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Background Aims Study Design Results Conclusions Relevance to Clinical Practice Ventilator‐associated pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs) and is a common cause of morbidity and mortality in intensive care patients. Previous studies show that insufficient knowledge and compliance barriers among nurses affect pneumonia. There have been no investigations into intensive care nurses' knowledge and compliance barriers to evidence‐based guidelines (EBGs) for VAP prevention in county‐level hospitals in China.To explore adult ICU nurses' knowledge and compliance barriers to EBGs for preventing VAP in county‐level hospitals in Hunan Province, China, examine the correlation between knowledge and compliance barriers, and analyse associated factors.A cross‐sectional electronic survey was conducted to focus on nurses' knowledge of and compliance barriers to EBGs for preventing VAP.A total of 386 valid questionnaires were collected, with a response rate of 97.47% (386/396 = 97.47%). The median scores for nurses' knowledge (out of 9) and compliance barriers (out of 8) to EBGs for preventing VAP were 7 (interquartile range: 5–8) and 3 (interquartile range: 2–4), respectively. Knowledge was negatively associated with compliance barriers (r = −0.437, p < .01). The results of the multiple linear regression analysis showed that hospital level, age, nurses' attendance at VAP training and years of experience in ICUs were related to the level of knowledge. Nurses' attendance at VAP training, age and years of experience in ICUs were associated with the level of compliance barriers.Intensive care nurses have satisfactory knowledge of EBGs for preventing VAP, but compliance barriers can be reduced. Better knowledge helps reduce the barriers to compliance among nurses.Nurse managers and nurse educators are suggested to examine nurses' knowledge and compliance barriers to EBGs for preventing VAP, develop personalized training plans, promote continuous education based on the latest EBGs and raise the nurse–patient ratio reasonably. [ABSTRACT FROM AUTHOR]

The aim of this study is to explore intensive care nurses' perceptions and experiences about death and dying patient. This study included 15 nurses from a university hospital's intensive care units (paediatric and internal medicine). Data were collected through face-to-face, in-depth and individual interviews using the "Nurse Information Form" and "Semi-Structured Interview Form". Six major themes and sixteen sub-themes were identified on the nurses' perceptions and experiences with death. After the nurses described their perceptions of death, their responses, approaches, coping mechanisms, and effects on the dead and dying patient in care and factors affecting perceptions of death were defined. Our findings suggest that nurses, particularly those working in intensive care, should be educated/trained on death, and dying patient care. Thus, orderly psychological support should be provided to nurses. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effects of psychological distress on the work ability of intensive care nurses during the COVID-19 pandemic in Turkey. Materials and Methods: The sample size of this descriptive and cross-sectional study was determined to be at least 220 nurses, with a level of significance of 0.05, a confidence interval of 99%, and the ability to represent the population of 80%. The research was completed with 233 nurses. A Participant Information Form, the COVID-19-related Psychological Distress Scale, and the Work Ability Index were used to collect data online using Google Forms and email or social media accounts. In the analysis of data, Pearson and Spearman correlation analysis was used along with descriptive statistics. Results: A statistically significant positive correlation was found between the nurses’ length of time working in the profession and their WAI scores (r=0.132, p=0.043), and a negative correlation was found with their COVID-19 PDS scores (r=-0.162, p=0.013). A statistically significant difference was found about WAI total scores in the effect on work ability of the working conditions of the COVID- 19 pandemic (p

Background: No previous study has examined the direct effect of occupational fatigue, inter-shift recovery and compassion competence on caring behaviours, including assurance, knowledge-skill, respect and commitment in intensive care nurses. Aim: We studied the direct effect of participating nurses' occupational fatigue, inter-shift recovery and compassion competence levels on their caring behaviours and the relationship among these variables. Study Design: This was a descriptive correlational study. All nurses who were registered members of the Turkish Intensive Care Nurses Association were invited to participate in this online survey. This study was conducted with 315 intensive care nurses using convenience sampling between April and July 2022. The data were collected using the Occupational Fatigue Exhaustion/Recovery Scale, which consists of three subscales: acute fatigue, chronic fatigue and inter-shift recovery; the Compassion Competence Scale, including communication, sensitivity and insight subscales; and the Caring Behaviours Inventory-24. In addition, a structural equation model was established using variables correlating with caring behaviours. Independent variables were occupational fatigue, inter-ship recovery and compassion competence; and the dependent variable was caring behaviours in this hypothesized model. Results: Three hundred and fifteen nurses completed the survey (315/1000) with a response rate of 31.5%. The increase in the inter-shift recovery levels of participants was statistically and positively associated with caring behaviours (95% confidence interval [CI]: 0.001-0.011, β = .154 [moderate effect size], p < .05). The sub-dimensions of the Compassion Competence Scale, that is, communication (95% CI: 0.110-0.443, β = .251 [moderate effect size]) and sensitivity (95% CI: 0.084-0.427, β =.241 [moderate effect size]), were statistically and positively associated with the caring behaviours of participants (p < .05). In addition, independent variables accounted for 35% (large effect size) of the total change in caring behaviours (R² = 0.350). Conclusions: This study suggests that the high inter-shift recovery and compassion competence levels of intensive care nurses are positively associated with their caring behaviours. Relevance to Clinical Practice: Nursing managers should consider the direct effect of occupational fatigue, inter-shift recovery and the compassion competence levels of intensive care nurses on their caring behaviours to provide high-quality care. [ABSTRACT FROM AUTHOR]

Objective: This study aims to determine the effects of psychological distress on the work ability of intensive care nurses during the coronavirus disease-2019 (COVID-19) pandemic in Turkey. Materials and Methods: This study is descriptive and cross-sectional design. The sample consisted of 233 intensive care nurses. Data were collected via online Google forms with the Participant Information form, the COVID-19-related Psychological Distress scale (PDS), and the Work Ability index (WAI). In the analysis of data, Pearson and Spearman correlation analysis was used along with descriptive statistics. Results: A statistically significant positive correlation was found between the nurses' length of time working in the profession and their WAI scores (r=0.132, p=0.043), and a negative correlation was found with their COVID-19 PDS scores (r=-0.162, p=0.013). A statistically significant difference was found about WAI total scores in the effect on work ability of the working conditions of the COVID-19 pandemic (p<0.001). A statistically significant positive correlation was found between the WAI total score and the COVID-19 PDS sub-section of doubt (r=0.128, p=0.049). Conclusion: It was found that the work abilities and COVID-19 psychological distress levels of nurses were medium and there are relationship between them. It is recommended that the many factors affecting work ability and psychological distress be taken under control. [ABSTRACT FROM AUTHOR]

Purpose: Triggers have been developed internationally to identify intensive care patients with palliative care needs. Due to their work, nurses are close to the patient and their perspective should therefore be included. In this study, potential triggers were first identified and then a questionnaire was developed to analyse their acceptance among German intensive care nurses. Methods: For the qualitative part of this mixed methods study, focus groups were conducted with intensive care nurses from different disciplines (surgery, neurosurgery, internal medicine), which were selected by convenience. Data were analysed using the "content-structuring content analysis" according to Kuckartz. For the quantitative study part, the thus identified triggers formed the basis for questionnaire items. The questionnaire was tested for comprehensibility in cognitive pretests and for feasibility in a pilot survey. Results: In the qualitative part six focus groups were conducted at four university hospitals. From the data four main categories (prognosis, interprofessional cooperation, relatives, patients) with three to 15 subcategories each could be identified. The nurses described situations requiring palliative care consults that related to the severity of the disease, the therapeutic course, communication within the team and between team and patient/relatives, and typical characteristics of patients and relatives. In addition, a professional conflict between nurses and physicians emerged. The questionnaire, which was developed after six cognitive interviews, consists of 32 items plus one open question. The pilot had a response rate of 76.7% (23/30), whereby 30 triggers were accepted with an agreement of ≥ 50%. Conclusion: Intensive care nurses see various triggers, with interprofessional collaboration and the patient's prognosis playing a major role. The questionnaire can be used for further surveys, e.g. interprofessional triggers could be developed. [ABSTRACT FROM AUTHOR]

Background: Intensive care units (ICUs) have been overwhelmed by the increasing number of coronavirus disease 2019 (COVID‐19) cases, causing psychological burdens, stress, and various types of conflict among nurses. Aim: To examine the occurrence, type, and intensity of conflict and preferred management styles among ICU nurses during the COVID‐19 pandemic. Study Design: This cross‐sectional descriptive study was conducted in a government hospital in Saudi Arabia using a convenience sample of 95 nurses from three ICUs. Data were collected using an e‐questionnaire comprising the Nursing Conflict Scale, Rahim Organizational Conflict Inventory‐II, and sociodemographic variables. Results: Most participants reported exposure to moderately (64.2%) or highly (34.79%) intense conflict during the pandemic. The competitive (2.23 ±.472) and intragroup (2.23 ±.385) types of conflict were the most frequently reported. The preferred conflict management style was collaborating (21.85 ± 5.49), followed by accommodating (18.39 ± 4.03). Pearson's correlation analysis showed that age, years of experience, and education were significantly associated with conflict type and management style. Preparedness to care for suspected or confirmed COVID‐19 cases was associated with interpersonal conflict (r =.20, p =.04). Conclusions: The participants experienced moderate‐ to high‐intensity conflict; however, they employed constructive rather than destructive management styles. Relevance to Clinical Practice: Nurse leaders, policymakers, and educators must initiate transformational intervention programmes to enhance and sustain nurses' competencies in constructive conflict management strategies. Interpersonal communication and crisis management training programmes should be formulated to raise nurses' awareness and enhance their competencies vis‐à‐vis taking a positive approach to overcoming various conflict types and levels, particularly during crises. [ABSTRACT FROM AUTHOR]

Aim(s): To explore intensive care nurses' (ICN) perceptions of simulation‐based learning (SBL). Design: A systematic review and meta‐synthesis. Methods: The review followed the PRISMA guidelines for reporting a systematic review. A systematic search strategy was developed using a modified PICo framework. A comprehensive search was conducted in July 2023 in CINAHL, OVID Embase, Medline complete, Web of Science, ERIC and Scopus databases for articles published in English between 2013 and 2023. Data were extracted using the Joanna Briggs Institute QARI Data Extraction, with data synthesis guided by Braun and Clark's thematic analysis approach. Quality appraisal was assessed using the CASP tool. Results: Eleven studies providing qualitative data were included for analysis. Analysis and meta‐synthesis led to the construction of two themes: The learning experience and professional growth through collaboration. Conclusion: The review highlights the balance needed in finding the appropriate simulation approach, with the right level of fidelity, conducted at appropriately regular intervals, incorporating the correct makeup of professional team members, conducted in the right environment and facilitated by a skilled facilitator, to ensure best outcomes and return on investment for ICN's education. Implications for Practice: These findings are a valuable resource for educators and organisations considering simulation‐based learning initiatives in the intensive care setting. No Patient or Public Contribution: This review involved analysis of existing literature and as such no unique patient or public involvement occurred. Reporting Method: The systematic review followed the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) reporting guidelines. [ABSTRACT FROM AUTHOR]

Background: An increasing number of studies persistently demonstrate that prone position ventilation can significantly improve the oxygenation index and blood oxygen saturation for most patients (70–80%) with acute respiratory distress syndrome (ARDS). Studies have also shown that the awake prone position was both safe and effective in helping patients with coronavirus disease 2019 (COVID‐19) breathe spontaneously. However, the prone position is not widely adopted when treating patients with COVID‐19 or ARDS from other causes. Basic knowledge, positive attitudes, and correct practices among the nursing staff are necessary to increase the use of prone positions, reduce the incidence of complications associated with prone positions, and improve the quality and safety of health care. Aim: This study aimed to investigate the knowledge, attitudes, and practice of prone positioning of patients among intensive care unit (ICU) nurses working in COVID‐19 units and provide suggestions for improvement. Study design: ICU nurses were recruited from two designated tertiary hospitals for COVID‐19 treatment in Shanghai, China, in April 2022, using convenience sampling. A questionnaire survey focusing on the dimensions of knowledge, attitudes, and practice of the prone position with 42 items, was conducted. Results: A total of 132 ICU nurses participated. The scores on the overall questionnaire and the dimensions of knowledge, attitudes, and practice of prone position were 167.28 (95% CI, 161.70–172.86), 78.35 (95% CI, 76.04–80.66), 32.08 (95% CI, 31.51–32.65), and 56.85 (95% CI, 52.42–61.28) respectively. The overall average score was 79.66% (95% CI, 0.77–0.82). The results of multiple linear regression analysis showed that prior experience in treating patients with COVID‐19 and professional titles were related to the level of knowledge, attitudes, and practice of prone position. Conclusions: The ICU nurses strongly believed in the effectiveness of prone positioning, but their knowledge and practice levels need improvement. The experience in treating patients with COVID‐19 and professional titles were related to the level of knowledge, attitudes, and practice of prone position. Nursing managers should ensure that ICU nurses are well trained in prone positioning and help enhance the knowledge and attitudes toward prone positioning to promote its widespread use. Relevance to clinical practice: Clinical guidelines and in‐service training modules need to be developed to promote the use of prone positioning and reduce prone position‐related complications. [ABSTRACT FROM AUTHOR]

Introduction: Medical devices and equipment are necessary for accurate and continuous monitoring of the patients admitted to intensive care units, one of which is alarm systems. Frequent sounds of alarms can affect nurses' concentration and accuracy when providing care. Complications such as headache, fatigue, and stress occur after repeated alarms, leading to poor quality of professional life among nurses. This study aimed to determine the relationship between quality of professional life and alarm fatigue syndrome among intensive care unit nurses. Methods: This cross‐sectional study used convenience sampling to select nurses working in intensive care units from three hospitals in southern Iran in 2021 (n = 201). Data were collected using three questionnaires, including sociodemographic form, the professional quality of life questionnaire (ProQOL), and the alarm fatigue symptom (AFS) scale. Results: The mean scores of compassion satisfaction (CS), burnout, secondary traumatic stress (STS) (subscales of the ProQOL), and AFS were 34.66 ± 7.54, 28.98 ± 7.59, 27.69 ± 5.87, and 13.48 ± 7.32, respectively. The majority of them had no or mild AFS, moderate CS, burnout, and STS. Among the study variables, only AFS were a significant predictor of CS and STS among ICU nurses. In addition, work experience in ICU, AFS, and a second job were significant predictors of burnout among ICU nurses. Conclusions: The study results showed a significant relationship between alarm fatigue syndrome, burnout, STS, and CS. Given that more than half of the nurses in the intensive care unit in the present study experienced some degree of alarm fatigue syndrome, it is necessary to plan and implement interventions to better manage the alarms in the intensive care unit. [ABSTRACT FROM AUTHOR]

Abstract Introduction Medical devices and equipment are necessary for accurate and continuous monitoring of the patients admitted to intensive care units, one of which is alarm systems. Frequent sounds of alarms can affect nurses' concentration and accuracy when providing care. Complications such as headache, fatigue, and stress occur after repeated alarms, leading to poor quality of professional life among nurses. This study aimed to determine the relationship between quality of professional life and alarm fatigue syndrome among intensive care unit nurses. Methods This cross‐sectional study used convenience sampling to select nurses working in intensive care units from three hospitals in southern Iran in 2021 (n = 201). Data were collected using three questionnaires, including sociodemographic form, the professional quality of life questionnaire (ProQOL), and the alarm fatigue symptom (AFS) scale. Results The mean scores of compassion satisfaction (CS), burnout, secondary traumatic stress (STS) (subscales of the ProQOL), and AFS were 34.66 ± 7.54, 28.98 ± 7.59, 27.69 ± 5.87, and 13.48 ± 7.32, respectively. The majority of them had no or mild AFS, moderate CS, burnout, and STS. Among the study variables, only AFS were a significant predictor of CS and STS among ICU nurses. In addition, work experience in ICU, AFS, and a second job were significant predictors of burnout among ICU nurses. Conclusions The study results showed a significant relationship between alarm fatigue syndrome, burnout, STS, and CS. Given that more than half of the nurses in the intensive care unit in the present study experienced some degree of alarm fatigue syndrome, it is necessary to plan and implement interventions to better manage the alarms in the intensive care unit.

Background/Aims: High staff turnover among nurses can be caused by a variety of factors, including job dissatisfaction. This study aimed to assess factors influencing job satisfaction and retention among intensive care nurses in three tertiary care hospitals in Saudi Arabia. Methods: A multi-centre comparative cross-sectional study was carried out with 326 intensive care nurses working across three hospitals in Saudi Arabia. The Minnesota satisfaction questionnaire and the anticipated turnover scale were used to assess nurses' job satisfaction levels and intention to leave their organisation, with items scored on a 7-point Likert scale. Respondents' sociodemographic characteristics were also collected, including age, sex, nationality, salary, years of experience and shift length. Responses were analysed using the Statistical Package for Social Sciences version 25 to identify relationships between variables, with P values of ≤0.05 being considered statistically significant. Results: Job satisfaction levels were generally low, with an average score of 58.34 out of 140. There was a significant inverse relationship between job satisfaction and intention to leave (P=0.001). Nurses who were not of Saudi Arabian nationality and those who earned less than 10,000 Saudi riyals had significantly higher levels of job satisfaction than Saudi Arabian nationals and those on higher salaries (P=0.001 and P=0.002 respectively). Other sociodemographic variables were not significantly associated with job satisfaction. Conclusions: Job satisfaction needs to be improved among nurses working in intensive care units to prevent high staff turnover rates. Understanding how sociodemographic variables can affect job satisfaction may help healthcare managers and policymakers to implement effective, targeted strategies to improve staff retention. [ABSTRACT FROM AUTHOR]

Background: Intensive care nurses play an important role in the management of critically ill patients including identification of cardiac arrhythmias. Interventions to improve arrhythmia identification can be expensive, time‐consuming, and are not always successful. Aims: This study aimed to explore the effectiveness of using short message service (SMS) messaging to improve intensive care nurses' cardiac arrhythmia interpretation skills. Design: This study was a prospective, two‐group, assessor‐blinded, randomized controlled trial with a pretest‐posttest experimental design. Methods: The study was conducted from February 2020 to February 2021 for the intervention as well as the control group, in a teaching hospital in northwest Turkey. The intervention group was sent the one‐way SMS messages on cardiac arrhythmias via WhatsApp during an 8‐week period, whereas the control group did not receive any intervention. The Cardiac arrhythmias assessment questionnaire (CAAQ) was used to measure outcomes. The data were analysed using ANCOVA and an independent t‐test. Results: A total of 66 intensive care nurses were randomly assigned to either the intervention or the control group. The ANCOVA analysis indicated that ICU nurses who received SMS messages about cardiac arrhythmias two times a week had significantly increased CAAQ scores (P < 0.001) with a large effect size (partial eta‐squared = 0.588). Conclusion: This study concluded that using SMS messages as a training tool has a positive influence on cardiac arrhythmias interpretation skills among ICU nurses. Relevance to clinical practice: Using SMS messages could be an alternative, effective, and innovative approach to improve nurses' clinical practice skills. [ABSTRACT FROM AUTHOR]

Background: The benefit of a stay in an intensive care unit (ICU) is not certain for older patients, particularly in the surgical context. Aims: The objective of this study was to identify the factors associated with an unfavourable outcome in this population. Design: Prospective, descriptive, monocentric study conducted in the surgical ICU of a French university hospital. Methods: Patients aged ≥75 years admitted in the surgical ICU for a predicted length of stay ≥48 hours were included. Patients received an initial and a 6‐months nutritional and functional assessment performed by physicians and nurses. The outcome was considered as favourable if the Katz Activities of Daily Living (ADL) variation (ADL delta = 6‐months ADL – ICU admission ADL) was between 0 and −0.5 point 6 months after ICU discharge and unfavourable if the ADL delta decreased by more than 0.5 points or if the patient had died 6 months after ICU discharge. Results: Fifty‐six patients—32 (57%) male—aged 79 [77; 83] y were included. ICU mortality was 19%; 6‐month mortality was 22%. Median ADL delta was −0.5 [−0.5–0] points. A low ADL score (P =.0438) and a low albumin level (P =.0213) at admission were the two independent factors associated with an unfavourable outcome. Conclusion: Mortality and loss of independence were high in this elderly population during and after their surgical ICU stay. The benefit of a systematic collaboration between intensive care specialists, ICU nurses, and geriatricians, to assess and manage nutritional and functional problems and to prevent a pejorative outcome in patients over 75 years old admitted in surgical ICU needs to be studied. Relevance to clinical practice: There should be systematic screening for objective markers of undernutrition and frailty on ICU admission of older patients as they are associated with a poor prognosis. [ABSTRACT FROM AUTHOR]

Background: The outbreak of the Corona virus (COVID‐19) pandemic led to a sharp rise in morbidity and hospitalizations, and a significant therapeutic burden fell on intensive care units (ICUs). Intensive care nurses reported physical and emotional stress in response to the extra workload caused by caring for critically ill COVID‐19 patients. However, at the time of publication of the study, to the best of our knowledge there have been no studies that examined uncertainty, stress, or hope in the context of functioning among intensive care nurses. Aim: To examine: (a) the challenges of operating and managing intensive care units during the COVID‐19 pandemic among nurse managers in intensive care units, and (b) the relationships between uncertainty, stress, burnout, hope, and professional functioning among intensive care nurses during the COVID‐19 pandemic. Design: This mixed‐methods study was conducted in intensive care units (ICUs) at a large tertiary medical center in Israel, during February–May 2021. Methods: The data were collected in two phases. In the first phase, qualitative data were collected from focus groups attended by 15 senior managerial nurses. The second phase involved a cross‐sectional study among 100 staff nurses working in 5 ICUs. The data were collected using a structured questionnaire. Results: Qualitative data analysis revealed two main themes: (a) challenges of the COVID‐19 pandemic and (b) positive aspects of the COVID‐19 pandemic. The nurses reported high levels of burnout, emotional stress and uncertainty, but moderate State Hope Scale scores, and moderate levels of professional functioning. There were no statistical differences in study variables by exposure to COVID‐19 patients. State Hope Scale levels, uncertainty, and burnout variables contributed significantly and explained 46% of the variance of the professional functioning. Conclusions: The intensity of the experiences and psych‐social phenomena, is not affected by exposure to treatment of COVID‐19 patients. The relationships between the study variables emphasize the importance of initiated and ongoing interventions to reduce uncertainty, address burnout, and strengthen hope. Improvement in these indices may lead to better ICU nurses' professional functioning and their work life well‐being. Clinical relevance: We have therefore identified a need to formulate policies and implement interventions to bolster morale and hope, and can recommend systematic provision and sharing of up‐to‐date information with ICU nurses during prolonged emergencies. [ABSTRACT FROM AUTHOR]

Background: Nurses working in shift duties, including night duties, are subject to a cumulative sleep debt, a decreased quantity and quality of sleep, and continuous sleep deprivation. Hence, nurses working in shift duties are prone to sleep disturbance. Objective: To determine and compare the quality of sleep among oncology and intensive care unit (ICU) nurses. Materials and Methods: Descriptive approach was adopted for this study. The sample comprised 126 nurses working at the units of Prince Bijay Singh Memorial (PBM) Hospital, Bikaner, Rajasthan, who were selected by purposive sampling technique. The quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 20.0. Results: In this study, majority of the participants (60.32%) were men. Majority of the nurses (75.40%) were working on a regular basis. The mean sleep quality scores of intensive care and oncology nurses were 3.863 ± 1.988 and 5.317 ± 1.899, respectively. The observed difference was statistically significant (t = 4.097; p < 0.001). Overall, there was poor quality of sleep in 46% of the participants. The intensive care unit (ICU) nurses are more likely to have poor quality of sleep than oncology nurses (61.90% vs. 30.16%; Χ2 = 18.15; p < 0.001). In addition, a moderate positive correlation (r = 0.6645, P = 0.0001FNx01) was observed between the sleep quality of ICU and oncology nurses. Among the intensive care nurses and oncology nurses, there was no significant association between sociodemographic variables such as gender, age, working status, job status, and the PSQI scores. (P > 0.05). Conclusion: Intensive care nurses and oncology nurses have poor quality of sleep, which can affect their health and professional performance. The ICU nurses have poorer quality of sleep than oncology nurses. Nurse administrators and hospital administration should take initiatives to reduce the prevalence of poor sleep among these nurses.

Abstract Aim To explore the perceptions and experiences of nurses in communicating the care and caring in the intensive care unit (ICU). Design A focused ethnography. Methods This study was conducted in an Australian metropolitan hospital, in which data were gathered from multiple sources: participant observations, document reviews, interviews, and participant's additional written information ‐ over six months (April‐September, 2014). The data were analysed thematically. Findings This study addressed inclusively communicating care and caring to patients, families, nurses and other health professionals in ICU. The findings identified main themes concerning the changing patterns of communicating the care and caring in ICU, various patterns of communication used, enablers and barriers of communicating care and caring, and significant issues in communicating care and caring in ICU. Documentation of patients’ psychological and emotional needs, and nurses’ caring behaviours are crucial. These findings need further consideration from all stakeholders.

Background: COVID‐19 has been linked to over 40 million infections and 1.1 million deaths in 210 countries as of October 19, 2020. This highly contagious communicable disease has put not only infected individuals but other patients and frontline workers like nurses at risk in hospitals, especially in Intensive Care units (ICUs). There is a need for minimizing patient contact, improving hand hygiene practices, and optimizing healthcare provider time, especially nurses. Globally it is estimated that nearly a million health care providers have been infected with COVID‐19 as of the end of October 2020. Methods: This retrospective service evaluation documents the experience of health care providers in a COVID‐19 ICU in India that was used to implement new protocols for secretion management and oral hygiene. Patient chart information and staff feedback were utilized. Intervention: This pilot study captures the practical benefits of using VAPCare, an automated, closed‐loop system for oral secretion removal. Results: Six patients were included in this small‐scale study; three patients following the current standard of care for suctioning and oral hygiene and three receiving the new VAPCare and Lumen device protocol. With the new device protocol, the number of infected secretion interactions by a nurse was 50% lower, and nursing time spent on oral hygiene and secretion management 70% less than seen with the current standard of care. The number of disposable gloves used with VAPCare and Lumen was reduced by over 50%. All 10 nurses and six doctors gave positive feedback on device usage. The department recommended updating protocols to prioritize the use of the new secretion management system for patients with COVID19 and other highly contagious conditions. Conclusion: The findings are an early indication that using VAPCare for patients could help protect infected patients, other ICU patients, and health care workers. [ABSTRACT FROM AUTHOR]

Background: Moral distress is a phenomenon that all nurses experience at different levels and contexts. The level of moral distress can be affected by individual values and the local culture. The sources of the values shape the level of moral distress experienced and the nurses' decisions. Aim: The present scoping review was conducted to examine the situations that cause moral distress in ICU nurses in different countries. Results: A scoping review methodology was adopted for the study, in line with the approach of Arksey, and O'Malley Literature was searched within PubMed/Medline, Scopus, Web of Science, and PsycINFO indexed keywords such as "moral distress", "Critical Care Nurse", and "Moral Distress Scale-Revised". Of the 617 identified citations, 12 articles matched the inclusion criteria. Conclusion: The moral distress experienced in countries and regions with similar cultures and geographies was parallel. The situations that cause the most moral distress are futile-care to prolong death, unnecessary tests and treatments, and working with incompetent healthcare personnel. [ABSTRACT FROM AUTHOR]

Background: Inadequate pain assessment and management is a problem in hospitalized patients that impairs their well‐being. Intensive care unit nurses' pain practices are affected by several barriers and enablers. Aims and objectives: To explore intensive care unit nurses' pain education, perceived barriers, and enablers of pain assessment and management practices among critically ill patients. Design: A cross‐sectional descriptive design was used in the study. Methods: Convenience sampling technique was used, including 300 nurses recruited from 22 intensive care units in Jordan. The Pain Assessment and Management for Critically Ill Adults Survey was used to collect data. Descriptive statistics, spearman correlation, and chi‐square tests were used to analyse the data. Results: Only 127 (42.3%) of the nurses reported moderate to extreme satisfaction about receiving professional development education related to pain among critically ill patients. Nurse workload (65.3%), patient instability (54.4%), patient inability to communicate (53.3%), and sedation interfering with pain assessment (50%) were reported by nurses as the most frequent barriers impacting pain assessment and management. Enablers of pain assessment and management reported most frequently were "pain assessment and management is a unit priority" (63.7%), "enthusiastic and motivated staff" (61.3%), "protocols and guidelines are in use" (57.4%), and "standardized assessment tools are in use" (57%). Some barriers and enablers to pain assessment and management and pain education differed significantly according to nurses' experience and hospital type. Conclusion: This study identified a range of enablers and barriers to pain assessment and management practices perceived by intensive care unit nurses. Nurse workload was an important barrier while making pain assessments, and management a unit priority was an important enabler for pain assessment and management. Frequent assessment of barriers and enablers of pain assessment and management is needed in critical care units to improve nurses' practices. Pain education should be included in the hospitals' continuous educational program. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Relevance to clinical practice The findings from the study highlighting family involvement, high‐quality communication and flexible visiting policy as central aspects of family care may inspire clinicians to identify aspects of everyday family care in their ICUs calling for further improvement. Aims and objectives: To describe family involvement, communication practices and visiting policies in adult ICUs. Design: A cross‐sectional survey. Method: A questionnaire consisting of 11 sections was developed, pilot tested and e‐mailed to 196 ICUs. The participants were intensive care nurses in adult ICUs in four Nordic countries. Results: The survey was conducted in October to December 2019. The response rate was 81% (158/196) of the invited ICUs. Most of the units had fewer than 11 beds. Family participation in patient care, including involvement in ward rounds and presence during cardiopulmonary resuscitation, varied between the countries, whereas most families in all countries were involved in decision‐making. Family conferences were generally initiated by staff or family members. Children under 18 did not always receive information directly from the staff, and parents were not advised about how to inform their children. Although most respondents described open visiting, restrictions were also mentioned in free‐text comments. Conclusions: The level of family care in ICUs in the four Nordic countries is generally based on nurses' discretion. Although most Nordic ICUs report having an open or flexible visiting policy, a wide range of potential restrictions still exists. Children and young relatives are not routinely followed up. Family members are included in communication and decision‐making, whereas family involvement in daily care, ward rounds and family‐witnessed resuscitation seem to be areas with a potential for improvement. [ABSTRACT FROM AUTHOR]

Background: The need for interprofessional collaboration in increasing, because a single professional group can no longer meet patients' increasingly complex and multifaceted health-related problems and needs. Researchers have found that effective interprofessional collaboration is needed, especially in primary care. Aim: The aim of the study was to explore care leaders' experiences of collaboration between different healthcare professions in primary care. Methodology: An explorative qualitative design and qualitative content analysis were used. Data were collected in February and March 2021. The data material consists of texts from interviews with care leaders working in outpatient care in a primary care setting. The method was inspired by content analysis. Results: Six main themes emerged: Physically close interaction, inclusion of clients and understanding clients' individual needs; Quick flow of communication, participation and common approach; Inclusion of other professions and sectors, and non-hierarchical work; Capacity for interaction and cooperation, respect for others' knowledge, commitment to change and utilization of potential; Purposeful action, enablement of developmental work and boundary-crossing work; Commitment of management, prioritization, structured action, justification and clear division of work. Conclusions: Factors considered to promote interprofessional collaboration are physically close interaction, inclusion of clients, understanding clients' individual needs, quick flow of communication, participation and common approach, inclusion of other professions and sectors, and non-hierarchical work. A focus on collaboration between different professions in other healthcare sectors could be included in future research. [ABSTRACT FROM AUTHOR]

Background: The organ donor process is challenging, not at least for intensive care nurses. The situation changes radically, from intensively working to save the patient's life to instead caring for the donor patient's organs so that those, in turn, can save another patient's life. The donation process challenges nurses' view on what dignified caring at end-of-life entails. The inner core of caring comprises love, mercy and compassion. Dignified caring is related to treating the patient as a unique human being and respecting human value, rooted in the theory of caritative caring that is the framework for this study. Aim: The aim was to illuminate intensive care nurses' experiences of caring during the organ donor process, from a caring science perspective. Methodology: A descriptive research design including inductive qualitative content analysis of interviews with twelve intensive care nurses in Sweden about their experiences of caring during the donor process. Results: The theme The complexity of caring during the organ donor process with two categories and five subcategories was generated. Intensive care nurses experienced caring during the donor process as being complex in relation to the potential donor patient and patient's family as well as communication, teamwork and organization. Caring affects not only the patient and families, but also the nurses and receivers of the donated organs. Intensive care nurses perceive the other's life situation as if it were their own and recognize the importance of shared humanity. Conclusion: The present study can increase knowledge from intensive care nurses and the caring team, in order to provide better conditions such as the development of effective intervention strategies in the process of organ donor care as well as caring for the families and members of the team. [ABSTRACT FROM AUTHOR]

Aim: To explore the perceptions and experiences of nurses in communicating the care and caring in the intensive care unit (ICU). Design: A focused ethnography. Methods: This study was conducted in an Australian metropolitan hospital, in which data were gathered from multiple sources: participant observations, document reviews, interviews, and participant's additional written information ‐ over six months (April‐September, 2014). The data were analysed thematically. Findings: This study addressed inclusively communicating care and caring to patients, families, nurses and other health professionals in ICU. The findings identified main themes concerning the changing patterns of communicating the care and caring in ICU, various patterns of communication used, enablers and barriers of communicating care and caring, and significant issues in communicating care and caring in ICU. Documentation of patients' psychological and emotional needs, and nurses' caring behaviours are crucial. These findings need further consideration from all stakeholders. [ABSTRACT FROM AUTHOR]

Background: Intensive care units (ICU) are associated with significant work stress and exert continuous physical and emotional demand upon health care providers. The health and well‐being of care providers, including ICU nurses, is a matter of great concern. However, to the researcher's knowledge, there have been no reviews synthesizing the evidence about the relationship between nurse staffing and nurse outcomes in the ICU. Purpose The purpose of this systematic review was to examine nurse staffing in the ICU and synthesize literature to examine the relationship with nurse outcomes such as job satisfaction, burnout, fatigue, and intent to leave. Methods: This review was reported based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Peer‐reviewed articles published between January 2000 and September 2019 were identified via eight electronic bibliographic databases. Articles were included and reviewed if they were correlational studies examining the relationships between nurse staffing and nurse outcomes in the ICU, and were published in peer‐reviewed journals written in either English or Korean. The Quality Assessment and Validity Tool for Correlation Studies was used for quality appraisal. Results: From 5086 articles, eight published between 2006 and 2019 were included in this review. Three studies found expected relationships between worse nurse staffing and adverse nurse outcomes (high burnout, fatigue state, emotional exhaustion, depersonalization, and stress). However, the relationships between nurse staffing and other adverse nurse outcomes were not significant. Perceived adequate staffing was negatively related to adverse nurse outcomes. However, a non‐significant relationship also was found. Conclusion: This study found limited evidence on relationships between nurse staffing and nurse outcomes in the ICU. More studies are needed to conduct to find a conclusive relationship. Relevance to clinical practice: Given high demands and workload in the ICU, nurse staffing levels should be closely monitored to prevent adverse nurse outcomes. [ABSTRACT FROM AUTHOR]

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This study aimed to determine the effect of spiritual well-being of intensive care nurses on compassion fatigue. It is a descriptive study. The sample of the study was composed of 167 nurses who were working in the intensive care units of the hospitals in Turkey. Data were collected by using "Personal Information Form", "The Spiritual Well-Being Scale" and "The Compassion Fatigue-Short Scale" between July and October 2022. Descriptive statistics, t-tests, correlation, and simple regression analysis were used to analyse data. 35% (n = 59) of the participants were between 22 and 27 years old; 73% (n = 122) were females; 67% (n = 112) had an undergraduate degree; 57% (n = 96) had an experience of 1 to 5 years in the intensive care. It was determined that intensive care nurses had a moderate level of compassion fatigue and a high level of spiritual well-being. Although especially the educational levels of the nurses contributed to their level of spiritual well-being, a younger age and being single and less experienced in the nursing profession and intensive care were identified as significant factors in determining compassion fatigue. Nurses' Spiritual Well-Being Scale mean score was 113.89 ± 15.50. The mean score of the Compassion Fatigue Scale was 60.15 ± 29.24. A positive correlation was found between the Spiritual Well-Being and the Compassion Fatigue Scales (ß = 0.358, p = 0.000). Although intensive care nurses have a high level of spiritual well-being in general, they experience a moderate level of compassion fatigue. Younger and less experienced nurses should get more attention in intensive care units against compassion fatigue. Management of feelings of compassion can be a protective factor for compassion fatigue and can be used as a prevention strategy in the context of improving mental well-being among intensive care nurses. Awareness and knowledge of nurses on spiritual needs should be enhanced. [ABSTRACT FROM AUTHOR]

To describe the impact of the COVID-19 pandemic on intensive care nurses personal and professional well-being. A descriptive, qualitative design was used. Two nurse researchers conducted one-on-one interviews via Zoom or TEAMS using a semi-structured interview guide. Thirteen nurses who were working in an intensive care unit in the United States participated in the study. A convenience sample of nurses who completed a survey in the larger parent study provided an email and were contacted by the research team to participate in interviews to discuss their experiences. An inductive approach to content analysis was used to develop categories. Five major categories emerged from the interviews: (1) We are not heroes, (2) inadequate support, (3) helplessness, (4) exhaustion, and (5) Nurses the second victim. The COVID-19 pandemic has taken a physical and mental health toll on intensive care nurses. The impact of the pandemic on personal and professional well-being has serious implications for retaining and expanding the nursing workforce. This work highlights the importance for bedside nurses to advocate for systemic change to improve the work environment. It is imperative for nurses to have effective training including evidence-based practice and clinical skills. There needs to be systems in place to monitor and support nurses' mental health and encourage bedside nurses to use self-care methods and practices to prevent anxiety, depression, post-traumatic stress disorder and burnout. [ABSTRACT FROM AUTHOR]

Aim: To explore the perceptions and experiences of nurses in communicating the care and caring in the intensive care unit (ICU)., Design: A focused ethnography., Methods: This study was conducted in an Australian metropolitan hospital, in which data were gathered from multiple sources: participant observations, document reviews, interviews, and participant's additional written information - over six months (April-September, 2014). The data were analysed thematically., Findings: This study addressed inclusively communicating care and caring to patients, families, nurses and other health professionals in ICU. The findings identified main themes concerning the changing patterns of communicating the care and caring in ICU, various patterns of communication used, enablers and barriers of communicating care and caring, and significant issues in communicating care and caring in ICU. Documentation of patients' psychological and emotional needs, and nurses' caring behaviours are crucial. These findings need further consideration from all stakeholders., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

The presence of a central venous catheter (CVC) leads to a high risk of blood infections, which are considered major causes of morbidity, mortality and high medical costs. The aim of this study was to assess the knowledge of nursing staff working in intensive care units (ICUs) regarding the prevention of central-line-associated bloodstream infections (CLABSIs). A nationwide survey was conducted among ICU nurses from August 2016 to April 2017. A modified Polish version of the questionnaire developed by Labeau et al. was used to assess the nurses' knowledge. Of the 750 questionnaires distributed, 468 were returned. Women accounted for 95.73% of all respondents, and over 80% were university educated. Most of the nurses surveyed (85.9%) had previously received training in CVC guidelines, and thus over 82% rated their knowledge as good or very good. The guidelines introduced in hospitals were the main declared sources of information. In addition, more than half (68%) of respondents also knew the international guidelines. The knowledge of nursing staff in the study area is not sufficient. Studies show that the guidelines for the prevention of CLABSIs in ICUs should be standardized, and continuous training of personnel in this field should be provided.

Background: Intensive care units (ICU) are associated with significant work stress and exert continuous physical and emotional demand upon health care providers. The health and well-being of care providers, including ICU nurses, is a matter of great concern. However, to the researcher's knowledge, there have been no reviews synthesizing the evidence about the relationship between nurse staffing and nurse outcomes in the ICU., Purpose: The purpose of this systematic review was to examine nurse staffing in the ICU and synthesize literature to examine the relationship with nurse outcomes such as job satisfaction, burnout, fatigue, and intent to leave., Methods: This review was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Peer-reviewed articles published between January 2000 and September 2019 were identified via eight electronic bibliographic databases. Articles were included and reviewed if they were correlational studies examining the relationships between nurse staffing and nurse outcomes in the ICU, and were published in peer-reviewed journals written in either English or Korean. The Quality Assessment and Validity Tool for Correlation Studies was used for quality appraisal., Results: From 5086 articles, eight published between 2006 and 2019 were included in this review. Three studies found expected relationships between worse nurse staffing and adverse nurse outcomes (high burnout, fatigue state, emotional exhaustion, depersonalization, and stress). However, the relationships between nurse staffing and other adverse nurse outcomes were not significant. Perceived adequate staffing was negatively related to adverse nurse outcomes. However, a non-significant relationship also was found., Conclusion: This study found limited evidence on relationships between nurse staffing and nurse outcomes in the ICU. More studies are needed to conduct to find a conclusive relationship., Relevance to Clinical Practice: Given high demands and workload in the ICU, nurse staffing levels should be closely monitored to prevent adverse nurse outcomes., (© 2021 British Association of Critical Care Nurses.)