Effect of Virtual Education on Knowledge and Practice of Critical Care Nurses Regarding the Administration of Drugs Through Enteral Feeding Tubes: A Prospective Randomized Pre-Post Intervention Study.

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.

Analysis of Nurses' Perceptions of Handover Practices: A Comparative Study in Different Medical Settings.

This article reports a comparative prospective study aimed to explore and compare nurses' perceptions of bedside clinical handover in 3 different settings (emergency unit, ICU, and medical ward). Results revealed that the participant nurses' perceptions varied significantly for different aspects of the handover process. Our data demonstrate department-specific variations in perceptions related to the adequacy, organization, relevance, availability of charts, use of charts for review, ease of following the information, and timeliness of the information.

Hypoglycemia in Critically Ill Patients: A Concise Clinical Review.

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.

Care Bundle Approach for Oral Health Maintenance and Reduction of Ventilator-Associated Pneumonia.

Caring for patients in the intensive care unit (ICU) creates competing priorities of interventions for nurses and other health care providers. Oral care might be prioritized lower; however, its neglect may lead to sequelae such as extended time in the ICU, nosocomial diseases most notably ventilator-associated pneumonia (VAP), or oral problems. Safe patient care depends on effective and efficient oral care. The aim of this study was to lower the incidence of VAP and maintain oral health through implementing an "oral care bundle" for mechanically ventilated (MV) patients. Using a quasi-experimental design, we divided 82 adult MV patients in the ICUs of a university-based hospital in Egypt into a control group (n = 41) that received the standard of care and a bundle group (n = 41) that received an "oral care bundle." The results of the study reported a significantly lower incidence of VAP in the intervention group (P = .015). It can be concluded that there is a significant relationship between receiving an oral care bundle and improved oral health and a reduction in the VAP rate among MV patients. This highlights the need to incorporate the oral care bundle in the daily nursing care for MV patients.

The mediating role of perceived social support between work-family conflict and presenteeism among ICU nurses working shift work in Chinese public hospitals: A cross-sectional investigation.

OBJECTIVE: Relative to explicit absenteeism, nurses' presenteeism has a more lasting impact and is more harmful and costly. This study aimed to explore the relationship between work-family conflict, perceived social support, and presenteeism and whether perceived social support mediates the relationship between work-family conflict and presenteeism among ICU nurses working on shifts in Chinese public hospitals. MATERIALS AND METHODS: A cross-sectional research design was conducted from January to April 2023 in Sichuan Province, China. A total of 609 valid questionnaires were collected. The questionnaires contained information on demographic characteristics, the Work-Family Conflict (WFC) scale, the Perceived Social Support Scale (PSSS), and Stanford Presenteeism Scale-6 (SPS-6). Multiple stratified regression was used to explore the mediating role of perceived social support between work-family conflict and presenteeism. The mediating effect of perceived social support in work-family conflict and presenteeism was tested by Model 4 in the PROCESS 4.1 macro program in SPSS. RESULTS: A total of 609 nurses were included in this study, and the mean presenteeism score for ICU nurses working on shifts was 16.01 ± 4.293 (Mean ± SD), with high presenteeism accounting for 58.46%. After controlling for sociodemographic characteristic variables, work-family conflict was positively associated with presenteeism, explaining 7.7% of the variance. High perceived social support was related to low presenteeism, explaining 11.5% of the variance. Perceived social support mediated the association between work-family conflict and presenteeism among ICU nurses working on shifts. CONCLUSIONS: Chinese shift-work ICU nurses' high presenteeism scores deserve managers' attention. Work-family conflict is a significant predictor of nurses' presenteeism. Perceived social support is essential in improving nurses' work-family conflict and mediates the relationship between work-family conflict and presenteeism. Improving social support can reduce the impact of work-family conflict on presenteeism among nurses working shifts.

The Effect of Laughter Yoga Applied to Intensive Care Nurses on Their Perceived Stress, Job Motivation, and Mental Well-being: Randomized Controlled Study.

AIM: The aim of this study was to examine the effect of laughter yoga applied to intensive care nurses on perceived stress, job motivation, and mental well-being. DESIGN: This study was a randomized controlled trial. METHODS: The study was conducted with nurses working at the university hospital's surgical intensive care and anesthesia intensive care units of the third-level intensive care unit in Turkey. Data obtained from 30 participants in the intervention group and 33 participants in the control group were analyzed. The Nurse Introduction Form, Nurse Job Motivation Scale, Perceived Stress Scale, and Warwick-Edinburgh Mental Well-being Scale were used to collect data. Data obtained from the study were evaluated using the SPSS 22.0 package. RESULTS: It was determined that there was no statistically significant difference in the average scores of the pretest/posttest 1/posttest 2 of the Perceived Stress Scale (13.70 ± 3.33 to 14.57 ± 4.57, P > .05; 13.50 ± 3.15 to 13.48 ± 4.59, P > .05; and 13.56 ± 3.15 to 13.15 ± 3.49, P > .05, respectively) and Work Motivation Scale (59.70 ± 7.58 to 59.69 ± 7.98, P > .05; 60.30 ± 8.07 to 58.48 ± 8.94, P > .05; and 60.56 ± 7.86 to 57.93 ± 9.54, P > .05, respectively) for both the intervention and control groups of nurses. A statistically significant difference was found in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the intervention group of nurses (50.90 ± 7.60, 51.50 ± 7.80, and 53.70 ± 7.08, respectively; F = 3.330, P = .043). However, the difference was found to be insignificant in pairwise comparisons in the further analysis (a = b = c). It was determined that there was no statistically significant difference in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the control group of nurses (52.21 ± 9.89, 51.93 ± 10.45, and 51.03 ± 9.63, respectively; P > .05). CONCLUSIONS: The application of laughter yoga on intensive care nurses did not result in a significant change in perceived stress levels and work motivation. However, statistically significant differences were observed in the average mental well-being scores among the intervention group.

Evaluating Intensive Care Nurses' Knowledge of Incontinence-Associated Dermatitis: A Multicenter Cross-sectional Study.

OBJECTIVE: To determine the knowledge levels of nurses working in the ICU about incontinence-associated dermatitis (IAD). METHODS: A descriptive cross-sectional study was conducted in adult ICUs at two private and three public hospitals in a province in Turkey. The study included 296 nurses who agreed to participate in the research. Researchers used the "Nurse Identification Form" and the "IAD Knowledge Test" to collect data on nurses' IAD knowledge. Data analysis included the use of percentage distribution and the Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests. RESULTS: The mean age of the nurses was 26.55 ± 3.89 years (range, 20-47 years), and the duration of working in the ICU was 2.71 ± 2.55 years (range, 1-22 years). Of the nurses, 183 (61.8%) worked in general ICUs. Of those, 69 (23.3%) received IAD training. Nurses achieved a 49.8% correct response rate on the IAD knowledge test. Nurses working in tertiary and general ICUs demonstrated higher IAD knowledge levels (Ps = .003 and .047, respectively). There were no relationships between age, career length, institution, ICU type, and IAD knowledge level. CONCLUSIONS: Nurses' knowledge level of IAD was low in intensive care. To remedy this, IAD should be added to intensive care nursing certificate programs as content, and the use of IAD risk assessment and diagnosis scales in ICUs should be expanded.

ICU nurses' practice and intention to implement early mobilization: A multi-centre cross-sectional survey.

BACKGROUND: Early mobilization (EM) is acknowledged for its safety and benefits in the recovery of critically ill patients, yet its implementation in intensive care units (ICU) remains inconsistently aligned with established guidelines. This discrepancy highlights a gap between theoretical endorsement and practical application. While barriers to EM have been extensively studied, the intentions and perceived practices of ICU nurses towards EM, especially in certain geographical regions, have not been adequately understood. AIM: The objective of this study is to assess the perceptions, actual practices and intentions of ICU nurses regarding the implementation of EM for patients in the ICU setting. STUDY DESIGN: A cross-sectional, multi-centre, survey-based study. RESULTS: The study collected data through an electronic questionnaire from 227 ICU nurses across eight hospitals in Beijing, China, concerning their experiences, practices and intentions related to EM. The survey response rate was 50% (114 of 227), indicating a moderate level of engagement by the target population. Among the surveyed participants, 68.7% (n = 156) reported having experience with EM for critically ill patients. Of these experienced nurses, 49.3% (n = 77) indicated they carried out EM less frequently than once per week, while only 29.5% (n = 46) reported dedicating more than 20 min to EM activities per patient. Only 24.2% (n = 55) of participants confirmed the presence of specific EM guidelines in their workplace. Notably, guideline adherence could be influenced by the patient's condition severity, which may affect how these protocols are applied. Notably, the approach and frequency of EM practices showed significant variation across different ICUs. A substantial majority (75%, n = 170) of participants expressed a strong intention towards implementing EM, correlating significantly with factors such as having a higher education level (bachelor's degree or higher), receiving departmental support, encountering fewer perceived barriers, and belonging to specific departments like respiratory (SICU) and surgery (RICU). The EM guidelines mentioned by participants were primarily focused on specific protocols and guidance, highlighting the emphasis on structured approaches to EM in their clinical settings. CONCLUSIONS: Despite the recognized experience with EM among ICU nurses, there is a notable divergence between their practices and the recommendations outlined in EM guidelines. This study underscores the need for the establishment of clear, actionable guidelines, alongside the provision of targeted educational programmes and robust support systems, to foster the consistent and effective implementation of EM in ICU settings. RELEVANCE TO CLINICAL PRACTICE: This study underscores the clinical relevance of EM in ICU settings, advocating for the development of precise EM guidelines to improve patient outcomes.

Oral care of intubated patients, challenging task of ICU nurses: a survey of knowledge, attitudes and practices.

INTRODUCTION: Patients' health outcomes can be positively affected by the oral care provided by intensive care unit (ICU) nurses. Providing effective oral care for intubated patients is a challenging task. The purpose of this study was to examine the knowledge, attitudes, and practices(KAP) of oral care among ICU nurses for intubated patients, as well as the underlying factors that influence these behaviors. METHOD: This cross-sectional survey was conducted on 200 nurses from adult ICUs in referral hospitals located in the central eighth area of healthcare management in Iran. The timeframe for data collection was April to June in 2023. Data were collected by questionnaires which consisted of four sections: demographic information, knowledge, attitudes and practices of oral care for intubated patients. The Pearson Correlation Coefficient was employed to determine the correlation between KAP and its main variables, which were distributed normally. RESULTS: The result showed that nurses were 32.19 ± 6.23 years old, with an average total work experience of 8.91 ± 5.54 years and an average ICU work experience of 5.89 ± 4.31 years. The mean KAP score were17.66 ± 3.04, 15.46 ± 4.23, and 7.57 ± 2.21, respectively. The knowledge of nurses was significantly impacted by their level of education (p = 0.04), and an increase in work experience each year was associated with improved attitudes among nurses (p = 0.04). A significant association was found between the nurses' oral care practice, knowledge (p = 0.03), and attitude (p = 0.04). CONCLUSION: This study revealed that ICU nurses possess a moderate level of knowledge, a higher-than-average level of practice, and they have a favorable attitude towards giving oral care to intubated patients. Therefore, providing continuous education about oral care is essential for ICU nurses.

Impacts of the COVID-19 Pandemic on Newly Licensed Critical Care Nurses.

Newly licensed registered nurses (NLRNs) were significantly impacted by the COVID-19 pandemic. NLRNs experienced interruptions or significant alterations across, academia, clinical rotations, precepted experiences, and transition to practice programs. All NLRNs were impacted, especially those in critical care who cared for the most acutely ill patients. This article represents a program evaluation of NLRNs in the critical care area during the COVID-19 pandemic and a comprehensive review of the literature related to COVID-19s impact on NLRNs.

A Post-Pandemic Review of American Association of Critical Care Nurses's Domains of Establishing and Sustaining Healthy Work Environments: Strategies for Nurse Leaders.

This article explores current evidence and practical strategies for nurse leaders to advance a healthy work environment. American Association of Critical Care Nurses's Standards for Establishing and Sustaining Healthy Work Environments should guide efforts to reconnect clinical teams with meaningful and satisfying work. Authors propose adding the domain of Wellbeing to guide leaders in holistically addressing the health of all care team members and the work environment.

Understanding the Evolving Pathophysiology of Coronavirus Disease 2019 and Adult Nursing Management.

Coronavirus disease 2019 (COVID-19) was first identified in December 2019 and quickly became a global pandemic. The understanding of the pathophysiology, treatment, and management of the disease has evolved since the beginning of the pandemic in 2020. COVID-19 can be complicated by immune system dysfunction, lung injury with hypoxemia, acute kidney injury, and coagulopathy. The treatment and management of COVID-19 is based on the severity of illness, ranging from asymptomatic to severe and often life-threatening disease. The 3 main recommended medication classes include antivirals, immunomodulators, and anticoagulants. Other supportive therapies include ensuring adequate oxygenation, mechanical ventilation, and prone positioning.