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Aim: The aim of this study was to estimate the number of nurses who independently care for pa-tients with severe respiratory failure receiving mechanical ventilation (MV) or veno-venous ex-tracorporeal membrane oxygenation (VV-ECMO). Additionally, the study analyzed the actual role of nurses in the treatment of patients with MV and VV-ECMO. Methods: We conducted a cross-sectional study using postal surveys. The study included 725 Japanese intensive care units (ICUs). Descriptive statistics were conducted. Results: Among the 725 ICUs, we obtained 302 re-sponses (41.7%) and analyzed 282 responses. The median number of nurses per bed was 3.25. The median proportion of nurses who independently cared for patients with MV was 60% [IQR: 42.3-77.3]. The median proportion of nurses who independently cared for patients with VV-ECMO was 46.9 (35.7-63.3%) in the ICU experiencing VV-ECMO use. Concerning task-sharing, 33.8% of ICUs and nurses did not facilitate weaning from MV. Nurses always ti-trated sedatives in 44.5% of ICUs. Conclusion: Nurse staffing might be inadequate in all ICUs, es-pecially for severe respiratory failure. The proportion of competent nurses for caring for severe respiratory failure in ICUs should be considered when determining the work force of nurses.

Determining the number of nurses required for patients with coronavirus disease receiving mechanical ventilation and/or veno‐veno extracorporeal membrane oxygenation is important to provide quality care. Therefore, we conducted this cross‐sectional survey of 725 intensive care units in Japan. Data from 152 units with experience of managing patients with coronavirus disease who required tracheal intubation were analyzed. The median number of nurses required for a patient receiving mechanical ventilation or veno‐veno extracorporeal membrane oxygenation was two. This number was more than that according to the Japanese standard determined by government. We conclude that more nursing staff is required for caring for patients critically ill with coronavirus disease in intensive care units.

Aim The aim of this study was to examine whether high social support has a protective effect on mental health for critical care nurses during the coronavirus disease 2019 (COVID‐19) pandemic. Methods This cross‐sectional anonymous web‐based survey was conducted from November 5 to December 5, 2020, in Japan and included critical care nurses. The invitation was distributed via mailing lists. Results Of the 334 responses that were obtained, 64.4% were from female respondents, and their mean age was 37.4. Of the total, 269 (80.5%) were taking care of COVID‐19 patients at the time the study was conducted. Participants with post‐traumatic stress disorder (PTSD) symptoms were found to be older (P, This study suggests that the social support is not associated with post‐traumatic stress disorder; however, it is associated with depression and anxiety symptoms for intensive care nurses during the coronavirus disease 2019 (COVID‐19) pandemic.

Physical restraint is widely used in the intensive care unit (ICU) to ensure patient safety despite its ethical implications. We performed a prospective observational study in six ICUs in Japan to determine the prevalence of and factors associated with physical restraint use in the ICU, a phenomenon that has not yet been reported on in Japan. Data were collected on 10 random days between November 2018 and February 2019. We evaluated physical restraint use in ICU patients aged ≥ 20 years during the data collection days. Among the 787 observations, the prevalence of physical restraint use was 32.9%; however, it was 41.5% in patients receiving invasive mechanical ventilation (IMV). The average age of patients was 68.5 years, and the average Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II score was 19.4. Among the included patients, 52.1% received IMV, and 17.2% were diagnosed with delirium. Logistic regression analysis revealed that the independent factors [odds ratio (95% confidence interval)] associated with physical restraint use were age [1.02 (1.00–1.05)], APACHE II score [1.05 (1.01–1.09)], IMV [2.15 (1.16–4.01)], central venous catheter indwelling [2.66 (1.46–4.85)], sedative medication [2.98 (1.72–5.17)], agitation [7.83 (2.96–20.8)], and delirium [4.16 (2.37–7.29)]. Approximately one-third of the ICU patients required physical restraint in Japan. In addition, physical restraint use was influenced by disease severity, mental condition, and the medical apparatus used. Based on these findings, further investigations are imperative to develop strategies to reduce physical restraint use.

Aim This study aims to translate the Healthy Work Environment Assessment Tool (HWE-AT) into Japanese and evaluate its validity and reliability. Design and methods The authors followed the guidelines for scale translation, adaptation, and validation in cross-cultural healthcare research. After translation and back-translation, a series of pilot studies were conducted to assess comprehensibility. Subsequently, an expert panel established the content validity. Content validity was calculated using the content validity index (CVI). Finally, we verified the construct validity and calculated the test-retest reliability. Results The updated HWE-AT achieved sufficient comprehensibility after conducting the two pilot tests. Content validity was calculated using the scale-level CVI/average and all the items were 1.00. The content validity indices CFI and RMSEA were 0.918 and 0.082, respectively. Intraclass correlation coefficients for all dimensions ranged from 0.618 to 0.903, indicating acceptable test-retest reliability. Our findings suggest that the Japanese version of the HWE-AT has good validity and reliability.