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Background: The COVID-19 pandemic highlighted the negative impact of moral injury on nurses' well-being. However, there is a lack of research about generational differences among nurses, particularly on newer nurses who have been identified as having a higher rate of intention to leave. Objective: This study examines generational differences among nurses on moral injury, well-being, resilience, and intention to leave their nursing position and profession. Methods: This is a secondary analysis of cross-sectional data from registered nurses in clinical practice in Ohio between July and August 2021. Data on demographics, moral injury, resilience, and well-being were collected using an online survey. Participants were categorized into 4 generational groups based on their age in 2021: Baby Boomers (57-75 years old), Generation X (42-56 years old), Generation Y (27-41 years old), and Generation Z (12-26 years old). Descriptive and inferential statistics, including logistic regression and analysis of variance, were employed for analysis. Results: Significant generational differences were found in years of clinical experience, moral injury, resilience, and well-being. Baby Boomers reported higher well-being and resilience and lower moral injury. Notably, the intention to leave the profession was more strongly associated with well-being and moral injury levels than with the years of experience or generational group. Conclusions: The findings suggest that interventions to improve nurse retention should prioritize enhancing well-being and addressing the root causes of moral injury. Tailored strategies addressing the needs of different generations are necessary for mitigating the adverse effects of current healthcare challenges on nurse attrition. [ABSTRACT FROM AUTHOR]

Background: Supporting the sleep health of surrogate decision-makers of patients in the intensive care unit is a research priority. However, few studies have approached sleep health as a multidimensional construct, instead focusing on 1 or 2 dimensions in isolation. Objective: To holistically examine the sleep health (satisfaction, timing, efficiency, duration) of surrogate decision-makers of critically ill patients. Methods: This secondary analysis involved surrogate decision-makers of incapacitated intensive care unit patients at a tertiary medical center in northeastern Ohio (n = 19). Sleep-health data were captured by means of a subjective scale (satisfaction) and objectively (timing, efficiency, duration) by means of a wrist-worn accelerometer (Actiwatch Spectrum Plus; Philips Respironics). Upon enrollment, participants completed the satisfaction scale and wore the Actiwatch Spectrum Plus for 3 consecutive days. Descriptive statistics of the study variables were evaluated. Results: A minority (15%) of the sample reported poor sleep satisfaction. Sleep timing variables were comparable to those found in other adult studies. Participants averaged approximately 6 hours of sleep per day with an average sleep efficiency of 83.7%. Conclusions: Despite adequate satisfaction scores, intensive care unit surrogate decision-makers' sleep duration is inadequate and sleep efficiency is suboptimal. Sleep-health interventions may be needed in this at-risk population. Future research should consider the impact of surrogate decision-maker sleep health on their capacity to serve in the surrogate decision-maker role. [ABSTRACT FROM AUTHOR]

A review of the article "Factors Associated With Parent-Perceived Miscommunication in the Pediatric Intensive Care Unit," which appeared in the periodical's November 2024 issue, is presented.

Background: Family intensive care unit (ICU) syndrome, a comorbid response to another person's stay in the ICU, is characterized by emotional distress, poor sleep health, and decision fatigue. Objectives: This pilot study examined associations among symptoms of emotional distress (anxiety and depression), poor sleep health (sleep disturbance), and decision fatigue in a sample of family members of patients in the ICU. Methods: The study used a repeated-measures, correlational design. Participants were 32 surrogate decision makers of cognitively impaired adults who had at least 72 consecutive hours of mechanical ventilation within the neurological, cardiothoracic, and medical ICUs at an academic medical center in northeast Ohio. Surrogate decision makers with a diagnosis of hypersomnia, insomnia, central sleep apnea, obstructive sleep apnea, or narcolepsy were excluded. Severity of symptoms of family ICU syndrome was measured at 3 time points in 1 week. Zero-order Spearman correlations of the study variables were interpreted at baseline and partial Spearman correlations of study variables were interpreted 3 days and 7 days after baseline. Results: The study variables showed moderate to large associations at baseline. Baseline anxiety and depression were associated with each other and with decision fatigue at day 3. Baseline sleep disturbance was associated with anxiety, depression, and decision fatigue at day 7. Conclusions: Understanding the temporal dynamics and mechanisms of the symptoms of family ICU syndrome can inform clinical, research, and policy initiatives that enhance the provision of family-centered critical care. [ABSTRACT FROM AUTHOR]

Summary: We investigated whether sleep health (each individual dimension and a composite measure) was associated with better glycaemia among a cohort of young adults with type 1 diabetes (mean age 21.5 years, mean body mass index 24.55 kg m−2). Multiple validated self‐report questionnaires were completed, and raw continuous glucose monitor data were shared. One self‐reported sleep characteristic for each of the five sleep health dimensions was selected. A composite score was calculated by summing the number of "good" sleep health dimensions. We evaluated the associations between sleep health and glycaemia, and whether covariates, including age, type 1 diabetes duration and sleep apnea risk, influenced the relationships among the study variables using multivariable linear regression. Individual dimensions of sleep satisfaction (β = 0.380, p = 0.019; β = −0.414, p = 0.010), timing (β = 0.392, p = 0.015; β = −0.393, p = 0.015) and sleep efficiency (β = 0.428, p = 0.007) were associated with higher achievement of glycaemic targets (J‐index and time in range); however, these associations did not persist after considering covariates. A better Sleep Health Composite score was associated with higher achievement of glycaemic targets even after considering covariates. Using a multidimensional framework can guide future research on causal pathways between sleep and diabetes health, interventions to target sleep health profiles, and may improve sleep screening in routine diabetes care. [ABSTRACT FROM AUTHOR]

Uptake of the COVID-19 vaccine by nurses lags behind that of other health care professionals with minimal empirical evidence to understand this phenomenon. In this secondary analysis, we examined nurses' individual and work-related characteristics and their association with COVID-19 vaccination status. Alumni of three Ohio nursing colleges and members of a professional organization were invited to complete questionnaires from June through August 2021. Logistic regression models were used to evaluate associations between nurse characteristics and vaccination status. Among 844 respondents, 754 (80.30%) had received at least one dose of the vaccine. Older age, having a bachelor's degree or higher, and working in critical care were associated with vaccination. Providing direct care for COVID-19 patients in the last 7 days and a higher perception of one's work being affected by COVID-19 were significantly associated with being vaccinated, whereas prior COVID-19 infection was inversely associated with vaccination status. Our findings suggest that COVID-19 vaccine uptake among nurses is influenced by a host of factors related to virus knowledge, beliefs, and risk perceptions. Awareness of these factors can aid the development of interventions to increase nurses' acceptance of vaccines. [ABSTRACT FROM AUTHOR]

A discussion guide for nurse-researcher Anna E. Krupp's article on a support tool for early mobility of critical ill patients is presented.

A review of the article "Noninvasive Ventilation for Moderate to Severe Acute Respiratory Distress Syndrome Due to COVID-10" by Alexander A. Botsch and colleagues which appeared in the July 2024 issue of the "American Journal of Critical Care" is presented.

We conducted a systematic review on the state of the science related to sleep interventions for informal caregivers of persons with Alzheimer's disease or related dementia (ADRD). This review included English-written, peer-reviewed articles that studied the effect of an intervention on sleep health outcomes for informal caregivers of persons with ADRD. Our search yielded 15 articles that met our a priori inclusion criteria. We categorized interventions into four categories: environmental, physical, cognitive, and collaborative. Intervention effects were heterogeneous, with most yielding nonsignificant sleep health effects. There is a need for theoretically sound and robust sleep health interventions for informal caregiver samples. Future research in this area could benefit from the use of more controlled, pragmatic, and adaptive research designs, and the use of objective measures that conceptually represent the multiple domains of sleep health to enhance intervention quality. [ABSTRACT FROM AUTHOR]

Aims and objectives: The purpose of this study was to report the psychometric properties, including validity and reliability, of the decision fatigue scale (DFS). Background: Decision fatigue may impair nurses' ability to make sound clinical decisions and negatively impact patient care. Given the negative impact of the COVID‐19 pandemic on psychological well‐being and the workplace environment, decision fatigue may be even more apparent among clinical nurses. Valid assessment of this condition among clinical nurses may inform supportive interventions to mitigate the negative sequelae associated with states of decision fatigue. Design: This study was a secondary analysis of a parent study using a cross‐sectional descriptive design. Methods: A convenience sample of 160 staff nurses was recruited online from across the United States. Participants completed a demographic questionnaire and subjective measures of decision fatigue, nursing practice environment scale and traumatic stress. Exploratory factor analysis (EFA), correlation coefficients and internal consistency reliability coefficients were computed to examine the DFS's validity and reliability within this sample. Results: The EFA yielded a single factor, 9‐item version of the DFS. The DFS scores were strongly correlated with traumatic stress and moderately correlated with the nursing practice environment, and the scale displayed appropriate internal consistency. Conclusions: This is the first known study to provide evidence of the DFS's validity and reliability in a sample of registered nurses working during the COVID‐19 pandemic. The results of this study provide evidence of a reliable and valid assessment instrument for decision fatigue that can be used to measure the burden of decision‐making among registered nurses. Relevance to clinical practice: Given the relationship between traumatic stress and the nursing work environment, decision fatigue may be a modifiable target for interventions that can enhance the quality of decision‐making among clinical nurses. [ABSTRACT FROM AUTHOR]

The article presents a discussion guide for the research "Bed Rest Reduction Following Cardiac Catheterizations Using Vascular Closure Devices" by Kristin A Tuozzo. It summarizes the effects of evidence-based bed rest practice change including groin complications and hospitalization, as well as the importance of a multidisciplinary approach to implementing changes. It considers the clinical implications of the evidence-based implementation of bed rest reduction after cardiac catheterization.