2024/10/29 by Josef G. Trapani, Nina Stewart, Sameh Eltaybani +1 · 1 voice
Medicine · Health Professions · #Intensive Care Unit Cognitive Disorders #Family and Patient Care in Intensive Care Units #Respiratory Support and Mechanisms
paper · pdf · doi:10.1111/nicc.13189
openalex publication_date 2024/10/29 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/22
Welcome to the sixth issue of Nursing in Critical Care for this year. In this bumper issue, we cast a spotlight on a number of topics that are of interest to critical care nurses. We explore delirium, well-being, moral injury and resilience, evidence-based practice and neonatal and paediatric care. We also share with you topics related to the renal and respiratory systems as well as the ongoing impact of COVID-19 still felt by so many critical care units, and other clinically relevant topics that should be of interest to critical care nurses in various settings. As the number of submissions to the journal was high, we decided to present a bumper issue with 62 papers that will be of relevance to an international audience of critical care nurses. We have 15 papers on the topic of respiratory care, 8 papers on delirium and 13 papers on the topic of well-being and moral injury and resilience. Again, many of the papers in this issue are quantitative in nature and investigate impacts or predict outcomes. There are a range of pilot studies, cross-sectional surveys, randomized controlled trials (RCTs) and papers on the development and validation of prediction tools. We open this issue with an editorial paper by McEvoy and Curley1 who discuss the influence of intensive care unit (ICU) dashboards on the quality of care. de Almeida Barcellos presents a critical commentary on the important role of science in nursing.2 We hope that these papers provide awareness of the way we practise, and the influence science has on that. This issue includes eight papers covering delirium, including three systematic reviews. Both Zhang and Diao3, 4 explored the predictive value of assessment methods, and Wang5 investigated the prevalence of delirium in emergency departments. Two further studies explored factors associated with delirium. Zhang et al. assessed serum interleukin-6 after bypass grafting,6 and Liang et al. on the associations of malnutrition on delirium.7 The burden and impact of delirium are also investigated in two papers, both situated in cardiac care. One paper8 used a mixed methods design to examine delirium care burden on nurses, while another9 explored the impact of delirium on clinical and functional outcomes. Nydahl et al.'s10 development of a flyer with re-orientating messages for families of patients with delirium in the ICU completes the papers on delirium. Also included in this issue are several studies and reviews on respiratory support and management. Prevention of ventilator-acquired pneumonia (VAP) is an important consideration for critical care nurses. A scoping review by Rehmani et al.11 considers nursing care bundles to reduce the incidence of VAP, while Şimşek et al.12 systematically reviewed the evidence for abdominal massage to prevent VAP. Jia et al.13 report an in vitro study of bacterial colonization in humidified oxygen circuits and Yao et al.14 examined nurses' knowledge of and compliance with evidence-based guidelines for VAP prevention. Considering ventilation management, Liu et al.15 report a quality improvement project on tracheostomy tube changes, Cambaz et al.16 considered risk factors for endotracheal tube-related pressure injuries and Mohamed et al.17 conducted a survey of nurses' knowledge and attitudes towards monitoring ventilator waveforms to detect ventilator asynchrony. Once patients are stable and ready to be weaned from ventilation, Sterr et al.18 considered the evidence for weaning-associated interventions in their scoping review, while Wang et al.19 explored the predictive value of fluid balance on outcomes following extubation. Once patients have been liberated from ventilation, there are many considerations for their ongoing care, several of which are explored in this issue. Luo et al.20 considered the risk factors for post-extubation dysphagia in their study, Elsayed et al.21 examined factors associated with readiness for oral intake following extubation in their observational study, and Edalatifard et al.22 present a case study of respiratory symptoms caused by a twisted nasogastric tube. Finally, two studies examined the delivery of high-flow nasal oxygen (HFNO). Galazzi et al.23 report on an RCT of the starting temperature for HFNO, while Seo et al.24 explored the effect of automatic adjustment of oxygen concentration during HFNO delivery on time spent in the optimal oxygenation range. Continuing the focus on common interventions in critical care, this issue includes two studies exploring the management of continuous renal replacement therapy. Mateos-Dávila et al.25 report an observational study of changes in pre-filter pressure, and how this affects decisions to return blood from the circuit to the patient. In their study, Shi et al.26 considered the use of sterile water and citrate anticoagulation to safely correct hyponatraemia. Several articles in this issue address the well-being of critically ill patients and their families. One systematic review27 highlighted the advantages of patient- and family-centred care interventions for patients, families and health care providers in adult ICUs. A meta-analysis28 examined the effectiveness of decision aids on the prognosis of critically ill patients and the knowledge, anxiety, depression and decisional conflict of their family members. A network meta-analysis29 assessed the efficacy of various non-pharmacological therapies for anxiety disorders in adult ICU patients. From Turkey, a qualitative study30 showed the multifactorial reasons ICU patients may not have quality night-time sleep. An RCT31 examined the effect of eye mask use on sleep quality and pain in patients undergoing coronary artery bypass graft surgery, and another RCT evaluated the effects of music and breathing exercises on anxiety and pain in patients undergoing coronary angiography. In addition, two studies examined ICU diaries. One33 explored the usability of an innovative digital diary from the perspectives of ICU patients' relatives using a cross-sectional online survey, and the other34 employed an interpretative narrative methodology to explore themes in nurse-written ICU diaries and their impact on nursing work and communication. The current issue also features five cross-sectional studies addressing ICU nurses' moral, psychological and emotional issues: two from China and three from Turkey. From China, one study35 examined the relationship between moral resilience and secondary traumatic stress, and the other one36 examined factors associated with moral sensitivity. From Turkey, one study37 analysed the relationship between burnout and quality of work–life, another38 examined emotional contagion and spiritual care competence, and the other39 studied the relationship between moral intelligence and compassion fatigue. Three studies on the COVID-19 pandemic are also included in this issue. The first40 applied hazard vulnerability analysis to investigate risk factors for converting traditional wards to temporary ICUs to meet the urgent health care demands during the pandemic. The second41 qualitatively explored how piloting and watch over, two key end-of-life nursing concepts, were addressed during the pandemic. The third,42 also a qualitative study, highlighted the negative impacts of visit restrictions imposed during the pandemic on ICU patients, their relatives, nurses and the care environment. This issue also features studies and reviews about prognostic indicators and recognition of deterioration. The meta-analysis by Lan et al.43 and the short research article from Iran by Shafigh et al.44 compare the prognostic accuracy of the Sequential Organ Failure Assessment (SOFA) score with that of other indicators. Elliot et al.45 performed an audit of an Australian national coronial database to explore associations between clinicians' neglect of vital signs assessment and patient mortality, while Gawronski et al.46 conducted a survey to investigate the processes that are in place to facilitate the early recognition of, and response to, the deterioration of children in European hospitals. As usual, this issue includes a number of other neonatal and paediatric critical care papers that affirm the Journal's commitment to present research about critical care across the lifespan. These include a qualitative study from the Republic of Korea exploring mothering experiences in paediatric critical care units with severely restricted family visitation47; a retrospective study investigating the most appropriate lower limb insertion site for peripherally inserted central catheters48; a quality improvement report from Qatar aimed at reducing the incidence of blood clotting in samples sent for laboratory investigations49; a prospective observational study from Spain testing the applicability and usability of an ocular assessment scale intended for the early detection of eye lesions in critically ill children50; and a scoping review on the severity scales available for reporting hospital-acquired skin injuries in neonates.51 Skin care in critically ill patients is the focus of the next set of papers in this issue. Cobos-Vargas et al.52 assessed the predictive validity of a pressure injury risk assessment scale for adult ICU patients. Kurt et al.53 performed a systematic review on nursing interventions to prevent pressure injuries in patients undergoing open heart surgery, whereas Arslan and Ates54 examined the effectiveness of heel protection in the prevention of plantar flexion contractures and pressure injuries in the heel through an RCT in Turkey. Another Turkish study55 examined the effect of applying cold gel packs in the prevention of phlebitis related to amiodarone administration, whereas the systematic review by Zhou et al.56 analysed the effectiveness of various devices aimed at preventing moderate to severe incontinence-associated dermatitis. Congruent with the critical commentary2 introduced earlier on, this issue concludes with a set of miscellaneous papers exploring the search, assimilation and implementation of evidence to support clinical practice. The RCT by Calpe-Damians et al.57 evaluated the safety and effectiveness of a urinary catheter securement device in preventing catheter-associated urinary tract infections, whereas the observational study by Favre et al.58 focussed on early processed electroencephalography for monitoring mechanically ventilated patients who are deeply sedated. The systematic reviews by Arevalo-Buitrago et al.59 and Motia et al.60 assessed the effectiveness of nursing interventions in the prevention of ocular surface disorder and the complications associated with the use of intra-aortic balloon pumps, respectively. A further systematic review by Shanahan et al.61 examined the impact of brain tissue oxygenation on the Glasgow Coma Scale score in patients with a brain injury. Finally, the evidence-based review by Borg and Trapani62 assessed the accuracy of continuous non-invasive blood pressure monitoring using radial artery applanation tonometry in comparison with intra-arterial blood pressure monitoring. We hope that you enjoy reading about the varied topics in this bumper issue. This is the last issue before we progress to a continuous publication model in the new year, through which issues will be compiled consecutively as soon as accepted papers undergo production, which means that individual papers will be added to a specific issue earlier. In this issue, we have included papers that will hopefully develop your knowledge and inspire you to continue delivering, researching or teaching expert, evidence-based critical care across the lifespan. We also hope you enjoyed the BACCN conference, and it was a pleasure to meet delegates and readers at the NICC stand. Data sharing is not applicable to this article as no new data were created or analyzed in this study.