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Intensive and Critical Care Nursing Research
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Intensive and Critical Care Nursing Research

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 64551

Special Issue Editors

Dr. Beata Dobrowolska

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Guest Editor
Department of Nursing Development, Medical University of Lublin, 20-000 Lublin, Poland
Interests: nursing care; nursing ethics; nursing education; health promotion and health education
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Alvisa Palese

E-Mail Website
Guest Editor
Department of Medical Science, Udine University, 33100 Udine, Italy
Interests: nursing education; nursing management
Special Issues, Collections and Topics in MDPI journals
Dr. Dorota Ozga

E-Mail Website
Guest Editor
Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, Poland St. Warzywna 1A, 35-310 Rzeszow, Poland
Interests: nursing education; medical education, learning environment, medical simulation; pain, delirium, ICU

Special Issue Information

Dear Colleagues,

The main purpose of this Special Issue is to present scientific evidence regarding multidimensional nursing care provided in Intensive Care Units (ICUs). Intensive and critical care nurses play a vital role in the whole process of treatment and care for patients in different critical health conditions. Their professional competences allow them to provide holistic nursing care focusing on patients and their families and to be important partners of interprofessional therapeutic teams.

This Special Issue of the International Journal of Environmental and Public Health on “Intensive and Critical Care Nursing Research” has been created to be an international and interdisciplinary forum for the dissemination of research results regarding the broad scope of nursing care delivered at ICUs. We welcome papers related, but not limited, to nurses’ role in quality-of-care improvement, development of critical care nurses’ competences, patient- and family-centered care in ICUs, ethical issues related to critical care nursing, prevention of moral distress and burnout of ICU nurses, critical care nurses’ cooperation within therapeutic teams, examples of good practices employing innovations and evidence-based procedures, management issues related to critical care nursing, end-of-life care in the ICU environment, and finally, critical care nurses’ challenges in time of the Covid-19 pandemic.

Manuscripts may cover any part of the practice of ICU nurses, including clinical, educational, psychological, spiritual, and other aspects. Different ICU environments may be considered. Research may be quantitative, qualitative, mixed-methods, or reviews that meet established review standards, and data may be from primary or secondary sources.

Prof. Dr. Beata Dobrowolska
Prof. Dr. Alvisa Palese
Dr. Dorota Ozga
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Critical care nurses
  • Critical care nurses’ competences
  • Delirium
  • Pain
  • Mechanical ventilation
  • Sleep deprivation
  • ICU nurses and Covid-19 pandemic
  • Patient-centerd care on ICU
  • Family-centered care on ICU
  • Critical care nursing ethics
  • Nursing management on ICU
  • End-of-life care

Published Papers (20 papers)

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Research

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17 pages, 401 KiB  
Article
(Dis)Agreement with Dysthanasia, Religiosity and Spiritual Experience as Factors Related to Nurses’ Workload during End-of-Life Care
by Brankica Juranić, Aleksandar Včev, Suzana Vuletić, Željko Rakošec, Domagoj Roguljić, Štefica Mikšić, Jelena Jakab, Jasenka Vujanić and Robert Lovrić
Int. J. Environ. Res. Public Health 2023, 20(2), 955; https://doi.org/10.3390/ijerph20020955 - 5 Jan 2023
Cited by 1 | Viewed by 1687
Abstract
This study intended to investigate whether the workload of nurses in the course of providing end-of-life care correlated with their religiousness, spiritual experience and level of agreement with dysthanasia procedures. The respondents included 279 nurses from four Croatian hospitals. A structured and validated [...] Read more.
This study intended to investigate whether the workload of nurses in the course of providing end-of-life care correlated with their religiousness, spiritual experience and level of agreement with dysthanasia procedures. The respondents included 279 nurses from four Croatian hospitals. A structured and validated instrument was applied. Almost 90% of respondents are religious, and almost 45% of them have daily spiritual experiences. Respondents, especially those with high levels of religiousness and spiritual experience, express a low level of agreement with dysthanasia (mean = 58.21; score = 25–125). Moreover, nurses self-rated (on a scale of 1–5) their workload as quite high, especially when performing contradictory tasks imposed on them by their superiors (mean = 3.05) and during direct contact with dying patients and their family members (mean = 2.56). This significantly highest level of workload was experienced by the youngest nurses (p = 0.01) and nurses with little work experience (p < 0.01). This study also indicated that nurses who agree with dysthanasia experienced a higher level of workload when providing end-of-life care (r = 0.178; p < 0.01), while more frequent spiritual experiences reduced the level of workload (r = −0.205; p < 0.01). A deeper understanding of nurses’ attitudes toward dysthanasia, as well as of their religiousness and spiritual experiences, may ensure the collection of data beneficial to the timely identification of potential risks caused by workload. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
17 pages, 4028 KiB  
Article
Anti-Inflammatory and Anti-Bacterial Effects of Mouthwashes in Intensive Care Units: A Systematic Review and Meta-Analysis
by Yong Xiang, Xiaolin Ren, Ye Xu, Li Cheng, He Cai and Tao Hu
Int. J. Environ. Res. Public Health 2023, 20(1), 733; https://doi.org/10.3390/ijerph20010733 - 30 Dec 2022
Cited by 1 | Viewed by 4322
Abstract
Mouthwashes are used as oral care for critical care patients to prevent infections. However, there are conflicting data concerning whether mouthwashes are needed as a part of daily oral care for critical care patients. This study aimed to evaluate the anti-inflammatory and anti-bacterial [...] Read more.
Mouthwashes are used as oral care for critical care patients to prevent infections. However, there are conflicting data concerning whether mouthwashes are needed as a part of daily oral care for critical care patients. This study aimed to evaluate the anti-inflammatory and anti-bacterial effects of mouthwashes for critical care patients. The PubMed, EMBASE, CENTRAL, and grey literature databases were searched by descriptors combining population (intensive care unit patients) and intervention (mouthwashes). After the screening, only randomized controlled trials (RCTs) evaluating the anti-inflammatory and anti-bacterial effects of mouthwashes in patient critical care were included. From the 1531 articles, 16 RCTs satisfied the eligibility criteria for systematic review and 10 were included in the meta-analyses. A significant difference was found in the incidence of ventilator associated pneumonia (VAP) (odds ratio [OR] 0.53, 95% confidential interval [95% CI] 0.33 to 0.86) between the mouthwash and placebo groups, while no significant difference was found in the mortality (OR 1.49, 95%CI 0.92 to 2.40); the duration of mechanical ventilation (weighted mean difference [WMD] −0.10, 95%CI −2.01 to 1.81); and the colonization of Staphylococcus aureus (OR 0.88, 95%CI 0.34 to 2.30), Escherichia coli (OR 1.19, 95%CI 0.50 to 2.82), and Pseudomonas aeruginosa (OR 1.16, 95%CI 0.27 to 4.91) between the two groups. In conclusion, mouthwashes were effective in decreasing the incidence of VAP. Thus, mouthwashes can be used as part of daily oral care for critical care patients. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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14 pages, 2076 KiB  
Article
Evaluation of Medical Staff Satisfaction for Workplace Architecture in Temporary COVID-19 Hospital: A Case Study in Gdańsk, Poland
by Agnieszka Gebczynska-Janowicz, Rafal Janowicz, Wojciech Targowski, Rafal Cudnik, Krystyna Paszko and Karolina M. Zielinska-Dabkowska
Int. J. Environ. Res. Public Health 2023, 20(1), 639; https://doi.org/10.3390/ijerph20010639 - 30 Dec 2022
Viewed by 2201
Abstract
This article analyses the architecture that was used in the temporary AmberExpo hospital in Gdańsk, Poland which was installed during the COVID-19 pandemic. The construction of this type of facility is often based on experimental approaches, aimed at caring for patients suffering from [...] Read more.
This article analyses the architecture that was used in the temporary AmberExpo hospital in Gdańsk, Poland which was installed during the COVID-19 pandemic. The construction of this type of facility is often based on experimental approaches, aimed at caring for patients suffering from an infectious disease in emergency conditions. In order to assess the level of employee satisfaction with the architectural and technical elements used in the first period of the hospital’s activity, medical staff were asked to fill out a questionnaire. The analysis of the survey’s results indicated that the majority of employees expressed satisfaction with the architectural and technical elements, with the design of the spatial layout of the individual medical zones receiving the most positive feedback. However, frequently selected drawbacks in the design included the lack of natural daylight, the artificial light that was used and the acoustics of the facility. This detailed examination of the satisfaction and feedback from medical employees working in this type of emergency facility enables the development of solutions that in the future will allow for the improved adaptive reuse and implementation of such structures, with enhanced time and economic efficiency, and most importantly, the ability to provide a safer workplace. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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17 pages, 409 KiB  
Article
Stressful Experiences of Parents in the Paediatric Intensive Care Unit: Searching for the Most Intensive PICU Stressors
by Ivana Debelić, Anamaria Mikolčić, Jovana Tihomirović, Iva Barić, Đurđica Lendić, Željka Nikšić, Barbara Šencaj and Robert Lovrić
Int. J. Environ. Res. Public Health 2022, 19(18), 11450; https://doi.org/10.3390/ijerph191811450 - 12 Sep 2022
Cited by 9 | Viewed by 2427
Abstract
Hospitalization of a child in the paediatric intensive care unit (PICU) is extremely stressful, both for the child and for his or her family. The purpose of this study was to gain deeper insight into the stressful experiences of parents of children hospitalized [...] Read more.
Hospitalization of a child in the paediatric intensive care unit (PICU) is extremely stressful, both for the child and for his or her family. The purpose of this study was to gain deeper insight into the stressful experiences of parents of children hospitalized in the PICU. This study included 96 parents. The data were collected using a translated and standardized scale “The Parental Stressor Scale: Paediatric Intensive Care Unit (PSS: PICU)”. This study confirms high exposure of parents to numerous PICU stressors. The most intense PICU stressor for parents was child’s breathing depending on the ventilator (4.22 ± 1.17), and the least intense was child’s demanding behaviour (1.17 ± 0.33). A significant positive correlation between the level of parents’ perceived stress and the number of their children was recorded (r = 0.240, p = 0.02), while there was no significant correlation between the level of stress and other sociodemographic variables. A significantly higher level of stress was experienced by parents with primary school education (p = 0.032) and parents who are not healthcare professionals (p < 0.01). It is necessary to establish a system that will enable continuous assessment of parents’ stress levels and timely prevention of stressful experiences for parents in the PICU. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
11 pages, 347 KiB  
Article
Moral Sensitivity and Emotional Intelligence in Intensive Care Unit Nurses
by Biyun Ye, Esther Luo, Jie Zhang, Xuelei Chen and Jingping Zhang
Int. J. Environ. Res. Public Health 2022, 19(9), 5132; https://doi.org/10.3390/ijerph19095132 - 23 Apr 2022
Cited by 7 | Viewed by 3075
Abstract
Moral sensitivity helps individuals resolve moral dilemmas as a precursor to moral decision-making. Intensive care unit (ICU) nurses are at high risk for encountering moral dilemmas and should have the moral sensitivity to recognize moral issues. The activities of ICU nurses in moral [...] Read more.
Moral sensitivity helps individuals resolve moral dilemmas as a precursor to moral decision-making. Intensive care unit (ICU) nurses are at high risk for encountering moral dilemmas and should have the moral sensitivity to recognize moral issues. The activities of ICU nurses in moral decision-making are guided by moral sensitivity but are also based on emotional intelligence (EI). EI, be recognized as an integral part of moral sensitivity with long-standing theoretical foundations. It is necessary to explicate the true role of EI in moral sensitivity through empirical research. To measure the level of moral sensitivity of ICU nurses and determine the relationship between moral sensitivity and EI. We recruited 467 ICU nurses of ten hospitals from March to June 2021 in Hunan Province, China for a cross-sectional questionnaire survey. The moral sensitivity and EI were measured using the Moral Sensitivity Questionnaire-Revised Version into Chinese (MSQ-R-CV) and the Wong and Law Emotional Intelligence Scale-Version into Chinese (WLEIS-C). A self-report questionnaire covered sociodemographic characteristics. The average moral sensitivity score of ICU nurses was 39.41 ± 7.21. The average EI score was significantly positively correlated with the moral sensitivity score (p < 0.001). This study demonstrated that the moral sensitivities of ICU nurses were at medium levels. EI of ICU nurses can indeed affect their moral sensitivity, and the impact of each element of EI should be clarified for practical application. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
22 pages, 2257 KiB  
Article
Promoting and Risk Factors of Nurses’ Hardiness Levels during the COVID-19 Pandemic: Results from an Italian Cohort
by Samuele Baldassini Rodriguez, Yari Bardacci, Khadija El Aoufy, Marco Bazzini, Christian Caruso, Gian Domenico Giusti, Andrea Mezzetti, Stefano Bambi, Andrea Guazzini and Laura Rasero
Int. J. Environ. Res. Public Health 2022, 19(3), 1523; https://doi.org/10.3390/ijerph19031523 - 28 Jan 2022
Cited by 7 | Viewed by 3068
Abstract
Aim: Few studies in the literature specifically address the hardiness of nurses during the COVID-19 pandemic. Thus, the primary aim of this study was to assess the impact of COVID-19 on the hardiness levels in an Italian cohort of nurses. The secondary aims [...] Read more.
Aim: Few studies in the literature specifically address the hardiness of nurses during the COVID-19 pandemic. Thus, the primary aim of this study was to assess the impact of COVID-19 on the hardiness levels in an Italian cohort of nurses. The secondary aims were to assess the level of hardiness in nurses directly caring for patients with COVID-19 and to verify the presence of related risk and promoting factors. Methods: A descriptive and explorative study was performed through an online survey from March to July 2020. The survey was composed of a multiple answer questionnaire with open, closed, and semi-closed-ended questions. Hardiness and anxiety were assessed using two psychometric instruments: the Dispositional Resilience Scale (DRS-15) and State-Trait Anxiety Inventory (STAI-Y). Results: A total of 1250 nurses completed the questionnaire entirely (92.3% of respondents). The average length of service was 17.8 ± 11.5 years. A decrease in the hardiness was recorded after the first wave of COVID-19 if compared to the baseline (mean Δ DRS-15 total = 1.3 ± 5.0), whereas in the subsample of nurses caring for COVID-19 patients, the total hardiness level decreased more consistently (mean Δ DRS Total = 1.9 + 5.3). Multivariate analysis showed that high levels of anxiety were risk factors for reducing hardiness. In contrast, anxiety, when associated with a greater length of service, was a promoting factor for the increase in hardiness. Conclusions: The correlation between anxiety and years of length of service appears to be pivotal. Future research should focus on the role of anxiety to establish its actual role as a predictor of hardiness. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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15 pages, 668 KiB  
Article
Difference in Pandemic-Related Experiences and Factors Associated with Sickness Absence among Nurses Working in COVID-19 and Non-COVID-19 Departments
by Matea Dolić, Vesna Antičević, Krešimir Dolić and Zenon Pogorelić
Int. J. Environ. Res. Public Health 2022, 19(3), 1093; https://doi.org/10.3390/ijerph19031093 - 19 Jan 2022
Cited by 8 | Viewed by 2789
Abstract
Background: The aim of this study is to determine the main variables associated with nurses’ sickness absence (SA) and to improve the prediction of SA based on pandemic-related experiences. The second aim is to examine the differences between COVID-19 (CoV) and non-COVID-19 (non-CoV) [...] Read more.
Background: The aim of this study is to determine the main variables associated with nurses’ sickness absence (SA) and to improve the prediction of SA based on pandemic-related experiences. The second aim is to examine the differences between COVID-19 (CoV) and non-COVID-19 (non-CoV) nurses in levels of post-traumatic stress disorder (PTSD) symptoms, personality traits, coping strategies and professional stressors experienced. Methods: This historical prospective study enrolled 1305 nurses from the University Hospital of Split, Croatia. A total of 380 subjects participated in the study, 163 non-CoV and 217 CoV subjects. Nurses’ pandemic-related experience questionnaires, Big Five Inventory (BFI), Post-traumatic Stress Disorder Checklist (PCL-5), Coping Inventory for Stressful Situations (CISS) and Occupational Stress Questionnaire, were used for evaluation. Results: Non-CoV nurses felt more fear of infection, were more socially distanced, had more PTSD symptoms and neuroticism and felt more stress due to public criticism and job requirements compared to CoV nurses; p < 0.001. The groups of SA users and non-SA users could be distinguished based on predictor variables in CoV and non-CoV nurses, with a correct classification of 84.8% vs. 79.1%. Conclusions: It was possible to predict the probability of using SA among nurses due to pandemic professional experience, personality traits and coping strategies. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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14 pages, 375 KiB  
Article
Educational Needs of European Intensive Care Nurses with Respect to Multicultural Care: A Mix-Method Study
by Aleksandra Gutysz-Wojnicka, Dorota Ozga, Eva Barkestad, Julie Benbenishty, Bronagh Blackwood, Kristijan Breznik, Bojana Filej, Darja Jarošová, Boris Miha Kaučič, Ivana Nytra, Barbara Smrke, Renáta Zeleníková and Beata Dobrowolska
Int. J. Environ. Res. Public Health 2022, 19(2), 724; https://doi.org/10.3390/ijerph19020724 - 10 Jan 2022
Cited by 5 | Viewed by 2221
Abstract
The aim of the study is the analysis of educational needs of European intensive care nurses (ICNs) with regard to multicultural care. A mixed-method multinational study was performed among 591 ICNs coming from 15 European countries. An online survey was utilised with three [...] Read more.
The aim of the study is the analysis of educational needs of European intensive care nurses (ICNs) with regard to multicultural care. A mixed-method multinational study was performed among 591 ICNs coming from 15 European countries. An online survey was utilised with three research tools: participants’ sociodemographic details, Healthcare Provider Cultural Competence Instrument, and a tool to assess the educational needs of ICU nurses with respect to multicultural care. The highest mean values in self-assessment of preparation of ICU nurses to provide multicultural nursing care and their educational needs in this regard were detected in the case of nurses coming from Southern Europe (M = 4.09; SD = 0.43). With higher age, nurses recorded higher educational needs in the scope of multicultural care (r = 0.138; p = 0.001). In addition, speaking other languages significantly correlated with higher educational needs related to care of patients coming from different cultures (Z = −4.346; p < 0.001) as well as previous education on multicultural nursing care (Z = −2.530; p = 0.011). Experiences of difficult situations when caring for culturally diverse patients in ICU were classified into categories: ‘treatment procedures and general nursing care’, ‘family visiting’, ‘gender issues’, ‘communication challenges’, and ‘consequences of difficult experiences’. The educational needs of intensive care nurses in caring for culturally diverse patients are closely related to experiencing difficult situations when working with such patients and their families. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
13 pages, 1511 KiB  
Article
Dose–Response Relationship between High-Fidelity Simulation and Intensive Care Nursing Students’ Learning Outcomes: An Italian Multimethod Study
by Angelo Dante, Carmen La Cerra, Valeria Caponnetto, Vittorio Masotta, Alessia Marcotullio, Luca Bertocchi, Fabio Ferraiuolo, Cristina Petrucci and Loreto Lancia
Int. J. Environ. Res. Public Health 2022, 19(2), 617; https://doi.org/10.3390/ijerph19020617 - 6 Jan 2022
Cited by 7 | Viewed by 2820
Abstract
Background: The best application modality of high-fidelity simulation in graduate critical care nursing courses is still rarely investigated in nursing research. This is an important issue since advanced nursing skills are necessary to effectively respond to critically ill patients’ care needs. The [...] Read more.
Background: The best application modality of high-fidelity simulation in graduate critical care nursing courses is still rarely investigated in nursing research. This is an important issue since advanced nursing skills are necessary to effectively respond to critically ill patients’ care needs. The aim of the study was to examine the influence of a modified teaching model based on multiple exposures to high-fidelity simulations on both the learning outcomes and the perceptions of graduate students enrolled in a critical care nursing course. Methods: A multimethod study involving a sample of graduate critical care nursing students was conducted. A theoretical teaching model focused on multiple exposures to high-fidelity simulations is currently applied as a teaching method in an Italian critical care nursing course. According to the Kirkpatrick model for evaluating training programs, the performance, self-efficacy, and self-confidence in managing critically ill patients were considered learning outcomes, while satisfaction with learning and students’ lived experiences during the experimental phases were considered students’ perceptions. Results: Multiple exposures to high-fidelity simulations significantly improved performance, self-efficacy, and self-confidence in managing virtual critically ill patients’ care needs. The satisfaction level was high, while lived experiences of participants were positive and allowed for better explanation of quantitative results of this study. Conclusions: Multiple exposures to high-fidelity simulations can be considered a valuable teaching method that can improve the learning outcomes of graduate nurses enrolled in an intensive care course. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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14 pages, 382 KiB  
Article
Nutritional Status Disorders and Selected Risk Factors of Ventilator-Associated Pneumonia (VAP) in Patients Treated in the Intensive Care Ward—A Retrospective Study
by Lucyna Ścisło, Elżbieta Walewska, Iwona Bodys-Cupak, Agnieszka Gniadek and Maria Kózka
Int. J. Environ. Res. Public Health 2022, 19(1), 602; https://doi.org/10.3390/ijerph19010602 - 5 Jan 2022
Cited by 7 | Viewed by 2805
Abstract
Introduction: The development of pneumonia in patients treated in intensive care wards is influenced by numerous factors resulting from the primary health condition and co-morbidities. The aim of this study is the determination of the correlation between nutritional status disorders and selected risk [...] Read more.
Introduction: The development of pneumonia in patients treated in intensive care wards is influenced by numerous factors resulting from the primary health condition and co-morbidities. The aim of this study is the determination of the correlation between nutritional status disorders and selected risk factors (type of injury, epidemiological factors, mortality risk, inflammation parameters, age, and gender) and the time of pneumonia occurrence in patients mechanically ventilated in intensive care wards. Material and method: The study included 121 patients with injuries treated in the intensive care ward who had been diagnosed with pneumonia related to mechanical ventilation. The data were collected using the method of retrospective analysis of patients’ medical records available in the electronic system. Results: Ventilator-associated pneumonia (VAP) occurred more frequently in patients over 61 years of age (40.4%), men (67.8%), after multiple-organ injury (45.5%), and those with a lower albumin level (86%), higher CRP values (83.5%), and leukocytes (68.6%). The risk of under-nutrition assessed with the NRS-2002 system was confirmed in the whole study group. The statistical analysis demonstrated a correlation between the leukocytes level (p = 0.012) and epidemiological factors (p = 0.035) and the VAP contraction time. Patients infected with Staphylococcus aureus had 4% of odds for the development of late VAP in comparison to Acinetobacter baumannii (p < 0.001), whereas patients infected by any other bacteria or fungi had about four times lower odds of the development of late VAP in comparison to Acinetobacter baumannii (p = 0.02). Patients with results in APACHE from 20 to 24 and from 25 to 29 had 13% and 21%, respectively, odds of the development of late VAP in comparison to patients with APACHE II scores ranging from 10 to 19 (respectively, p = 0.006; p = 0.028). Conclusions: The development of VAP is impacted by many factors, the monitoring of which has to be included in prophylactics and treatment. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
10 pages, 316 KiB  
Article
Knowledge of Sepsis in Nursing Students—A Cross-Sectional Study
by Gloria Valičević, Adriano Friganović, Biljana Kurtović, Cecilija Rotim, Sanja Ledinski Fičko and Sabina Krupa
Int. J. Environ. Res. Public Health 2021, 18(23), 12443; https://doi.org/10.3390/ijerph182312443 - 26 Nov 2021
Cited by 4 | Viewed by 3724
Abstract
Background: Sepsis is defined as life-threatening organ dysfunction caused by an unregulated host response to infection. The emphasis is on the imbalance of homeostasis and the response to infection, as well as mortality and the importance of recognizing sepsis as early as possible. [...] Read more.
Background: Sepsis is defined as life-threatening organ dysfunction caused by an unregulated host response to infection. The emphasis is on the imbalance of homeostasis and the response to infection, as well as mortality and the importance of recognizing sepsis as early as possible. The knowledge of undergraduate nursing students is an extremely important indicator for future work in the healthcare system after graduation. The aim of this study was to investigate the levels of knowledge about sepsis among undergraduate nursing students and to compare differences in different years of study, as well as differences in their study model. Methods: A cross-sectional study was conducted on 618 nursing students at the University of Applied Health Sciences in Zagreb, Croatia. All three years of study and both full-time and part-time (employed) nursing students were included. The questionnaire “Determinants of Sepsis Knowledge” was used in the research. Results: The percentage and number of third-year students who correctly answered the items on Knowledge of Sepsis were statistically significant compared to the first two years of study. The percentage and number of employed students who responded correctly to the items on Knowledge of Sepsis were statistically significant compared to students who were not employed. Conclusions: The ability of nursing students to recognize and respond to the deterioration in a patient’s condition due to sepsis is very important, so appropriate education about sepsis is essential. We recommend a greater representation of sepsis content in the core curriculum of nursing students’ education in terms of theoretical instruction and clinical and simulation exercises. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
9 pages, 4044 KiB  
Article
Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit
by Lucyna Płaszewska-Żywko, Aurelia Sega, Agnieszka Bukowa, Katarzyna Wojnar-Gruszka, Marcelina Podstawa and Maria Kózka
Int. J. Environ. Res. Public Health 2021, 18(21), 11178; https://doi.org/10.3390/ijerph182111178 - 25 Oct 2021
Cited by 7 | Viewed by 3236
Abstract
In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients’ severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye [...] Read more.
In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients’ severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye care can have a significant impact on incidences of eye complications and patient quality of life after discharge from the intensive care unit (ICU). The aim of the study was to determine risk factors for ocular complication, especially those related to nursing care. The study was conducted in the ICU of a university hospital. Methods for estimating and analyzing medical records were used. The patient’s evaluation sheet covering 12 categories of risk factors for eye complications was worked out. The study group included 76 patients (34 patients with injuries and 42 without injuries). The Shapiro–Wilk test, the Spearman’s rank correlation test, the Mann–Whitney U test and the Friedman’s ANOVA test were used. The level of significance was set at α = 0.05. The most important risk factors for eye complications in the study group were: lagophthalmos (p < 0.001), sedation (p < 0.01), use of some cardiological drugs and antibiotics (p < 0.01), mechanical ventilation (p < 0.05), use of an open suctioning system (p < 0.01), presence of injuries (p < 0.01) including craniofacial trauma (p < 0.001), high level of care intensity (p < 0.01), failure to follow eye care protocol (p < 0.001), length of hospitalization at the ICU (p < 0.001), and the frequency of ophthalmological consultations (p < 0.001). There was no correlation between the incidence of these complications and the age and gender of the patients. The exposure of critically ill patients to eye complications was high. It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk factors. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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11 pages, 607 KiB  
Article
Implementation of a Follow-Up Program for Intensive Care Unit Survivors
by Marta Villa, Silvia Villa, Simona Vimercati, Mara Andreossi, Fabrizia Mauri, Daniela Ferlicca, Roberto Rona, Giuseppe Foti and Alberto Lucchini
Int. J. Environ. Res. Public Health 2021, 18(19), 10122; https://doi.org/10.3390/ijerph181910122 - 26 Sep 2021
Cited by 4 | Viewed by 3087
Abstract
In Intensive Care Unit (ICU) survivors, critical illness has an impact on an individual’s long-term health status and quality of life. Adults who have recovered from intensive care management could develop muscle weakness, neurocognitive impairment, difficulties in managing activities of daily living and [...] Read more.
In Intensive Care Unit (ICU) survivors, critical illness has an impact on an individual’s long-term health status and quality of life. Adults who have recovered from intensive care management could develop muscle weakness, neurocognitive impairment, difficulties in managing activities of daily living and to returning to work, and psychological problems such as depression and anxiety. A prospective, observational study was designed. Data were collected from January to December 2018 from a structured follow-up program, at 3 time points after ICU discharge: at seven days, a visit in the general ward, a phone interview at three months and an ambulatory visit at six months. A total of 95 patients were enrolled, 36% female, with a median age of 65 (55–73) years and a median ICU length of stay of 13 (8–20) days. At the seven days follow-up, patients who had a positive Hospital Anxiety and Depression Scale showed a significantly longer time of intubation (p = 0.048) and length of ICU stay (p = 0.023). At three months, we observed a significant relationship between a positive Hospital Anxiety and Depression Scale and a median value of EuroQol-5D (p = 0.048). At six months, we observed that patients who had a positive Post-Traumatic Symptom Scale were significantly younger than the other group. Findings from the present study suggest that a longer time of intubation and length of ICU stay are associated with a higher level of anxiety and depression immediately after ICU discharge. Follow-up programs are recommended to assess and rehabilitate cognitive function at ICU discharge. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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10 pages, 322 KiB  
Article
Personality Traits and the Sense of Self-Efficacy among Nurse Anaesthetists. Multi-Centre Questionnaire Survey
by Magdalena Kwiatosz-Muc, Marzena Kotus and Anna Aftyka
Int. J. Environ. Res. Public Health 2021, 18(17), 9381; https://doi.org/10.3390/ijerph18179381 - 6 Sep 2021
Cited by 10 | Viewed by 2680 | Correction
Abstract
Introduction: Anaesthesia and intensive care units are specific workplaces. The purpose of this study was to evaluate the level of the sense of self-efficacy and the intensification of personality traits in a group of nurse anaesthetists and to develop a regression model explaining [...] Read more.
Introduction: Anaesthesia and intensive care units are specific workplaces. The purpose of this study was to evaluate the level of the sense of self-efficacy and the intensification of personality traits in a group of nurse anaesthetists and to develop a regression model explaining the sense of self-efficacy. Method: The population of the questionnaire survey included nurse anaesthetists from five hospitals in south-eastern Poland. The NEO-FFI was used in assessing their personality traits. The general self-efficacy scale was employed for the self-efficacy assessment. A total of 143 correctly filled surveys were analyzed. Results: The respondents typically perceived their own self-efficacy level as upper moderate. The nurse anaesthetists participating in the study revealed a tendency to high scores in conscientiousness and extraversion, and low scores related to neuroticism. The persons characterized by high conscientiousness, extraversion and openness to experience revealed a tendency to high scores related to the sense of self-efficacy. The relationship between personality traits and experiencing the nuisance of selected stressful job factors was demonstrated. Regression analysis showed that conscientiousness and extraversion are most closely related to the sense of self-efficacy. Conclusions: It seems to be beneficial to implement occupational consulting for nurses, who are starting their work or/and taking into consideration working in anesthesiology and intensive care units. The importance of personality traits and self- efficacy in relation with well-being of medical personnel needs deeper investigations. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
8 pages, 315 KiB  
Article
Home Mechanical Ventilation: A Patient’s Perspective Survey Study
by Magdalena Kwiatosz-Muc and Bożena Kopacz
Int. J. Environ. Res. Public Health 2021, 18(8), 4048; https://doi.org/10.3390/ijerph18084048 - 12 Apr 2021
Cited by 1 | Viewed by 1726
Abstract
Background: An increasing number of patients included in home mechanical ventilation (HMV) care has been under observation for many years. The study aimed to assess the patients opinion concerning the expected and perceived quality of care in an HMV system and a patient’s [...] Read more.
Background: An increasing number of patients included in home mechanical ventilation (HMV) care has been under observation for many years. The study aimed to assess the patients opinion concerning the expected and perceived quality of care in an HMV system and a patient’s satisfaction with care. Methods: In 2017, patients treated with HMV were surveyed in Poland with the modified SERVQUAL questionnaire. Results: One hundred correctly completed surveys were analyzed. Patient Satisfaction Index was high. In every examined area, the expectations were statistically significant larger than the perception of the services. The biggest gap was in the tangibility dimension and the smallest gap was in the empathy dimension. Perceived respect and understanding for a patient’s needs are close to the expectations. Conclusions: The level of satisfaction with health care among patients treated with HMV in majority of investigated components is high. Moreover, the difference between perceived and expected quality of health care in the HMV system was relatively small in the opinion of the patients themselves. Further investigations with alternative methods are needed. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
12 pages, 851 KiB  
Article
Occurrence of Delirium during ECMO Therapy in a Critical Care Unit in Poland—A Cross-Sectional Pilot Study
by Sabina Krupa, Adriano Friganovic and Wioletta Mędrzycka-Dąbrowska
Int. J. Environ. Res. Public Health 2021, 18(8), 4029; https://doi.org/10.3390/ijerph18084029 - 12 Apr 2021
Cited by 4 | Viewed by 2233
Abstract
Background: The problem of delirium during extracorporeal membrane oxygenation (ECMO) therapy, which has rarely been studied, is an important issue since it is necessary to ensure patient safety during therapy. This study aimed to show the incidence of delirium in patients after extracorporeal [...] Read more.
Background: The problem of delirium during extracorporeal membrane oxygenation (ECMO) therapy, which has rarely been studied, is an important issue since it is necessary to ensure patient safety during therapy. This study aimed to show the incidence of delirium in patients after extracorporeal membrane oxygenation therapy and factors affecting the occurrence of delirium in this group of patients. Design: A cross-sectional study was conducted. Method: The study involved a group of patients from an intensive cardiac care unit who received extracorporeal membrane oxygenation therapy. The study lasted for more than two years, in the period from 2018 until 2020. The Nursing Delirium Screening Scale (NuDESC) and the Delirium Observation Screening Scale (DOSS) were applied. Additionally, the patients were examined using Numeric Rating Scale (NRS), the Insomnia Severity Index (ISI), the Richmond Agitation Sedation Scale (RASS), the Ramsay Sedation Scale (RSS), and a thirst intensity scale; ultimately, relationships between these factors and delirium were examined. Results: In patients who underwent ExtraCorporeal Membrane Oxygenation (ECMO) therapy, delirium was confirmed by the NuDESC in 68.75% of patients in the evening hours, while it was measured by the DOSS scale in 84.38% of patients in the morning. The study found that ECMO delirium was not associated with hyperactivity, sleep disturbance, sedation, pain, or thirst. Conclusion: Delirium in patients undergoing ECMO therapy was confirmed by both the NuDESC and DOSS. Factors such as thirst and sleep disturbance after ECMO therapy were shown to influence the occurrence of delirium. The diagnosis of delirium using standardized scales is possible provided that more tests are carried out. Research should be conducted to determine whether the NuDESC is equivalent to the DOSS. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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Review

Jump to: Research, Other

14 pages, 2086 KiB  
Review
Nursing Interventions for Patient Empowerment during Intensive Care Unit Discharge: A Systematic Review
by Cecilia Cuzco, Rodrigo Torres-Castro, Yolanda Torralba, Isabel Manzanares, Pilar Muñoz-Rey, Marta Romero-García, Ma. Antonia Martínez-Momblan, Gemma Martínez-Estalella, Pilar Delgado-Hito and Pedro Castro
Int. J. Environ. Res. Public Health 2021, 18(21), 11049; https://doi.org/10.3390/ijerph182111049 - 21 Oct 2021
Cited by 5 | Viewed by 5919
Abstract
Intensive care unit discharge is an important transition that impacts a patient’s wellbeing. Nurses can play an essential role in this scenario, potentiating patient empowerment. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (the PRISMA Statement. [...] Read more.
Intensive care unit discharge is an important transition that impacts a patient’s wellbeing. Nurses can play an essential role in this scenario, potentiating patient empowerment. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (the PRISMA Statement. Embase), PubMed/MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), CUIDEN Plus, and LILACS databases; these were evaluated in May 2021. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. Quality of the studies included was assessed using the Cochrane risk-of-bias tool. Of the 274 articles initially identified, eight randomized controlled trials that reported on nursing interventions had mainly focused on patients’ ICU discharge preparation through information and education. The creation of ICU nurse-led teams and nurses’ involvement in critical care multidisciplinary teams also aimed to support patients during ICU discharge. This systematic review provides an update on the clinical practice aimed at improving the patient experience during ICU discharge. The main nursing interventions were based on information and education, as well as the development of new nursing roles. Understanding transitional needs and patient empowerment are key to making the transition easier. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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13 pages, 450 KiB  
Review
Nursing-Sensitive Outcomes among Patients Cared for in Paediatric Intensive Care Units: A Scoping Review
by Matteo Danielis, Adele Castellano, Elisa Mattiussi and Alvisa Palese
Int. J. Environ. Res. Public Health 2021, 18(18), 9507; https://doi.org/10.3390/ijerph18189507 - 9 Sep 2021
Cited by 3 | Viewed by 2298
Abstract
Measuring the effectiveness of nursing interventions in intensive care units has been established as a priority. However, little is reported about the paediatric population. The aims of this study were (a) to map the state of the art of the science in the [...] Read more.
Measuring the effectiveness of nursing interventions in intensive care units has been established as a priority. However, little is reported about the paediatric population. The aims of this study were (a) to map the state of the art of the science in the field of nursing-sensitive outcomes (NSOs) in paediatric intensive care units (PICUs) and (b) to identify all reported NSOs documented to date in PICUs by also describing their metrics. A scoping review was conducted by following the framework proposed by Arksey and O’Malley. Fifty-eight articles were included. Publications were mainly authored in the United States and Canada (n = 28, 48.3%), and the majority (n = 30, 51.7%) had an observational design. A total of 46 NSOs were documented. The most reported were related to the clinical (n = 83), followed by safety (n = 41) and functional (n = 18) domains. Regarding their metrics, the majority of NSOs were measured in their occurrence using quantitative single measures, and a few validated tools were used to a lesser extent. No NSOs were reported in the perceptual domain. Nursing care of critically ill children encompasses three levels: improvement in clinical performance, as measured by clinical outcomes; assurance of patient care safety, as measured by safety outcomes; and promotion of fundamental care needs, as measured by functional outcomes. Perceptual outcomes deserve to be explored. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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Other

Jump to: Research, Review

21 pages, 1315 KiB  
Systematic Review
Effectiveness of Music-Based Intervention in Improving Uncomfortable Symptoms in ICU Patients: An Umbrella Review
by Yu-Fen Chen, Mei-Yu Chang, Lok-Hi Chow and Wei-Fen Ma
Int. J. Environ. Res. Public Health 2021, 18(21), 11500; https://doi.org/10.3390/ijerph182111500 - 1 Nov 2021
Cited by 6 | Viewed by 4322
Abstract
Background: Intensive care unit (ICU) patients experience multiple uncomfortable symptoms, which may be alleviated using music-based intervention, a nondrug treatment. This umbrella review aims to combine the data of systematic reviews and/or meta-analyses to evaluate the effectiveness of music-based intervention in improving uncomfortable [...] Read more.
Background: Intensive care unit (ICU) patients experience multiple uncomfortable symptoms, which may be alleviated using music-based intervention, a nondrug treatment. This umbrella review aims to combine the data of systematic reviews and/or meta-analyses to evaluate the effectiveness of music-based intervention in improving uncomfortable symptoms in ICU patients. Methods: A comprehensive literature search was performed on the PubMed, Embase, Cochrane Library, Airiti Library, CINAHL, ProQuest, and Web of Science databases, and Epistemonikos. The search had no language restrictions, and articles on the improvement of symptoms using music-based intervention in adult ICU patients were included. This review protocol was registered on PROSPERO (CRD42021240327). Results: This umbrella review retrieved 5 systematic reviews and 41 original studies, including 39 randomized controlled trials, and 2 nonrandomized controlled trials. Diverse music was the most common music type used for music-based intervention, the intervention music was typically decided by the study participants (61%), and most subjects underwent one intervention session (78%). Furthermore, most music intervention sessions lasted for 30 min (44%). The positive results included decreased anxiety, decreased pain, decreased agitation, decreased anesthesia dose and sedative use, decreased chances of delirium, decreased feelings of uncomfort, and improved sleep quality. Conclusions: A systematic review on the effectiveness of music-based intervention in improving uncomfortable symptoms in ICU patients revealed that 20–30 min intervention sessions showed the best improvement in the uncomfortable symptoms in patients. This study provides a basis for using music-based intervention to relieve the uncomfortable symptoms in critically ill ICU patients, and a reference for empirical clinical practice. Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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2 pages, 234 KiB  
Correction
Correction: Kwiatosz-Muc et al. Personality Traits and the Sense of Self-Efficacy among Nurse Anaesthetists. Multi-Centre Questionnaire Survey. Int. J. Environ. Res. Public Health 2021, 18, 9381
by Magdalena Kwiatosz-Muc, Marzena Kotus and Anna Aftyka
Int. J. Environ. Res. Public Health 2021, 18(21), 11118; https://doi.org/10.3390/ijerph182111118 - 22 Oct 2021
Cited by 3 | Viewed by 1221
Abstract
There was an error in the original article [...] Full article
(This article belongs to the Special Issue Intensive and Critical Care Nursing Research)
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