Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses

BACKGROUND: There are two types of suction methods used clinically: closed tracheal suction system (CTSS) and open tracheal suction system (OTSS). However, the safety and efficacy of these two suction systems for patients remain to be analysed. OBJECTIVE: The objective of this study was to assess the safety and efficacy of OTSSs and CTSSs in adult mechanical ventilation. METHODS: Computer searches were conducted on PubMed, Web of science, MEDLINE, CINAHL, and Cochrane Library databases...

BACKGROUND: Postextubation is common in the intensive care unit, and bedside screening by nurses is important to detect the condition and avoid aspiration to the airways. OBJECTIVE: The objective of this study was to assess the implementation of nurse-led, systematic dysphagia screening in the intensive care unit and to identify barriers and facilitators for dysphagia screening. METHODS: Design: pragmatic implementation study. Based on a programme theory, key behaviours were identified using the Behaviour Change Wheel framework...

BACKGROUND: The Augmented versus Routine Approach to Giving Energy Trial (TARGET) was a 4000-patient trial in which augmented enteral calorie dose did not influence outcomes. AIM: We aimed to quantify practice change following TARGET. METHODS: Three single-day, prospective, multicentre, point-prevalence audits of adult patients receiving enteral nutrition (EN) in participating Australian and New Zealand intensive care units at 10:00 AM were conducted: (i) 2010 (before conducting TARGET); (ii) 2018 (immediately before publishing TARGET results); and (iii) 2020 (2 years after TARGET publication)...

AIM/OBJECTIVES: Fit testing of N95/FFP2 respirators is universally recommended before exposure to airborne infectious diseases such as COVID-19. Respirator supply shortage in the COVID-19 pandemic encouraged extended-use for up to 4 h, despite uncertainty about seal integrity over time. The aim of our study was to assess N95 seal integrity after at least 2 h of continuous clinical use in the intensive care unit (ICU). We hypothesised that seal integrity would deteriorate over time, with variability between respirator shapes...

BACKGROUND: Adequate nutrition is important for recovery after critical illness. Even so, our knowledge of patients' nutritional intake after intensive care unit (ICU) discharge is scarce. OBJECTIVES: We aimed to explore nutritional planning and achieved nutritional intake in ICU patients who transfer from the ICU to general wards. METHODS: A retrospective quality assurance study. INCLUSION CRITERIA: adult ICU patients transferring to a general ward at Copenhagen University Hospital-Herlev from May to August 2021...

BACKGROUND: Ventilator-associated pneumonia is a common and life-threatening complication in intensive care unit (ICU) patients. Maintaining oral hygiene is crucial for reducing ventilator-associated pneumonia incidence. Various mouthwash solutions are used for oral care in ICU settings, but their comparative effectiveness remains unclear. This study aims to systematically evaluate and compare the efficacy and safety of commonly used mouthwashes for oral care in mechanically ventilated ICU patients...

BACKGROUND: Survival of children with complex medical conditions has increased over time. Around 5% of children admitted to a neonatal unit (NNU) later have an admission to a paediatric intensive care unit (PICU) in early life. No work to date has explored the needs of parents who have a child admitted to both of these healthcare settings. OBJECTIVE: The overall aim of this study was to understand parents' experiences as they navigate the transition between admissions to the NNU and the PICU...

BACKGROUND: Use of high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) in the intensive care unit (ICU) is increasing, yet reporting of nutrition intake, muscle thickness, or recovery outcomes in this population is limited. OBJECTIVE: The objective of this study was to quantify muscle thickness, nutrition intake, and functional recovery outcomes for patients receiving HFNC/NIV within the ICU. METHODS: A single-centre, prospective, observational study in adult ICU patients recruited within 48 hrs of commencing HFNC/NIV...

BACKGROUND: Evidence for music's beneficial effect on physical and mental disorders is mounting. Intensive care unit (ICU) patients experience multiple uncomfortable symptoms, which may be alleviated using a music-based intervention. Few studies have examined the experience and the physical impact of patient-tailored live music offered by trained health musicians in an adult ICU. AIMS: This study aimed to explore the experience of live music in adult patients admitted to an ICU, focusing on its effects on relaxation, stress, and pain...

BACKGROUND: The COMHON Index is an intensive-care-specific pressure injury risk assessment tool, which has demonstrated promising psychometric properties. It has been translated into Chinese Mandarin but requires inter-rater reliability testing and comparison to the standard care instrument (Braden Scale) before clinical use. OBJECTIVES: This study aimed to test and compare the inter-rater reliability and convergent validity of the Chinese Mandarin versions of the COMHON Index and Braden Scale...

BACKGROUND: Compassion among intensive care unit (ICU) nurses is an essential component of humanistic care in the ICU However, the enormous pressures of the job and the lack of social support have led to persistently severe compassion fatigue. Sensory processing sensitivity, as a personality trait for individuals to perceive external factors, has underlying significance for compassion fatigue. AIMS: This study aims to investigate the internal and external environmental factors and the underlying mechanisms that influence the impact of sensory processing sensitivity among ICU nurses on the development of compassion fatigue...

AIM: The aim of this study was to codesign a Family Members' Voice Reorientation Intervention (FAMVR) for delirium prevention and management in critically ill adult patients through collaborative process with previous patients, families, and clinical staff. BACKGROUND: Delirium is a common consequence of intensive care admission, and there is limited evidence to support family-led interventions to prevent or minimise delirium in intensive care. People with lived experience of intensive care are seldom involved in codesigning delirium prevention and management interventions despite the identified benefits of their involvement in delirium care...

BACKGROUND: Timely goals-of-care (GOC) discussions are essential for end-of-life planning, particularly during acute hospital admissions, where ambiguity often persists. Frailty, prevalent in the ageing population and linked to adverse outcomes, underscores the need to align treatment strategies with quality of life. Recognising frailty as a trigger for GOC discussions during rapid response calls (RRCs) is critical for efficient resource management and improving patient outcomes. METHODS: This single-centre retrospective cohort study included all hospitalised patients aged ≥65 years admitted between September 2021 and June 2023 who experienced an RRC...

BACKGROUND: To prevent the infection from spreading, patients who were dying from COVID-19 were treated in isolation with restricted family access, which differed from existing end-of-life care procedures. This was a significant change that affected the care provided by nurses. OBJECTIVES: This study explored nurses' end-of-life care experiences in a limited family visitation setting during the COVID-19 pandemic. METHODS: A descriptive qualitative study was conducted...

BACKGROUND: During the Covid-19 pandemic, family visitation to intensive care was severely restricted. In response, family communication moved to remote-only options. The effect on patients and families of this communication change is poorly understood. OBJECTIVE: The aim of this review was to synthesise the available research on remote-only communication interventions and their effect on patient and family outcomes within the intensive care environment. REVIEW METHOD USED: A systematic review of relevant studies was undertaken...

BACKGROUND: Weaning from mechanical ventilation is a complex and central intensive care process. This complexity indicates that the challenges of weaning must be explored from different perspectives. Furthermore, physicians' experiences and the factors influencing their decision-making regarding weaning are unclear. OBJECTIVES: This study aimed to explore and describe the factors influencing physicians' decision-making when weaning patients from invasive mechanical ventilation in Swedish intensive care units (ICUs)...

BACKGROUND: Early mobilisation interventions play a role in preventing intensive care unit-acquired weakness in critically ill patients and may contribute to improved recovery. Patient-and-family-centred care includes collaborative partnerships between healthcare professionals and families and is a potential strategy to promote early mobilisation in critical care; however, we currently do not know family member preferences for partnering and involvement in early mobilisation interventions...

No abstract text is available yet for this article.

OBJECTIVES: This scoping review was undertaken to understand the degree of variation in clinical practices associated with postoperative atrial fibrillation (POAF), following coronary revascularization surgery by collating and synthesising key concepts from current published literature. REVIEW METHODS AND DATA SOURCES: This scoping review was conducted following the framework outlined by Askey and O'Malley. Reporting of this scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist...

OBJECTIVES: This study investigated the feasibility and safety of interactive virtual reality rehabilitation (VRR) for patients with a critical illness and a long stay in the intensive care unit (ICU), as a motivational tool for rehabilitation. DESIGN: Single-centre, non-randomised proof-of-concept clinical trial. PARTICIPANTS: Adult, calm, and alert critically ill patients with a prolonged stay (≥8 days) in the ICU. METHODS: Patients received interactive VRR therapy for upper limb rehabilitation with a VR-app designed specifically for use in bedridden patients in the supine position...