Intensive Care Nurses Research Articles

What Enables Implementation of Pain Management Interventions in Intensive Care Units and Why: A Realist Evaluation to Refine Program Theory.

To uncover perspectives and refine 12 initial program theories concerning the implementation of pain management interventions in intensive care units. Contexts enabling implementation are delineated, and causal mechanisms within these contexts are described. A realist evaluation approach was employed. Fourteen purposively selected Australian nurses of variant roles were virtually and individually interviewed between July and September 2023. Participants were presented with initial program theory, and their perspectives were collated. Data were analysed using an integrated approach of context (C), mechanism (M), outcome (O) categorisation coding, CMO configurations connecting and pattern matching. Pain management interventions work if perceived to be beneficial, precise, comprehensive and fit for purpose. Nurses should be willing to change attitudes and update knowledge. Unit leaders should nurture the development of nurses' professional identity, access to learning, autonomy and self-determination. Organisations should change the infrastructure, provide resources, mitigate barriers, develop shared mental models, update evidence and institute quality assurance. Adherence to interventions is affected by the outcomes of implementation and intrinsic merits of interventions. In these contexts, confidence is boosted; feelings of empowerment, self-efficacy, reflective motivation, trust, awareness and autonomy are developed; and capacity is built. Furthermore, frustration from the variability of practices is reduced, accountability and ownership are augmented, yielding positive implementation outcomes. Findings have implications on nurses, team leaders and organisations concerned with implementation. The findings provided a fortified understanding of conditions favouring successful implementation of pain management interventions. Actions should be undertaken at an individual, unit and organisation level to ensure successful implementation. RAMESES II Reporting Standards for Realist Evaluations informed presentation of study. Intensive care nurses contributed insights to refine the program theory.

Nursing Knowledge and Preventive Practices of Ventilator-Associated Pneumonia as Perceived by Intensive Care Nurses in Hail City, KSA

Context: Ventilator-associated Pneumonia (VAP) is a recognized nosocomial infection and a leading cause of high morbidity and mortality. Intensive Care Unit (ICU) nurses are in the best position to put the known evidence-based strategies into practice to prevent VAP. Aim: The study assessed nursing knowledge and preventive practices of ventilator-associated pneumonia as perceived by intensive care nurses in Hail City, Saudi Arabia. Methods: Data were collected using a descriptive cross-sectional research design. The study was conducted in intensive care units of Government hospitals in Hail City on a convenient sample of all available critical care nurses who met the inclusion criteria during the data collection period. The sample size (n) for this analysis was 84. Data were collected using a structured interview questionnaire including sociodemographic data and nurses' knowledge of VAP. The second tool is nurses’ practice observational checklist regarding VAP prevention. Results: revealed that age median (IQR) is 30(6), median years of experience (IQR) 6(6), 67.9% had received VAP prevention training, and 78.6% had received information for preventing VAP. The study also reveals that 38.09% of the nurses had poor knowledge regarding VAP prevention, and they had a good median (IQR) 6(4) in the preventive practice of VAP. Age, experience in nursing, in the ICU, training on VAP prevention, and receiving information on preventing VAP significantly affected nurses' knowledge about preventing VAP in ICU patients. Experience in ICU and educational institutions as source of information and more than one source of information significantly affect the nurses' total preventive practice regarding VAP. Correlation analysis between overall knowledge and practice indicates no statistically significant correlation (the p-value for the correlation was 0.060). Conclusion: Over one-third of the nurses had poor knowledge regarding VAP. The study recommended that there should be in-service training and periodic educational programs targeting nurses to improve nurse’s knowledge and practices regarding VAP guidelines by the Ministry of Health.

Effects of visit restriction in the COVID-19 pandemic: Experiences and perceptions of intensive care nurses.

The visit restrictions imposed as a result of COVID-19 precluded the entrance of the patient's family into the confines of the intensive care unit. This study evaluated the experiences of intensive care nurses (ICNs) regarding COVID-19 visit restrictions and their opinions on these restrictions. From May 2023 to July 2023, semi-structured interviews with 15 ICNs from intensive care units in a tertiary public hospital in Türkiye were conducted. Data were analysed using qualitative content analysis with an inductive approach. Reporting of the study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The analysis revealed two main themes, 'widespread negative impacts of visit restrictions' and 'adaptive strategies to the visitation ban', and seven sub-themes supporting the main themes. Nurses perceived that the visit restrictions imposed during the COVID-19 pandemic had a severe negative effect on patients, their relatives, themselves and the care environment. They also did not support visit restriction in future pandemics. The COVID-19 visitation policy weakened the involvement of family members in patient care and created serious challenges in the intensive care setting. The study revealed an urgent need for patient-centred, family-sensitive and consistently applied protocols in future pandemics. In future pandemics, strategies such as the benefit-benefit ratio of the visit, the provision and use of adequate personal protective equipment, and vaccination requirements should be considered in visiting decisions of patients hospitalized because of infection. Participation of nurses responsible for patient care in decisions regarding visitor practices should be supported.

Incidence, characteristics and risk factors of endotracheal tube-related pressure injuries in intensive care units.

Medical devices commonly used for the treatment and care of critically ill patients can cause pressure injuries in intensive care units (ICUs). The endotracheal tube (ETT) is one of the most common medical devices to cause pressure injuries. This study investigated the incidence of, characteristics of and risk factors for ETT-related pressure injuries for ICU patients. This study adopted a prospective descriptive research design. The sample consisted of 146 endotracheally intubated patients. Data were collected using a patient information form, an Endotracheal Tube-Related Pressure Injuries Assessment Form, the Braden Risk Assessment Tool and the Nutritional Assessment Test. The study revealed that 80.14% of the patients developed ETT-related pressure injuries. Over half of the ETT-related pressure injuries appeared on Day 3 or 4 (56.41%). High body mass index was found to be associated with the development of ETT-related pressure injuries (OR: 1.15, 95% CI: 1.05-1.26, p = .003). None of the other variables were statistically significant in the development of pressure injuries. The incidence of ETT-related pressure injuries was quite high in the internal, surgical and anaesthesia ICUs. High body mass index was associated with the development of ETT-related pressure injuries. Intensive care nurses should implement interventions to prevent ETT-related pressure injuries in critically ill patients receiving mechanical ventilation support. ETT-related pressure injuries are common in ICU patients. High body mass index was associated with the development of ETT-related pressure injuries in critically ill patients. The skin and mucosa should be assessed for the development of ETT-related pressure injuries during the daily assessment of the patients receiving mechanical ventilation support. The ETT should be repositioned regularly, and the most suitable ETT fixation method should be used.

The effect of safe blood and blood products transfusion training on knowledge of intensive care nurses

Aim: Nurses play an essential role in blood transfusion, and more than half of the steps in the transfusion chain are dependent on the nurses’ knowledge, awareness and skills. This study was conducted to determine the effect of safe blood and blood products transfusion training on knowledge of nurses in intensive care unit (ICU). Methods: This quasi-experimental pretest-posttest designed research was completed on (n=166) volunteering nurses working in ICUs. At first, a pretest evaluating the knowledge of nurses on blood and blood products transfusion was performed. Then, a training was provided to nurses and pop-up informative screen messages were sent via hospital information system each time when they sign in the system. Posttest was performed on nurses one month after the completion of the blood and blood products transfusion training. p

Futile therapeutic nursing interventions in adult intensive care: A descriptive study.

Background: Despite the progress made in recent decades on the phenomenon of futility in adult intensive care, recognizing it during clinical care practice remains a complex and sensitive process, during which questions are often raised for which concrete answers are difficult to find. Aims: To analyze the frequency with which futile nursing interventions are implemented in critically ill patients admitted to adult intensive care in specific situations and how often futile autonomous and interdependent nursing interventions are implemented in the same population, as perceived by adult intensive care nurses. Research design: Cross-sectional, quantitative, and descriptive study, which employed a questionnaire constructed specifically for this research to assess the perception of therapeutic futility in nursing in adult intensive care. Following an evaluation of the psychometric properties, the questionnaire was made available in an electronic format on the EUSurvey platform between August and October 2024. The data was analyzed between November 2023 and March 2024 using the statistical software packages SPSS and R. Participants and research context: A simple random sample of nurses working in level II and level III intensive care units in Portugal. Ethical considerations: Research ethical approvals were obtained, and the participants provided informed consent. Findings/results: Four hundred and fourteen valid questionnaires were obtained. The results allow the identification of thirty-three statistically significant associations, the inference of intervals for the mean and median for the perception of futility of nursing interventions with a 95% confidence interval, and enable the hierarchization of nursing interventions implemented in critically ill patients admitted to adult intensive care units according to the nurses' perception of their futility. Conclusion: There is a balance in nurses' perception of the futility of their interventions in the specific situations analyzed. There is statistically significant evidence that interdependent nursing interventions are, in general, more frequently perceived as futile when compared to autonomous nursing interventions.

A mountain of waste created daily: a thematic analysis of environmental sustainability experiences of postgraduate intensive care nursing students

BackgroundThe healthcare sector has a negative ecological impact, and intensive care is one of the most resource-consuming areas. Nurses have a duty to contribute to climate change reduction, design climate-resilient healthcare systems, and support individuals and communities in adapting to the effects of the planetary health crisis. It is essential to incorporate environmental sustainability into nursing education so that nurses can advocate for conscientious and ethically sustainable healthcare that benefits both patients and the planet. This study aimed to explore postgraduate intensive care nursing student experiences of environmental sustainability in clinical practice at intensive care units.MethodsData were collected using a qualitative questionnaire, and the data were analysed using inductive thematic analysis. The participants were 24 registered nurses studying postgraduate, specialist intensive care nursing courses at four universities in the south and west regions of Sweden.ResultsThe results describe critical care students’ environmental sustainability experiences in one overarching theme with five subthemes. Intensive care is a challenging context in terms of sustainability, where saving lives is the number one priority. There were good and bad sustainability habits among the staff, and awareness was key to improving. Clinical supplies come in unsustainable packages, and the participants wished for better alternatives and they wanted more knowledge and education on sustainable practices. The findings also emphasized the importance of a holistic perspective throughout each patient’s pathway.ConclusionsSustainability in intensive care units is somewhat unrecognised today, although intensive care nurses want that to change. The context where saving lives is prioritized makes implementing ecologically responsible practices a challenge. However, environmental sustainability in intensive care is feasible, with education needed for nurses to take on the responsibility of making improvements. Hospital management prioritizing sustainability is also important to support clinicians in implementing sustainable practices in intensive care units.

The Effect of Delirium Training Given to Intensive Care Nurses on their Knowledge Level: Quasi-Experimental Study

Objective: This study was conducted to determine the effect of delirium training given to intensive care nurses on their knowledge levels. Methods: The study was conducted in a quasi-experimental design. The population of the research consisted of nurses working in the intensive care units of the training and research hospital in Istanbul between September 2022 and October 2022. The study sample consisted of 69 intensive care nurses who met the inclusion criteria for the study. Research data were collected with the "Descriptive Information Form" and "Delirium Management Information and Application Form". Face-to-face interviews were held with nurses for pre-test and post-test data collection. “Delirium Management Information and Application Form” was applied before and 2 weeks after the training. The data were analyzed with the SPSS for Windows 26.0 package program. Results: It was determined that 78.3% of the nurses participating in the study were women, 56.5% were 26 years old and over, and 75.4% had a bachelor's degree. It was determined that 56.5% of the nurses had not received training on delirium before. The pre-test total score average of the delirium information form was 53.84%, and the post-test total average score was 83.18%. It was determined that the total score average of the nurses in the "Delirium Management Information Form" post-test was significantly higher than the average score in the pre-test (p=0.000

Insights into the relationship between professional values and caring behavior among nurses in neonatal intensive care units

ObjectiveProfessional values are crucial for delivering high-quality care in neonatal intensive care units while caring behavior impacts nurses’ performance and well-being. The purpose of this study was to assess the relationship between professional values and caring behavior among nurses in neonatal intensive care units.MethodsA cross-sectional study involving 172 nurses was conducted using the Nursing Professional Value Scale and Caring Behaviors Assessment Tool. The study was carried out between 1 October and 5 December 2023.ResultsNurses demonstrated a moderate to high degree of professional commitment, with a mean professional value score of 91.1 ± 11.1. The mean score for caring behavior was 99.7 ± 12.4. The highest-rated domain was setting up a supporting, protective, and corrective environment, with a mean score of 22.8 ± 2.7. A low positive relationship was found between the supportive, protective, and corrective environment domain and nurses’ professional value (r = 0.18, p = 0.017), as well as between overall caring behavior and nurses’ professional value (r = 0.16, p = 0.038).ConclusionThe results indicate a favorable relationship between professional values and caring behavior, especially in areas like establishing a supportive workplace. However, both professional value and caring behavior needs improvement in certain aspect. Enhancing these aspects could further strengthen their relationship, ultimately improving the quality of care provided to newborn patients and their families.Practice implicationsTo cultivate a positive work environment and instill caring behaviors and professional values among NICU nurses, it is imperative to allocate sufficient time and resources. This investment is necessary for nurturing a culture of care, improving patient outcomes, and fostering a supportive environment for NICU nurses, newborn, and their families.

How emotional contagion shapes spiritual care competence: Insights from a cross-sectional study on intensive care nurses.

Intensive care units (ICUs) are environments where nurses are open to emotional interactions because of complex structures and dynamic relationships. Nurses' susceptibility to emotional contagion and their spiritual care competence may affect the quality of care by influencing their ability to manage and respond to the emotional dynamics present in these environments. This study aimed to determine the level of emotional contagion and spiritual care competence in intensive care nurses. This study is a descriptive cross-sectional study conducted with 199 nurses working in the ICUs of a training and research hospital in Turkey. The data were collected between December 2021 and June 2022 using the Emotional Contagion Scale (ECS) and the Spiritual Care Competence Scale (SCCS). The mean score of the nurses was 50.29 ± 15.36 on the ECS and 90.29 ± 29.53 on the SCCS. A statistically significant difference was found between the ECS and SCCS and gender, marital status, weekly working hours and some approaches about spiritual care (p < .05). It was determined that there was a statistically significant positive correlation between the total scales and sub-dimensions of the ECS and SCCS (p < .05). In this study, it was found that intensive care nurses' susceptibility to emotional contagion was high, and that their spiritual care competence was at a moderate level. The results show that gender, marital status, weekly working hours, type of ICU and some approaches about spiritual care are crucial factors in nurses' emotional contagion and spiritual care competence. In addition, as the intensive care nurses' susceptibility to emotional contagion increased, their spiritual care competence also increased. The results of this study will guide the planning of interventions to protect intensive care nurses from the negative effects of emotional contagion and increase their spiritual care competence. It is necessary to protect intensive care nurses from the negative effects of emotional contagion and to increase their competences in spiritual care.

Burnout Among Nurses Working in Critical Care Units in Africa: An Integrative Review

Background: Burnout is a syndrome resulting from chronic workplace stress that has not been effectively managed. The level of burnout that is experienced by nurses varies according to geographical region and specialties, such as paediatric and critical care nursing. However, little is known about burnout among nurses in African critical care units. Aim: To explore the available evidence on burnout among nurses in African critical care units. Methods: The review was guided by the Whittemore and Knafl framework for integrative review. Literature was searched in Web of Science, Embase, PubMed, and SCOPUS databases. The search strategy applied Boolean operators AND, OR using the following key terms: critical care nurses, burnout, and Africa. The alternative keywords were: nurs*, OR intensive care nurses OR Critical Care Nursing OR Intensive Care Nursing OR critical care nurs* AND “burnout syndrom*depersonalis/zation” OR “emotional exhaustion, workplace stress, Occupational Stresses, Professional Stress, Job-related Stress” AND specific names of the African countries. Findings: The review included eighteen articles. Two hundred and forty-nine nurses (n = 2,249) who work in critical care settings participated in the studies. The findings showed that nurses in critical care settings experience moderate to high levels of burnout, with emotional exhaustion being a common characteristic. Burnout is associated with factors related to the individual, work, and organization. The consequences of burnout include secondary traumatic stress, intention to leave the job, and increased risk of infection to the patient. Conclusions: The review has significant implications for nursing at various levels. The findings provided could inform future research and interventions to reduce burnout among critical care nurses in Africa.

Adult intensive care unit nurses' knowledge of and compliance barriers to evidence-based guidelines for prevention of ventilator-associated pneumonia: A cross-sectional survey.

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.

Criticality of Nursing Care for Patients With Alzheimer's Disease in the ICU: Insights From MIMIC III Dataset.

Alzheimer's disease (AD) patients admitted to intensive care units (ICUs) exhibit varying survival outcomes due to the unique challenges in managing AD patients. Stratifying patient mortality risk and understanding the criticality of nursing care are important to improve the clinical outcomes of AD patients. This study aimed to leverage machine learning (ML) and electronic health records (EHRs) only consisting of demographics, disease history, and routine lab tests, with a focus on nursing care, to facilitate the optimization of nursing practices for AD patients. We utilized Medical Information Mart for Intensive Care III, an open-source EHR dataset, and AD patients were identified based on the International Classification of Diseases, Ninth Revision codes. From a cohort of 453 patients, a total of 60 features, encompassing demographics, laboratory tests, disease history, and number of nursing events, were extracted. ML models, including XGBoost, random forest, logistic regression, and multi-layer perceptron, were trained to predict the 30-day mortality risk. In addition, the influence of nursing care was analyzed in terms of feature importance using values calculated from both the inherent XGBoost module and the SHapley Additive exPlanations (SHAP) library. XGBoost emerged as the lead model with a high accuracy of 0.730, area under the curve (AUC) of 0.750, sensitivity of 0.688, and specificity of 0.740. Feature importance analyses using inherent XGBoost module or SHAP both indicated the number of nursing care within 14 days post-admission as an important denominator for 30-day mortality risk. When nursing care events were excluded as a feature, stratifying patient mortality risk was also possible but the model's AUC of receiver operating characteristic curve was reduced to 0.68. Nursing care plays a pivotal role in the survival outcomes of AD patients in ICUs. ML models can be effectively employed to predict mortality risks and underscore the importance of specific features, including nursing care, in patient outcomes. Early identification of high-risk AD patients can aid in prioritizing intensive nursing care, potentially improving survival rates.

Intensive Care Nurses' Performance of Open versus Closed Endotracheal Suction on Critically Ill Patients in Ismailia City.

Endotracheal Tube Suctioning (ETS), which involves either an open or closed suctioning system, is a crucial practice for mechanically ventilated patients. The nursing practice of airway suctioning is inevitable. This study was designed to compare the intensive care nurses' performance of open versus closed endotracheal suction on critically ill patients in Ismailia City. A non-participant structured observational study design was conducted on a convenient sample (N = 63) at intensive care units at a teaching hospital through March and August 2022 to evaluate how nurses practice different procedures in open suctioning compared with the closed suctioning system of Endotracheal Suction (ES) through a 32-item structured checklist. Additionally, authors compared their levels of knowledge in both suctioning systems. Approximately 75% and 65% of the study participants had a satisfactory level of knowledge about the open system compared with the closed system, respectively. The total percentage of patients who achieved a satisfactory level of practice was 72% for the open-system group, compared with 56% for the closed-system group. Overall, there were significant differences between total nurses' performances in the open-system and closed-system systems. Independent sample t-tests revealed a statistically significant correlation between overall nurses' performance in both systems (t = 6.04, p < 0.001). The findings revealed significant differences in nurses' performance between open and closed-system suctioning. The researchers recommend in-service-led training programs to improve nurses' performance, and other studies with larger sample sizes should be supported.

Evaluating Intensive Care Nurses' Knowledge of Incontinence-Associated Dermatitis: A Multicenter Cross-sectional Study.

To determine the knowledge levels of nurses working in the ICU about incontinence-associated dermatitis (IAD). A descriptive cross-sectional study was conducted in adult ICUs at two private and three public hospitals in a province in Turkey. The study included 296 nurses who agreed to participate in the research. Researchers used the "Nurse Identification Form" and the "IAD Knowledge Test" to collect data on nurses' IAD knowledge. Data analysis included the use of percentage distribution and the Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests. The mean age of the nurses was 26.55 ± 3.89 years (range, 20-47 years), and the duration of working in the ICU was 2.71 ± 2.55 years (range, 1-22 years). Of the nurses, 183 (61.8%) worked in general ICUs. Of those, 69 (23.3%) received IAD training. Nurses achieved a 49.8% correct response rate on the IAD knowledge test. Nurses working in tertiary and general ICUs demonstrated higher IAD knowledge levels (Ps = .003 and .047, respectively). There were no relationships between age, career length, institution, ICU type, and IAD knowledge level. Nurses' knowledge level of IAD was low in intensive care. To remedy this, IAD should be added to intensive care nursing certificate programs as content, and the use of IAD risk assessment and diagnosis scales in ICUs should be expanded.

The Effect of Laughter Yoga Applied to Intensive Care Nurses on Their Perceived Stress, Job Motivation, and Mental Well-being: Randomized Controlled Study.

The aim of this study was to examine the effect of laughter yoga applied to intensive care nurses on perceived stress, job motivation, and mental well-being. This study was a randomized controlled trial. The study was conducted with nurses working at the university hospital's surgical intensive care and anesthesia intensive care units of the third-level intensive care unit in Turkey. Data obtained from 30 participants in the intervention group and 33 participants in the control group were analyzed. The Nurse Introduction Form, Nurse Job Motivation Scale, Perceived Stress Scale, and Warwick-Edinburgh Mental Well-being Scale were used to collect data. Data obtained from the study were evaluated using the SPSS 22.0 package. It was determined that there was no statistically significant difference in the average scores of the pretest/posttest 1/posttest 2 of the Perceived Stress Scale (13.70 ± 3.33 to 14.57 ± 4.57, P > .05; 13.50 ± 3.15 to 13.48 ± 4.59, P > .05; and 13.56 ± 3.15 to 13.15 ± 3.49, P > .05, respectively) and Work Motivation Scale (59.70 ± 7.58 to 59.69 ± 7.98, P > .05; 60.30 ± 8.07 to 58.48 ± 8.94, P > .05; and 60.56 ± 7.86 to 57.93 ± 9.54, P > .05, respectively) for both the intervention and control groups of nurses. A statistically significant difference was found in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the intervention group of nurses (50.90 ± 7.60, 51.50 ± 7.80, and 53.70 ± 7.08, respectively; F = 3.330, P = .043). However, the difference was found to be insignificant in pairwise comparisons in the further analysis (a = b = c). It was determined that there was no statistically significant difference in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the control group of nurses (52.21 ± 9.89, 51.93 ± 10.45, and 51.03 ± 9.63, respectively; P > .05). The application of laughter yoga on intensive care nurses did not result in a significant change in perceived stress levels and work motivation. However, statistically significant differences were observed in the average mental well-being scores among the intervention group.

Relation between Workplace Civility and Prosocial Organizational Behavior among Intensive Care Nurses

Relation between Workplace Civility and Prosocial Organizational Behavior among Intensive Care Nurses

Safety Work Climate and Performance Limitations among Intensive Care Nurses: A Comparative Study

Safety Work Climate and Performance Limitations among Intensive Care Nurses: A Comparative Study

Incidence of medical device-related pressure injuries and identification of risk factors in the neonatal unit

AimThis study was conducted to investigate the incidence of medical device-related pressure injuries (MDRPIs) and the risk factors influencing their occurrence in the neonatal intensive care unit (NICU). MethodThis study is a prospective, descriptive study. The research was conducted with 116 newborns between June 1, 2022, and June 1, 2023. Newborns who stayed in the neonatal intensive care unit for at least 24 h were observed daily for medical device-related pressure injuries under and around each medical device throughout their stay in the intensive care unit. The "Case Report Form," "MDRPIs Monitoring Form," "Braden Q scale for children," National Pressure Injury Advisory Panel (NPIAP) Pressure Grading, and Glasgow Coma Scale were used in the research. ResultsThe incidence of medical device-related pressure injuries is 35.3 % (41/116). It was found that 38.1 % (16/42) of medical device-related pressure injuries developed due to Near-Infrared Spectroscopy (NIRS) probes, and 33.5 % (14/42) developed due to medical devices related to the respiratory system. In terms of anatomical location, 38.1 % occurred on the forehead, and 23.8 % on the arm/leg. The difference between birth weight, gestational age, development of MDRPIs in newborns receiving sedation and inotropes was found to be statistically significant. Regression analysis identified gestational age (p = 0.040, OR = 0.795, 95%CI = [0.632–1.000]) as an independent risk factor for the occurrence of medical device-related pressure injuries. ConclusionsThe incidence of medical device-related pressure injuries in newborns was relatively high in this study, with gestational age being the most significant risk factor for MDRPIs formation. It is crucial for neonatal intensive care nurses to consider associated risk factors while providing newborn care and implement appropriate preventive measures to reduce the incidence of MDRPIs.

Determination of the Relationship Between Intensive Care Nurses’ Attitudes Towards Evidence-Based Nursing and Decision Making Skills

Determination of the Relationship Between Intensive Care Nurses’ Attitudes Towards Evidence-Based Nursing and Decision Making Skills