Intensive Care Unit Experience Research Articles

Congenital Colorectal Conditions: Caregiver Perspectives of Their Experience in the Neonatal Intensive Care Unit.

This study aimed to examine the experiences of children with colorectal conditions who spent time in the Neonatal Intensive Care Unit (NICU) and their caregivers. In March 2024, a 36-question survey was sent to the Colorectal Support Network Facebook community, to gather information from caregivers of children who have a congenital colorectal diagnosis and spent time in the NICU. Fifty-two families completed the survey. Most patients were diagnosed after birth (89.47%). Approximately half of respondents stayed in the NICU for one to two weeks (50.88%), lived less than 60 minutes away from the hospital (54.91%), and felt somewhat uncomfortable (28.07%) or very uncomfortable (21.05%) caring for their child's medical needs after discharge. Also 49.12% of caregivers were informed of their child's future bowel control prognosis. When asked for suggestions to improve care in the NICU, common themes included the importance of having colorectal congenital anomalies addressed by colorectal surgeons, and the need for families to be informed about support groups. Counseling families in the NICU with congenital colorectal conditions can be improved by providing additional information and support for families prior to discharge, informing them about their child's prognosis for bowel control, and connecting them with other families.

Factors Influencing Radiation Protection Behavior of Nurses in Intensive Care Units

Purpose : The purpose of this study was to identify the factors that influence the behavior of intensive care unit (ICU) nurses regarding radiation protection, and to provide basic data to improve radiation protection educational programs. Methods : This descriptive research study included 143 nurses working in ICUs. Data were collected through a self-reported structured questionnaire and analyzed using t-test, Pearson’s correlation coefficients, and hierarchical multiple regression analysis. Results : Radiation protection environment (<i>β</i>=.35, <i>p</i>=.001), radiation protection self-efficacy (<i>β</i>=.25, <i>p</i> =.002), type of hospital (<i>β</i>=-.25, <i>p</i>=.002) and experience in ICU (<i>β</i>=-.18, <i>p</i>= .022) affected the radiation protection behavior of ICU nurses. The total explanatory power of model was 60.0% (R<sup>2</sup>=.64, Adj. R<sub>2</sub>=.60, F=17.71, <i>p</i>＜.001). Conclusion : In order to enhance the standards of radiation protection behavior among intensive care unit nurses and improve radiation protection self-efficacy, educational and training programs should be developed. Additionally, administrative support should be considered to create environments with better radiation protection at the organizational level.

Factors Influencing Intensive Care Unit Nurses’ Competency in Delirium Care in A Tertiary General Hospital

Purpose : In this study, we aimed to identify the factors affecting nurses’ competency in delirium care in an intensive care unit at a tertiary general hospital. Methods : The participants were 149 nurses in the intensive care unit. Collected data were analyzed using independent t-tests, ANOVA, Sheffé test, Pearson correlations coefficients, and multiple regressions using the SPSS 28.0 program. Results : The factors that significantly influenced the participants’ competency in delirium care were delirium nursing confidence (<i>β</i>=.44, <i>p</i> ＜.001) and intensive care unit clinical career (<i>β</i>=.25, <i>p</i> =.002). These factors explained 32.5% of the total variance outcomes regarding the competency in delirium care (F=12.87, <i>p</i> ＜.001). Conclusion : The study results indicated that the higher the confidence in delirium care and the more extensive intensive care unit experience, the higher the competency in delirium care. Moreover, these results suggested that various policy strategies should be implemented to enable intensive care unit nurses to work for a long time and to develop educational programs to increase confidence in delirium care.

Comparing the Sedative Effect of Dexmedetomidine and Propofol in Mechanically Ventilated Patients Using Salivary Alpha-Amylase as a Stress Marker: A Randomized Open-Label Trial

Background: Patients receiving mechanical ventilation (MV) in the intensive care unit (ICU) experience significant distress, which triggers a stress response. Objectives: This study aimed to assess the effectiveness of dexmedetomidine and propofol in reducing stress levels, using salivary alpha-amylase (SAA) as a specific indicator of stress. Methods: A randomized, open-label trial was conducted involving 40 patients newly placed on MV. In a parallel study design, participants were randomly assigned into two equal groups (n = 20) through the sealed envelope method using computer-generated randomization. Group D received dexmedetomidine at a dosage of 0.2 to 1.4 μg/kg/h, while group P received propofol at a dosage of 0.3 to 4 mg/kg/h for sedation. Salivary alpha-amylase levels were measured according to the kit manufacturer's protocol. Results: Salivary alpha-amylase levels were significantly lower in group D than in group P at 12, 24, 36, and 48 hours after the initiation of MV (P < 0.05). Heart rate and mean arterial pressure were also significantly lower in group D at 12, 18, and 24 hours (P < 0.05). The duration of MV was significantly shorter in group D compared to group P (4.4 ± 1.85 vs 6.1 ± 2.45 days, P = 0.018). There were no significant differences in ICU length of stay, mortality, or adverse events between the groups. Conclusions: Dexmedetomidine demonstrated superior stress-reducing effects compared to propofol in MV patients, as evidenced by lower SAA levels and improved hemodynamic stability. The shorter duration of MV in the dexmedetomidine group further suggests potential clinical benefits of its use in managing stress in MV patients.

Impact of Shared Decision-Making on Family Satisfaction With Intensive Care Services: 'Share With Care' has a New Meaning in ICU.

Background: Physician's clinical inputs and informed bystander opinions are essential for successful intensive care unit (ICU) patient outcomes. There is insufficient data regarding the impact of shared decision-making on treatment outcomes and family satisfaction in Indian ICU settings. We aimed to determine the effect of shared decision-making factors on family satisfaction with ICU services. Patients and Methods: Family bystanders of 336 ICU patients with a stay >72 hours were conveniently surveyed across 13 months prospectively using Family Satisfaction in the Intensive Care Unit 24 Revised (FS-ICU 24R) questionnaire. We analyzed the responses to determine shared decision-making factors impacting family satisfaction. Results: Univariate analysis of ten variables of FS-ICU 24R questionnaire decision-making subscale revealed that consistency of information (OR 8.71, P < 0.001), honesty of information (OR 7.04, P < 0.001), and frequency of communication with doctors (OR 6.25, P < 0.001) were associated with highest odds of family involvement and satisfaction. Multivariable logistic regression showed that consistency of information (adjusted OR 3.85, P < 0.001) and frequent doctor communication (adjusted OR 2.22, P = 0.02) were independent predictors associated with family satisfaction. The number of decision-makers (P = 0.463) or family's prior ICU experience (P = 0.430) was not associated with family satisfaction. Conclusion: A consistent and honest effort to cater to the family's information needs and frequent physician-bystander interaction is essential for family's satisfaction with ICU services. This even outweighs other decision-making factors such as number of decision-makers and their prior ICU experience. Incorporating shared decision-making in counseling should be a continuing practice.Trial registry name: Clinical Trials Registry - India.Registration number: CTRI/2022/09/045571.

Improving Outcomes for ICU Family Members: The Role of Spiritual Care.

Having a family member hospitalized in the intensive care unit (ICU) can be a stressful experience for family members, encompassing both psychological and spiritual distress. With over 5 million ICU admissions annually in the United States, it is imperative to enhance the experiences and coping mechanisms of ICU family members. In particularly challenging situations, some family members even face psychological effects known as post-intensive care syndrome-family, which includes anxiety, depression, and posttraumatic stress. The distress may be worsened when patients and families experience poor communication or medical care, which has been shown to be more common among minoritized populations including Black and Hispanic patients and families. Family members' emotional and spiritual distress also has an effect on the medical decisions they make for the patient. While research has delved into the impact of spiritual care for ICU family members, further investigation is still needed to determine the most effective approaches for delivering such care. This narrative review will describe a conceptual model aimed at guiding future research in this endeavor. The model proposes that chaplains provide emotional, spiritual, and information support to ICU family members. This affects both their ICU experience, decision making, and outcomes for the patient and family. This process is also affected by characteristics of the family such as race, ethnicity, and economic status. This model helps identify gaps in research, including the need for randomized trials of spiritual care that identify mechanisms underlying outcomes and demonstrate impact of spiritual care, and consider race, ethnicity, and other characteristics.

Validity of a new weaning index of discontinuation from mechanical ventilation in intensive care unit

Background Failure to wean from mechanical ventilation (MV) is a frequent problem in the intensive care unit (ICU) setting. Herein, we investigate a new WI measured at the initial spontaneous breathing trial (SBT) in order to predict successful liberation from MV in mechanically ventilated ICU cases. Patients and methods This prospective cross-sectional study consisted of two phases; Phase I was designed to create a new WI from the criteria of 60 mechanically ventilated patients, while Phase II aimed to assess the accuracy of that index in another 40 patients. Results The incidence of failed weaning was 33.3% in phase I, and 35% in phase II. Multivariate regression analysis was done for phase I variables, and the following equation was created; (((Cough strength×0.743)–1.927)×0.05+((PaCO2 (mmHg)×-0.126)+6.786)×0.08+((mean airway pressure (CmH2O)×-1.304)+14.119)×0.193+((PaO2/FIO2 × 0.268)-58.555)×0.328+((rapid shallow breathing index×-0.485)+24.406)×0.353). Using a cut-off value of &gt;0.69 and Applying this index in phase II, it showed a mean value of -1.43 and 4.67 in the failure and success groups, respectively (P&lt;0.001). This new WI with cut-off value (&gt;0.69) had 88.5% sensitivity, 57.1% specificity, and a 77.5% accuracy to predict the success of weaning from MV. Conclusion We developed a new WI using formula including (semiquantitative Cough strength, PCO2 gradient mean airway pressure, PO2/FIO2 ratio, Rapid shallow breathing index) with accepted sensitivity and moderate specificity for predicting successful weaning from MV in ICU patients. Its use should be encouraged in the ICU setting, especially by less experienced ICU physicians.

Understanding Intensive Care Unit Family Caregivers' Vulnerability to Post-Traumatic Stress Disorder: The Impact of Neurotic Personality Traits, Emotional Suppression, and Perceptions of Unexpected Death.

Rationale: Family members of patients who die in an intensive care unit (ICU) are at heightened risk of post-traumatic stress disorder (PTSD) symptoms. Not all surrogates develop these symptoms and heterogeneity exists in PTSD symptom clusters. Objectives: The study tested a personality model of PTSD symptoms in bereaved family caregivers of ICU patients. It was hypothesized that family members endorsing higher levels of neurotic personality traits would report higher levels of PTSD symptom clusters and that these associations would be explained by tendencies to view the patient's death as unexpected and to cope by suppressing their emotions. Methods: Participants were family members of ICU patients at an urban, academic medical center who either died or were discharged to an inpatient hospice unit. Participants were contacted for participation at least six months after the patient's death. Participants completed measures of personality, emotion regulation, and PTSD symptoms. Data were analyzed using path analysis. Results: Approximately one-third (35%) of the sample of 162 caregivers endorsed at-risk levels of PTSD. Individuals reporting higher levels of neurotic personality traits reported more PTSD symptoms (r = 0.53, p < 0.001). Perceptions that the patient death was unexpected partially explained the association of neuroticism with the intrusive re-experiencing PTSD symptoms (B = 0.45, p = 0.031). In contrast, emotional suppression partially explained the association of neuroticism with avoidance (B = 0.70, p = 0.010) and hyperarousal symptom clusters (B = 0.37, p = 0.041). Conclusions: Family vulnerability to PTSD after an ICU death can be conceptualized based on neurotic personality traits. Tendencies to view the patient's death as unexpected may contribute to intrusive thoughts and memories of the ICU experience. Individuals may avoid reminders and remain at heightened levels of arousal when they suppress their emotional experiences. Key Message: Family members who experience the death of a loved one following ICU treatment are vulnerable to PTSD symptoms. These reactions to ICU-related losses may be shaped by family members' personalities, expectations, and emotion regulation styles. Understanding these characteristics could inform family screening and intervention efforts in the ICU.

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.

Sterile water and regional citrate anticoagulation: A simple CRRT strategy for safe correction of severe hyponatraemia.

Hyponatraemia is a prevalent electrolyte disturbance observed in critically ill patients. The rapid correction of low plasma sodium levels by continuous renal replacement therapy (CRRT) carries the risk of developing osmotic demyelination syndrome (ODS), which can be prevented by implementing an individualized CRRT method. This study aims to introduce a CRRT protocol for the safe and gradual correction of severe hyponatraemia. This retrospective case series study was conducted in an intensive care unit (ICU). All four patients with severe hyponatraemia (<125 mmol/L) and renal failure between October 1, 2022, and September 30, 2023, were treated by CRRT with sterile water and regional citrate anticoagulation (RCA). Data on patient demographics, laboratory biochemical parameters, urine outputs and CRRT-related adverse events were collected. Laboratory parameters and urine outputs were compared by paired t-tests before and after CRRT. After CRRT, sodium levels were significantly increased (112.7 ± 6.7 vs. 141.9 ± 2.8 mmol/L, p = .005). Abnormal urine outputs, potassium, creatinine and bicarbonate were corrected (p for all <.05). Safe and gradual correction of hyponatraemia and internal environmental dysregulation was achieved in all patients without any complications related to CRRT, particularly ODS. It is a novel and simple strategy to correct severe hyponatraemia effectively while ensuring the safety of patients that can be easily implemented by experienced nurse staff. The sterile water-based protocol for postfilter dilution is safe to correct severe hyponatraemia with RCA and can be easily performed by experienced critical care nurses according to the precalculated formula. CRRT-trained, experienced ICU nurses are competent to initiate and adjust sterile water infusion discretely to prevent overcorrection of hyponatraemia.

Enhancing ICU care with nurse-written diaries.

Patient diaries are a supportive intervention aiding intensive care unit (ICU) survivors and their families post-critical illness. Despite their growing acceptance, ICU diary usage varies across settings. This study explored themes in nurse-written ICU diaries and their impact on nursing work and communication. This qualitative study employed an interpretative narrative methodology to explore the experiences of ICU nurses. The narrative approach enabled the synthesis of diverse events and impressions into coherent stories, facilitating a deeper understanding of participants' perspectives. Data collection involved thematic analysis of diaries following Braun and Clarke's methodology. The analysis included familiarization, coding, theme identification and validation by the research team. The findings were reviewed by participants and translated into English using the WHO's cultural adaptation guidelines, ensuring reliability and credibility in the study's outcomes. The sample consisted of 28 ICU nurses, each with professional experience ranging from 1 to 23 years. The hospitalized subjects for whom our sample wrote the diary consist of 13 participants aged 23-79 years. Two main themes emerged from the analysis: (1) simplifying the intensive care situation with specific minimization strategies and (2) attention to nonverbal communication. This study highlights the role of nurse-written ICU diaries in making the ICU environment more understandable and less intimidating for patients. Nurse-written ICU diaries contribute to improved communication and emotional support within the ICU environment. Further research is needed to explore these effects more fully and to assess the broader implications of ICU diaries on patient outcomes. Nurse-written intensive care unit (ICU) diaries have a significant impact on both patient care and nursing practice in ICUs. ICU diaries serve as a crucial tool for enhancing communication, emotional support and empathetic care within these high-stress environments. By simplifying complex medical information and focusing on nonverbal communication, nurses can make the ICU experience more comprehensible and less intimidating for patients. This approach reduces patient anxiety and psychological stress while fostering a stronger nurse-patient relationship, ultimately improving care quality.

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.

Patient recall of intensive care delirium: A qualitative investigation.

Many patients in the Intensive Care Unit (ICU) experience delirium. Understanding the patient perspective of delirium is important to improve care and reduce suffering. The aim of our study was to investigate the subjective patient experience of delirium, delirium-related distress, and delirium management in ICU. Our study had a qualitative multicenter design applying individual interviews and thematic analysis. Participants were critically ill adult patients that were determined delirium positive according to validated delirium screening tools during ICU admission. The interviews were conducted after ICU discharge when patients were delirium-free as assessed by the "Rapid clinical test for delirium" (4AT) and able to participate in an interview. We interviewed 30 patients choosing the main themes deductively: Delirium experience; Delirium related distress; and Delirium management. Despite variations in recollection detail, ICU survivors consistently reported delirium-related distress during and after their ICU stay, manifesting as temporal confusion, misinterpretations, and a sense of distrust towards ICU staff. Delusions were characterized by a blend of factual and fictional elements. Impaired short-term memory hindered communication and intensified feelings of isolation, neglect, and loss of control. The ICU survivors in our study recalled delirium as an unpleasant and frightening experience, often leading to delirium-related distress during and after their ICU stay, indicating the necessity for enhanced assessment and treatment.

Placental Abruption: Unveiling Persistent Challenges and Management Strategies from the Obstetrical Intensive Care Unit Experience in Fes, Morocco

Introduction: Postpartum haemorrhage (PPH) remains the leading cause of maternal mortality, with placental abruption (PA) being a serious and challenging etiology. Late diagnosis and inadequate management of PA can exacerbate PPH and worsen maternal outcomes. This work aims to analyse the epidemiological, clinical and Para-clinical profile of PA in the Intensive Care Unit (ICU); as well as to determine the profile of coagulopathy in PPH and to discuss various treatment modalities. Materials &amp; Methods: This retrospective, descriptive, non-interventional study reviews cases of PA requiring ICU admission at Hassan II University Hospital in Fez from January 2019 to December 2023. Results: Forty-two patients met the inclusion criteria, with a mean age of 32 years. Primiparae constituted 33.4% of the cohort. 78.6% lacked prenatal care. The average gestational age was 32 weeks. Preeclampsia was the predominant risk factor (57.1%). Symptoms included mostly slow fetal movements, hemorrhage, and abdominal rigidity. At admission, 26% of patients exhibited hemorrhagic shock. General anesthesia was used in 82.5% of cases. In the operating room, 12% of patients received fibrinogen, and 50% received tranexamic acid. Blood transfusions were administered to 67% of patients, with an average of 2.14 packed red blood cells (PRBCs), 5.3 platelets (PLTs), and 3.5 fresh frozen plasma (FFP). Surgical interventions included hysterectomy, B-Lynch procedure, and vascular ligature. The mean duration of mechanical ventilation in the ICU was 3.66 days. The maternal mortality rate was 9.5%, and five newborns survived to discharge. Conclusion: This study emphasizes the need for a multidisciplinary approach and early intervention to manage PPH from PA effectively, and highlights the importance of national programs to address modifiable risk factors. Keywords: Fibrinogen, Placental Abruption, Postpartum Hemorrhage, Tranexamic Acid, Transfusion, Morocco

Immigrant and minority parents' experiences in a neonatal intensive care unit: A meta-ethnography review.

To examine immigrant and minority parents' experiences of having a newborn infant in the neonatal intensive care unit and explore healthcare professionals' experiences in delivering care to immigrant and minority families. A meta-ethnographic review informed by eMERGe guidelines. We conducted a systematic literature review. Studies were included if they explored immigrant or minority parent experiences in neonatal intensive care units and health professional experiences delivering care to immigrant and minority families in neonatal intensive care. Reporting followed ENTREQ guidelines. Database searches included CINAHL, MEDLINE, PubMed, PsycINFO, Scopus and Google Scholar. Boolean search strategies were used to identify qualitative studies. No limitations on commencement date; the end date was 23rd August 2022. PRISMA guidelines used for screening and article quality assessed using Joanna Briggs Institute criteria for qualitative studies. Initial search yielded 2468 articles, and nine articles met criteria for inclusion. Three overarching themes were identified: (1) Overwhelming Emotions, (subthemes: Overwhelming Inadequacy; Cultural Expressions of Guilt; Not Belonging), (2) Circles of Support, (subthemes: Individual Level-Spirituality; External Level-Connecting with Family; Structured Peer-to-Peer Support), (3) Negotiating Relationships with Healthcare Professionals (subthemes: Connecting; Disconnected; Linguistic Barriers). Interactions between healthcare professionals and immigrant and minority parents were the strongest recurring theme. There can be a mismatch between immigrant and minority families' needs and the service support provided, indicating improvements in neonatal intensive care are needed. Despite challenges, parents bring cultural and family strengths that support them through this time, and many neonatal intensive care staff provide culturally respectful care. Professionals should be encouraged to identify and work with family strengths to ensure parents feel supported in the neonatal intensive care unit. Findings can inform policy and practice development to strengthen health professionals capabilities to support immigrant and minority families in neonatal units. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklists were used to report the screening process.

Healthcare providers’ communication experience in the pediatric intensive care unit: a phenomenological study

BackgroundHealthcare providers must effectively communicate with other professionals, multidisciplinary teams, and parents of patients in pediatric intensive care units (PICUs) to improve outcomes in children and satisfaction levels of parents. Few studies have focused on healthcare providers’ communication experiences, which are crucial for identifying current problems and suggesting future directions. This phenomenological study was conducted to address this gap.MethodsA qualitative study using online and face-to-face interviews was conducted from January to June 2021 by a trained researcher in PICUs of two tertiary hospitals. Participants were five physicians and four registered nurses who worked in the PICUs and had over five years of clinical experience. The interviews were audio recorded with the participant’s consent and analyzed by the researchers using Colaizzi’s seven-step method.ResultsHealthcare providers’ communication experiences revealed four categories: facing communication difficulties in PICUs, communication relying on individual competencies without established communication methods, positive and negative experiences gained through the communication process, and finding the most effective communication approach.ConclusionsWithout adequate support or a systematic training program, healthcare providers often have to overcome communication challenges on their own. Therefore, support and training programs should be developed to facilitate better communication in the future.

Rapid complete blood count and C-reactive protein determination with the Horiba Microsemi analyzer: the experience in neonatal intensive care unit of Careggi University Hospital

Microsystems represent an alternative but proficient approach of analysis outside the laboratory, and their use could help in reducing the impact of pre-analytical errors, in particular in challenging newborn samples. The study purpose is to compare the Horiba Microsemi CRP LC-767G system for rapid 3-part complete blood count (CBC) and C-reactive protein (CRP) determination with the laboratory reference systems (respectively Sysmex XN-9100™ and Roche Cobas® c702) in samples of adult patients and newborns hospitalized in the neonatal intensive care unit (NICU) samples. The comparison between the analyzers was performed through Passing-Bablok regression analysis and Bland–Altman plot. One hundred eighty-three blood samples were analyzed. The regression analysis results, performed in the newborn (n = 70) and in adult (n = 113) populations, showed a good agreement between the instruments. The evaluation of the Bland–Altman plots showed comparable values of bias < 10% for most of the parameters, but not for MPV, lymphocyte, and monocyte count. Conclusion: The comparison between the Microsemi CRP LC-767G system and the laboratory instrumentations demonstrated comparable results. The Microsemi CRP LC-767G system provides reliable analytical data and faster turnaround time, particularly useful in NICU. What is Known:• Microsystems for point-of-care testing (POCT) represent an alternative but proficient approach of analysis outside the laboratory, in order to perform a rapid, safe, and exhaustive evaluation for critical patients’ management, acting as a valid support for treatment in acute care.What is New:• The Microsemi CRP LC-767G system can represent an alternative but effective testing approach outside the laboratory, particularly in NICU, to reduce the impact of pre-analytical errors on newborn samples.

Non-invasive neurally adjusted ventilatory assist (NIV-NAVA) in the neonatal intensive care unit (NICU): an Australian NICU experience

BackgroundPreterm infants often require non-invasive breathing support while their lungs and control of respiration are still developing. Non-invasive neurally adjusted ventilatory assist (NIV-NAVA) is an emerging technology that allows infants to breathe spontaneously while receiving support breaths proportional to their effort. This study describes the first Australian Neonatal Intensive Care Unit (NICU) experience of NIV-NAVA.MethodsRetrospective cohort study of infants admitted to a major tertiary NICU between October 2017 and April 2021 supported with NIV-NAVA. Infants were divided into three groups based on the indication to initiate NIV-NAVA (post-extubation; apnoea; escalation). Successful application of NIV-NAVA was based on the need for re-intubation within 48 h of application.ResultsThere were 169 NIV-NAVA episodes in 122 infants (82 post-extubation; 21 apnoea; 66 escalation). The median (range) gestational age at birth was 25 + 5 weeks (23 + 1 to 43 + 3 weeks) and median (range) birthweight was 963 g (365–4320 g). At NIV-NAVA application, mean (SD) age was 17 days (18.2), and median (range) weight was 850 g (501–4310 g). Infants did not require intubation within 48 h in 145/169 (85.2%) episodes [72/82 (87.8%) extubation; 21/21 (100%) apnoea; 52/66 (78.8%) escalation).ConclusionNIV-NAVA was successfully integrated for the three main indications (escalation; post-extubation; apnoea). Prospective clinical trials are still required to establish its effectiveness versus other modes of non-invasive support.

Parent Emotions Regarding the Neonatal Intensive Care Unit Experience &amp; Transition Home

Abstract Date Presented 03/21/24 Emotions around the neonatal intensive care unit (NICU) experience and transition home were explored. Fear was expressed equally for NICU and home, and happiness was discussed twice as often for home experiences. Professionals need to consider parent emotions during this period. Primary Author and Speaker: Audrey Kane Contributing Authors: Christine M. Spence, Corri Stuyvenberg, Rachel Gaston, Jennifer Burnsed, Karen D. Hendricks-Muñoz, Richard D. Stevenson, Stacey Dusing

Exploring Patients Service Experience of Psychiatric Intensive Care Unit (PICU) Admissions

Background: A psychiatric intensive care unit (PICU) is a tertiary mental health service that provides short-term care for patients who present with highly challenging behaviours during their psychiatric admission and require close supervision and observation due to their elevated risk of self-harm and harm towards others. A key feature of a PICU is its high level of staffing and more secured facilities. The main purpose of a PICU admission is to optimise management of patients who pose a risk to themselves and others whilst benefiting from a low-stimulus environment. However, the body of knowledge that sub serves the perspective of patients’ ‘service experience’ regarding PICU admissions remains relatively unexplored. Objective: The purpose of this study is to explore patients’ service experience of PICU admissions with the hope that this will help improve service delivery on these wards/units. Methods: The study employed a descriptive qualitative research approach. Data for this study was collected using a semi-structured questionnaire over a six-month period. The study participants involved psychiatric patients admitted to PICU under the Irish Mental Health Act of 2001 legislation from other approved centres in Ireland. Results: Six themes emerged from participants’ responses namely, communication and therapeutic engagement, unit environment, recreational and activity therapies, privacy and confidentiality, access to information as well as general experience of care and service provision in PICU. The results provide moderately less evidence for the engagement of PICU patients in recreational activities during the period of admission in PICU. Additionally, there was significantly inadequate pre-discharge debriefing for patients prior to discharge from PICU. Lastly, a greater proportion of the study participants were satisfied with PICU services and expressed their willingness to recommend PICU to individuals who may benefit from PICU services. Conclusion: Understanding the experiences of this patient population and their perspectives on PICU services is crucial to informing and developing concrete strategies for clinical practice in acute psychiatric settings. Therefore, therapeutic programs and more flexible activities are required to facilitate easy access by patients that will enhance or positively shape their experiences of PICU and other acute psychiatric services.