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Nursing care factors influencing patients' outcomes in the intensive care unit: Findings from a rapid review.

ABSTRACT:

Aims

To examine the nursing care factors investigated regarding their influence on outcomes of critically ill patients.

Background

A large number of studies have considered patients' outcomes as sensitive to nursing practice in intensive care unit environments. However, no summary of nursing factors influencing these outcomes has been provided.

Design

Rapid review, following the seven-stage process outlined by Tricco and colleagues.

Data sources

Articles published up to March 2020 were identified in MEDLINE (via PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus databases.

Review methods

Eligibility of studies was first assessed at the title and abstracts level. Study inclusion was then established by two researchers by analysing the full texts.

Results

A total of 93 studies were included, with a total of 21 nursing care factors documented. At the structural level, nursing factors have been investigated at the organizational and at the personnel level. At the process level, nurse-led programmes, independent nursing interventions and nurse behaviours have been investigated to date.

Conclusion

The set of nursing factors that emerged can be used in future research to improve poorly developed areas and to accumulate further evidence through additional studies, both at managerial and practice levels.

SUBMITTER: Danielis M

PROVIDER: S-EPMC9286446 | biostudies-literature |

REPOSITORIES: biostudies-literature

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| S-EPMC8582948 | biostudies-literature

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| S-EPMC6944385 | biostudies-literature

Exploring the Nursing Factors Related to Ventilator-Associated Pneumonia in the Intensive Care Unit.

Project description:ObjectiveThe purpose of this study was to investigate the key nursing factors associated with ventilator-associated pneumonia (VAP) in critical care patients.MethodsThrough the quality control platform of Hebei Province, questionnaires were sent to intensive care nurses in 32 tertiary hospitals in Hebei Province, China to collect data concerning the incidence of VAP and the status of the nursing staff. All the data were analyzed using an independent t-test and a one-way analysis of variance (ANOVA). The Pearson correlation coefficient was used to analyse the correlation between the nursing factors and the incidence of VAP. Multivariate logistic regression analysis was used to determine the risk factors affecting VAP.ResultsIn terms of nursing, the incidence of VAP was affected by the differential nursing strategies. Multivariate logistic regression analysis showed that the incidence of VAP was significantly associated with the following six variables: the ratio of nurses to beds (p = 0.000), the ratio of nurses with a bachelor's degree or higher (p = 0.000), the ratio of specialist nurses (p = 0.000), the proportion of nurses with work experience of 5-10 years (p = 0.04), the number of patients nurses were responsible for at night (p = 0.01) and the frequency of oral care (p = 0.000).ConclusionThe incidence of VAP is closely related to nursing factors. In terms of nursing human resources, even junior nurses (less experienced nurses) can play an essential role in reducing VAP. In addition, to reduce VAP, the number of patients that nurses are responsible for at night should be reduced as much as possible, and improving nursing qualifications.

| S-EPMC9019058 | biostudies-literature

Factors Influencing Patients' Sleep in the Intensive Care Unit: Perceptions of Patients and Clinical Staff.

Project description:BackgroundMultiple factors are believed to contribute to disruption of patients' sleep and negatively affect clinical outcomes in the intensive care unit. Achieving restorative sleep for critically ill patients remains a challenge.ObjectivesTo explore the perceptions and beliefs of staff, patients, and surrogates regarding the environmental and nonenvironmental factors in the medical intensive care unit that affect patients' sleep.MethodsThis qualitative study included 24 medical intensive care unit staff (7 physicians, 5 respiratory therapists, 10 nurses, and 2 patient-care assistants), 8 patients, and 6 patient surrogates. Semistructured interviews were conducted, and qualitative analysis of content was used to code, categorize, and identify interview themes.ResultsInterview responses revealed 4 themes with related subthemes: (1) The overnight medical intensive care unit environment does affect sleep, (2) nonenvironmental factors such as difficult emotions and anxiety also affect sleep, (3) respondents' perceptions about sleep quality in the medical intensive care unit were highly variable, and (4) suggestions for sleep improvement included reassuring patients and care-clustering strategies.ConclusionsResults of this study suggest that environment is not the only factor influencing patients' sleep. Decreases in environmental sources of disturbance are necessary but not sufficient for sleep improvement. Guideline-recommended clustered care is needed to provide adequate sleep opportunity, but patients' emotions and anxiety also must be addressed.

| S-EPMC5559223 | biostudies-literature

Factors influencing sleep quality in the intensive care unit: a descriptive pilot study in Korea.

Project description:BackgroundAs sleep disturbances are common in the intensive care unit (ICU), this study assessed the sleep quality in the ICU and identified barriers to sleep.MethodsPatients admitted to the ICUs of a tertiary hospital between June 2022 and December 2022 who were not mechanically ventilated at enrollment were included. The quality of sleep (QoS) at home was assessed on a visual analog scale as part of an eight-item survey, while the QoS in the ICU was evaluated using the Korean version of the Richards-Campbell Sleep Questionnaire (K-RCSQ). Good QoS was defined by a score of ≥50.ResultsOf the 30 patients in the study, 19 reported a QoS score <50. The Spearman correlation coefficient showed no meaningful relationship between the QoS at home and the overall K-RCSQ QoS score in the ICU (r=0.16, P=0.40). The most common barriers to sleep were physical discomfort (43%), being awoken for procedures (43%), and feeling unwell (37%); environmental factors including noise (30%) and light (13%) were also identified sources of sleep disruption. Physical discomfort (median [interquartile range]: 32 [28.0-38.0] vs. 69 [42.0-80.0], P=0.004), being awoken for procedures (36 [20.0-48.0] vs. 54 [36.0-80.0], P=0.04), and feeling unwell (31 [18.0-42.0] vs. 54 [40.0-76.0], P=0.01) were associated with lower K-RCSQ scores.ConclusionsIn the ICU, physical discomfort, patient care interactions, and feeling unwell were identified as barriers to sleep.

| S-EPMC10497899 | biostudies-literature

Factors Influencing Nursing Students' Person-Centered Care.

Project description:Background and objectives: Numerous theoretical and clinical advances have been made through research on person-centered care (PCC). Nevertheless, care is still focused on the medical aspects of treating patients' diseases in Korea, and thus providing individualized PCC to patients tends to be neglected. This study aimed to investigate the relationship between PCC competence, empathic competence, interpersonal competence, and perceived stress to identify the factors that impact PCC competence for developing programs that foster PCC competence in nursing students. Materials and Methods: Data were collected from 149 participants, which comprised third- and fourth-year nursing students from two universities in Korea who have experienced clinical training. PCC competence, empathic competence, interpersonal competence, and perceived stress were measured using structured self-reported questionnaires. Results: PCC competence was positively correlated with empathic competence (p < 0.001) and interpersonal competence (p < 0.001), and negatively correlated with perceived stress (p < 0.001). Empathic competence, perceived stress, interpersonal competence, and satisfaction with the participants' nursing major were identified as factors that influenced the PCC competence (adjusted R2 = 0.570). Conclusions: To enhance PCC competence in nursing students, empathic competence, interpersonal competence, and satisfaction with the participants' nursing major need to be improved and perceived stress needs to be reduced.

| S-EPMC7466314 | biostudies-literature

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Project description:BackgroundThe terminal ill patients in the Intensive Care Unit had physical, mental, social, and spiritual suffering. Nursing students must be aware of own feelings to be able to deliver humanistic care and enable patients to live the rest of lives with dignity. The aim of the study was to investigate experiences of providing palliative care in the Intensive Care Unit (ICU).MethodThis study is a qualitative case study research. In-depth interviews were conducted with the key informants. The key informants were nine Thai third-year nursing students were purposively selected.ResultsThe experiences of providing palliative care involved two Themes: (1) self-perception while providing care for terminal ill patients and (2) providing care for terminal ill patients with respect in the patients' dignity.ConclusionThese results can be applied to create learning activities to promote nursing students' self-awareness and enable them to provide humanized care for terminal ill patients.

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intensive care unit shotgun raw sequences

Project description:intensive care unit shotgun raw sequences Metagenome

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Genomic analyses reveal high diversity and rapid evolution of Pichia kudriavzevii within a neonatal intensive care unit in Delhi, India

Project description:Pichia kudriavzevii causes life-threatening infections in immune compromised hosts including hospitalized neonates. This pathogen is resistant to fluconazole while uncommon, strains resistant to multiple antifungal drugs voriconazole, amphotericin B and echinocandins have been reported in healthcare environments. Understanding how P. kudriavzevii spread, persist, and adapt to healthcare settings could help us develop better management strategies. In this study, whole genome sequencing identifies multiple outbreaks of bloodstream infections caused by P. kudriavzevii in a single neonatal intensive care unit (NICU) over five years. Interestingly, two genetically diverse clusters of P. kudriavzevii population showed frequent loss of heterozygosity (LOH) events between two temporal samples. The first outbreak cluster (during 2015-16) showed LOH at chromosomes 1, 4 and 5 and the other outbreak cluster (year 2020) exhibited marked LOH at chromosome 2. The circulation of two separate strain clusters of P. kudriavzevii suggests nosocomial transmission in the NICU in different time periods. Further, to evaluate the gene expression difference between isolates from two clusters, we compared the transcriptomic profiles of three isolates of cluster I and II and exhibiting distinct fluconazole MICs. While no difference was found at the azole target gene ERG11 or the ATP-binding cassette (ABC) transporter genes, differences in transcript abundance were found between the two isolates in genes coding for cell division and filamentation, repressor of ABC gene, FCR1 and ERG5 gene involved in ergosterol biosynthesis pathway. Our study indicates significant diversity, persistence, and rapid evolution of P. kudriavzevii within a single NICU.

2024-12-16 | GSE282019 | GEO

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