Intensive Care Unit Nurses Research Articles

The Knowledge and Practice of ICU Nurses Regarding Enteral Nutrition

Background: Enteral nutrition is a critical aspect of care for patients in intensive care units (ICUs) who cannot consume food orally. Understanding the practices and knowledge of ICU nurses regarding enteral nutrition is essential for ensuring effective patient care and outcomes. Objective: This study aimed to assess the knowledge and practices of ICU nurses regarding enteral nutrition and identify any gaps that could potentially impact patient care. Methods: A cross-sectional study was conducted at Jinnah Hospital, Lahore, using purposive sampling to recruit 142 ICU nurses. Data were collected over a nine-month period using a validated questionnaire designed to evaluate the nurses' knowledge and practices concerning enteral nutrition. Statistical analysis was performed using SPSS software version 25, focusing on descriptive and inferential statistics to understand the trends and associations within the data. Results: The study revealed that 65% of nurses correctly identified pancreatitis as an indication for starting enteral nutrition. However, 73% incorrectly believed that a continuous drip method of enteral feeding does not require a pump. Furthermore, 63% recognized tube dislodgement as a complication, yet 57% either did not know or incorrectly handled protocols for flushing enteral feeding tubes before use. The assessment of nasogastric tube placement every 24 hours was misunderstood by 57% of the participants. Conclusion: The findings indicate a considerable deficiency in the knowledge and practices of ICU nurses regarding enteral nutrition, with significant implications for patient care. There is a clear need for targeted educational programs and updated protocols to enhance the skills and understanding of nurses in this crucial area.

The current state of intensive care unit discharge practices - Results of an international survey study.

Increasing pressure on limited intensive care capacities often requires a subjective assessment of a patient's discharge readiness in the absence of established Admission, Discharge, and Transfer (ADT) guidelines. To avoid suboptimal care transitions, it is important to define clear guidelines for the admission and discharge of intensive care patients and to optimize transfer processes between the intensive care unit (ICU) and lower care levels. To achieve these goals, structured insights into usual ICU discharge and transfer practices are essential. This study aimed to generate these insights by focusing on involved stakeholders, established processes, discharge criteria and tools, relevant performance metrics, and current barriers to a timely and safe discharge. In 2022, a structured, web-based, anonymous cross-sectional survey was conducted, aimed at practicing ICU physicians, nurses, and bed coordinators. The survey consisted of 29 questions (open, closed, multiple choice, and scales) that were divided into thematic blocks. The study was supported by several national and international societies for intensive care medicine and nursing. A total of 219 participants from 40 countries (105 from Germany) participated in the survey. An overload of acute care resources with ~90% capacity utilization in the ICU and the general ward (GW) leads to not only premature but also delayed patient transfers due to a lack of available ward and intermediate care (IMC) beds. After multidisciplinary rounds within the intensive care team, the ICU clinician on duty usually makes the final transfer decision, while one-third of the panel coordinates discharge decisions across departmental boundaries. By the end of the COVID-19 pandemic, half of the hospitals had implemented ADT policies. Among these hospitals, nearly one-third of the hospitals had specific transfer criteria established, consisting primarily of vital signs and laboratory data, patient status and autonomy, and organization-specific criteria. Liaison nurses were less common but were ranked right after the required IMC capacities to bridge the care gap between the ICU and normal wards. In this study, 80% of the participants suggested that transfer planning would be easier if there was good transparency regarding the capacity utilization of lower care levels, a standardized transfer process, and improved interdisciplinary communication. To improve care transitions, transfer processes should be managed proactively across departments, and efforts should be made to identify and address care gaps.

The prevalence of hand dermatitis among intensive care unit nurses.

Healthcare workers are at high risk of developing occupational hand dermatitis (HD) due to their frequent exposure to wet-work and use of gloves. Complaints of HD may interfere with work and cause loss of work productivity, or sick leave, and may have impact on job pleasure and performing daily activities. The prevalence of HD among intensive care unit (ICU) nurses is unknown. To investigate the point prevalence and the 1-year prevalence of HD among ICU nurses, and to determine the impact of HD on work and daily activities. A questionnaire-based cross-sectional study was performed among ICU nurses. Participants were recruited in the Amsterdam University Medical Centre. A symptom-based questionnaire was used to determine HD and atopic predisposition, and an additional questionnaire was used concerning the influence of HD. ICU nurses with an atopic predisposition or symptoms suiting HD were invited for the hand dermatitis consultation hour (HDCH). Data were analysed with logistic regression. A total of 184 ICU nurses were included. The point prevalence of HD was 9.8% (95% CI: 5.9-15.0) and the 1-year prevalence was 26.6% (95% CI: 20.4-33.6). Sick leave was reported by 0.5%. HD seemed to have more impact on job pleasure than on work productivity. The high prevalence rate of HD resulting from our study highlights the need for the prevention of occupational HD among healthcare workers.

Weak Correlation Between Perceived and Measured Intensive Care Unit Nursing Workload: An Observational Study.

Efficient management of nursing workload in the intensive care unit (ICU) is essential for patient safety, care quality, and nurse well-being. Current ICU-specific workload assessment scores lack comprehensive coverage of nursing activities and perceived workload. The purpose of this study was to assess the correlation between ICU nurses' perceived workload and the Nine Equivalents of Nursing Manpower Use Score (NEMS). In a 45-bed adult ICU at a tertiary academic hospital, nurses' perceived shift workload (measured with an 11-point Likert scale) was correlated with the NEMS, calculated manually and electronically. The study included 1734 observations. The perceived workload was recorded for 77.6% of observations. A weak positive correlation was found between perceived and objectively measured workload. Findings indicate a need to consider the multifaceted nature of nursing activities and individual workload perceptions in the ICU.

Factors Related to Post-traumatic Stress Disorder Symptoms Among Intensive Care Unit Nurses

PurposeTo identify the factors affecting the post-traumatic stress disorder (PTSD) symptoms of intensive care unit (ICU) nurses. The variables include event experiences, cognitive flexibility, and co-worker support. MethodsA survey was conducted among 153 ICU nurses working in a general hospital or an advanced general hospital. The questionnaire was completed between October and December 2018, and 153 copies were used for the final analysis. Data were analyzed using multiple linear regression to determine the factors associated with PTSD symptoms among ICU nurses. ResultsThe level of PTSD symptoms of ICU nurses was 1.20±0.82 out of 4. Full PTSD, signified by a total score of 25 or more, was reported by 45.1% of the study's 153 participants. The significant influencing factors of PTSD symptoms among ICU nurses were the “experience of traumatic events”, “trusted alliance”, which is a sub-area of “coworker support,” and both “control” and “alternative”, which are sub-areas of “cognitive flexibility.” The explanatory power (49.8%) was statistically significant. ConclusionThese results suggest that a program to enhance the cognitive flexibility and coworker support of ICU nurses needs to be developed to reduce the PTSD symptoms of ICU nurses.

Prevalence and characteristics of medical emergency teams in Switzerland: a nationwide survey of intensive care units.

Medical Emergency Teams (METs) have been implemented in many hospitals worldwide and are considered an integral part of the hospital patient safety system. However, data on prevalence, staffing and activation criteria of METs are scarce. Such data are important as they may help to identify areas of quality improvement and barriers to implementation of rapid response systems (RRS). This survey aimed to analyze current characteristics, prevalence, and organization of METs in Switzerland. We conducted a cross-sectional nationwide online survey, inviting physicians' and nurses' representatives from all registered adult intensive care units (ICU) in Switzerland. Of the 74 hospitals invited to participate in the survey, 57 responded (response rate 77%). We obtained 82 individual responses (from 50 physicians and 32 nurses). Twenty-five hospitals (44%) have a MET in place. In most Swiss hospitals, METs are composed of ICU consultants (64%) and ICU nurses (40%) and are activated by phone, with a usual response time of less than 10 minutes. The most common triggers are single abnormal vital signs (80%), while multiple-parameter warning scores are less commonly used (28%). While more than half of the nurses have regular trainings for their MET members (57%), most MET physicians (63%) do not. Systematic data collection of MET calls occurs in only 43% of institutions. Finally, the most common reasons for not having a MET are staff shortage (44%) and lack of funding (19%). Less than 50% of Swiss hospitals with an adult ICU have a MET in place. METs in Switzerland typically include an ICU doctor and an ICU nurse and are available 24/7. Major barriers to MET introduction are staff shortage and lack of funding.

Professional quality of life among intensive care unit nurses in Saudi Arabia: A cross-sectional study

ABSTRACT Background: Stressful and challenging intensive care settings may influence nurses’ professional quality of life (ProQOL), in terms of job satisfaction, burnout (BO), and secondary traumatic stress (STS). Aims: This study aimed to measure the ProQOL of critical care nurses, and its association with sociodemographic variables. Settings and Design: The study was conducted in the intensive care unit (ICU) of a tertiary referral hospital in Saudi Arabia. Materials and Methods: Cross-sectional design utilizing the self-administered ProQOL 5.0 questionnaire composed of three subscales for compassion satisfaction (CS), BO, and STS. Statistical Analysis: scores of the three subscales of the ProQOL questionnaire were presented as mean and standard deviation, and their association with categorical sociodemographic variables was explored using analysis of variance or Kruskal–Wallis test. Results: With a response rate of 48.4%, the majority of nurses were in the moderate category of all three subscales of the questionnaire, with mean scores of CS, BO, and STS of 35.8 ± 6.6, 27 ± 4.4, and 23.9 ± 8.7, respectively. Higher levels of education and longer experience were significantly associated with lower STS scores. Conclusion: Moderate levels of all subscales of ProQOL prevail in our ICU. Longer experience and higher educational levels may be significant factors in minimizing STS.

Impact of Bedside Laparotomy Simulation and Microlearning on Trauma Nurse Role Clarity, Knowledge, and Confidence.

The care of patients undergoing low-volume, high-risk emergency procedures such as bedside laparotomy (BSL) remains a challenge for surgical trauma critical care nurses. This study evaluates simulation and microlearning on trauma nurse role ambiguity, knowledge, and confidence in caring for patients during emergency BSL. The study is a single-center, prospective pretest-posttest design conducted from September to November 2022 at a Level I trauma center in the Mid-Atlantic United States using simulation and microlearning to evaluate role clarity, knowledge, and confidence among surgical trauma intensive care unit (STICU) nurses. Participants, nurses from a voluntary convenience sample within a STICU, attended a simulation and received three weekly microlearning modules. Instruments measuring role ambiguity, knowledge, and confidence were administered before the simulation, after, and again at 30days. From the pretest to the initial posttest, the median (interquartile range [IQR]) Role Ambiguity scores increased by 1.0 (1.13) (p <.001), and at the 30-day posttest, improved by 1.33 (1.5) (p <.001). The median (IQR) knowledge scores at initial posttest improved by 4.0 (2.0) (p <.001) and at the 30-day posttest improved by 3.0 (1.75) (p<.001). The median (IQR) confidence scores at initial posttest increased by 0.08 (0.33) (p =.009) and at the 30-day posttest improved by 0.33 (0.54) (p =.01). We found that simulation and microlearning improved trauma nurse role clarity, knowledge, and confidence in caring for patients undergoing emergency BSL.

Nurses' experience of end-of-life care for patients with COVID-19: A descriptive phenomenology study.

The mortality rates among critically ill patients with COVID-19 have been high. The national and institutional infection control policies and resource shortages caused by the pandemic led patients to undergo deaths without dignity and inevitably changed intensive care unit (ICU) end-of-life care (EOLC) practices. This study explores ICU nurses' experiences of providing EOLC for patients with COVID-19 who died. Eight nurses participated in a qualitative phenomenological study. Semi-structured interviews were conducted from July to September 2022. Colaizzi's data analysis method was used, and the following four main themes emerged: (i) only companion in the death journey; (ii) helping families prepare for death; (iii) EOLC trapped within a framework; and (iv) EOLC in retrospect. To secure high-quality EOLC in ICU, it is important to promote practical support for nurses and EOLC-related discussions/education. Technical support, such as digital communication technologies, should be reinforced to help patients and their families participate in EOLC.

Educating Neonatal Intensive Care Unit Nurses in Identifying Postpartum Depression: A Pilot Study

Educating Neonatal Intensive Care Unit Nurses in Identifying Postpartum Depression: A Pilot Study

The mental workload of ICU nurses performing human-machine tasks and associated factors: A cross-sectional questionnaire survey.

To assess the level of mental workload (MWL) of intensive care unit (ICU) nurses in performing different human-machine tasks and examine the predictors of the MWL. A cross-sectional questionnaire study. Between January and February 2021, data were collected from ICU nurses (n = 427) at nine tertiary hospitals selected from five (east, west, south, north, central) regions in China through an electronic questionnaire, including sociodemographic questions, the National Aeronautics and Space Administration Task Load Index, General Self-Efficacy Scale, Difficulty-assessing Index System of Nursing Operation Technique, and System Usability Scale. Descriptive statistics, t-tests, one-way ANOVA and multiple linear regression models were used. ICU nurses experienced a medium level of MWL (score 52.04 on a scale of 0-100) while performing human-machine tasks. ICU nurses' MWL was notably higher in conducting first aid and life support tasks (using defibrillators or ventilators). Predictors of MWL were task difficulty, system usability, professional title, age, self-efficacy, ICU category, and willingness to study emerging technology actively. Task difficulty and system usability were the strongest predictors of nearly all typical tasks. ICU nurses experience a medium MWL while performing human-machine tasks, but higher mental, temporal, and effort are perceived compared to physical demands. The MWL varied significantly across different human-machine tasks, among which are significantly higher: first aid and life support and information-based human-machine tasks. Task difficulty and system availability are decisive predictors of MWL. This is the first study to investigate the level of MWL of ICU nurses performing different representative human-machine tasks and to explore its predictors, which provides a reference for future research. These findings suggest that healthcare organizations should pay attention to the MWL of ICU nurses and develop customized management strategies based on task characteristics to maintain a moderate level of MWL, thus enabling ICU nurses to perform human-machine tasks better. No patient or public contribution.

Determination of the Knowledge Level of Surgical Intensive Care Nurses in Medical Device Induced Pressure Injury

Aim: The purpose of this study was to measure the level of knowledge and attitudes of nurses in surgical intensive care units (ICUs) about medical device-induced pressure injury. Method: The cross-sectional study was conducted with 227 surgical intensive care nurses in Turkey between November 2022 and June 2023. “Nurse Introduction Form” and “Pressure Ulcer Knowledge Level Assessment Tool Scale” were used as data collection tools. Since the scale score averages did not comply with normal distribution, Mann Whitney U and Kruskal Wallis tests were used in the statistical analysis of the data. Results: It was found that the majority of participants (n=227) were in the age range of 26-33 years (n=115), and 66.1% (n=113) had been working in the ICU for 1-5 years. 51.5% (n=117) of the participants reported having received training in medical device-related pressure injury. In the pressure ulcer knowledge level assessment tool, the mean of the "prevention of pressure ulcers" sub-dimension (mean: 4.74) was found to be the highest, while the total knowledge level score was 14.87±5.6 and it was found that the nurses had a moderate level of knowledge. Conclusion: The findings of the study indicated that nurses' knowledge of medical device-related pressure injuries was inadequate, but that their knowledge of pressure injury prevention increased with increasing levels of education.

Testing Construct Validity of the Clinical Supervision Scale in Intensive Care Units at Tertiary Care Hospitals in the Northeast of Thailand

Clinical supervision is the process by which supervisors treat their supervisees through interpersonal relationships to help supervisees develop their knowledge of the ability to perform clinical duties to provide quality service. However, from the literature review, it was found that a tool for assessing supervisors’ clinical supervision has not been clearly developed, especially in the context of the Intensive Care Unit (ICU), which requires close supervision and monitoring of nurses to provide the highest level of safety for patients. Therefore, the research objective was to analyze the construct validity of the clinical supervision scale in the care units of tertiary hospitals in Northeast Thailand. Methods Participants were 234 nurses in intensive care units at tertiary hospitals located in Northeast of Thailand. Data were collected using a questionnaire as perceived by registered nurses based on the framework of Proctor’s model using the 18-item Clinical Supervision Scale. Content validity was explored by seven experts, and the Cronbach’s alpha coefficient for reliability was .967. EFA was conducted to identify factors affecting the function of clinical supervision. CFA was used to ascertain the model fit. Results The EFA showed a three-factor clinical supervision and CFA. The results indicated that the hypothesis model of clinical supervision showed goodness of fit with empirical data throughout the sample (Chi-square = 103.501, df = 100, p-value = .385, CFI = .999, GFI = .955, AGFI= .923, RMSEA =.012). These results were within acceptable ranges, which indicated that the construct validity of the clinical supervision scale in the intensive care unit was consistent with Proctor’s functions: promoting professional accountability and quality control (normative function), skill and knowledge development (formative function), and providing support and personal well-being (restorative function).

Attitudes, knowledge and practices concerning delirium among paediatric intensive care unit nurses: a multisite cross-sectional study in Sichuan, China.

Delirium is an acute mental state associated with poor outcomes. The incidence of delirium is high, especially in the paediatric intensive care unit (PICU). It is important for staff, particularly nurses, to understand delirium and implement interventions to prevent it. We performed a survey with the aim of evaluating and analysing the factors influencing the knowledge, attitudes and behaviour of PICU nurses towards delirium. This cross-sectional descriptive study included 215 PICU nurses in 6 PICUs from five teaching hospitals in Sichuan Province, China. An online survey about the knowledge, attitudes and practices related to delirium care was conducted among PICU nurses used a self-made and validated questionnaire. The data were analysed using descriptive statistics; differences between groups were compared using t tests, ANOVA and rank-sum tests. Variables with a significance level of 0.05 in the univariate analysis were entered into the multivariable regression analysis to identify predictors. Only 14.4% of the nurses had a good understanding of delirium, and 40.9% had received relevant training. The mean knowledge score was 9.01 ± 3.86, and the overall passing rate of knowledge was 49.8%. The mean attitude and behaviour scores were 40.95 ± 5.62 and 40.33 ± 8.01, respectively. Among the hospitals, different delirium assessments for children and specific training were performed, explaining approximately 10% of the variability in knowledge scores (F = 6.152), approximately 10% of the variability in attitude/belief scores (F = 5.908), and approximately 17% of the variability in practice scores (F = 10.767). PICU nurses have poor knowledge of delirium, particularly regarding its clinical manifestations, influencing factors and medications used, and they have adequate attitudes and confidence and good behaviour regarding delirium in children. To better prevent delirium, we suggest that PICU departments routinely assess delirium and conduct delirium training for nurses. Not applicable.

The effect of resilience training with mHealth application based on micro-learning method on the stress and anxiety of nurses working in intensive care units: a randomized controlled trial

IntroductionNurses in intensive care units (ICUs) face high stress and anxiety, impacting their well-being and productivity. Addressing this, this study evaluated the impact of resilience training via a mHealth application based on micro-learning on ICU nurses’ stress and anxiety levels.Materials and methodsThis study, a single-blind randomized controlled trial conducted in 2022-23, involved sixty ICU nurses from two Tehran hospitals. Nurses were chosen through purposive sampling and divided into intervention and control groups by simple randomization. The intervention group was taught resilience via an educational mHealth application based on micro-learning, with data collected using the anxiety and stress subscales of DASS-21.ResultsBefore the intervention, there were no significant differences in stress and anxiety scores between the intervention and control groups (P > 0.05). Upon utilizing the mHealth application, the intervention group exhibited significant reductions in stress, from 10.77 ± 3.33 to 9.00 ± 1.66 (P = 0.001), and in anxiety, from 9.43 ± 3.35 to 7.93 ± 0.98 (P < 0.001). In contrast, the control group experienced a slight increase in stress levels, from 10.10 ± 2.19 to 10.73 ± 2.15 (P = 0.002), and in anxiety levels, from 9.10 ± 1.63 to 10.23 ± 1.65 (P < 0.0001).ConclusionsThe micro-learning-based mHealth application for resilience training significantly reduced ICU nurses’ stress and anxiety, recommending its adoption as an innovative educational method.Trial registrationThe study has been registered in the Iranian Registry of Clinical Trials (No. IRCT20221225056916N1, Date: 04/29/2023).

Role of Emotional Intelligence, in Relationship between Compassion Satisfaction, Compassion Fatigue and Quality of Life Among Nurses Working in ICU

Background: Intensive Care Unit (ICU) nurses encounter emotionally taxing situations that can affect their well-being, making the examination of factors such as emotional intelligence (EI), compassion satisfaction, and fatigue crucial in understanding their quality of life. Objective: This study aimed to explore the interplay between EI, compassion satisfaction, compassion fatigue, and quality of life among ICU nurses, and to examine the mediating role of EI in these relationships. Methods: A convenience sampling method was employed to collect data from 167 ICU nurses using a structured online questionnaire. Demographic data and measures for compassion satisfaction, fatigue, EI, and quality of life were analyzed using SPSS version 25. Path coefficients and mediation analysis were conducted using Partial Least Squares (PLS). Results: The majority of participants were below 30 years (76.2%) and female (67.9%). EI positively correlated with quality of life (path coefficient = 0.139, p = 0.007) and was a partial mediator between compassion satisfaction and quality of life. Higher compassion satisfaction was significantly associated with increased EI and quality of life (path coefficients = 0.264 and 0.628, respectively, p &lt; 0.001). Gender-based analysis revealed differences in quality of life (Males: M = 100.65, SD = 7.98; Females: M = 96.58, SD = 12.59; p = 0.035) and compassion fatigue (Males: M = 65.24, SD = 7.77; Females: M = 61.42, SD = 8.59; p = 0.007). Conclusion: Emotional intelligence is instrumental in enhancing quality of life by mediating the effects of compassion satisfaction and fatigue among ICU nurses. These insights suggest that interventions aimed at increasing EI may be beneficial for nurses facing the demanding conditions of ICU environments.

Alarm fatigue and perceived stress among critical care nurses in the intensive care units: Palestinian perspectives

ObjectiveThe frequency of alarms generated by monitors and other electro-medical devices is undeniably valuable but can simultaneously escalate the workload for healthcare professionals, potentially subjecting intensive care unit nurses to alarm fatigue. The aim of this study is to investigate alarm fatigue and stress levels among critical care nursing personnel. Additionally, the study aims to assess predictors for both alarm fatigue and perceived stress.Methodology: A descriptive cross-sectional study recruited 187 Intensive Care Unit (ICU) nurses from hospitals located in the northern and central regions of the West Bank, Palestine. Data were gathered through online surveys due to logistic concerns using the Alarm Fatigue Scale and the Perceived Stress Scale. The research was conducted between November 2023 and January 2024.ResultsThe mean overall alarm fatigue score was 23.36 (SD = 5.57) out of 44. The study showed that 62.6% of the participating ICU nurses experience average to high degree of alarm fatigue, while 69.5% experience average to high levels of perceived stress. A significant positive Pearson correlation was found between stress and alarm fatigue (0.40, P < 0.01). Important predictors of alarm fatigue include perceived stress, nurse-to-patient ratio, gender, and years of experience, while important predictors of perceived stress include alarm fatigue, type of working shift and hospital unit.ConclusionAlarm fatigue can compromise the timely intervention required to prevent adverse outcomes by causing delayed responses or missed critical alarm, which can have major ramifications for patient safety. Addressing stress is crucial for mitigating alarm fatigue and fostering a supportive work environment to ensure optimal patient care. Consequently, exploring strategies to alleviate the negative impacts of alarm fatigue on critical care nurses’ stress merits further investigation in future research studies.

Intensive care nurses' perceptions and awareness of delirium and delirium prevention guidelines.

Delirium is an acute and fluctuating disturbance of cognition and is a common occurrence in critically ill patients. It is a manifestation of an acute brain dysfunction often attributed to higher survival rates and a subsequently aging population. Intensive Care Unit (ICU) treatment and survival often contributes towards development of delirium, and lack of or inappropriate management can translate into the development of long-term psychological effects that last even after discharge. While a lot is already known about this topic, and several assessment tools exist, these are not being consistently used by ICU nurses and as a result delirium often goes unrecognized, with unwarranted consequences. The study aimed to explore the perception of delirium among ICU nurses, and the extent of their awareness about guidelines to assess and prevent delirium in ICU patients. It also sought to understand the application of delirium guidelines in ICU practice. A quantitative, exploratory, self-reporting survey was conducted among 145 ICU nurses from one critical care unit in the Republic of Ireland. The overall response rate was 71% (103/145). Most nurses (85%) who participated in this survey believed delirium was expected. However, only 45% acknowledged it is a complication. Only 31% of nurses monitored delirium using a validated scale and few observed this as a part of routine care. Most nurses had received education; however, this did not translate to their clinical practice. Guidelines on managing delirium may not be routinely implemented in the ICU settings of hospitals in the Republic of Ireland. As the findings suggest, a gap exists between theory and practice, necessary revision of policy or creating a new policy, supplemental educational sessions such as bedside sessions, e-learning module, study day or seminars need to be organized to improve nurses' awareness related to delirium and delirium prevention guidelines.

Nurses' Assessment of Pain in Saudi Neonatal Intensive Care Units

BackgroundResearch reveals that neonatal pain management in Neonatal Intensive Care Units (NICUs) is suboptimal. There is limited research that assessed NICU nurses’ pain assessment practices in Saudi Arabia. AimTo assess the nurses’ pain assessment practices in the NICU in Saudi Arabia. DesignThis study used a descriptive cross-sectional design. SettingsResearch was conducted using an online survey. Participants/SubjectsThis study was carried out on 65 NICU nurses. The participants were recruited from one governmental and one private hospital in Saudi Arabia. MethodsData on pain assessment practices were collected, including the frequency of pain assessment, pain assessment scales used for preterm and term neonates, and pain assessment documentation. Data were analyzed using frequencies and percentages. ResultsThe majority of the participants (94%) routinely assessed pain and documented pain assessment (97%). One-third of the participants assessed pain regularly every hour (32%). The most used pain assessment scales for term neonates were the neonatal infant pain scale (40%) and the cry, required oxygen, increased vital signs, expression, and sleeplessness scale (23%). The most used pain assessment scales for preterm neonates were the neonatal infant pain scale (31%), the cry, required oxygen, increased vital signs, expression, sleeplessness scale (19%), and the premature infant pain profile (17%). ConclusionsNICU nurses in Saudi Arabia consistently assessed for and documented pain; however, the tools chosen were sometimes suboptimal. A substantial number of NICU nurses used invalid tools to assess pain in term and preterm neonates. An interventional program is needed to enhance the use of evidence-based practice recommendations regarding neonatal pain assessment by nurses in the Neonatal Intensive Care Units in Saudi Arabia.

Essential components of an educational program for implementing skin-to-skin contact for preterm infants in intensive care units: an integrative literature review

BackgroundGlobally, prematurity is the primary factor behind the mortality of children under the age of 5 years, resulting in approximately 1 million children dying annually. The World Health Organization (WHO) recommends Skin-to-Skin Contact (SSC) as part of routine care for preterm infants. Evidence shows that SSC reduces mortality, possibly by improving thermoregulation, facilitating the earlier initiation of breastfeeding and reducing the risk of nosocomial infection. An educational program for implementing SSC has been demonstrated to enhance the knowledge and practice of parents and nurses in intensive care units. This study, the first of its kind in the North West Province (NWP), aims to identify the essential components of an educational program for implementing SSC for premature infants in intensive care units.ObjectiveThis paper presents an integrative literature review that critically synthesizes research-based literature on essential components of an educational program for implementing SSC for preterm infants in intensive care units.MethodsA comprehensive search of electronic databases, such as CINAHL, MEDLINE, PsycINFO, ProQuest and Health Source: Nursing/Academic Edition and Health Source-Consumer Edition, was conducted using different keywords and references lists from the bibliography.ResultsTwelve articles relevant to this review were identified, read and synthesized to answer the research question. Three essential components emerged from the findings of this review, namely (1) the necessity of policy and role players for implementing SSC, (2) the availability of education and training, and (3) counseling and support for parents of preterm infants.ConclusionsThe outcomes of this study have the potential to facilitate the implementation and expansion of SSC in intensive care units. This could aid program implementers, policymakers, and researchers to implement and scale up this important tool in intensive care units.