Practices Of Intensive Care Unit Nurses Research Articles

Impact of knowledge, attitudes and self-reported practices of nurses on early mobilization of mechanically ventilated patients in the ICU.

Many ICUs worldwide are striving to integrate early mobilization as part of critical care rehabilitation. However, ICU nurses, who are essential contributors to the early mobilization of critically ill patients, still lack comprehensive surveys assessing their knowledge, beliefs, and practices regarding the early mobilization of mechanically ventilated patients. To analyse the knowledge, attitudes, and practices of intensive care unit (ICU) nurses regarding the early mobilization of mechanically ventilated patients and to explore the effects of these practices. A multicentre cross-sectional study. ICU nurses in five tertiary hospitals in Zhejiang Province, China, were selected by convenience sampling and invited to complete an online questionnaire between 1 June 2021 and 15 June 2021. Sociodemographic data and the knowledge, attitudes, and practices of ICU nurses regarding early mobilization. A total of 296 valid questionnaires were collected, for a response rate of approximately 77.5%. The average scores for knowledge, attitudes, and practices of ICU nurses regarding the early mobilization of mechanically ventilated patients were 42.7 ± 7.4, 34.3 ± 6.5, and 47.1 ± 6.5, respectively, which were good scores. Quantile regressions showed that at the 25% and 50% quartiles, increases in knowledge and attitude scores resulted in increases in practice scores (p < .001); however, at the 75% quartile, increases in knowledge scores did not result in practice score increases (t = 0.000, p = .999); moreover, there was still a 0.5-point increase in practice scores per 1-point increase in attitude scores (t = 0.500, p < .001). The knowledge, attitudes, and self-reported practices of ICU nurses were good, although there is room for improvement. Considering that the influence of attitudes on practice improvement is more important than knowledge, ICU managers should promote knowledge transformation, strengthen attitudes, and adopt comprehensive measures to promote the early mobilization of mechanically ventilated patients in the ICU. To optimize the early mobilization of mechanically ventilated patients in the ICU, introducing multipronged support strategies based on the knowledge and attitudes of ICU nurses is recommended to promote the implementation of such practices.

INTENSIVE CARE NURSES' KNOWLEDGE, PRACTICE AND ATTITUDE IN PREVENTION OF CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTION (CLABSI)

Central line-associated bloodstream infections (CLABSI) are mainly preventable with evidence-based guidelines. However, it needs to be made clear how well these guidelines are followed in critical care units in Malaysia. Therefore, this study evaluates critical care nurses’ knowledge, practices, and attitude toward evidence-based guidelines for preventing CLABSIs issued by the Centers for Disease Control and Prevention and the Malaysia Ministry of Health. This study aims to identify the level of knowledge, practice, and attitudes regarding preventing CLABSI among critical care nurses in a teaching hospital. A cross-sectional descriptive study was carried out among 203 nurses working in seven units consisting of the Intensive Care Unit (ICU), Coronary Care Unit (CCU), Intermediate Dependency care Unit (IDCU), Neonatal Intensive Care Unit (NICU), Neurosurgery Intensive Care Unit (Neuro ICU), Cardiac Intensive Care Unit (CICU), and Pediatric Intensive Care Unit (PICU) in University Malaya Medical Center in Kuala Lumpur. Nurses completed online questionnaires regarding their demographic characteristics, knowledge, practices, and attitudes toward evidence-based guidelines for preventing CLABSIs from December 2022 to January 2023. The data was analyzed using T-Test, ANOVA, and Fisher’s Exact Test. 203 ICU nurses completed the questionnaire, and none correctly answered all the knowledge-related questions. The response rate of the correct answer regarding the knowledge question was only 49.7%. Mean scores for 11 questions regarding knowledge of evidence-based guidelines for preventing CLABSI were low, 5.85 (± 1.29). Meanwhile, individual total scores were significantly associated with time spent as a nurse in the ICU (2–4 years). The mean score for eight questions related to CLABSI prevention was 4.19 (± 0.50), which was acceptable for the compliance score. There was an association between nurses’ gender (p-value: 0.01) and their duration of working experiences in the ICU (p-value: 0.04) with the practice regarding the prevention of CLABSI. The overall mean score for nurses’ attitudes toward the guidelines was high; 8.63 (± 1.37). However, there was no association between the demographic characteristic and attitude regarding preventing CLABSI. The knowledge and practice of ICU nurses need to be improved. Regular training with the implementation of available guidelines and protocols was essential to improve the knowledge and compliance on preventing CLABSIs in ICUs.

Model construction of factors influencing intensive care unit nurses' medical device-related pressure injury knowledge, attitude, and practice.

The ability of knowledge, attitude, and practice of intensive care unit (ICU) nurses to perform medical device-related pressure injuries (MDRPIs) can affect the incidence of MDRPI in ICU patients. Therefore, in order to improve ICU nurses' understanding and nursing ability of MDRPIs, we investigated the non-linear relationship (synergistic and superimposed relationships) between the factors influencing ICU nurses' ability of knowledge, attitude, and practice. A Clinical Nurses' Knowledge, Attitude, and Practice Questionnaire for the Prevention of MDRPI in Critically Ill Patients was administered to 322 ICU nurses from tertiary hospitals in China from January 1, 2022 to June 31, 2022. After the questionnaire was distributed, the data were collected and sorted out, and the corresponding statistical analysis and modelling software was used to analyse the data. IBM SPSS 25.0 software was used to conduct Single factor analysis and Logistic regression analysis on the data, so as to screen the statistically significant influencing factors. IBM SPSS Modeler18.0 software was used to construct a decision tree model of the factors influencing MDRPI knowledge, attitude, and practice of ICU nurses, and ROC curves were plotted to analyse the accuracy of the model. The results showed that the overall passing rate of ICU nurses' knowledge, attitude, and practice score was 72%. The statistically significant predictor variables ranked in importance were education background (0.35), training (0.31), years of working (0.24), and professional title (0.10). AUC=0.718, model prediction performance is good. There is a synergistic and superimposed relationship between high education background, attended training, high years of working and high professional title. Nurses with the above factors have strong MDRPI knowledge, attitude, and practice ability. Therefore, nursing managers can develop a reasonable and effective scheduling system and MDRPI training program based on the study results. The ultimate goal is to improve the ability of ICU nurses to know and act on MDRPI and to reduce the incidence of MDRPI in ICU patients.

Knowledge, attitudes and practices of ICU nurses regarding subsyndromal delirium among 20 hospitals in China: a descriptive cross-sectional survey

ObjectivesThis study sought to investigate nurses’ knowledge, attitudes and practices, and analyse the influencing factors for subsyndromal delirium (SSD).DesignA descriptive cross-sectional survey.SettingE-questionnaires were distributed to intensive care unit (ICU) nurses...

To Study Effect of Education Programme on Central Venous Site Care Among ICU Nurses in Selected Hospital

To Study Effect of Education Programme on Central Venous Site Care Among ICU Nurses in Selected Hospital

Effect of Training Eye Care Clinical Guideline for ICU Patients on Clinical Competence of Eye Care in Nurses.

Introduction Sight is one of the most important and vital human senses. Lack of proper eye care (EC) in anesthetized patients can lead to serious ocular complications and even vision loss. Insufficient knowledge, attitude, and skills of nurses are considered as a barrier to providing EC in the intensive care unit (ICU). The aim of the present study was to determine the effect of training EC clinical practice guidelines for ICU patients on nurses' knowledge, attitude, and practice of EC. Methods This was an interventional study with a pre-post design performed on 60 ICU nurses. For the experimental group, EC clinical guideline training was performed for anesthetized patients in three sessions. The data collection tool included nurses' clinical competence of the EC questionnaire with a possible score range of 0–86. This tool consists of three domains, including knowledge (0–18), attitude (0–28), and practice (0–40), which was completed in a self-assessment manner before and three months after the training program. Data analysis was carried out using SPSS16. Findings. The mean scores of knowledge, attitude, and practice after the intervention in the experimental and control groups were 15.03 ± 2.72 and 11.11 ± 3.50, 25.65 ± 3.47 and 22.07 ± 3.08, and 33.88 ± 4.14 and 28.5 ± 55.08, respectively, which were statistically significant (P ≤ 0.001). Also, the total score of clinical competence of EC after the intervention in the experimental and control groups was 74.56 ± 7.93 and 61.74 ± 9.66, which showed a significant difference (P ≤ 0.001). Conclusion Training nurses based on EC clinical guidelines for anesthetized patients can improve the knowledge, attitude, and practice of ICU nurses. Evidence-based EC practice requires continuous training based on clinical guidelines and EC practice monitoring by nursing managers according to EC clinical guideline for an anesthetized patient.

Knowledge, attitude, and expertise of nurses in intensive care unit regarding oral and dental care in hospitalized patients.

The purpose of this study was conducted to evaluate the knowledge, attitude, and practice of intensive care unit (ICU) nurses about oral and dental care in hospitalized patients. In this descriptive-analytic study, the statistical population included 214 nurses working in the ICU of the affiliated hospitals of Isfahan University in 1394. The level of knowledge, attitude, and practice of ICU nurses was assessed using questionnaires whose justifiability and stability were verified at the beginning of the study with a pilot study. Data were entered into SPSS software and tested by t-test, Spearman, one-way variance, and least significant difference test. The significance level was < 0.05. The data of this study showed that the score of knowledge and performance in male nurses was significantly different from female nurses. There was a significant relationship between nurse's education and their knowledge score (P < 0.001). Furthermore, the performance score of nurses working in different parts was different too (P < 0.001). The findings showed that the knowledge and performance of female nurses about oral care were higher than men, but the attitude of the two sexes is almost the same. Nurses with lower educational degree had less knowledge, but their attitude and performance did not differ. The performance score of nurses working in ICU was different, but they had similar knowledge and attitudes.

EVALUATING THE EffECTIVENESS OF EDUCATIONAL INTERVENTION ON NURSES' KNOWLEDGE AND PRACTICES REGARDING ENDOTRACHEAL TUBE SUCTIONING OF HUE CENTRAL HOSPITAL, VIET NAM

Background: Endotracheal suctioning (ETS) is a common procedure performed by nurses in the intensive care unit (ICU) to remove accumulated secretion from the endotracheal tube, upper airways, and lower airways in patients for the purpose of establishing in critically ill mechanical ventilated patients”. Many Studies in the world recording that the staff nurses to improve their knowledge and skill and also practice on endotracheal suctioning after receive the education program as suction protocol. In Viet Nam, there have not yet been published comprehensive and scientific assessments of knowledge and skills of Nurse as critically ill mechanical ventilated patients. This study was aimed to evaluate the effectiveness of Educational Intervention to improve the knowledge and practice of endotracheal suctioning among ICU nurses in Hue Central Hospital, Viet Nam. Method and subject: This study was quasi-experimental research, two groups, the pre-test and post-test design to an evaluation of 126 nurses who were work at three departments where are Intensive Care Unit, Department of Anesthesiology and Critical Care and Stroke Center at Hue Central Hospital. Results: The participants in the intervention group who received the education program had statistically significant higher mean scores of knowledge and practice than before and those in the control group who did not receive the education program (all p &lt; 0.05). Conclusion: The Educational Intervention on knowledge and practice of endotracheal suctioning improve the knowledge and practice of ICU Nurses. This education program should be approached to provide all ICU Nurse to take care of the endotracheal patient better. Key words: ETS, Educational Intervention, Knowledge, Practice

Knowledge, attitude and oral care practices for preventing ventilator-associated pneumonia among critical care nurses - A questionnaire study.

A cross-sectional study was conducted among intensive care unit (ICU) nurses in private hospitals in India to identify knowledge and practice of ICU nurses in the prevention of ventilator-associated pneumonia (VAP). Knowledge of 135 nurses working in ICU was tested using a questionnaire consisting of 18 questions. Fourteen forms were excluded from the statistical analysis due to incomplete data entry by the participants. The data of 121 filled questionnaires were analyzed. The information letters, consent forms, and questionnaires were handed to ICU nurses by Research assistant. Data were coded and entered into SPSS version for descriptive and inferential statistics. A majority of the participants perceived oral care as a necessity in all critically ill patients. Nurses were generally aware of the most likely mechanism of acquiring pneumonia. The type and frequency of oral care varied widely. Many of them stated that they had adequate supplies to provide oral care. Although a majority of nurses had some formal training in oral care, they would appreciate an opportunity to enhance and improve their knowledge and skills. The methods of oral care provided vary widely. In summary, randomized controlled trial to date has demonstrated that tooth brushing is associated with a trend toward lower rates of VAP in intubated mechanically ventilated critically ill patients. But it is also to be noted that there was no clear difference between electric and manual tooth brushing. In-house training and workshop can provide required skills needed for the betterment of the treatment provided.

Current status and analysis of knowledge-attitude-practice on modified early warning score system in Intensive Care Unit nurses

Objective To investigate the knowledge-attitude-practice level of the Intensive Care Unit (ICU) nurses on the Modified Early Warning Score (MEWS) system, and analyze its influencing factors, so as to lay a foundation for the establishment of related training program later. Methods From October to November 2018, by convenience sampling, ICU nurses in General Hospital of Ningxia Medical University were selected as objects of the study. Self-designed ICU Nurses' Knowledge-Attitude-Behavior on System Questionnaire was used to investigate the nurses by means of Wenjuanxing online. The influencing factors were analyzed by single factor analysis and multiple linear regression analysis. Results Totally 92 valid questionnaires were retrieved. The ICU nurses got the score of (68.42±22.09) in the knowledge of MEWS, and (52.29±19.75) in the of MEWS , and (56.64±18.99) in the of MEWS; multiple linear regression analysis results indicated that working length, whether or not had contacted before, and educational background were the influencing factors of the practice of (P<0.05) . Conclusions The knowledge, attitude and practice of ICU nurses in Ningxia are generally at the medium and low levels, among which is still acceptable, while attitude and practice are relatively poor. It suggests that managers should focus on attitudes, guide ICU nurses to recognize and actively apply them to assess patients' condition, and actively explore early warning management mode suitable for ICU critical patients. Key words: Intensive Care Unit; Nurses; Modified early warning score system; Knowledge; Attitude; Practice

\u201cIt\u2019s better to have three brains working instead of one\u201d: a qualitative study of building therapeutic alliance with family members of critically ill patients

BackgroundStudies in the intensive care unit (ICU) suggest that better communication between families of critically ill patients and healthcare providers is needed; however, most randomized trials targeting interventions to improve communication have failed to achieve family-centered outcomes. We aim to offer a novel analysis of the complexities involved in building positive family-provider relationships in the ICU through the consideration of not only communication but other important aspects of family-provider interactions, including family integration, collaboration, and empowerment. Our goal is to explore family members’ perspectives on the enablers and challenges to establishing therapeutic alliance with ICU physicians and nurses.MethodsWe used the concept of therapeutic alliance as an organizational and analytic tool to conduct an interview-based qualitative study in a 20-bed adult medical-surgical ICU in an academic hospital in Toronto, Canada. Nineteen family members of critically ill patients who acted as substitute decision-makers and/or regularly interacted with ICU providers were interviewed. Participants were sampled purposefully to ensure maximum variation along predetermined criteria. A hybrid inductive-deductive approach to analysis was used.ResultsParticipating family members highlighted the complementary roles and practices of ICU nurses and physicians in building therapeutic alliance. They reported how both provider groups had profession specific and shared contributions to foster family communication, integration, and collaboration, while physicians played a key role in family empowerment. Families’ lack of familiarity with ICU personnel and processes, physicians’ sporadic availability and use of medical jargon during rounds, however, reinforced long established power differences between lay families and expert physicians and challenged family integration. Family members also identified informal interactions as missed opportunities for relationship-building with physicians. While informal interactions with nurses at the bedside facilitated therapeutic alliance, inconsistent and ad-hoc interactions related to routine decision-making hindered family empowerment.ConclusionsMultiple opportunities exist to improve family-provider relationships in the ICU.The four dimensions of therapeutic alliance prove analytically useful to highlight those aspects that work well and need improvement, such as in the areas of family integration and empowerment.

Awareness among intensive care nurses regarding oral care in critically ill patients.

Background:Oral health and general health are interdependent which influence each other through biological, psychological, emotional, and developmental factors. As patients in Intensive Care Unit (ICU) are completely dependent on the caregivers, the knowledge, attitude, and practices of the nurses influence the recovery of patients to a greater extent.Objectives:Unfortunately, oral health problems are usually overshadowed by other serious needs in critically ill patients. In addition, nursing staff appear to perceive oral health as the most difficult part of their work, hence been a low-priority intervention. Therefore, the aim of the study was to assess the knowledge, attitude, and practices of ICU nurses on oral care in critically ill patients.Materials and Methods:A total of 200 nurses working in 21 different hospitals in Mysore, Karnataka, participated in the cross-sectional survey. The survey instrument included the demographic details, knowledge, attitude, and practice of oral care, complications in ICU due to lack of oral care, and educative programs attended.Results:Among the 200 ICU nurses, 67% had ICU experience of more than 5 years. About 94% were diploma candidates, 5% were graduates, and only 2% were postgraduates with a mean age of 27.5 years. All the participants were aware of the concept of focal infection theory and 93% knew about the potential complications associated with poor oral hygiene in ICU. About 95.5% of the nurses performed oral care after every shift change and used gauze soaked in chlorhexidine routinely. Nearly 76.5% of the participants stated mechanical obstruction as a main barrier toward oral care.Conclusion:A variety of oral care practices exist for ventilated patients but, the majority of nurses used chlorhexidine with gauze. They failed to adhere to the latest evidence-based practice despite ranking oral care as a high priority. They need to be educated to improve clinical outcomes thereby reducing the hospital mortality and stay in ICU.