ICU Nurses Research Articles

Prevention of Ventilator-associated Pneumonia: Knowledge and Practice of Ventilator Care Bundle among ICU Nurses of Tertiary Care Hospitals of Jodhpur, Rajasthan

Prevention of Ventilator-associated Pneumonia: Knowledge and Practice of Ventilator Care Bundle among ICU Nurses of Tertiary Care Hospitals of Jodhpur, Rajasthan

Nguy cơ căng thẳng liên quan đến nghề nghiệp và một số yếu tố liên quan ở điều dưỡng tại hệ thống bệnh viện đa khoa Quốc Tế Vinmec năm 2022

Objectives: To describe occupational stress and its related factors among nurses. Subjects and methods: A descriptive cross-sectional study was conducted with a sample of 319 non-frontline nurses during the COVID-19 pandemic at the Vinmec Healthcare System across Vietnam from December 2021 to August 2022 by the use of the Expanded Nursing Scale. Nurses had low stress levels at all subscales following the ENSS (the mean scores ranged from 1.52 to 1.73). The highest score was “death and dying” (1,73 ± 0,49). There was a significant association between gender and the level of stress, p<0.05. In terms of stress levels regarding patients and families, pediatric nurses (Md=1,71, n=25) experienced more stress than ICU nurses (Md= 1,43, n= 110), p<0,05. The level of stress was low among non-frontline nurses. Gender and working department were significantly associated with stress levels.

Attitudes and perceptions of ICU nurses in caring for COVID-19 patients

ICU Nurses’ attitudes and Perceptions towards COVID-19 Patients is crucial because it illuminates challenges regarding caring these patients in the critically ill. This cross-sectional descriptive correlational study employed 85 Saudi ICU nurses worked with critically ill COVID-19 patients since 2020 until present in the government hospitals affiliated in the Ministry of Health (MOH) in Hail Region. These hospitals included King Khalid Hospital, King Salman Specialist Hospital, Hail general Hospital, Maternity and Child Hospital, and Sharaf Hospital, as they all have intensive care units in different specialties. A self-administered questionnaire through online survey was used and composed of three parts, (1) socio-demographic profile of the respondents, (2) the attitudes of the respondents in Caring for COVID-19 Patients and (3) perceptions of the respondents in Caring for COVID-19 Patients. The tool was adopted from Al-Dossary et al. (2020). The majority of nurses participated in the study aged between 25-34 years old, hold bachelor’s degree, and had between 2-5 years clinical experience. Nurses’ perception and attitude were moderately positive. However, male and females were differed in respect to attitude and perception. Likewise, education, age, and length of hospital experience were also influential to the attitudes and perception. In conclusion, healthcare organizations should evaluate ICU nurses attitudes and perception of pandemics to ensure safer and optimal practice.

The Association between Working Hours with Vigilance and Executive Function of Intensive Care Unit Nurses

Background. Vigilance and executive functions are integral to nursing practice. Prolonged working hours are associated with heightened fatigue and increased nursing errors. However, the impact of work duration on the vigilance and executive function of ICU nurses remains unexplored. Objective. This study aims to elucidate the association between ICU nurses’ working hours, vigilance, and executive function. Design. A cross-sectional study. Setting. Intensive care medicine department of a tertiary hospital in Zhengzhou, China. Participants. A total of 51 registered nurses who participated in 12 h shifts in the ICU completed the survey. Methods. E-prime software was employed to develop four test tasks to measure the vigilance and executive functioning of ICU nurses. The test was performed before the start of the shift and after 4, 8, and 12 h. Results. The analysis revealed no statistically significant differences in the response time of vigilance for ICU nurses across shifts ( p = 0.503 ) or working hours ( p = 0.078 ). However, a significant difference existed in lapses across working hours ( p = 0.005 ), significantly increasing after 8 and 12 h. The analysis indicated a significant difference in Flanker effect size across different working hours ( p = 0.035 ). The analysis revealed no significant differences in the switch cost ( p = 0.200 ) or response accuracy ( p = 0.479 ) of the task switching across working hours. The response accuracy for the 2-back task differed significantly ( p = 0.003 ) across working hours. Conclusion. Limited evidence demonstrated that vigilance and specific aspects of executive functioning (inhibitory control and working memory) of ICU nurses were negatively correlated with the duration of their work in a real clinical setting. Furthermore, no vigilance and executive function differences were identified between day and night shifts. Implications for Nursing Management. Nursing administrators should reconsider scheduling 12 h shifts, shortening shifts, or implementing short rest periods to reduce fatigue and cognitive load. In addition, flexible scheduling and rationalizing the order of work may help reduce the possible risks associated with prolonged work.

A Study to Assess the Effectiveness of An Information Booklet on Knowledge regarding Varicose Veins and its Contributing Factors among ICU Nurses in Selected Hospital of Guwahati, Assam

A Study to Assess the Effectiveness of An Information Booklet on Knowledge regarding Varicose Veins and its Contributing Factors among ICU Nurses in Selected Hospital of Guwahati, Assam

Strategic Deployment of ICU Nurses in Response to the Omicron Variant Epidemic in Shanghai.

In the first half of 2022, Shanghai faced the challenge of an emerging wave of epidemics caused by the Omicron variant. In response, 48 hospitals, spanning municipal and district levels, were rapidly converted into designated hospitals. This case study focuses on the South Branch of Renji Hospital, School of Medicine, Shanghai Jiaotong University, as one such designated hospital. Facing unprecedented challenges without prior experience, we devised a strategic approach to deploy ICU nurses effectively. This approach involved crisis event gradation, establishing a human resources pool, and classifying nursing staff based on qualifications and proficiencies. By May 11, 2022, all 48 designated hospitals were operational. The South Branch of Renji Hospital treated 3310 Omicron-infected patients between April 7 and June 21, 2022, including 115 critically ill patients in a 38-bed ICU. We meticulously assigned 136 nurses, distributed as follows: Grade A 12.5%, Grade B 12.5%, Grade C 40%, and Grade D 35%, with three specialized nursing managers. Nurses worked tirelessly in 4-hour shifts, wearing full protective gear. Remarkably, the hospital maintained a flawless record, with no nursing-related adverse events and zero patient mortality in the ICU. Effective management of ICU nursing personnel is associated with patient safety. Strategic rostering and placement of ICU nurses in designated hospitals optimize resource utilization, enhancing service effectiveness and working conditions. This technique is a crucial resource for hospitals facing unforeseen public health crises requiring rapid ICU nurse resource allocation and management.

Construction and Application of a Training Program for ICU Nurses to Manage Artificial Airway Gasbags to Prevent Ventilator-Associated Pneumonia

Construction and Application of a Training Program for ICU Nurses to Manage Artificial Airway Gasbags to Prevent Ventilator-Associated Pneumonia

The relationship between role ambiguity and anxiety in intensive care unit nurses: The mediating role of emotional intelligence

BackgroundRole ambiguity is recognized as a significant psychological risk stressor in nursing practice, which undermines the psychological well-being of nurses. Since the well-being of nurses plays a crucial role in ensuring positive patient outcomes, it becomes imperative to identify strategies for improving nurses' psychological well-being. ObjectivesThis study aimed to explore the effects of role ambiguity on anxiety in intensive care unit nurses and the mechanisms mediating emotional intelligence. MethodsIn April–June 2023, a convenience sampling method was used to collect data from 360 intensive care unit nurses in a total of 7 hospitals in Shaanxi Province, Hunan Province, Beijing, and Jiangsu Province, China. A linear regression model was used to verify the mediating effect. ResultsRole ambiguity was significantly and positively associated with anxiety in ICU nurses (p < 0.01). A mediating mechanism between role ambiguity and anxiety was established for emotional intelligence (p < 0.01). ConclusionsRole ambiguity has a significant impact on the mental health of intensive care nurses, and emotional intelligence plays a mediating role in reducing role ambiguity and anxiety in nurses. Implications for clinical practiceThis study highlights that role ambiguity in the intensive care unit setting increases nurses' anxiety, while emotional intelligence alleviates the anxiety associated with role ambiguity. Creating support systems and improving the environment is a top priority for nursing administrators. This includes, but is not limited to, clarifying the roles of nurses, conducting social-emotional training, and developing emotional intelligence to prevent and regulate nurses' anxiety and maintain mental health.

Insomnia among Intensive Care Unit Nurses in the United Arab Emirates and its Association to Work Productivity and Quality of Life

Background: A healthy workforce is essential for sustainable healthcare systems, disease control, and the provision of quality and safe healthcare services. Insomnia is a common problem among critical care nurses attributed to the hard nature of their work, long and irregular shifts, high levels of stress and tension, and exposure to traumatic situations associated with critical care environments. These issues compromise their professional and personal lives, have financial consequences for health organizations, and may reduce the quality of care provided to patients. Aim: To assess the prevalence of insomnia among ICU nurses and determine its impact on their Quality of Life (QoL) and work productivity. Methods: This cross-sectional study involved 430 ICU nurses working in three major governmental hospitals in the United Arab Emirates. Nurses were selected via convenient sampling. Data collected included nurses’ demographic characteristics, insomnia levels using the Athens Insomnia Scale, work productivity using the workability index, and QoL using the World Health Organization Quality of Life Scale-Brief questionnaire Results: Approximately 237 (55%) of participants reported moderate to severe levels of insomnia, and 195 (45.3%) had moderate productivity levels. However, the majority of participants reported low QoL levels in physical, psychological, social, and environmental QoL domains (61.4%, 60.2%, 47.2%, and 70.5%), respectively. Bivariate correlations demonstrated a significant negative relationship; correlation coefficient of -0.517, between participants' insomnia levels and work productivity levels. Additionally, significant negative relationships were found between insomnia levels and the QoL domains, with correlation coefficients of -0.629, -0.568, -0.469, and -0.485, respectively. Conclusion: This study found that insomnia has a negative relationship with ICU nurses’ work productivity and QoL. This may impact care delivery patient care and safety.Regular counseling sessions, better working hours, less overtime, and a better work-life balance may contribute to increased productivity and improved QoL among ICU nurses in the UAE.

Barriers to Safe Oxygen Therapy and the Effect of the Training on the Knowledge and Performance of ICU Nurses.

Proper oxygen therapy is crucial in hospitals, particularly intensive care units, to ensure safety and accuracy. The role of nurses during oxygen therapy is vital, as their knowledge and correct performance significantly impact patients' clinical conditions. A study was carried out to examine the knowledge and performance of nurses regarding safe oxygen therapy. The study aimed to identify the obstacles hindering safe oxygen therapy and assess the impact of training on the knowledge and performance of intensive care nurses. This study was conducted among the ICU nurses at Shahid Rahnemoun Teaching Hospital in Yazd, Iran. The study method is a sequential combination of descriptive, qualitative, and educational phases. The first stage involved examining the knowledge and performance of 80 ICU nurses in oxygen therapy. The study employed content analysis to elaborate on participants' perspectives on safe oxygen therapy challenges and potential solutions. The third phase involved a two-group study with pre- and post-tests to examine the effect of training on ICU nurses' knowledge and performance in oxygen therapy. The study found that intervention and control groups had low average scores in knowledge, performance, and total score of oxygen therapy before the study, with no significant difference. There was a significant difference between intervention and control groups one and three months after the intervention in the areas of knowledge (after-1 month 24.41 vs. 20.29, 95% CI [3.144-5.098], after-3 month 22.13 vs. 20.24, 95% CI [0.729-3.053]), performance (after-1 month 21.54 vs. 18.05, 95% CI [2.898-4.073], after-3 month 19.74 vs. 18.63, 95% CI [0.400-1.824]), and total score of oxygen therapy (after-1 month 45.95 vs. 38.34, 95% CI [6.288-8.925], after-3 month 41.87 vs. 38.87, 95% CI [1.394-4.613]). The study's findings revealed that nurses in ICUs lack the appropriate knowledge and performance in oxygen therapy. A lack of knowledge and correct practice, insufficient monitoring of oxygen therapy, and defects in hospital equipment are contributing factors. The training was found to improve the knowledge and performance of nurses significantly. Consistent training at shorter intervals is suggested for nurses to keep their knowledge current.

Relationship Between Intensive Care Nurses' Attitudes and Behaviors Toward End-of-Life Care and Ethical Attitudes.

Nurses are in a central position to improve care for dying patients and their families by challenging current end-of-life practices in their settings. Nurses who care for such patients experience the associated ethical dilemmas. However, the relation between their attitude and behavior regarding end-of-life care and their ethical attitudes is not known. The aim of this study was to examine the relation between the attitudes and behaviors of intensive care unit nurses to end-of-life care and their ethical attitudes in the care process. The research was conducted in Antalya, one of the most populous provinces in Turkey, with 287 intensive care nurses working in 4 different hospitals. The research data were collected between June 30 and August 30, 2021. Self-report data were collected using a Nurses' Description Form, the Attitudes and Behaviors of ICU Nurses to End-of-Life Care Scale, and the Ethical Attitude Scale for Nursing Care. The mean score of the intensive care nurses for attitude and behaviors to end-of-life care was 62.36 ± 13.22, and their mean score for ethical attitude for nursing care was 149.76 ± 24.98. It was found that intensive care nurses' attitudes and behaviors to end-of-life care had a positive correlation on their ethical attitudes in the care process (P < .001). It would be of interest to understand how these attitudes impact clinical decision-making for the ultimate understanding of whether nurses' attitudes can be a barrier to the delivery of quality end-of-life care.

The association between workplace physical environment and nurses’ safety compliance: A serial mediation of psychological and behavioral factors

AimThis study describes Jordanian intensive care unit nurses' satisfaction with their physical environment and investigates the association between workplace physical environment and nurses' safety compliance. Additionally, the study offers serial mediation analyses of psychological and behavioral factors between satisfaction with the workplace physical environment and nurses’ safety compliance. IntroductionCompliance with safety measures is a vital indicator of safety performance, as less compliance directly reflects undesirable safety outcomes among nurses, like occupational accidents, injuries, and fatalities. Social cognitive theory and the safety triad model contribute to understanding safety compliance behaviors to safety procedures. Thus, enhancing safety compliance in healthcare organizations remains a challenge and concern. MethodsA quantitative research method was used based on cross-sectional and descriptive data from eight governmental hospitals in Jordan. The population included all intensive care unit nurses in the Ministry of Health's hospitals (n = 1104). A cluster sampling technique selected 285 nurses to participate. Empirical results were obtained through structural equation modeling (i.e., Smart PLS-SEM), which has become popular in this kind of research. ResultsThe mean of Jordanian ICU nurses' satisfaction with the workplace physical environment was 3.36, which is moderate. Although the Smart PLS findings did not support the direct association between the workplace physical environment and nurses' safety compliance, serial mediation of safety participation in the workplace physical environment and nurses’ safety compliance and perceived safety management commitment confirm the indirect association in the study model. ConclusionThis study fills a gap in available safety and nursing literature, especially when considering the scarce studies that investigated the physical elements in the workplace and both safety compliance and safety participation. The findings are valuable for academicians, health providers, and policymakers and may trigger creative ideas and interventional solutions to improve nurses’ safety compliance in healthcare organizations.

Latent profile analysis and influence factors study of presenteeism among ICU nurses in China.

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. 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. 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. 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 presenteeism-work limitation group. 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.

The Nurses-family Members’ Relationship at the Intensive Care Units in Jordan: A Phenomenological Study

Background: Communication with patients’ families facilitates and creates a trustful relationship between nurses and patients' families and helps nurses to identify and understand patients' and families’ needs. Aims: This study aimed to explore Jordanian ICU nurses’ communication experience with patients’ families. Methods: A phenomenological approach was utilized to explore the nurses’ communication experience with family members of patients in the ICU. Participants were recruited from three ICU units in Amman, the capital of Jordan. Results: Eighteen critical care nurses were interviewed. Two major themes of nurses’ communication experiences were identified: Precarious relationships and disruptive communication patterns. Conclusion: To achieve high-quality care, participants recognized the importance of appropriate communication with family members. Results showed the importance of continuous improvement of communication skills with patients and their family members.

Patient Admission and Mechanical Ventilator Allocation Decision-Making Processes by Frontline Medical Professionals in a Japanese ICU During the COVID-19 Pandemic: A Qualitative Study.

During the COVID-19 pandemic, the need to triage COVID-19 patients in ICUs emerged globally. Triage guidelines were established in many countries; however, the actual triage decision-making processes and decisions themselves made by frontline medical providers may not have exactly reflected those guidelines. Despite the need to understand decisions and processes in practice regarding patient ICU admission and mechanical ventilator usage to identify areas of improvement for medical care provision, such research is limited. This qualitative study was conducted to identify the decision-making processes regarding COVID-19 patient ICU admissions and mechanical ventilator allocation by frontline medical providers and issues associated with those processes in an ICU during the COVID-19 pandemic. Semi-structured, in-depth interviews were conducted with ICU physicians and nurses working at an urban tertiary referral hospital in Japan between February and April 2022. Patient characteristics that influenced triage decisions made by physicians and the interaction between physicians, nurses, and senior management staff upon making such decisions are discussed in this article. An implicated issue was the lack of legal support for Japanese physicians to practice withdrawal of life-sustaining treatments even during emergencies. Another issue was the impact of non-clinical forces-likely specific to health emergencies-on physicians' decisions regarding mechanical ventilator allocation, where such forces imposed a significant mental burden on the medical providers. We consider public policy and legal implications for future pandemics.

Nurses' Knowledge of Adverse Medication Events and its Contributing Factors at Intensive Care Units: A Cross-Sectional Study

Context: Medication errors are a major concern in the healthcare setting, as they result from the inappropriate use of products related to the treatment or the effects that lead to harm. In Saudi Arabia, prescription errors constitute nearly one-fifth of all medication errors. Still, there is a difference in dealing with the process of using medications based on each country and its background.&#x0D; Aim: To assess the ICU nurses’ knowledge and contributing factors regarding adverse medication events at Makkah City Hospitals in Saudi Arabia.&#x0D; Methods: The study was a cross-sectional study conducted among nurses at different hospitals in Makkah City, Saudi Arabia. A random probability sampling technique was used to choose the appropriate sample of nurses. The sample size was 155 nurses. A valid and reliable knowledge questionnaire on medication errors was used.&#x0D; Results: There was good knowledge regarding adverse medication events for 13.5% of participants. Most participants (86.5%) had poor knowledge of adverse medication events. The mean knowledge score of ICU Nurses about Adverse Medication Events was 4.81±1.91 among males and 4.28±1,96 among females. There was no significant statistical relationship between nurses’ knowledge about adverse medication events with gender (t-test 1.653, p-value=0.598), education level (r=-0.137, p-value=0.089), and workplace (r=0.072, p-value=0.376). There was a significant statistical negative relationship between ICU nurses’ knowledge score about Adverse Medication Events with age (r=-0.251, p-value=0.002), nationality (r=-0.739, p-value=0.000), role/profession (r=-0.242, p-value=0.002). There was a significant statistically positive relationship between ICU nurses’ knowledge score about Adverse Medication Events with work weekly hours (r=0.205, p=0.010)&#x0D; Conclusion: The study's result underscores the importance of enhancing ICU nurses' knowledge and skills related to adverse medication events. Hospital management should provide training opportunities to help nurses develop their knowledge and skills in medication administration to prevent medication errors and ensure patient safety.

Knowledge and Attitude on Patient Safety among ICU Nurses in Selected Hospital at Chennai

Knowledge and Attitude on Patient Safety among ICU Nurses in Selected Hospital at Chennai

Correlation between professional quality of life and alarm fatigue symptoms among intensive care unit nurses.

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

Project to Improve FloTrac Cognition and Skill Accuracy in Nurses Working in the Intensive Care Unit

FloTrac is used to monitor hemodynamics in patients. Insufficient awareness of and inexperience with this machine put patients at risk. A project was developed to increase FloTrac cognitive accuracy from 57.6% to 85% and skill accuracy from 73.3% to 91% in ICU nurses. Also, FloTrac installation time was intended to be reduced to less than 8 minutes and 38 seconds. Create a pithy, easy-to-remember formula; make operation teaching videos, operation manuals, and reminder cards; arrange educational training; and monitor quality regularly. FloTrac cognitive accuracy increased from 57.6% to 90.4%; FloTrac skill accuracy increased from 73.3% to 99.7%; and installation time was shortened from 8 minutes and 38 seconds to 5 minutes and 42 seconds. After implementation of the project, nurses improved their professional knowledge and were better able to help doctors obtain hemodynamic data efficiently to provide patients with accurate and rapid treatment.

상급종합병원 중환자실 간호사의 간호역량인식과 도덕적 민감성이 인간중심간호에 미치는 영향

상급종합병원 중환자실 간호사의 간호역량인식과 도덕적 민감성이 인간중심간호에 미치는 영향