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Background: Since the outbreak of COVID‐19, researchers worldwide have focused more on the issue of secondary traumatic stress (STS) experienced by nurses. This stress has an adverse effect on the health of nurses and the quality of nursing care, potentially undermining the stability of the nursing team and hindering the ability to meet the growing demand for nursing services. The impact of the COVID‐19 pandemic, and the rise in global demand for ICU nursing, has placed a significant strain on ICU nurses, severely damaging their mental and physical health. Notably, ICU nurses also face high levels of moral distress, and moral resilience can effectively alleviate this distress and improve the quality of care. Aim: This study aimed to examine the levels of moral resilience and STS among ICU nurses, to explore their relationship and identify the factors influencing STS. Study Design: This cross‐sectional study involved 229 ICU nurses from two tertiary hospitals in Xi'an, China, who participated between November and December 2023. The data were collected through email using anonymous electronic questionnaires, encompassing a self‐designed demographic‐ and work–life‐related characteristic questionnaire; the Rushton Moral Resilience Scale; and the Secondary Traumatic Stress Scale. Descriptive statistics, t‐tests, analysis of variance and hierarchical regression analysis were performed to analyse the data. Results: The findings of the study indicated that ICU nurses' moral resilience and STS scores were at an intermediate level. Hierarchical regression analysis indicated that STS was negatively correlated with the subscales of the Rushton Moral Resilience Scale, specifically moral adversity coping (β, −0.156; 95% CI, −1.241 to −0.039) and relational integrity (β, −0.245; 95% CI, −1.453 to −0.388), which are significant predictors of STS. Additionally, good sleep quality (β, −.396; 95% CI, −14.948 to −7.117) and seeking psychological counselling because of work difficulties (β,.107; 95% CI, 0.237–9.624) emerged as significant predictors of STS among ICU nurses, with the model's explanation of the variance in STS increasing to 45.5%, △R2 =.167, F = 16.482 (p <.001). Conclusion: This study found that ICU nurses have moderate levels of moral resilience and STS, which are negatively correlated. This suggests that improving the moral resilience of ICU nurses may help reduce their STS levels. Relevance to Clinical Practice: The study revealed that ICU nurses' moral resilience and secondary traumatic stress levels were at a moderate level, indicative of the need to take measures to enhance their moral resilience and reduce their secondary traumatic stress, as their presence not only affects the health of ICU nurses but also diminishes the quality of care and increases turnover rates. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the current status of delirium care self-efficacy among nurses in the intensive care unit (ICU) and the level of their knowledge about delirium in the ICU, more importantly, to analyze factors influencing the delirium care self-efficacy of ICU nurses and to provide a theoretical basis for ICU nursing managers to develop strategies for effective delirium care and management. Methods: The study was based on a sample of 283 ICU nurses from eight hospitals in Chongqing selected using a convenience sampling method between July 2023 and September 2023. The tools used included a general information questionnaire, the Chinese version of the Delirium Care Self-Efficacy of ICU Nurses Scale, and the Chinese version of the ICU Delirium Knowledge Level Questionnaire. Results: The self-efficacy score (47.84 ± 9.93) of ICU nurses was positively correlated with the delirium knowledge level score (12.32 ± 3.47, r = 0.591, P < 0.001). Multivariate linear regression analysis identified the gender of the nurse, hospital level (tier), duration of ICU work experience, whether the nurse was a specialized ICU nurse, whether the nurse received delirium-related training, and the level of knowledge about delirium (all P < 0.05) as the influencing factors for the delirium care self-efficacy of ICU nurses. Conclusion: It is recommended that ICU nursing managers offer targeted interventions based on the influencing factors to improve the delirium care self-efficacy of ICU nurses and their delirium knowledge levels, thereby reducing the incidence of delirium and improving the quality of care provided for patients with delirium in the ICU. [ABSTRACT FROM AUTHOR]

Background: ICU nurses play a critical role in managing delirium in critically ill patients, yet their competency in this area remains under-explored. Aim: To assess ICU nurses' competency including their knowledge, practice, and attitudes toward delirium among critically ill patients. Methods: A correlational descriptive study was conducted with 67 nurses in the medical intensive care unit at Suez Canal University Hospitals. Data was collected using an online survey and analyzed using descriptive statistics, ANOVA, and Pearson's correlation. Results: Nurses showed a moderate knowledge level (M = 8.55), a low practice level (M = 6.62), and positive attitudes (M = 21.65) toward ICU delirium. ANOVA results indicated significant differences in practice scores based on educational level, F (2, 64) = 3.361, p =.041, and in knowledge scores based on ICU experience, F(3, 63) = 6.455, p <.001. Nurses with Master of Science in Nursing (MSN) degrees had higher practice scores than those with diplomas or Bachelor of Science in Nursing (BSN) degrees. There were no significant differences in knowledge and attitude scores based on educational level or age. Gender differences were minimal, with male nurses slightly outperforming female nurses. Correlation analysis showed positive relationships between age, education, ICU experience, and ICU nurses' levels of knowledge and practice. Conclusion: ICU nurses demonstrate a knowledge-practice gap in delirium management. Targeted educational interventions, mentorship programs, and a focus on practical skills are essential to enhance delirium care. Relevance to clinical practice: These findings highlight the urgent need for comprehensive delirium education and training programs for ICU nurses. By improving nurses' knowledge and practice, healthcare organizations can significantly enhance the early detection, prevention, and management of delirium, ultimately leading to improved patient outcomes and reduced length of stay in the ICU. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this study was to assess the current status of delirium care self-efficacy among nurses in the intensive care unit (ICU) and the level of their knowledge about delirium in the ICU, more importantly, to analyze factors influencing the delirium care self-efficacy of ICU nurses and to provide a theoretical basis for ICU nursing managers to develop strategies for effective delirium care and management. Methods The study was based on a sample of 283 ICU nurses from eight hospitals in Chongqing selected using a convenience sampling method between July 2023 and September 2023. The tools used included a general information questionnaire, the Chinese version of the Delirium Care Self-Efficacy of ICU Nurses Scale, and the Chinese version of the ICU Delirium Knowledge Level Questionnaire. Results The self-efficacy score (47.84 ± 9.93) of ICU nurses was positively correlated with the delirium knowledge level score (12.32 ± 3.47, r = 0.591, P

Abstract Background ICU nurses play a critical role in managing delirium in critically ill patients, yet their competency in this area remains under-explored. Aim To assess ICU nurses’ competency including their knowledge, practice, and attitudes toward delirium among critically ill patients. Methods A correlational descriptive study was conducted with 67 nurses in the medical intensive care unit at Suez Canal University Hospitals. Data was collected using an online survey and analyzed using descriptive statistics, ANOVA, and Pearson’s correlation. Results Nurses showed a moderate knowledge level (M = 8.55), a low practice level (M = 6.62), and positive attitudes (M = 21.65) toward ICU delirium. ANOVA results indicated significant differences in practice scores based on educational level, F (2, 64) = 3.361, p = .041, and in knowledge scores based on ICU experience, F(3, 63) = 6.455, p

Abstract Purpose To analyze the key factors influencing the psychological resilience of intensive care unit (ICU) nurses during the COVID-19 pandemic and put forward suggestions promoting resilience based on key improvement factors and clinical experience. Methods Data were collected from 35 ICU nurses in a hospital in Zhejiang Province, China, through a questionnaire survey conducted between January and February 2023. The Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was then used to construct and visualize the relationship structure between the factors. The DEMATEL-based Analytical Network Process (DANP) was applied to determine the influential weights of all factors. Finally, the key improvement factors were identified using importance-performance analysis (IPA). Results Based on the cause-effect impact network diagram (CEIND), it was concluded that (C 11), (C 22), and (C 32) are the key factors that promote the improvement of psychological resilience among ICU nurses. Additionally, these factors were the key factors that influence psychological resilience. The confidence levels of these results and the gap were 99.6% and 0.4%, respectively, which exceed the threshold value of 95%, indicating good stability. Finally, for the case hospitals, (C 13) was identified as the key improvement factor. Conclusions Hospital administrators should support ICU nurses in enhancing their psychological resilience during major epidemics by: (i) Providing training on comprehensive protective measures and nursing skills; (ii) Effectively managing the human resources of nurses in the hospital to reduce their workload; (iii) Increasing social and organizational support for nurses to alleviate anxiety caused by large-scale public health events and improve their psychological resilience.

Intensive Care Unit (ICU) nurses are burdened by excessive number of false and irrelevant alarms generated by patient monitoring systems. Nurses rely on these patient monitoring systems for timely and relevant medical information concerning patients. However, the systems currently in place are not sensitive to the perceptual and cognitive abilities of nurses and thus fail to communicate information efficiently. An efficient communication and an effective collaboration between patient monitoring systems and ICU nurses is only possible by designing systems sensitive to the abilities and preferences of nurses. In order to design these sensitive systems, we need to gain in-depth understanding of the user group through revealing their latent individual characteristics. To this end, we conducted a survey on individual characteristics involving nurses from two IC units. Our results shed light on the personality and other characteristics of ICU nurses. Subsequently, we performed hierarchical cluster analysis to develop data-driven nurse profiles. We suggest design recommendations tailored to four distinct user profiles to address their unique needs. By optimizing the system interactions to match the natural tendencies of nurses, we aspire to alleviate the cognitive burden induced by system use to ensure that healthcare providers receive relevant information, ultimately improving patient safety. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the key factors influencing the psychological resilience of intensive care unit (ICU) nurses during the COVID-19 pandemic and put forward suggestions promoting resilience based on key improvement factors and clinical experience. Methods: Data were collected from 35 ICU nurses in a hospital in Zhejiang Province, China, through a questionnaire survey conducted between January and February 2023. The Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was then used to construct and visualize the relationship structure between the factors. The DEMATEL-based Analytical Network Process (DANP) was applied to determine the influential weights of all factors. Finally, the key improvement factors were identified using importance-performance analysis (IPA). Results: Based on the cause-effect impact network diagram (CEIND), it was concluded that (C11), (C22), and (C32) are the key factors that promote the improvement of psychological resilience among ICU nurses. Additionally, these factors were the key factors that influence psychological resilience. The confidence levels of these results and the gap were 99.6% and 0.4%, respectively, which exceed the threshold value of 95%, indicating good stability. Finally, for the case hospitals, (C13) was identified as the key improvement factor. Conclusions: Hospital administrators should support ICU nurses in enhancing their psychological resilience during major epidemics by: (i) Providing training on comprehensive protective measures and nursing skills; (ii) Effectively managing the human resources of nurses in the hospital to reduce their workload; (iii) Increasing social and organizational support for nurses to alleviate anxiety caused by large-scale public health events and improve their psychological resilience. [ABSTRACT FROM AUTHOR]

Background Aim Study design Results Conclusions Relevance to Clinical Practice Implicit rationing of nursing care is defined as the withholding of necessary nursing measures for patients because of a lack of nursing resources. However, no studies have explored the experience of decision‐making about implicit rationing of nursing care in an intensive care unit (ICU).To explore the process of ICU nurses' decisions and judgement based on the conceptual framework of implicit rationing of nursing care.A qualitative study was undertaken between June 2020 and September 2020. The data collection methods were participative observation and interview. Eighteen ICU nurses participated in interviews. A thematic analysis was performed for the data analysis.The following five themes emerged: assessment of the condition and nature of nursing and time taken; strategies for setting personal priorities; plan implementation under mitigation strategy; existing nursing in reality; evaluation of the implementation of implicit rationing care. Nurses choose different strategies during plan implementation.In the absence of explicit guidelines on rationing nursing care, nurses often rely on intuitive and situational decision‐making processes for setting priorities. Given the vulnerability of ICU patients and the absence of family caregivers, nurses bear a heightened ethical responsibility to provide care. Establishing a positive nursing culture is essential. It is both reasonable and effective to organize work by accurately quantifying workload, improving staffing levels and optimizing scheduling methods. These themes align with the decision‐making process outlined in the conceptual framework and offer fresh perspectives.Nurses have a greater responsibility to provide care in an ethical manner and to increase awareness of the importance of holistic nursing care for the patient, that is to raise awareness of the importance of care that is often missed. Nurses actively adopt strategies to reduce implicit rationing of nursing care, including teamwork, organized nursing, working overtime and ignoring quality. The findings highlight the importance of creating a positive nursing culture that encourages nurses to adopt positive strategies. [ABSTRACT FROM AUTHOR]

Research Purpose: This study aimed to develop a preliminary Nurses' Physical Environmental Stress Scale (NPESS) that explores the relationships between the physical environment in the intensive care unit (ICU) and work-related stress among ICU nurses. Background: Working within the healthcare field is stressful and comes with a high level of responsibility for nurses, especially ICU nurses. The ICU work environment is associated with risk factors such as excessive workload, increased expectations, and long working hours that can lead to burnout among nurses. There is some evidence that environmental design has the potential to prevent or mitigate work-related stress; however, an adequate assessment tool to identify physical environmental stressors or supports for moderating stress is lacking. Methods: To develop the preliminary environmental assessment tool, an exploratory sequential methodology was used. The approach consisted of three distinct phases, including (a) a qualitative content analysis of existing focus group data, (b) a qualitative content analysis of pertinent literature related to environmental assessment tools in a healthcare context, and (c) the development and refinement of the NPESS assessment tool. Tool refinement was based on interviews with ICU nurses. Results: The resulting NPESS tool was comprised of seven sections (sounds, lighting, smells, staff respite spaces, staff workspaces, patient rooms, and aesthetic qualities) containing a total of and 81 items that address factors that were identified as potential moderators of environmental stress in ICU settings. Conclusions: The resulting NPESS assessment tool provides a feasible approach for evaluating ICU settings to identify possible improvements to reduce stress among nurses. Future research will be conducted to assess the validity and reliability of the final tool by distributing it to a larger sample of ICU nurses. [ABSTRACT FROM AUTHOR]

Background: Nurses are the largest occupational group in the health field, with inestimable value in realizing universal health coverage, and nurses’ physical and mental health has become an ordinary global reality. Compared with explicit absence, nurses’ presenteeism has a more lasting impact and significant harm and loss. It has become an essential factor affecting nurses’ physical and mental health, declining quality of healthcare services, and elevated healthcare-related risks. There is a lack of research exploring whether occupational coping selfefficacy influences nurses’ presenteeism behavior, especially in less-developed regions of China. Objective: This study aimed to investigate the current status of ICU nurses’ occupational coping self-efficacy and presenteeism in public hospitals in western China and to explore the impact of ICU nurses’ occupational coping self-efficacy on presenteeism. Methods: A cross-sectional research design selected 722 ICU nurses in western China from January to February 2023 as survey respondents. A general information questionnaire, Occupational Coping Self-Efficacy Scale (OCSE-N), and Stanford Presenteeism Scale (SPS-6) were used. SPSS 21.0 software was used for statistical analysis. Pearson correlation analysis and multivariate hierarchical regression were used to explore the influence of ICU nurses’ occupational coping self-efficacy on presenteeism. Results: A total of 722 ICU nurses completed the questionnaire. The OCSE-N score of ICU nurses was (22.24  ±  6.15), and the SPS-6 score was (16.83  ±  4.24). The high presenteeism was 67.23%. Correlation analysis showed that in ICU nurses, OCSE-N total score was negatively correlated with SPS-6 total score (r  = −0.421, p  <  0.05), indicating that the higher the level of occupational coping self-efficacy, the lower the presenteeism. Multiple hierarchical regression analysis showed that occupational coping self-efficacy strongly predicted presenteeism, accounting for approximately 18.35% of the total variance. Conclusion: There is a correlation between ICU nurses’ occupational coping self-efficacy and presenteeism, and nurses’ occupational coping self-efficacy affects presenteeism differently. Managers should pay attention to nurses’ occupational coping self-efficacy to promote nurses’ presenteeism reduction. [ABSTRACT FROM AUTHOR]

BackgroundIntensive Care Unit (ICU) nurses frequently confront significant psychological challenges, including compassion fatigue, moral distress, and diminished moral resilience. These issues not only affect their well-being but also impact the quality of care provided to patients. The interplay of these factors is complex and not fully understood, particularly how compassion fatigue influences the relationship between moral resilience and moral distress.ObjectivesTo explore the complex interplay between compassion fatigue and moral distress among ICU nurses, and to elucidate how compassion fatigue influences the protective role of moral resilience against moral distress.Research designA cross-sectional study was conducted using a nationwide random sample of ICU nurses in China. Latent profile analysis identified subgroups based on levels of compassion fatigue. Moderation analysis examined whether compassion fatigue moderated the association between moral resilience and moral distress.ResultsAmong 612 ICU nurses, latent profile analysis revealed three distinct groups with high, moderate, and low levels of compassion fatigue. Being female was protective against high compassion fatigue, while ages 30–49 yrs., lack of bachelor’s degree, and dissatisfaction with salary increased compassion fatigue risk. Moderation analysis showed compassion fatigue significantly moderated the relationship between moral resilience and moral distress. Nurses with higher compassion fatigue exhibited a stronger association between low moral resilience and high moral distress.ConclusionCompassion fatigue and moral distress are interconnected phenomena among ICU nurses. Demographic factors like gender, age, education, and income satisfaction impact compassion fatigue risk. High compassion fatigue impairs moral resilience, exacerbating moral distress. Comprehensive interventions targeting both compassion fatigue and moral resilience, tailored to nurses’ demographic profiles, are needed to support this workforce.

Abstract Background Mental health problems are critical and common in medical staff working in Intensive Care Units (ICU) even at the late stage of COVID-19, particularly for nurses. There is little research to explore the inner relationships between common syndromes, such as depression and burnout. Network analysis (NA) was a novel approach to quantified the correlations between mental variables from the perspective of mathematics. This study was to investigate the interactions between burnout and depression symptoms through NA among ICU nurses. Method A cross-sectional study with a total of 616 Chinese nurses in ICU were carried out by convenience sampling from December 19, 2022 to January19, 2023 via online survey. Burnout symptoms were measured by Maslach Burnout Inventory-General Survey (MBI-GS) (Chinese version), and depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9). NA was applied to build interactions between burnout and depression symptoms. We identified central and bridge symptoms by R package qgraph in the network model. R package bootnet was used to examined the stability of network structure. Results The prevalence of burnout and depressive symptoms were 48.2% and 64.1%, respectively. Within depression-burnout network, PHQ4(Fatigue)-MBI2(Used up) and PHQ4(Fatigue)-MBI5(Breakdown) showed stronger associations. MBI2(Used up) had the strongest expected influence central symptoms, followed by MBI4(Stressed) and MBI7 (Less enthusiastic). For bridge symptoms. PHQ4(Fatigue), MBI5(Breakdown) and MBI2(Used up) weighed highest. Both correlation stability coefficients of central and bridge symptoms in the network structure were 0.68, showing a high excellent level of stability. Conclusion The symptom of PHQ4(Fatigue) was the bridge to connect the emotion exhaustion and depression. Targeting this symptom will be effective to detect mental disorders and relieve mental syndromes of ICU nurses at the late stage of COVID-19 pandemic.

Aim: The purpose of this study was to translate and validate the ethical awareness scale for nurses working in Iranian intensive care units. Design: A cross‐sectional psychometric study. Methods: The study was conducted in Oct 2020 to Sep 2021, involving the participation of 200 ICU nurses. The process included translation of the original version of the ethical awareness scale into Persian, following the World Health Organization guideline, for use in Iran. The translated version was then evaluated for reliability, face validity, content validity ratio, content validity index, convergent validity and construct validity. Results: The initial reliability of the scale was established. In qualitative face validity, a few items changed slightly and all items were retained in the quantitative face validity assessment. Based on Lawshe's values, three items were removed from the scale during CVR assessment. All items exhibited acceptable CVI scores. Convergent validity was established with an average variance extracted greater than 0.5. The fit indices, such as CFI = 0.94, GFI = 0.94, RMSEA = 0.01, AGFI = 0.97 and CMIN/DF = 2.99, supported the structural model of the scale. The fit indices for the structural model of the scale were all within acceptable ranges, suggesting that the model fit the data well. Its reliability was confirmed through the test–retest method, with Cronbach's alpha = 0.84 and McDonald's omega coefficient >0.8. Conclusion: The findings of this study indicate the Persian version of the ethical awareness scale for Iran (EAS‐IR) is comparable in content to the original version, demonstrating its validity and reliability for assessing ethical awareness among Iranian nurses in ICUs. The scale can be a valuable resource for measuring ethical awareness in the Iranian healthcare context and may contribute to improving ethical practices and decision‐making in ICU settings. Patient or Public Contribution: In this project, no patient or public contribution was necessary, because it was not applied to our work. [ABSTRACT FROM AUTHOR]

Background: Mental health problems are critical and common in medical staff working in Intensive Care Units (ICU) even at the late stage of COVID-19, particularly for nurses. There is little research to explore the inner relationships between common syndromes, such as depression and burnout. Network analysis (NA) was a novel approach to quantified the correlations between mental variables from the perspective of mathematics. This study was to investigate the interactions between burnout and depression symptoms through NA among ICU nurses. Method: A cross-sectional study with a total of 616 Chinese nurses in ICU were carried out by convenience sampling from December 19, 2022 to January19, 2023 via online survey. Burnout symptoms were measured by Maslach Burnout Inventory-General Survey (MBI-GS) (Chinese version), and depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9). NA was applied to build interactions between burnout and depression symptoms. We identified central and bridge symptoms by R package qgraph in the network model. R package bootnet was used to examined the stability of network structure. Results: The prevalence of burnout and depressive symptoms were 48.2% and 64.1%, respectively. Within depression-burnout network, PHQ4(Fatigue)-MBI2(Used up) and PHQ4(Fatigue)-MBI5(Breakdown) showed stronger associations. MBI2(Used up) had the strongest expected influence central symptoms, followed by MBI4(Stressed) and MBI7 (Less enthusiastic). For bridge symptoms. PHQ4(Fatigue), MBI5(Breakdown) and MBI2(Used up) weighed highest. Both correlation stability coefficients of central and bridge symptoms in the network structure were 0.68, showing a high excellent level of stability. Conclusion: The symptom of PHQ4(Fatigue) was the bridge to connect the emotion exhaustion and depression. Targeting this symptom will be effective to detect mental disorders and relieve mental syndromes of ICU nurses at the late stage of COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective To explore the status quo of ICU nurses' knowledge, attitude and practice of physical restraints use in general hospitals in Guangxi, and to provide a theoretical basis for clinical training and quality control. Methods A simple random sampling method was used to select ICU nurses from Grade III and Grade II hospitals in Guangxi, including 2 Grade III hospitals and 3 Grade II hospitals, with a total of 201 ICU nurses. The knowledge, attitude and practice status of nurses on physical restraints use were investigated by using a physical restraints knowledge, attitude and behavior questionnaire, and the influencing factors were analyzed. Results The total score and scores of knowledge dimension, attitude dimension, and behavior dimension were (135. 08±18. 07), (68. 70±9. 49), (20. 73±4. 82), (45. 66±8. 95), respectively, indicating a low-to-medium level awareness of physical restraints among ICU nurses in general hospitals in Guangxi. There were statistically significant differences in the level of knowledge, attitude and practice of ICU nurses with different hospital levels, ICU working years, and ICU specialist qualifications (P＜0. 05). Conclusion ICU nurses in Guangxi have a more positive attitude towards physical restraint, and their knowledge and behavior level need to be strengthened urgently. ICU managers should improve the physical restraint training mechanism, types and teams of ICU nurses, strengthen relevant knowledge and skills training according to the different characteristics of nurses, build positive attitudes and emotions through enhanced knowledge, promote behavioral changes, and improve the development of physical restraint specialization. (目的 探讨广西壮族自治区ICU护士身体约束知信行现状, 为临床开展相关的培训及质控提供理论依据。方法 采用简单随机抽样法, 选取广西壮族自治区三级甲等、二级甲等共5所医院的ICU护士共201名作为研究对象, 采用“ICU护士实施身体约束知信行评估量表”调查护士对患者实施身体约束的知识、态度和行为现状, 并分析影响因素。结果 广西壮族自治区ICU护士身体约束知信行总分、知识维度、态度维度、行为维度得分分别为(135. 08±18. 07)分、(68. 70±4. 82)分、(45. 66±8. 95)分, 整体上为中等偏低水平。不同医院等级、ICU工作年限、有无ICU专科资质的ICU护士身体约束知信行水平差异有统计学意义(P＜0. 05)。结论 广西壮族自治区ICU护士身体约束态度较为积极, 知识及行为水平亟待加强。ICU管理者应健全ICU护士身体约束培训机制、种类和队伍, 根据护士的不同特征强化相关知识与技能培训, 通过增强知识建立积极态度和情感, 促使行为改变, 促进身体约束专科化发展。)

Purpose: The aim of the study is to assess the experiences, barriers, and expectations regarding current patient monitoring systems among intensive care unit nurses at one university hospital. Methods: A qualitative exploratory study approach was adopted to test the research questions. Results: Intensive care unit personnel placed a high value on practical criteria such as user friendliness and visualization while assessing the present monitoring system. Poor alarm handling was recognized as possible patient safety hazards. The necessity of high accessibility was highlighted once again for a prospective system; wireless, noninvasive, and interoperability of monitoring devices were requested; and smart phones for distant patient monitoring and alert management improvement were required. Conclusion: Core comments from ICU personnel are included in this qualitative research on patient monitoring. All national healthcare involved parties must focus more on user-derived insights to ensure a speedy and effective introduction of digital health technologies in the ICU. The findings from the alarm control or mobile device studies might be utilized to train ICU personnel to use new technology, minimize alarm fatigue, increase medical device accessibility, and develop interoperability standards in critical care practice. [ABSTRACT FROM AUTHOR]

Abstract Aim The purpose of this study was to translate and validate the ethical awareness scale for nurses working in Iranian intensive care units. Design A cross‐sectional psychometric study. Methods The study was conducted in Oct 2020 to Sep 2021, involving the participation of 200 ICU nurses. The process included translation of the original version of the ethical awareness scale into Persian, following the World Health Organization guideline, for use in Iran. The translated version was then evaluated for reliability, face validity, content validity ratio, content validity index, convergent validity and construct validity. Results The initial reliability of the scale was established. In qualitative face validity, a few items changed slightly and all items were retained in the quantitative face validity assessment. Based on Lawshe's values, three items were removed from the scale during CVR assessment. All items exhibited acceptable CVI scores. Convergent validity was established with an average variance extracted greater than 0.5. The fit indices, such as CFI = 0.94, GFI = 0.94, RMSEA = 0.01, AGFI = 0.97 and CMIN/DF = 2.99, supported the structural model of the scale. The fit indices for the structural model of the scale were all within acceptable ranges, suggesting that the model fit the data well. Its reliability was confirmed through the test–retest method, with Cronbach's alpha = 0.84 and McDonald's omega coefficient >0.8. Conclusion The findings of this study indicate the Persian version of the ethical awareness scale for Iran (EAS‐IR) is comparable in content to the original version, demonstrating its validity and reliability for assessing ethical awareness among Iranian nurses in ICUs. The scale can be a valuable resource for measuring ethical awareness in the Iranian healthcare context and may contribute to improving ethical practices and decision‐making in ICU settings. Patient or Public Contribution In this project, no patient or public contribution was necessary, because it was not applied to our work.

To provide insight into the effects of the coronavirus disease (COVID-19) pandemic on the physical and psychological health of critical care nurses in adult units.

Abstract Aim To explore the psychological experience and coping methods of nurses exposed to workplace violence and to propose measures to prevent and control workplace violence and provide psychological assistance for health workers. Design We adopted a phenomenological qualitative design. Twelve nurses in intensive care units assisting in Wuhan who experienced workplace violence during the COVID‐19 outbreak were selected using purposeful sampling. Data were collected through semi‐structured individual telephone interviews and analysed using Colaizzi's 7‐step method. Results Analysis revealed three main categories including “Full of negative emotions”, “Facing challenges and danger” and “Coping methods”. The subjects experienced stress, fear, anger, helplessness, disappointment, sympathy and job burnout after suffering from workplace violence. The coping methods for workplace violence mainly included seeking support and help, escaping, making explanations, exercising tolerance and confronting the issue. Patient or Public Contribution No patient or public contribution since nurses' experiences were explored.

Abstract Aim To determine the associated factors of professional identity among intensive care unit (ICU) nurses during the COVID‐19 pandemic in China. Design Multicentre cross‐sectional study. Methods This study invited 348 ICU nurses in five hospitals in China from May to July 2020. Online self‐report questionnaires were adopted to collect their demographic and occupational characteristics, perceived professional benefits and professional identity. Based on univariate and multiple linear regression analysis, a path analysis was performed to determine the associated factors' effects on professional identity. Results The mean score of professional identity was 102.38 ± 16.46. Perceived professional benefits, doctor recognition level and family support level were associated with ICU nurses' professional identity. The path analysis revealed that perceived professional benefits and doctor recognition level had direct effects on professional identity. In addition, doctor recognition level and family support level had indirect effects on professional identity through the mediation of perceived professional benefits.

PurposeThe aim of the study is to assess the experiences, barriers, and expectations regarding current patient monitoring systems among intensive care unit nurses at one university hospital.MethodsA qualitative exploratory study approach was adopted to test the research questions.ResultsIntensive care unit personnel placed a high value on practical criteria such as user friendliness and visualization while assessing the present monitoring system. Poor alarm handling was recognized as possible patient safety hazards. The necessity of high accessibility was highlighted once again for a prospective system; wireless, noninvasive, and interoperability of monitoring devices were requested; and smart phones for distant patient monitoring and alert management improvement were required.ConclusionCore comments from ICU personnel are included in this qualitative research on patient monitoring. All national healthcare involved parties must focus more on user-derived insights to ensure a speedy and effective introduction of digital health technologies in the ICU. The findings from the alarm control or mobile device studies might be utilized to train ICU personnel to use new technology, minimize alarm fatigue, increase medical device accessibility, and develop interoperability standards in critical care practice.

Background: A critically ill patient is someone who has a chance of recovery, if properly managed, but is usually in a life-threatening condition, associated with a high mortality rate, with significant financial impact on households, and associated with the cost of medical care. Purpose: To explore the lived experiences of nurses caring for persons with critical illnesses sustained with healthcare technologies. Design and Methods: A hermeneutic phenomenological design was utilized. Data were collected through in-depth individual interviews with sample size of ten participants, observations, and field notes. Data were analyzed using Paul Ricoeur's Theory of Interpretation and Nvivo software for data management. Results: The results revealed that the Intensive Care Unit (ICU) is a complex unit, and Nurses are occupied with fear and worries associated with having to operate various health gadgets. They also experienced challenges in how to balance their attention between technology-based care and seeing patients as human beings. Conclusion: Based on the outcomes of this study, it was suggested that ICU nurses require continual retraining in operating various health technologies without fear or worry. They must also improve their ability to be inclusive in their profession; balancing their focus between technology-based care and handling patients as human beings. The implication of this on practice is that ICU is a difficult learning environment for new nurses because of the numerous skills that must be learned quickly. Developing supportive social relationships was crucial for new ICU nurses to learn and adjust to this challenging clinical environment.

The coronavirus disease (COVID-19) pandemic had a global impact on health systems and health professionals. Nurses, particularly those working in intensive care units (ICUs), held a central critical role in the care of COVID-19 patients, facing numerous challenges in the delivery of care, leading to significant psychological and mental health issues. This article reports on findings from a qualitative narrative review of the literature related to psychological ill-being and mental health of ICU nurses' during the pandemic. Four key themes emerged: (1) isolation (2) workload (3) clinical preparedness and lack of protocols and (4) fear. [ABSTRACT FROM AUTHOR]

Background: Presenteeism is a significant global public health problem, and nurses are a high-prevalence group of presenteeism, affecting not only nurses' physical and mental health, work efficiency, and quality of work but even poses a serious threat to patient safety. Objective: The categorization of presenteeism among ICU nurses is unclear. Our research aims to explore the subtypes of presenteeism among ICU nurses based on latent profile analysis, analyze the influencing factors of different subtypes, and provide a reference basis for developing targeted interventions to reduce the presenteeism rate. Methods: From January to February 2023, 509 ICU nurses in Sichuan Province, China, were selected as respondents and surveyed using the general information questionnaire, the presenteeism scale, and the perceived social support scale. Potential categories of presenteeism among ICU nurses were explored using potential profile analysis, and factors influencing the potential types of presenteeism among ICU nurses were investigated using the chi-square test and multivariate logistic regression analysis. Results: The best model was suggested to consist of three profiles: low presenteeism-normal coping group (18.3%), moderate presenteeism group (47.9%), and high presenteeism-work limitation group (33.8%). Multiple logistic regression results showed that secondary hospitals (OR = 0.116, p = 0.015), good physical health (OR = 0.084, p = 0.023), general physical health (OR = 0.016, p = 0.037), ICU human resource allocation = 1:2.5 to 3 (OR = 0.315, p = 0.007), and higher social support scores (OR = 0.975, p = 0.047) were more likely to be grouped into low presenteeism-normal coping group; married with no children (OR = 24.554, p = 0.005) were more likely to be grouped into moderate presenteeism group; and having experienced workplace violence in the past year (OR = 1.182, p = 0.049) were more likely to be grouped into high presenteeismwork limitation group. Conclusion: There is group heterogeneity in the presenteeism of ICU nurses, and nursing managers should develop targeted interventions to reduce the presenteeism rate of ICU nurses according to the characteristics and influencing factors of each type of presenteeism of ICU nurses. [ABSTRACT FROM AUTHOR]

Aim: To explore the psychological experience and coping methods of nurses exposed to workplace violence and to propose measures to prevent and control workplace violence and provide psychological assistance for health workers. Design: We adopted a phenomenological qualitative design. Twelve nurses in intensive care units assisting in Wuhan who experienced workplace violence during the COVID‐19 outbreak were selected using purposeful sampling. Data were collected through semi‐structured individual telephone interviews and analysed using Colaizzi's 7‐step method. Results: Analysis revealed three main categories including "Full of negative emotions", "Facing challenges and danger" and "Coping methods". The subjects experienced stress, fear, anger, helplessness, disappointment, sympathy and job burnout after suffering from workplace violence. The coping methods for workplace violence mainly included seeking support and help, escaping, making explanations, exercising tolerance and confronting the issue. Patient or Public Contribution: No patient or public contribution since nurses' experiences were explored. [ABSTRACT FROM AUTHOR]

Tao Sun,1,&ast; Xian-Hong Huang,1,&ast; Shu-E Zhang,2,&ast; Hong-Yan Yin,3 Qing-Lin Li,2 Lei Gao,2 Ye Li,2 Li Li,4 Bing Cao,5 Jin-Hong Yang,6 Bei Liu7 1Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of China; 2Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China; 3Department of Humanities and Social Sciences, Harbin Medical University (Daqing), Daqing, 163319, People’s Republic of China; 4Department of Administration, School of Law, Zhejiang University City College, Hangzhou, 310015, People’s Republic of China; 5Department of Oncology, Weifang People’s Hospital, Weifang, 261000, People’s Republic of China; 6Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, People’s Republic of China; 7Global Center for Infectious Disease and Policy Research, Peking University, Beijing, 100191, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bei Liu, Global Center for Infectious Disease and Policy Research, Peking University, Beijing, 100191, People’s Republic of China, Email 18827380717@163.comAim: To clarify the mediating role of burnout and the moderating role of turnover intention in the association between fatigue and job satisfaction among Chinese nurses in intensive care units (ICU) during the COVID-19 pandemic.Methods: A cross-sectional survey of fifteen provinces in China was conducted, using an online questionnaire, from December 2020 to January 2021, during the COVID-19 pandemic. A total of 374 ICU nurses (effective response rate: 71.37%) provided sufficient responses. Sociodemographic factors, job demographic factors, fatigue, burnout, job satisfaction, and turnover intention were assessed using questionnaires. General linear modeling (GLM), hierarchical linear regression (HLR) analysis, and generalized additive modeling (GAM) were performed to examine all the considered research hypotheses.Results: Fatigue was found to be negatively and significantly associated with job satisfaction. Moreover, burnout played a partial mediating role and turnover intention played a moderating role in the relationship between fatigue and job satisfaction.Conclusion: Over time, a state of physical and mental exhaustion and work weariness among Chinese ICU nurses potentially results in job burnout and consequently promotes the level of job dissatisfaction. The results also found that turnover intention played a moderating role in the relationship between burnout and job satisfaction. Specific policies could be considered to eliminate nurses’ fatigue and negative attitudes during times of public health emergencies.Keywords: ICU nurses, fatigue, burnout, job satisfaction, turnover intention, COVID-19 pandemic

Aim: To determine the associated factors of professional identity among intensive care unit (ICU) nurses during the COVID‐19 pandemic in China. Design: Multicentre cross‐sectional study. Methods: This study invited 348 ICU nurses in five hospitals in China from May to July 2020. Online self‐report questionnaires were adopted to collect their demographic and occupational characteristics, perceived professional benefits and professional identity. Based on univariate and multiple linear regression analysis, a path analysis was performed to determine the associated factors' effects on professional identity. Results: The mean score of professional identity was 102.38 ± 16.46. Perceived professional benefits, doctor recognition level and family support level were associated with ICU nurses' professional identity. The path analysis revealed that perceived professional benefits and doctor recognition level had direct effects on professional identity. In addition, doctor recognition level and family support level had indirect effects on professional identity through the mediation of perceived professional benefits. [ABSTRACT FROM AUTHOR]

Abstract Background Intensive care unit (ICU) nurses are at high risk of burnout and warranting attention. Existing literature found that work frustration was related to burnout, whilst perceived organization support influenced the association of work frustration with burnout. The purpose of this study was to investigate the relationship of work frustration and burnout among ICU nurses, and to examine the moderating effect of perceived organization support in their relationship. Methods The cross-sectional study was conducted with a convenience sample of 479 ICU nurses from several 3 tertiary hospitals during December 2021 to May 2022. The Maslach Burnout Inventory-Human services survey (MBI-HSS), National Aeronautics and Space Administration Task Load Index (NASA-TLX) and perceived organization support Scale (POSS) were used to collect data. The PROCESS macro was performed to test the moderation effect of perceived organization support. Results The total score of burnouts was (55.79 ± 17.20), the total score of work frustration was (7.44 ± 1.86). Burnout was positively correlated with work frustration (r = 0.301, P

Abstract Introduction Intensive care unit patients and families experience significant stress. It creates frustrations, nervousness, irritability, social isolation for patients, anxiety, and depression for families. An open visitation policy with no time or duration limits may assist in reducing these negative experiences. However, most Jordanian and regional hospitals within the Middle-East and Northern Africa (MENA) have not implemented this strategy. Purpose To evaluate nurse managers' and nurses' perspectives on the effects of an open visitation policy at intensive care units (ICUs) on patients, families, and nurses' care. Method A cross-sectional, descriptive, and comparative survey design was used. Results A total of 234 nurses participated in the study; 59.4% were males, and 40.6% were females. The mean of their age was 28.6 years, with a mean of 4.1 years of experience. Nurses generally had negative perceptions and attitudes toward the open visitation policy and its consequences on the patient, family, and nursing care. Conclusions ICU managers and staff nurses did not favor implementing an open visitation in their units despite its known benefits, international recommendations, and relevance and compatibility with the local religious and cultural context. A serious discussion regarding this hesitation from the side of the healthcare professionals should be started to find a suitable solutions that consider the benefits of the open visitation policy and the challenges that prevent its implementation in the Jordanian and Arabic cultures.

Background: Intensive care unit (ICU) nurses are at high risk of burnout and warranting attention. Existing literature found that work frustration was related to burnout, whilst perceived organization support influenced the association of work frustration with burnout. The purpose of this study was to investigate the relationship of work frustration and burnout among ICU nurses, and to examine the moderating effect of perceived organization support in their relationship. Methods: The cross-sectional study was conducted with a convenience sample of 479 ICU nurses from several 3 tertiary hospitals during December 2021 to May 2022. The Maslach Burnout Inventory-Human services survey (MBI-HSS), National Aeronautics and Space Administration Task Load Index (NASA-TLX) and perceived organization support Scale (POSS) were used to collect data. The PROCESS macro was performed to test the moderation effect of perceived organization support. Results: The total score of burnouts was (55.79 ± 17.20), the total score of work frustration was (7.44 ± 1.86). Burnout was positively correlated with work frustration (r = 0.301, P < 0.001) and negatively correlated with perceived organizational support (r = -0.430, P < 0.001). The moderation model analysis showed that perceived organizational support could moderate the relationship between work frustration and burnout (β = -0.111, ΔR2 = 0.011, P = 0.007). Conclusions: The findings highlight the moderating role of perceived organizational support in the relationship between work frustration and burnout. Hence, interventions to reduce burnout among ICU nurses should consider targeting organizational support and work frustration. [ABSTRACT FROM AUTHOR]

Introduction: Intensive care unit patients and families experience significant stress. It creates frustrations, nervousness, irritability, social isolation for patients, anxiety, and depression for families. An open visitation policy with no time or duration limits may assist in reducing these negative experiences. However, most Jordanian and regional hospitals within the Middle-East and Northern Africa (MENA) have not implemented this strategy. Purpose: To evaluate nurse managers' and nurses' perspectives on the effects of an open visitation policy at intensive care units (ICUs) on patients, families, and nurses' care. Method: A cross-sectional, descriptive, and comparative survey design was used. Results: A total of 234 nurses participated in the study; 59.4% were males, and 40.6% were females. The mean of their age was 28.6 years, with a mean of 4.1 years of experience. Nurses generally had negative perceptions and attitudes toward the open visitation policy and its consequences on the patient, family, and nursing care. Conclusions: ICU managers and staff nurses did not favor implementing an open visitation in their units despite its known benefits, international recommendations, and relevance and compatibility with the local religious and cultural context. A serious discussion regarding this hesitation from the side of the healthcare professionals should be started to find a suitable solutions that consider the benefits of the open visitation policy and the challenges that prevent its implementation in the Jordanian and Arabic cultures. [ABSTRACT FROM AUTHOR]

Background: Intensive Care Unit (ICU) nurses frequently confront significant psychological challenges, including compassion fatigue, moral distress, and diminished moral resilience. These issues not only affect their well-being but also impact the quality of care provided to patients. The interplay of these factors is complex and not fully understood, particularly how compassion fatigue influences the relationship between moral resilience and moral distress., Objectives: To explore the complex interplay between compassion fatigue and moral distress among ICU nurses, and to elucidate how compassion fatigue influences the protective role of moral resilience against moral distress., Research Design: A cross-sectional study was conducted using a nationwide random sample of ICU nurses in China. Latent profile analysis identified subgroups based on levels of compassion fatigue. Moderation analysis examined whether compassion fatigue moderated the association between moral resilience and moral distress., Results: Among 612 ICU nurses, latent profile analysis revealed three distinct groups with high, moderate, and low levels of compassion fatigue. Being female was protective against high compassion fatigue, while ages 30-49 yrs., lack of bachelor's degree, and dissatisfaction with salary increased compassion fatigue risk. Moderation analysis showed compassion fatigue significantly moderated the relationship between moral resilience and moral distress. Nurses with higher compassion fatigue exhibited a stronger association between low moral resilience and high moral distress., Conclusion: Compassion fatigue and moral distress are interconnected phenomena among ICU nurses. Demographic factors like gender, age, education, and income satisfaction impact compassion fatigue risk. High compassion fatigue impairs moral resilience, exacerbating moral distress. Comprehensive interventions targeting both compassion fatigue and moral resilience, tailored to nurses' demographic profiles, are needed to support this workforce., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yin, Zhao, Zhang and Xia.)

Objective To investigate the prevalence rate of occupational musculoskeletal injury (OMSI) of the ICU nurses in Dalian class A tertiary hospitals,and analyze its related factors,so as to improve the awareness of OMSI and self-protection consciousness,improve their quality of life,and provide the basis for nursing managers to formulate the countermeasures to prevent and control the OMSI of ICU nurses.Methods From December 2017 to September 2018,a total of 667 ICU nurses who had worked in the ICU of class A tertiary hospitals in Dalian for more than one year were surveyed using a self-designed nurses' general status questionnaire and the Nordic Occupational Musculoskeletal Symptom Self-rating Scale.Results The prevalence rate of OMSI in the lower back (waist) of clinical nurses who had worked in the ICU for more than one year in class A tertiary hospitals in Dalian was the highest (annual incidence rate of 67.3%),followed by neck (annual incidence rate of 45.7%),shoulder (annual incidence rate of 40.5%).The maximum weight of the object lifted each time (OR=1.284,P =0.033),the average daily working time (OR=1.790,P =0.033), whether the job tired (OR=1.507,P =0.037) were the independent influencing factors affecting the occurrence of the neck OMSI in ICU nurses.The daily working hours with head bowed (OR=1.537,P =0.002) and average daily working hours (OR=1.563,P =0.043) were the independent risk factors affect the occurrence of the neck OMSI in ICU nurses.The daily working time with the head bowed (OR=1.313,P = 0.024),whether you felt nervous at work (OR=1.328,P =0.046) were the independent influencing factors affect the occurrence of the shoulder OMSI in ICU nurses.Conclusion It is recommended that the medical institutions formulate the standardized occupational protection measures.The nursing managers can focus on the pathogenic factors of the OMSI among ICU nurses of in Dalian class A tertiary hospitals,and strengthen ICU nurses' awareness of OMSI and self-protection consciousness,so as to reduce the incidence of the OMSI among ICU nurses and improve their job satisfaction and quality of life,and stabilize the ICU nursing team. [ABSTRACT FROM AUTHOR]

As an exploitable positive psychological state that individual performs during growth and development processes, psychological capital (PsyCap) was deemed as an essential factor in occupational health. This study aims to explore mediating effects of PsyCap on the relationship between job stress and coping style among ICU nurses. A cross-sectional sample of 288 nurses was recruited. A high-level of occupational stress (2.32 ± 0.69) and PsyCap (4.62 ± 0.93) were found among participants who mainly used a positive coping style (2.04 ± 0.59). PsyCap was significantly negatively correlated with job stress (β = −0.250; p <.01) and positively with coping style (β = 0.416; p <.01). Structural equation model analysis revealed that job stress negatively influenced PsyCap, while PsyCap positively influenced coping style. Results verified the mediating role of PsyCap and suggested that an increase in PsyCap contributes to better control of job stress and the improvement of one's coping style. [ABSTRACT FROM AUTHOR]

This evidence-based research project provides an appraisal of current research on how an alarm management program impacts alarm fatigue among registered nurses (RNs) in both intensive care units (ICUs) and telemetry units. Alarm fatigue is a major problem recognized by both the American Association of Critical-Care Nurses (AACN) and the Joint Commission. RNs are the primary caretakers of critically ill patients in ICUs and telemetry units and therefore are at the greatest risk for alarm fatigue. The researchers performed an evidence synthesis to determine the impact of an alarm management program on alarm fatigue among ICU and telemetry RNs. A literature search was conducted using scientific databases such as PubMed, CINAHL, Trip, Cochrane Review, and Google Scholar. Our search strategy included the following terms: adult registered nurse, inpatient registered nurse, ICU registered nurses, RNs, Nurse Practitioners, alarm fatigue, alarm management strategy, education, cardiac monitor alarm, alarm strategies, alarm bundle, telemetry alarm, and cardiac monitor. Any studies involving the pediatric population, pulse oximeter alarms, and ventilator alarms were excluded. Due to the lack of available randomized control trials and cohort studies, the authors included two quality improvement (QI) projects. Finally, six studies were taken into consideration for review. The authors appraised each of the six articles using the Critical Appraisal Skills Programme Checklist (CASP) Tool. This tool allowed the authors to synthesize information based on the outcomes and determine the level of the evidence of each article in order to make evidence-based practice recommendations on implementing alarm management programs. Conclusion: Despite extensive literature highlighting the astronomical prevalence of alarm fatigue in RNs, there was a lack of current high-quality data related to implementing alarm management programs. Therefore, more research is needed to support the utilization of alarm management programs in ICUs and telemetry units to improve alarm fatigue among RNs. [ABSTRACT FROM AUTHOR]

Background: professional quality work-life, as one of the most important issues in the nursing profession, can negatively affect the healthcare system. Purpose: To examine the professional quality work life. Method: A descriptive cross-sectional study a non-probability sampling method used and total sample collected was (126) of ICU nurses. Results: Burnout, Secondary Traumatic Stress, and, Compassion Satisfaction among intensive care units nurses were moderate. Conclusion & Recommendation: Nurses in ICUs suffered from moderate Burnout and Secondary Traumatic Stress, and the result can be negative effects on the quality of care. Although nurses' Compassion Satisfaction, it is still an important issue that nurses may face in intensive care units. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine practice and confidence in electrocardiogram (ECG) interpretation among intensive care unit (ICU) nurses in Fujian Province, China, and identify predictors of ECG interpretation practice., Research Methodology/design: A quantitative cross-sectional study was conducted between October 2021 and December 2021 among 357 respondents., Setting: Conducted online at twenty-one hospitals in all nine cities of Fujian Province., Main Outcome Measures: Purposive and convenient sampling techniques were employed in selecting hospitals and respondents, respectively. A validated and pre-tested Chinese version of the questionnaire was used in data collection. We conducted binary logistic regression to identify the predictors of ICU nurses' ECG interpretation practice, and linear regression to analyze the relationship between ECG interpretation practice and confidence. We considered statistically significant a p-value < 0.05., Results: The practice mean score of the respondents was 5.54 (SD = 2.26) out of 10 points, and only 2.2 % of nurses correctly interpreted all the patient ECG strips. Few ICU nurses (25.5 %) had good ECG interpretation practice, with a confidence mean score of 2.02 (SD = 0.99) out of 4 points in their overall ability to interpret patient ECG strips. Currently working unit in comparison to cardiac ICU (emergency ICU: AOR = 5.71, 95 % CI: 1.84-17.75); previous ECG training (AOR = 2.02, 95 % CI: 1.10-3.70); source of ECG training (university/school) (AOR = 2.02, 95 % CI: 1.12-3.65); and ECG knowledge (AOR = 16.18, 95 % CI: 7.43-35.25) were significantly associated with the ECG interpretation practice., Conclusions: ICU nurses' ECG interpretation practice in the current study was relatively poor. An ECG education program is recommended to impart ICU nurses with basic ECG knowledge for enhancing good ECG interpretation practice and confidence in nursing care provision., Implications for Clinical Practice: Good ECG interpretation skills are paramount among ICU nurses for better patient outcomes. ECG knowledge among ICU nurses is an important predictor of effective ECG monitoring for cardiac arrhythmias. Therefore, frequent, continuouszgood practice and boost confidence in the provision of quality nursing care., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The coronavirus (COVID-19) pandemic presented unprecedented challenges to healthcare systems worldwide, with intensive care unit (ICU) nurses at the forefront of patient care. To date, there is limited evidence into ICU nurses'experiences of the pandemic in Kuwait., Research Question/aims/objectives: To elucidate the challenges faced by ICU nurses in Kuwait during the pandemic, by considering two research questions: "What contributed to intensified pressure for the ICU nurses?" and "How were the nurses affected?"., Research Design: This was a qualitative study which utilised semi-structured interviews. Interviews were conducted between January 2021 and June 2022 with ICU nurses who worked during the COVID-19 pandemic. The data were analysed using Charmaz's grounded theory methodology., Participants and Research Context: 25 nurses from three ICUs in Kuwait., Ethical Considerations: The study was approved by the University Ethics Committee and by the Ministry of Health in Kuwait., Findings/results: The analysis identified two themes (the factors contributing to intensified pressure in the ICU, and the impact on the nurses) and seven sub-themes. The pressure in the ICU intensified due to the rise in the number of patients, staff shortages, and the requirement to adhere to unrealistic new procedures for infection control. Restricted and cancelled leave, as well as impaired autonomy at work, impeded the nurses' ability to recover from stress. The heightened stress also contributed to a worsening in interpersonal relationships between the nurses and their colleagues. The nurses' care was compromised by these challenges, leading to moral distress and a range of mental health symptoms (e.g., stress, anxiety, emotional exhaustion)., Conclusions: The study accords with other research conducted during the pandemic in revealing a significant mental health toll among healthcare workers during the pandemic. The stressors were similar to those which have been reported in other studies, although there were also context-specific effects relating to the environment of the ICU and the Kuwaiti context., Competing Interests: There are no conflicts of interest., (© 2024 The Authors. Published by Elsevier Ltd.)

Purpose: Understand the effects of the COVID-19 pandemic on depression in intensive care unit (ICU) nurses, analyze high-risk factors, and propose appropriate measures to maintain physical and mental health.Methods: A total of 78 nurses in ICU of Beijing Ditan Hospital affiliated with Capital Medical University (Beijing area, COVID-19 patient designated hospital) were investigated with self-rating depression scale (SDS). The Cronbach'sαcoefficient was 0.874, the content validity was 0.853, and the internal consistency was good. General information for the questionnaire: gender, marriage, education, age, title, length of service, ICU years of service, COVID-19 pandemic training, concerns about the COVID-19 pandemic, and current health status.Results: According to the SDS scale score, ICU nurses had a total depression score of 51.36 ± 11.667, and the prevalence rate of depression was 44.9% (35/78). Multi-line regression analysis shows that stress perception, work experience in critical diseases, education and other total scores are risk factors for the occurrence of depression.Conclusion: Work experience in critical illness (β = 9.930, P < 0.001) had a positive predictive effect on the total score of depression, while stress perception (β = −0.884, P < 0.001) and education (β = −6.061, P < 0.001) had a negative predictive effect on the total score of depression, and explained 52.7% variation. These findings point to the need for interventions to address psychological distress and provide the necessary support.

During the COVID-19 pandemic ICU nurses endure high levels of stress. VR relaxation (VRelax, containing 360° immersive environments) provides an easy-to-use and effective means to induce positive affect and reduce perceived stress. We investigated feasibility and immediate effect on perceived stress of VRelax use by ICU nurses during work shifts. ICU nurses working with COVID-19 patients in an academic hospital could use VRelax as a 10-min break during their shift. Primary outcome was the difference between perceived stress immediately before and after VRelax use measured by a single-question VAS-stress scale. Statistically significant difference of the mean VAS-stress before and after use was determined using the paired t student test. A socio-demographic questionnaire, a questionnaire on perceived stress and stress resilience and VRelax user experiences were sent by email. Eighty-six (26%) nurses used VRelax at least once; 77% (N=66) of these filled out the VAS-stress scale before and after use of VRelax. Mean perceived stress lowered with 39.9% after use of VRelax (mean difference=14.0, SD=13.3, p

Background: Even though literature revealed the problem of nurses' knowledge deficit regarding the care of chest drain in general, no study that investigated the prevalence of chest drains in ICUs and nurses' knowledge of chest drain among Jordanian nurses was found in the literature. This study aims were to describe the prevalence rate of chest drain insertion in Jordanian ICUs, and to evaluate Jordanian nurses’ level of knowledge regarding chest drain care. Methods: Anon-experimental descriptive design using cross-sectional survey was used for evaluating nurses’ knowledge utilizing researchers-developed instrument. In addition, a retrospective chart review for patients who had chest drain in the previous three months to assess the prevalence rate of chest drain insertion. Data was analysis using the Statistical Package for Social Sciences (SPSS) program. Results: The 3-month period prevalence of chest drain insertion was 8%. The most common indication for chest drains insertion was cardiac surgery (84.8%, n = 134) followed by pleural effusion (6.3%, n = 10). The results revealed that the mean score for nurses’ knowledge regarding care of chest drain was 15.7 out of 30 (52.3%), with the majority had insufficient or intermediate level of knowledge (47.6%, n = 107 vs. 51.1%, n = 115). The areas with least level of knowledge were in the troubleshooting (31.9%), and removal (39.5%). Nurses from private hospitals had significantly higher (M = 16, SD ± 2.77) level of knowledge (F[2, 222] = 8.467, p < .001) than nurses from other sectors. Conclusions: Chest drain is prevalent in Jordanian ICUs, which requires nurses to know how to care for patients with this critical intervention. However, they seemed to lack the needed knowledge for the appropriate care. Developing, implementing and continuous monitoring of guidelines regarding chest drain care for nurses and physicians are recommended.

During the COVID-19 pandemic ICU nurses endure high levels of stress. VR relaxation (VRelax, containing 360° immersive environments) provides an easy-to-use and effective means to induce positive affect and reduce perceived stress. We investigated feasibility and immediate effect on perceived stress of VRelax use by ICU nurses during work shifts. ICU nurses working with COVID-19 patients in an academic hospital could use VRelax as a 10-min break during their shift. Primary outcome was the difference between perceived stress immediately before and after VRelax use measured by a single-question VAS-stress scale. Statistically significant difference of the mean VAS-stress before and after use was determined using the paired t student test. A socio-demographic questionnaire, a questionnaire on perceived stress and stress resilience and VRelax user experiences were sent by email. Eighty-six (26%) nurses used VRelax at least once; 77% (N =66) of these filled out the VAS-stress scale before and after use of VRelax. Mean perceived stress lowered with 39.9% after use of VRelax (mean difference=14.0, SD=13.3, p <0.005). Mean score on the perceived stress scale-10 was 11.4 (SD=6.50), mean score on the Connor-Davidson Resilience Scale-10 was 29.0 (SD=5.51). Sixty-two percentage of the ICU nurses thought VRelax was helpful to reduce stress. Main barrier for use was a high workload. It is feasible for nurses to use VRelax in an ICU context. VRelax is an effective intervention to reduce immediate perceived stress and is of added value in stressful situations as during the COVID-19 pandemic, inducing a positive affective state and lowering perceived stress. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore how the presence of family and health professionals influences long‐term critically ill patients' inner strength and willpower as an incitement to keep fighting for recovery. Background: This study reports long‐term critically ill patients' experiences of family and health professionals as health‐promoting resources in terms of significance for their inner strength and willpower. Earlier research on this topic is scarce. Design: A qualitative, hermeneutic‐phenomenological approach, within the context of Antonovsky's salutogenic theory. Methods: Seventeen long‐term critically ill patients were interviewed once, at 6–18 months after ICU discharge. The consolidated criteria for reporting qualitative research (COREQ) were used (Supplementary File 1). Results: Four main themes identified how family and staff promoted and challenged the patient's inner strength and willpower: (a) the importance of family and friends; my family was surrounding me, (b) staff contributions, (c) challenges to inner strength and willpower in relation to family and (d) loneliness and indifferent care. Conclusion: This study brings new knowledge from the long‐term critically ill patient's view about the impact of family, friends and nurses on the patient's inner strength and willpower. All impact is experienced positively and negatively. Relevance to clinical practice: Knowledge from the long‐term critically ill patient's view is vital in nurse–patient interactions to facilitate liberation of inner strength and willpower. [ABSTRACT FROM AUTHOR]

Introduction: When speech is integral, the interactions will come out automatically; but if the speech is damaged, even the necessary conversation is challenging to handle. While providing nursing care to the patients, nurses must appreciate the uniqueness of each patient and try to promote good health and well-being as much as they can. To do so, the nurses must help the patients to fulfil their needs by adequately listening to the patients' 'voices'. Objective: To appraise available evidence that investigates voiceless among patients in the Intensive Care Unit. Design: A literature review. Data sources: Six online databases namely CINAHL, ProQuest, ScienceDirect, Clinical key, Scopus, and Ovid Medline were searched. Review methods: Relevant studies were identified using the combined approaches of electronic database search and manually searched journals. Results: Twelve 12 studies met the inclusion criteria. A few topics summarised from the studies provided a general view of the nurse-patient communication in the Intensive Care Unit, barriers and factors that limit the nurse-patient communication, consequences of voicelessness, and the methods to overcome voicelessness. Conclusion: Supports from nurses are needed by patients, especially when they are mechanically ventilated, for them to make sense of their conditions and to try to cope with it. [ABSTRACT FROM AUTHOR]

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Background: The SBAR (situation, background, assessment, and recommendation) is a standardized handover tool that has been utilized in health care settings. It has positive impacts on staff communication and patient quality of care. In Jordan, few reports are available about handover tools' impacts. Purpose: To evaluate the implementation of the SBAR among nurses in intensive care units (ICUs) in Jordan. Methods: A pretest--posttest quasi-experimental design was used. A convenience sample of 71 ICU nurses participated. The 43-item ICU physician-nurse questionnaire was used to measure SBAR effectiveness as measured by the following subscales: general relationship and communication, teamwork and leadership, and job satisfaction. Results: There was a significant improvement in posttest knowledge scores and in "general relationships and communication" and "satisfaction" scores. There was a significant improvement in both "general relationships and communication" and "satisfaction" posttest scores compared with their pretest scores (t = 16.709, 2.656; P < .001, P < .01) consecutively. Conclusions: This study revealed a strong indicator to encourage the SBAR utilization among nurses in health care settings. The SBAR has a positive impact on enhancing communication between nurses and increasing their job satisfaction. Thus, the utilization of such a standardized tool that maintains and assures good communication relationships shall increase level of satisfaction. Future studies are recommended to provide further evidence on its feasibility and efficacy as compared with traditional handover tools and among different health care contexts. [ABSTRACT FROM AUTHOR]

Background: It has been recommended that critically ill patients start mobilization as early as possible. However, the clinical utilization rate of early mobilization remains low in the intensive care unit (ICU), and respiratory therapists and nurses are the primary practitioners of early mobilization in China. Aim: The aim of this study is to investigate the knowledge, attitudes, and perceived barriers of ICU nurses regarding the early mobilization of ICU patients. Design A descriptive and cross‐sectional design was used. Methods: A cross‐sectional design was used, with an e‐questionnaire for ICU nurses (n = 227) to assess knowledge and attitudes regarding early mobilization via the "Tencent WeChat" app on their smart phones. Results: As the primary implementers of the early mobilization of ICU patients in China, more than half of ICU nurses passed the knowledge test (scored ≥20/25 points) and had positive attitudes (scored 45/55 points) regarding early mobilization. Nurses had good knowledge (more than 96.5%) of the benefits and stopping indications of early mobilization; however, they had a poor understanding (less than 51.1%) of the population in which early mobilization is applicable and monitoring indicators during early mobilization, and 39.2% of nurses did not support routine implementation of early mobilization for patients in the ICU. The major barriers that they perceived were very heavy workload (76.8%), insufficient equipment and devices (50.2%), lack of written protocols or guidelines (50.2%), inadequate training (47.1%), potential work risks (42.3%), and limited staffing (41.4%). Conclusions: Although over half of ICU nurses exhibited relatively comprehensive knowledge of and positive attitudes to early mobilization, some misunderstandings, negativity, and barriers remain. Relevance to clinical practice: Training programmes should be conducted continuously, especially focused on common misunderstandings and negative attitudes. Organizational support is required to overcome barriers to the implementation of early mobilization. [ABSTRACT FROM AUTHOR]