of experience (r = 0.774, p < 0.001), and satisfaction with care (r = 0.746, p < 0.001)). Males (ß = -0.139, p < 0.05), and patients who were university and higher education graduate (ß = 0.137, p < 0.05) had higher positive ICU experiences. It was also found length of ICU stay was correlated with ICU experiences and nursing presence. CONCLUSIONS: The more positively the patients perceive nurses, the better ICU experiences they have. Gender and education level were found determinants of adult ICU patients' experiences. ICU length of stay predicted what kind of experience patients have and how much they feel the presence of nurses. RELEVANCE TO CLINICAL PRACTICE: Nurses should make their presence felt completely and holistically by using their communication skills for patients have more positive intensive care experiences. Nurses should consider variables which affects patients' ICU experiences and nursing presence.


Asunto(s)
Unidades de Cuidados Intensivos , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Cuidados Críticos/psicología , Satisfacción del Paciente/estadística & datos numéricos , Relaciones Enfermero-Paciente , Enfermería de Cuidados Críticos , Encuestas y Cuestionarios , Percepción
18.
Crit Care Nurs Q ; 47(4): 286-295, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39265110

RESUMEN

A study was conducted to evaluate the effect of virtual education on knowledge and practice of nurses regarding administration of drugs through enteral feeding tubes (EFTs). Sixty nurses working in 4 intensive care units were enrolled. A questionnaire evaluating knowledge and practice of nurses regarding drug administration through EFTs was used. At the pre-intervention stage, all nurses responded to the questionnaire. Then an educational videoclip was provided to the intervention group. One month later, post-intervention stage, both groups answered to the questionnaire again. At the end of the study, the scores of all items in the knowledge domain including medication preparation (mean difference [MD] [95% CI]: 1.11 [0.57; 1.66]), tube flushing (MD [95% CI]: 2.15 [1.59; 2.79]), recognizing drug-drug/drug-feed interactions (MD [95% CI]: 0.57 [0.05; 1.09]), and recognizing dosage forms (MD [95% CI]: 1.51 [0.94; 2.10]) and practice domain including medication preparation (MD [95% CI]: 1.63 [1.04; 2.21]), tube flushing (MD [95% CI]: 1.19 [0.64; 1.74]), and recognizing drug-drug/drug-feed interactions [MD (95% CI): 2.16 (1.53; 2.80)] in the intervention group were significantly higher than those in the control group (P < .05). Education of proper technics of preparation and administration of drugs through EFTs improved knowledge and practice of the participants.


Asunto(s)
Competencia Clínica , Enfermería de Cuidados Críticos , Nutrición Enteral , Unidades de Cuidados Intensivos , Humanos , Enfermería de Cuidados Críticos/educación , Estudios Prospectivos , Femenino , Masculino , Adulto , Encuestas y Cuestionarios , Conocimientos, Actitudes y Práctica en Salud , Educación Continua en Enfermería/métodos
19.
Crit Care Nurs Q ; 47(3): 175-183, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38860947

RESUMEN

Innovations in oncology have expanded treatment eligibility, leading to a rise in cancer patients requiring critical care. This necessitates that all critical care clinicians possess a fundamental knowledge of prevalent oncological conditions and identify emergent scenarios requiring immediate action. This article will explore key oncological complications and their management approaches.


Asunto(s)
Urgencias Médicas , Neoplasias , Humanos , Neoplasias/terapia , Cuidados Críticos , Enfermería de Cuidados Críticos
20.
Crit Care Nurs Q ; 47(4): 270-274, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39265108

RESUMEN

Hypoglycemia in critical care is a well-documented phenomenon, linking both physiological and clinical evidence to harmful outcomes and an increased risk of mortality. Its implications span medical and non-medical consequences, such as cardiovascular and cerebrovascular complications, and escalated health care expenses and hospitalization duration. Mitigation measures for modifiable risk factors and education for both patients and health care providers on hypoglycemia can effectively prevent the onset of inpatient hypoglycemia. This concise clinical review offers a brief overview of hypoglycemia in critically ill patients, encompassing its pathophysiology, etiology, diagnosis, management, and prevention.


Asunto(s)
Enfermedad Crítica , Hipoglucemia , Humanos , Hipoglucemia/terapia , Factores de Riesgo , Unidades de Cuidados Intensivos , Enfermería de Cuidados Críticos
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