Intensive Care Training Research Articles

Spiritual care competences of healthcare workers in emergency and intensive care-aprospective questionnaire study

In intensive and emergency care, patients and their relatives are confronted with potentially existential crises. Spiritual care can be an additional resource to address related psychosocial and physical symptoms and to support patients and their relatives. Accordingly, healthcare workers need spiritual skills to recognize and respond to these needs. What spiritual competencies do healthcare workers in intensive and emergency care have? Are there differences between professions and genders? What factors influence spiritual competencies? The prospective questionnaire study included physicians participating in intensive care and emergency medicine courses and nurses who were training or working in intensive and emergency care. Self-reported spiritual competencies were assessed using the Spiritual Care Competence Questionnaire (SCCQ), which captures the following areas: perceptual competence, team-spirit, documentation competence, self-awareness and proactive opening, knowledge about other religions, competence in conversation techniques and proactive empowerment-competence. We included 465 physicians (50% female, years in profession: mean = 4.0, standard deviation [SD] = 3.5) and 86nurses (80% female, years in profession: mean = 12.7, SD = 10.7). The average SCC was2.3 (SD 0.4) out of amaximum of 4points, with higher spiritual competences among spiritual and religious respondents. There were differences in specific competencies between the professions and genders. Women indicated ahigher level of competence in the area of perception and conversation skills, physicians in documentation skills. Overall, there is aclear need to train healthcare staff in the field of intensive care and emergency medicine.

Consensus statements for the establishment of medical intensive care in low-resource settings: international study using modified Delphi methodology

BackgroundThe inadequacy of intensive care medicine in low-resource settings (LRS) has become significantly more visible after the COVID-19 pandemic. Recommendations for establishing medical critical care are scarce and rarely include expert clinicians from LRS.MethodsIn December 2023, the National Association of Intensivists from Bosnia and Herzegovina organized a hybrid international conference on the topic of organizational structure of medical critical care in LRS. The conference proceedings and literature review informed expert statements across several domains. Following the conference, the statements were distributed via an online survey to conference participants and their wider professional network using a modified Delphi methodology. An agreement of ≥ 80% was required to reach a consensus on a statement.ResultsOut of the 48 invited clinicians, 43 agreed to participate. The study participants came from 20 countries and included clinician representatives from different base specialties and health authorities. After the two rounds, consensus was reached for 13 out of 16 statements across 3 domains: organizational structure, staffing, and education. The participants favored multispecialty medical intensive care units run by a medical team with formal intensive care training. Recognition and support by health care authorities was deemed critical and the panel underscored the important roles of professional organizations, clinician educators trained in high-income countries, and novel technologies such as tele-medicine and tele-education.ConclusionDelphi process identified a set of consensus-based statements on how to create a sustainable patient-centered medical intensive care in LRS.

Artificial intelligence and informatics in neonatal resuscitation

Neonatal intensive care unit resuscitative care continually evolves and increasingly relies on data. Data driven precision resuscitation care can be enabled by leveraging informatics tools and artificial intelligence. Despite technological advancements, these data are often underutilized due to suboptimal data capture, aggregation, and low adoption of artificial intelligence and analytic tools. This review describes the fundamentals and explores the evidence behind informatics and artificial intelligence tools supporting neonatal intensive care unit resuscitative care, training and education. Key findings include the need for effective interface design for accurate data capture followed by storage and translation to wisdom using analytics and artificial intelligence tools. This review addresses the issues of data privacy, bias, liability and ethical frameworks when adopting these tools. While these emerging technologies hold great promise to improve resuscitation, further study of these applications in neonatal population and awareness of informatics and artificial intelligence principles among clinicians is imperative.

Evaluation of the effect of the COVID-19 pandemic on the depression, anxiety and stress levels of anesthesiology and reanimation doctors, and their work and social lives

Aims: To measure the effects of the Coronavirus Disease-19 (COVID-19) pandemic on the socioeconomy and their depression, anxiety and stress scores of anesthesiology and reanimation specialists, using the DASS-21 (Depression, Anxiety and Stress Scale – 21). Methods: The study was conducted with an online questionnaire directed to the participants online, following the approval of Uludağ University Ethics Committee labeled 2020-16/1. The questionnaire was prepared on SurveyMonkey and distributed via a specially acquired link. Participants were prevented from completing the questionnaire more than once. 38 questions were asked to the participants. At the end of the questionnaire, the participants were asked to fill the DASS-21 scale. Questionnaire link has been distributed through social media and mobile communication applications. Results: 198 volunteers participated in the study. 122 of the participants were female (61.62%) and 76 (38.38%) were males. 75 of the participants (37.88%) were trainees, 113 (57.07%) were anesthesiology and reanimation specialists, 2 (1.01%) were specialist physicians undergoing intensive care training, 4 (%) 2,02) were intensive care specialists, 1 was a specialist physician receiving algology training, and 3 (1.52%) were algologists. 42 participants were (21.21%) in a training-research hospital, 87 participants (43.94%) in a university hospital, 35 participants (17.68%) in a state hospital, 13 participants (6.57%) in city hospitals, and 21 participants (10.61%) were working in private hospitals. %81.6 of all physicians participating in the survey show depression symptoms, %62 of participants were showing symptoms of anxiety and 71.1% of participants described stress symptoms. All scores were higher in female physicians (p <0,05). Depression scores of residents were higher than specialists (p<0,05). All scores of physicians working in training-research hospitals are higher than physicians working in other institutions (p <0,05). Conclusion: Almost all physicians have experienced changes in workload, income and workplaces during the pandemic. High DASS-21 scores in all physicians were thought-provoking and highlighted the psychological pressure that anesthesiology and reanimation physicians had been under.

Advances in pediatric anesthesia services over the past 10 years in French-speaking sub-Saharan Africa.

To improve and maintain quality and safety in anesthesia, standards have been proposed regarding human resources, facilities and equipment, medications and intravenous fluids, monitoring, and the conduct of anesthesia. Compliance with these standards remains a challenge in French-speaking sub-Saharan Africa (SSA) and results in high morbidity and mortality particularly in children. This aim of this study was to assess the progress made in improving the pediatric anesthesia infrastructures, human resources, education, medications, and equipment in French-speaking SSA over the past 10 years (2013-2022). This is a descriptive, multicenter, cross-sectional study with retrospective data collection, conducted from September 1 to November 5, 2023. Comparative data from 2012 to 2022 were collected through an online survey. Descriptive statistics were used to summarize data. Data were obtained from 12 countries out of 14. The number of hospitals providing pediatric surgery and anesthesia rose from 94 in 2012 to 142 in 2022 (+51%). The total number of physician anesthesiologists rose from 293 (0.1 physician anesthesiologists/100 000 inhabitants) in 2012 to 597 (0.2 physician anesthesiologists/100 000 inhabitants) in 2022 (+103.7%). Five (0.006 physician anesthesiologists/100 000 children) had completed a fellowship in pediatric anesthesia and intensive care in 2012, and 15 (0.01 physician anesthesiologists/100 000 children) in 2022 (+200%). Five physician anesthesiologists had an exclusive pediatric anesthesia practice in 2012, whereas they were 32 in 2022 (+540%). There is no specialized training in pediatric anesthesia and intensive care in any of these countries. Halothane was always available in 81.5% of the hospitals in 2012, and in 50.4% of the hospitals in 2022. Sevoflurane was always available in 5% of the hospitals in 2012, and in 36.2% in 2022. Morphine was always available in 32.2% in 2012, whereas it was available in 52.9% of them in 2022. Pediatric pulse oximeter sensors were available in 36% of the hospitals in 2012, and in 63.4% in 2022. Capnography was available in 5.3% of the hospitals in 2012, and in 48% in 2022. Progress have been made over the last 10 years in French-speaking SSA to improve infrastructures, human resources, education, medications, and equipment for pediatric anesthesia in French-speaking SSA. However, major efforts must be continued. Standards adapted to the local context should be formulated.

Perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda: A mixed method study.

Comprehensive abortion care is an emerging intervention being integrated into nursing and midwifery curricula. Yet, no studies have been conducted in Rwanda to determine whether faculty perceive themselves as capable of teaching comprehensive abortion care. This study aims to evaluate the perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda. The University of Rwanda College of Medicine and Health Sciences Institutional Review Board approved this study (UR-CMHS-IRB No 335/CMHSIRB/2022). In quantitative, a self-administered questionnaire was administered to 98 study participants. Data were entered into Statistical Package for the Social Sciences (SPSS) version 26 and analyzed using Chi-square test with a p-value of 0.05 set as the significance level. In the qualitative part, an interview guide was developed based on quantitative data to understand comprehensive abortion care teaching fully. Data were collected from four focus group discussions with eight participants in each group, entered in Dedoose, and analyzed thematically. Among the 98 study participants who were invited to participate in this study, only 85 filled out the questionnaires. This translates into 86.7% of the response rate. More than half 58.8% had adequate self-efficacy in teaching comprehensive abortion care. A Chi-square test has revealed that being a male, being a midwife, and having more years of working experience in nursing education were significantly associated with self-efficacy in teaching comprehensive abortion care (p value <0.05). In the qualitative phase, 32 study participants participated in four focus group discussions and four themes were identified: a) variability in confidence levels to teach comprehensive abortion care; b) readiness about teaching comprehensive abortion care; c) facilitators of teaching comprehensive abortion care; and d) contextual challenges to teach comprehensive abortion care. The findings revealed that faculty's self-efficacy in teaching comprehensive abortion care was not adequate. Personal and religious beliefs and institutional barriers were also reported to hinder self-efficacy in teaching comprehensive abortion care. Therefore, intensive comprehensive abortion care training for nursing and midwifery faculty in higher learning institutions should be provided, including values clarification and attitude transformation training for attitudes and beliefs. It is also critical for higher learning institutions to develop strategies for overcoming the challenges faculty face when teaching comprehensive abortion care.

Onboarding in intensive care and emergency medicine in Germany

The treatment of acute life-threatening conditions in intensive care and emergency medicine requires in-depth training and education, with initial training playing akey role. What is the structure and quality of the initial training of physicians and nurses in intensive care units and emergency departments in Germany? With the help of survey software, an online questionnaire comprising 40questions in German on the aforementioned topic was designed. It was distributed via the website of the German Society for Internal Intensive Care and Emergency Medicine (DGIIN) and via pertinent social media channels. In total, 103 nurses and 125 physicians participated in the survey. The average work experience of the participating nurses and physicians was 8.5 ± 5.1 and 3.0 ± 3.1years, respectively. The majority of participants worked primarily in intensive care units (59%) or in emergency departments (22%). On average, the initial training lasted 45 ± 27 and 13 ± 13days for nurses and physicians, respectively. Only 20% of the initial training comprised seminars or hands-on workshops taught outside of routine clinical care. In all, 47% of the participants stated that they were not able to complete the entire initial training period. Only 49% had been officially certified for usage of the technical equipment in their department. Atotal of 35% reported feeling confident or somewhat confident in handling predictable tasks after initial training, but only 15% in handling acute emergencies. The present study revealed that initial training in intensive care and emergency medicine is frequently incomplete, unstructured, as well as inadequate and bears both safety and liability risks. New concepts are needed to improve the initial training across clinics.

A Salutogenic Perspective on Critical Care Nurse’s Experiences of Supervising Nurses Without Training in Intensive Care to Comprehend, Manage, and Feel Meaning During a Crisis

Introduction: Using the COVID‐19 pandemic as an example of a national and international crisis, it has been possible to show how critical care nurses (CCNs) were affected by their work situation with impact on health and wellbeing. This study sought out to investigate how CCNs stress was affected and to provide some answers as to how to react and organize care in a future crisis. The specific focus was CCNs’ stressors related supervision of nurses untrained in intensive care and how these were handled in a salutogenic perspective.Aim: The aim of this study was to analyze CCNs’ experiences of supervision of nurses without training in intensive care during the COVID‐19 pandemic, and to analyze these experiences with the help of the salutogenic concept sense of coherence.Materials and Methods: The phenomena under study were explored during the years of 2021–2022 through in‐depth interviews and interpreted using deductive content analysis.Results: By analyzing CCNs experiences of supervising nurses without training in intensive care with the lens of sense of coherence, it was possible to show in what way these concepts influenced how to cope with the demanding situation. Sense of coherence was influenced by the inevitable prioritization of patient care and nursing interventions. This prioritization caused moral distress, but was also enhanced or decreased by CCNs sense of coherence.Conclusion: When recruiting and introducing new personnel in a future crisis to any field of healthcare, but particularly to the intensive care, we would, on the basis of these findings, suggest that well‐established plans are vital for how to move personnel throughout the organization, and for how to introduce the field of intensive care. Plans for how to model care with the help of RNs without specialist training should be put in place. A communication plan for the organization is also of importance to enhance transparency.

Body-weight support gait training in neurological intensive care: safety, feasibility, and delays before walking with or without suspension

BackgroundEarly Mobilization in Intensive Care Units (ICUs) enhances patients’ evolution, but has been rarely studied in neurological ICUs. The aim of this study was to assess gait training with body-weight support (BWS) in neuroICU, and to report on its safety, feasibility and on delays before walking with and without BWS.MethodsThis study was an observational one-year single-center study. Inclusion criteria were adults with a neurological injury requiring mechanical ventilation. Exclusion criteria were early death or ICU transfer. After weaning from ventilation, patients were screened for indications of BWS walking using predefined criteria.ResultsPatients’ conditions were mostly brain injuries: 32% subarachnoid hemorrhages, 42% focal strokes, and 12% traumatic brain injuries. Out of 272 admissions, 136 patients were excluded, 78 were eligible, and 33 performed BWS walking. Among non-eligible patients, 36 walked unsuspended upon ventilation weaning, 17 presented too severe impairments. Among the 45 eligible patients who did not receive BWS training, main reasons were workload and weekends (31%), medical barriers (29%), and early ICU discharge (22%). 78 BWS sessions were performed on the 33 beneficiaries (median sessions per patient 2, max 10). Pre-session, most patients had inadequate response to pain, orders, or simple orientation questions. Sitting without support was impossible for 74%. Most pre-post changes in hemodynamic, respiratory, and pain parameters were small, and recovered spontaneously after the session. Eight sessions were interrupted; reasons were pain, fatigue or major imbalance (4), syncope (1), occurrence of stool (2), and battery failure (1). None of these adverse events required medical intervention, patients recovered upon session interruption. Median session duration was 31 min, patients walked on median 17 m. First BWS session occurred on median 3 days after ventilation weaning, and 11 days before patients were able to walk unsuspended.ConclusionsVerticalization and walking using a suspension device in patients in neuroICU allows early gait training, despite challenging neurological impairments. It is safe and generally well tolerated.Trial registration: ClinicalTrials database (ID: NCT04300491).

Publication outcomes among intensive care trainees.

There is a paucity of literature describing the research productivity among trainees in intensive care medicine. We sought to examine the occurrence and determinants of successful publication outcomes associated with intensive care training. The study cohort consisted of all individuals admitted to fellowship of the College of Intensive Care Medicine of Australia and New Zealand (CICM) from 2012 to 2019. The primary outcome measure of this study was manuscripts indexed on PubMed within one year after and four years prior to admittance to CICM fellowship. Four hundred and eighty-five fellows were identified of whom 216 (45%) had at least one publication; 129 (27%) had one, 34 (7%) had two, 21 (4%) had three and 32 (7%) had four or more publications. Overall 138 (28%) fellows had at least one publication that was likely associated with their mandatory CICM training project for which they were first (n = 110; 80%) and/or corresponding (n = 72; 52%) author in the majority of cases. Overall 107 different senior/mentor authors were identified, with 13 individuals supporting more than one publication. Although gender and location at the time of fellowship award were not associated, location of receipt of medical degree, shorter time period between medical school graduation and fellowship award, more recent year of award, and completion of medical degree/fellowship in the same geographical region were associated with project publication. A minority of CICM fellows have PubMed-indexed publications related to their training. Further efforts are warranted to better define the determinants of successful project publication to optimise future opportunities.

The Effect of the Knowledge, Skills, and Attitudes from Nurse Training Using In Situ Simulation in an Intensive Care Unit.

In situ simulation is the practice of using simulated scenarios to improve skill implementation, train critical thinking and problem-solving abilities, and enhance self-efficacy. This study aimed to enhance nursing knowledge, skills, and attitudes toward clinical work by applying in situ simulation training to improve the healthcare of critically ill patients. This study was conducted from a medical center in northern Taiwan and included 86 trainees who received intensive care training courses from 1 June 2017 to 31 May 2019. The self-report knowledge assessment, empathetic self-efficacy scale, skill assessment, and attitudes of instructors before and after training were collected. The statistical analysis used the Wilcoxon test for knowledge and attitudes, and chi-square tests were used for skills to evaluate the learning effect. The results showed a statistically significant improvement in knowledge, skills, attitudes, and empathy in nursing care. In situ simulation learning can be an accepted method for nursing skills in the intensive care unit. Through this study, we understood that the in situ simulation method was beneficial to nurses' care and care thinking processes. It is worth developing and evaluating integrated simulation education to enhance learning, change behavior, and promote holistic care in the nursing field.

Newly qualified intensive care nurses’ lived experiences of being a shift leader in a private healthcare institution in Gauteng, South Africa

ObjectiveNewly qualified intensive care nurses (NQICNs) are expected to execute the shift-leading role immediately after graduation. Critical reasoning, problem-solving, decision-making, and evidence-based clinical judgment are thus essential skills for intensive care nursing graduates. This study aimed to explore and describe NQICNs’ lived experiences of being shift leaders. MethodsThis descriptive qualitative study was based on the data collected through semi-structured individual interviews. Five NQICNs in five hospitals from one region in Gauteng, South Africa, were interviewed between September and December 2019. NQICNs working as shift leaders for 10 to 12 months after intensive care training were eligible for inclusion in the study. Data were analyzed using the four steps suggested by Giorgi. ResultsThe results revealed three themes and seven sub-themes. NQICNs suffered greatly intrapersonally (NQICNs reported intrapersonal suffering, manifesting as pre-shift anxiety, severe work stress, and post-shift exhaustion; NQICNs employed coping mechanisms and either fought, fled, or froze during conflict or crises; NQICNs lack of shift-leading experience did not match their heavy load of responsibilities and accountability); the NQICNs interpersonally matured and empowered themselves (NQICNs experienced support and challenges on an interpersonal level; NQICNs improved their interpersonal relationships and felt proud of and empowered by their professional growth); NQICNs highlighted various requirements to help them manage the high demands of leading shifts (others should fulfill certain needs to enable NQICNs to handle the shift-leading role; self-awareness as a need to enable NQICNs to embrace the shift-leading role). ConclusionA greater understanding of NQICNs and their unmet needs will enable nurse managers, educators, and nurses to better support NQICNs’ evolution from novice to competent shift leaders.

The effect of flipped approach in teaching critical respiratory care among nurses during the COVID-19 era

ObjectivesThis study investigated the efficacy of flipped approach on the nurses’ knowledge and motivation regarding critical respiratory care during the COVID-19 pandemic.ResultsThis pretest-posttest quasi-experimental study was performed in a hospital affiliated with Shiraz University of Medical Sciences during March-December 2021. One hundred and twenty eligible nurses selected by convenience sampling underwent a seven-day flipped approach respiratory intensive care training. The nurses’ motivation and knowledge were evaluated using the Students’ Motivation Towards Science Learning (SMTSL) and a 20-researcher-made four-option questionnaire before and two weeks after the intervention, for knowledge assessment respectively. The nurses’ knowledge and learning motivation were significantly higher after the intervention (P < 0.001). The flipped approach can improve learning motivation and nurses’ knowledge of critical respiratory care.

Clinical Informatics needs to be a competency for Intensive care training

Clinical informatics is a cornerstone in the delivery of safe and quality critical care in Australia and New Zealand. Recent advances in the field of clinical informatics, including new technologies that digitise healthcare data, improved methods of capturing and storing these data, as well as innovative analytic methods using machine learning and artificial intelligence, present exciting new opportunities to leverage data for improving the delivery of critical care and patient outcomes. However, ICU training in Australian and New Zealand does not adequately address capability gaps in this area, potentially leaving future intensivists without the necessary skills to provide leadership in the application of informatics within ICUs. This highlights the need to examine how competency in clinical informatics can be incorporated into ICU training, potentially through a range of activities such as curriculum redesign, the formal project, and workshops or datathons. Further work to identify relevant informatics competencies and methods to develop and assess these competencies within ICU training is needed.

Echocardiography and Ultrasound Committee statement for theaccreditation programme in point-of-care ultrasonography in Poland.

Ultrasonography is becoming an essential part of the management of critically ill patients. There has been a sufficient body of evidence to support the incorporation of point-of-care ultrasound (POCUS) in anaesthesia and intensive care medicine training programme. Recently the European Society of Intensive Care Medicine reco-gnized POCUS as an essential skill for European Intensive Care Medicine specialists and updated Competency Based Training in Intensive Care (CoBaTrICe). Following European training standards, the Ultrasound and Echocardiography Committee of the Polish Society of Anaesthesiology and Intensive Therapy issued this Position Statement for recommendations for the accreditation process in POCUS in Poland.

Effectiveness of nursing virtual training courses based on the Kirkpatrick Model.

Educational evaluation is one of the most significant programs of any organization. In fact, evaluating training effectiveness allows managers and staff of the organization to get a clear picture of the qualities of training activities. The purpose of this study was to evaluate virtual nursing intensive care training courses at Shariati Hospital based on the Kirkpatrick Model in 2020. The current cross-sectional study is an evaluation of the outcome-oriented program to evaluate the results of the e-learning course on nursing intensive care at Shariati Teaching Hospital from March 20, 2020 to September 20, 2020. The total number of nurses working in intensive wards was 168, of whom 150 participated in this research study with convenience sampling. The data collection tool consisted of four-part questionnaires including demographic information and three levels of the Kirkpatrick Model. The mean age of participants was 34.41 ± 6.63 years. The mean score of participant satisfaction was 76.77, indicating that they showed good reaction to virtual training courses. Virtual training course for intensive care nurses was statistically significant at the levels of learning (P < 0.0001) and behavior (P < 0.0001). Virtual training courses are effective educational method based on three levels of Kirkpatrick's Model in intensive care nurses and it can be used along with traditional training approaches.

Differential attainment and recruitment to Intensive Care Medicine Training in the UK, 2018–2020

BackgroundDifferences exist among doctors in examination performance, clinical and academic career progression, and prevalence of performance assessment by professional regulatory bodies. Some of these differences have been reported in relation to individual characteristics. The purpose of this study is to establish whether any specific individual characteristics are associated with performance in selection for entry into specialty training in Intensive Care in the United Kingdom.MethodsWe evaluated data of 509 candidates from the national recruitment rounds of 2018/19 and 2019/20. The outcome evaluated was “success at interview". Variables reaching statistical significance at univariate logistic regression analysis were fed in the multivariable analysis to identify independent predictors of success, with additional exploratory analyses performed, where indicated.ResultsThe candidates’ median age was 31.5 (interquartile range, IQR 30–33.7) years, 324 (63.7%) were male, 256 (50.3%) not married/in civil partnership, 6 (1.2%) pregnant. The majority (316, 62.1%) were White British, 99 (19.5%) of Asian background, other ethnicities represented less than 20% of the sample. Of the 509 candidates, 155 (30.5%) were Atheist, 140 (27.5%) Christian; most were heterosexual (440, 86.4%); 432 (84.9%) reported no disability, while 4 (0.8%) had a minor and 1 (0.2%) had a major disability; 432 (84.9%) candidates held a UK medical degree; 77 (15.1%) a non-UK degree. At univariate logistic regression analysis (LRA) multiple factors were found to be associated with a lower likelihood of success, the strongest being an international medical graduate (IMG, holding a non-UK medical degree); others were increasing age, male gender, being married, Asian or mixed ethnicity, specific religious beliefs (Buddhism, Islam and Hinduism).After feeding all factors significant at univariate analysis, the only two retained as independent predictors at multivariable regression were Asian ethnicity and holding a non-UK degree. Asian UK graduates success rate was 92.7%, comparable to the national average of 92.3%, the Asian IMGs success rate was significantly lower, at 45.5%.ConclusionsAs the imbalances seen within the candidates of Asian background are explained by considering the country of primary medical training, the variations in performance is likely to reflect differences in training systems and understanding of the UK NHS.

Clinical Profile of Patients Admitted to the PICU in a Tertiary Care Teaching Hospital in Bangladesh

Background: Care of critically ill children remains one of the most demanding and challenging aspects in the field of pediatrics. PICU aims at promoting early intervention with an objective of achieving good results and better prognosis. This study was undertaken to know about the clinical profile and outcome of patients admitted in pediatric ICU in a tertiary care teaching Hospital. Objective: To find out the Clinical profile of patients admitted to the PICU of a tertiary care teaching hospital in Bangladesh. Methods: This is a hospital based, retrospective, descriptive study, done on patients admitted to pediatric ICU of Dhaka medical College Hospital from October 2019 -June 2022 (2 years and 9 months). Results: Total 437 patients were admitted in pediatric ICU. According to the age distribution of patients, most 172(39.36%) respondents were aged &lt;1 year. The mean age was 3.55±3.52 years SD. There was a male preponderance 299(68%), females were 138(32%). Patients from rural area were 308(70%) and 129(30%) from urban area. Clinical profile showed that meningoencephalitis was the most common diagnosis 85(19.45%) for admission in PICU. This was followed by pneumonia 75(17.16%), septicemia 39(8.92%), and neurosurgical patient 34(7.78%). Although few percentages, some other diseases were significantly important like GBS, AGN, hepatic encephalopathies, accidental emergencies, Dengue shock syndrome, needed PICU support. The outcome revealed, overall mortality was 92(21.05%), 330(75.52%) were discharged, 9(2.06%) patients went against medical advice, 6(1.37%) patients were referred for specific comorbidities. Use of inotropes, need for mechanical ventilation, and presence of co morbid illness and low level of Glasgow coma scale less than seven were independent predictors of mortality. Conclusions: Mortality is moderate in our PICU. We conclude that a well-equipped intensive care unit with modern and innovative intensive care and appropriate training greatly ..........

The impact of a “short-term” basic intensive care training program on the knowledge of nonintensivist doctors during the COVID-19 pandemic: An experience from a population-dense low- and middle-income country

BackgroundThe utility of basic intensive care unit (ICU) training comprising a “1-day course” has been scientifically evaluated and reported in very few studies, with almost no such study from resource-limited settings. AimThe study assessed the utility of basic ICU training comprising of a “1-day course” in increasing the knowledge of nonintensivist doctors. Materials and methodsThis is an observational study conducted at a medical university in North India in 2020. The participants were nonintensivist doctors attending the course. The course was designed by intensivists, and it had four domains. The participants were categorised on the basis of their duration of ICU experience and broad speciality. Pretest and posttest was administered, which was analysed to ascertain the gain in the knowledge score. ResultsA total of 252 participants were included, of which the majority were from the clinical medicine speciality (85.3%) and had ICU experience of 1–6 months (47.6%). There was a significant improvement in the mean total score of the participants after training from 14/25 to 19/25, with a mean difference (MD) of 5.02 (p < 0.001). Based on ICU experience, in groups I (<1 month), II (1–6 months), and III (>6 months), there was a significant improvement in the total score of the participants after training with MD with 95% confidence interval (CI) limits of 5.27 (4.65–5.90), 4.70 (4.38–5.02), and 5.33 (4.89–5.78), respectively. In the clinical surgery specialty (n = 37), there was a significant improvement in the total score after training from 11/25 to 16.4/25 with an MD (95% CI limits) of 5.38 (4.4–6.3). Similarly, in the clinical medicine group (n = 215), the MD (95% CI limits) score after training was 4.95 (4.71–5.20), from 14.5/25 to 19.5/25. In feedback, more than half of the participants showed interest in joining ICU after training. ConclusionsTraining nonintensivist doctors for 1 day can be useful in improving their knowledge, regardless of their prior ICU experience and speciality.

Nurses’ perception on competency requirement and training demand for intensive care nurses

ObjectivesVarious authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units (ICUs). Nurses’ perception of training is an element that must be studied in order to adopt appropriate educational measures. This study aimed to evaluate nurses’ perception of the importance of intensive care training in Spain. MethodsA descriptive, cross-sectional, multicentre study was conducted on a national level in Spain. Totally 85 ICUs took part in the study. The questionnaire used was developed using the Delphi method and had 66 items to investigate nurses’ perception on competency requirements and training needs. The evaluation was conducted by a 10-point Likert scale. ResultsThe sample was 568 Spanish nurses. Significant differences were found on an academic level, in terms of gender and hospital type, and in the professional experience of the nurse when it comes to evaluating the different training items; the differences in overall questionnaire scores among these groups were statistically significant (P < 0.05). The nurses analyzed believe that previous training and professional experience in other care services are necessary before starting work in an ICU. ConclusionImplementation of training programs tailored to the needs of critical nurses had benefits for nurses and the health system. Nurses benefited from training focused on the skills and knowledge of each moment of their working life. Nurses have a different evaluation of their training needs throughout their professional cycle. Therefore, their training must be adapted to the professional stage of each nurse.