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Background: Frailty is prevalent among older patients in intensive care units (ICUs) and poses significant challenges to recovery. Despite its importance, there is limited research on effective nurse-led frailty management strategies in this context., Objective: The purpose of this qualitative study was to explore nurses' perceptions of frailty management in cardiac ICUs through the lens of the Wuli-Shili-Renli (WSR) system approach., Methods: Sixteen nurses from two tertiary hospitals in Shandong province, China, participated in semi-structured interviews. Participants were selected based on their involvement in frailty training, educational background, and cardiac ICU work experience. Thematic analysis was conducted to identify key themes and sub-themes., Results: Analysis in three categories revealed the need for foundational support, including the need for appropriate screening tools, updated evidence-based practices, and institutional support. Closed-loop management involved frailty screening, personalized program implementation, information management, and follow-up assessment. Personnel training and coordination emphasized enhancing nurses' professionalism, multidisciplinary teamwork, and cooperation from patients and their caregivers., Conclusion: The insights gained can inform evidence-based practices and improve the quality of care provided to frail patients in cardiac ICUs. There is a need for future research to empirically investigate these strategies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

A need for an interventional cardiology patient care unit was identified. Obtaining qualified registered nurses to staff a new unit during a nursing shortage was viewed as a challenge. Staff nurse involvement was sought in all phases of development and was a key component in our success. Using a variety of recruitment and retention strategies, we met the challenge and opened the unit on time.

Recruitment and retention of critical care nurses to care for increasing numbers of complex patients is a challenge in the midst of a national nursing shortage. Strategies to address the shortage begin with implementation of a professional practice model that builds on a meaningful nursing philosophy. This model becomes the basis for development and implementation of multiple strategies that "proactively" involve staff nurses. Critical care new graduate internships, patient care assistant programs, creative care delivery models, and unit clinical committees are some of the strategies that have resulted in positive outcomes.