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مقالهها، منابع و پژوهشهای تازه حوزه پرستاری
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جستوجوی دقیقپرستاری و مامایی
مراقبت، آموزش و پژوهش پرستاری و مامایی
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پرستاری مراقبت ویژه
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ورود به زیرشاخهپرستاری سلامت جامعه
مقالهها، منابع و پژوهشهای تازه حوزه پرستاری سلامت جامعه
ورود به زیرشاخهپرستاری روانپزشکی
مقالهها، منابع و پژوهشهای تازه حوزه پرستاری روانپزشکی
ورود به زیرشاخهپرستاری سالمندی
مقالهها، منابع و پژوهشهای تازه حوزه پرستاری سالمندی
ورود به زیرشاخهپرستاری کودکان
مقالهها، منابع و پژوهشهای تازه حوزه پرستاری کودکان
ورود به زیرشاخهمامایی
مقالهها، منابع و پژوهشهای تازه حوزه مامایی
ورود به زیرشاخهسلامت مادر
مقالهها، منابع و پژوهشهای تازه حوزه سلامت مادر
ورود به زیرشاخهآموزش پرستاری
مقالهها، منابع و پژوهشهای تازه حوزه آموزش پرستاری
ورود به زیرشاخهتازهترین رکوردها
شواهد پرستاری و مامایی
PubMed2026
Caring Behaviours in Nursing: A Bibliometric Analysis of Global Research Trends and Knowledge Structure.
BACKGROUND: Caring behaviours constitute one of the most visible ways in which "caring" is translated into everyday nursing practice, yet the field has become increasingly heterogeneous across settings, outcomes, and conceptual traditions. A field-level map is therefore needed to clarify how the literature has evolved and where it is currently concentrating. OBJECTIVE: This study aimed to bibliometrically map the literature on caring behaviours in nursing, focusing on global research trends, thematic development, collaboration networks, citation performance, and the field's intellectual structure. METHODS: A bibliometric analysis was conducted on publications indexed in the Web of Science Core Collection between 1987 and 2025, following the SALSA framework. Analyses included performance indicators (publication growth; most productive journals and countries), Author Keyword-based frequency, trend-topic, co-occurrence, and thematic analyses following synonym merging and spelling harmonization, co-authorship network analysis (collaboration patterns), citation analyses, and co-citation mapping to examine the field's intellectual structure. RESULTS: A total of 351 documents from 158 sources (1987-2025) were included. The literature demonstrated steady growth, accelerating after 2016. Core source outlets included BMC Nursing, Journal of Nursing Administration, and Perspectives in Psychiatric Care. The USA, Iran, China, and Turkey were among the most productive countries, while international co-authorship remained limited (14.25%). Thematic signals suggested a shift from earlier emphases on patient satisfaction toward a more recent focus on nursing education, empathy, emotional intelligence, and, most recently, compassion fatigue. The thematic map positioned caring behaviours within the basic-themes quadrant, whereas work environment and related humanistic-care concepts showed greater thematic development. Foundational influences remained anchored in Watson and Swanson, and measurement-oriented works (notably Wu and Wolf) functioned as key intellectual bridges. CONCLUSIONS: Caring behaviours research appears to be a maturing but still expanding field with strong theoretical and measurement "anchors," yet comparatively constrained cross-national collaboration. Future work may benefit from more internationally coordinated programmes and greater attention to cross-cultural validation of measurement tools and to the emotional, organizational, and digitally mediated contexts in which caring behaviours are enacted.
PubMed2026
Machine Learning in Causal Effect Estimation and Causal Evaluation of ML-Enabled Interventions in Nursing-Related Research: A Scoping Review.
Machine learning (ML) informs nursing practice, but prediction cannot establish intervention or workflow effects. Aim To map ML use within causal effect estimation and causal evaluations of ML-enabled interventions in nursing and midwifery. Eight electronic sources were searched for reports published January 2015-June 2026, followed by backward citation searching. Eligibility required a causal estimand, corresponding identification strategy, substantive ML role, and nursing or midwifery relevance. Two reviewers independently screened records and full texts. Fifteen studies (17 reports) were included. Five addressed acute deterioration or sepsis; others covered care prioritization, falls, post-discharge care, and nurse- or midwife-led services. Five used ML within causal effect estimation to examine longitudinal and spillover effects, treatment-effect heterogeneity, and targeting strategies. Ten evaluated ML-enabled interventions or workflows; reported favorable effects on mortality, care escalation, message-review time, and nursing processes, while several controlled estimates were null or imprecise. Evidence remains small and methodologically uneven. Future studies should align estimands, identification strategies, analytic methods, and workflows and evaluate model-plus-workflow effects on nursing processes and patient outcomes.
PubMed2026
Nursing Students' Reports of Patient Safety Incidents and Reasons During Clinical Placements: A Secondary Analysis of the International Data.
Clinical placements expose nursing students to patient safety incidents and provide important opportunities for learning about safe care. This study explored how nursing students in four countries recognized and interpreted patient safety incidents encountered or witnessed during clinical practice, including perceived contributing factors. A secondary qualitative content analysis was conducted using narrative data from 1442 undergraduate nursing students in the Czech Republic, Italy, Slovakia, and Türkiye. In total, 287 incident descriptions and 263 explanations of perceived reasons were analyzed using an inductive-deductive approach supported by descriptive frequency counts. Medication safety incidents and patient falls were most frequently reported, alongside infection prevention breaches, missed or inadequate care, communication failures, adverse outcomes, and environmental hazards. Students described incidents as multifactorial, involving patient and contextual factors, organizational and system conditions, and human and professional factors. Cross-country differences reflected patterns within the analyzed narratives rather than differences in incident prevalence or quality of care. The findings support practice-integrated patient safety education, effective supervision, structured reflection and debriefing, clear reporting pathways, and psychologically and emotionally safe, nonpunitive learning environments.
PubMed2026
Bridging the Awareness-Action Gap in Disaster Preparedness: A Qualitative Study of Immersive Virtual Reality Learning Among Nursing Students.
BACKGROUND: Disasters increasingly challenge healthcare systems, highlighting the need to strengthen preparedness among future healthcare professionals. Although disaster risk awareness is important, it does not consistently translate into preparedness behaviours, reflecting the awareness-action gap. Immersive virtual reality (VR) may enhance experiential disaster learning, but how it influences preparedness processes remains insufficiently understood, particularly in healthcare and critical care education. AIMS: To explore how immersive VR-based disaster simulations influence disaster risk perception and preparedness among nursing students, with particular attention to the awareness-action gap and implications for future healthcare and critical care practice. STUDY DESIGN: A qualitative descriptive study using immersive VR-based disaster simulations followed by semi-structured interviews. Twelve undergraduate and graduate nursing students in Japan experienced immersive VR simulations depicting floods and landslides. Individual semi-structured interviews explored emotional responses, disaster risk perception, preparedness awareness and anticipated behavioural responses. Data were analysed using Krippendorff's content analysis with researcher triangulation. RESULTS: Five categories were identified: (1) heightened vulnerability and psychological burden through immersion; (2) persistence of the awareness-action gap despite increased risk perception; (3) enhanced risk recognition and preparedness intentions; (4) recognition of the need for social and structural support systems; and (5) emerging responsibility accompanied by perceived limitations. VR transformed abstract disaster risk into emotionally salient experiences, strengthening threat appraisal and preparedness awareness; however, awareness did not consistently translate into preparedness behaviours, reflecting insufficient coping appraisal and self-efficacy. CONCLUSIONS: Immersive VR may strengthen disaster risk perception and preparedness awareness, but immersive experiences alone may be insufficient to bridge the awareness-action gap. Combining VR with reflective learning, skills-based training and collaborative simulation may strengthen coping appraisal and preparedness action. RELEVANCE TO CLINICAL PRACTICE: Immersive VR combined with reflective and skills-based learning may support psychological readiness, situational awareness and disaster preparedness competencies among future nurses, including those preparing for critical care practice.
PubMed2026
Comparison of the Validity and Reliability of Five Pressure Injury Risk Scales in Intensive Care.
BACKGROUND: The lack of consensus on the best pressure injury (PI) risk assessment tools demonstrates the need for further comparative research to identify the most effective options for intensive care unit (ICU) populations. AIM: This study compared the predictive validity and reliability of five PI risk assessment tools in adult ICU patients. STUDY DESIGN: A prospective cohort study was conducted with patients aged ≥ 18 years, admitted to the ICUs for at least 24 h and without pre-existing PI. Five tools (Braden Scale, CALCULATE, Cubbin & Jackson, EVARUCI and Sunderland) were used daily to assess PI risk until either a PI developed or the participant was discharged, died or completed 21 days in the ICUs. The main outcome measures included area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, relative risk and reliability. RESULTS: Of the 150 participants, 40 (26.7%) developed PIs. None of the five tools demonstrated good predictive accuracy. AUC values ranged from 0.605 to 0.692 across the five tools, with none exceeding the predefined threshold of 0.70. Participants classified as high risk by Sunderland, Cubbin & Jackson and EVARUCI had a 3.0, 2.5 and 2.1 times higher risk, respectively, of developing a PI. Cubbin & Jackson was the only tool to achieve acceptable reliability values in Cronbach's alpha, intraclass correlation coefficient (ICC) and Cohen's weighted kappa. CONCLUSIONS: High-risk classification using the Sunderland, Cubbin & Jackson and EVARUCI scales was more strongly associated with subsequent PI development than classification using the other tools. Reliability findings varied across parameters, with Cubbin & Jackson being the only tool to meet acceptable thresholds across all assessed reliability measures. RELEVANCE TO CLINICAL PRACTICE: PI assessment in ICU patients should integrate validated tools with clinical judgement to address patient-specific and device-related risk factors.
PubMed2026
Cross-Sectional Survey of Critical Care Provision in Ministry of Health Hospitals in Zambia.
BACKGROUND: Critical care is an essential component of universal health care; however, its provision in low- and middle-income countries remains poorly understood. Although Zambia has expanded critical care services over the last 15 years, national evidence regarding workforce capacity, infrastructure and service provision remains limited. AIMS: To evaluate critical care workforce, service provision and patient case mix across Ministry of Health hospitals in Zambia. STUDY DESIGN: A cross-sectional survey was administered across 14 public hospitals with critical care units across Zambia, representing all 10 provinces. Data were collected via an e-survey questionnaire instrument. Descriptive statistical analysis was conducted using SPSS. Ethics approval was obtained prior to the study. RESULTS: All hospitals responded (n = 14/14, 100% response rate), accounting for a capacity of 131 critical care beds. Only 28.6% of hospitals had 24-h intensivist coverage, whereas all had registered critical care nurses. Equipment availability varied, with universal access to ventilators and monitors but limited access to syringe pumps and inconsistent availability of functional CT scanners. Over a 7-day period, 121 admissions were recorded, predominantly medical (29%), surgical (24.8%) and trauma-related (19.8%). Paediatric cases accounted for 40% of admissions. Formal admission and discharge protocols were present in fewer than half of the hospitals. CONCLUSION: The study provides the first national overview of public critical care provision in Zambia and provides a snapshot of current provision. The findings highlight urgent areas for capacity strengthening. RELEVANCE TO CLINICAL PRACTICE: Findings are similar to other studies within the sub-Saharan region and highlight the need to strengthen workforce training, particularly in critical and paediatric care, improve access to essential equipment and standardise care protocols to enhance patient safety and outcomes. The study demonstrates the importance of strengthening the multidisciplinary critical care workforce.
PubMed2026
Effects of Aromatherapy on Stress and Anxiety Among Intensive Care Unit Nurses: A Systematic Review.
BACKGROUND: Nurses working in intensive care units (ICU) are at high risk for stress and anxiety. Aromatherapy stands out as a non-pharmacological and easily implementable complementary approach for alleviating these symptoms. To our knowledge, this is the first systematic review specifically examining the effects of aromatherapy on stress and anxiety among ICU nurses. AIMS: This systematic review aimed to evaluate the effects of aromatherapy on stress and anxiety among ICU nurses and to assess the methodological quality of the evidence. STUDY DESIGN: In this systematic review, a literature search was conducted in the Scopus, PubMed, Web of Science and Cochrane Library databases without any time restrictions. The review includes randomised controlled, experimental and quasi-experimental studies evaluating the effects of aromatherapy interventions on stress and/or anxiety among ICU nurses. The selection of studies, data extraction and assessment of methodological quality were conducted independently by two researchers. RESULTS: This systematic review included five studies involving a total of 254 participants. Two of these studies are randomised controlled trials, and three are quasi-experimental studies. The studies included in the review demonstrate that aromatherapy is administered using various essential oils and application methods (inhalation, topical application, etc.). The findings suggest that aromatherapy interventions may reduce stress among ICU nurses, whereas evidence regarding anxiety reduction is mixed and less consistent across studies. CONCLUSION: Aromatherapy may have potential benefits for reducing stress among ICU nurses, whereas evidence for anxiety reduction remains limited and inconsistent. Further high-quality studies are needed before firm conclusions or routine clinical implementation can be recommended. RELEVANCE TO CLINICAL PRACTICE: Aromatherapy may be considered as an optional supportive intervention within staff well-being programs, provided that safety, scent sensitivity, infection-control procedures and individual preferences are taken into account. However, standardised protocols and further high-quality evidence are required to support its routine clinical use.
PubMed2026
Electrical Impedance Tomography-Guided Precision Nursing in an Older Patient With Septic Shock and ARDS: A Case Report.
Septic shock complicated by acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) presents a fundamental therapeutic conflict: shock demands aggressive fluid resuscitation, whereas lung protection requires fluid restriction and a negative fluid balance. We report the precision nursing management of a 79-year-old patient with septic shock, ARDS and MODS who received invasive mechanical ventilation and continuous renal replacement therapy (CRRT). A closed-loop 'monitoring-decision-intervention' strategy was built around electrical impedance tomography (EIT): EIT-guided positive end-expiratory pressure (PEEP) titration optimised respiratory support; during CRRT fluid management, continuous EIT monitoring of ventilation distribution provided early safety warnings regarding lung ventilation; EIT-based position titration established the 45° left lateral decubitus as the optimal ventilation position; real-time EIT imaging localised airway secretions to guide targeted postural drainage; and a prevention protocol for EIT electrode belt-related pressure injuries was implemented. After 10 days of intervention, the PaO2/FiO2 ratio increased from 150 to 356 mmHg, and the patient was successfully weaned and extubated. This case suggests that EIT-guided precision nursing may help balance fluid management with lung protection and provide visual guidance for airway clearance and position management; its effectiveness warrants validation in prospective studies. This case provides a reproducible, nurse-led framework that integrates EIT ventilation monitoring to reconcile competing treatment goals in septic shock complicated by ARDS, offering a practical reference for complex critical care nursing.
PubMed2026
Electronic Patient-Reported Health-Related Quality of Life Trajectories in ICU Survivors: A Multicentre Pilot Study-Within-a-Trial Protocol.
BACKGROUND: Patient-important outcomes beyond mortality, particularly health-related quality of life (HRQoL), are frequently used in intensive care unit (ICU) trials. However, HRQoL assessment remains challenging due to methodological complexities, including poorly defined recovery trajectories, lack of consensus on measurement instruments, complexity of statistical analysis, and missing data. Electronic patient-reported outcomes (ePROs) may improve data collection and efficiency, though their feasibility in ICU survivors is uncertain. METHODS: This protocol outlines a longitudinal, multicentre pilot study-within-a-trial aimed at evaluating the feasibility of ePRO-based HRQoL follow-up and exploring a trajectory-based approach to HRQoL characterisation after critical illness. We plan to enrol 100 participants already undergoing 180-day HRQoL follow-up in the Intensive Care Platform Trial (INCEPT) to complete monthly EQ-5D-5L surveys delivered by text messages from 6 to 12 months after randomisation. Feasibility outcomes include enrolment and response rate, time to completion, reminder-dependency, attrition pattern, agreement between modes of collection, and accessibility. Agreement between telephone- and ePRO-based assessments at 180 days will be evaluated at the group and at the individual level. Longitudinal EQ-5D-5L index values and visual analogue scale trajectories will be analysed using area-under-the-curve methods based on linear interpolation. Scenario-based sensitivity analyses will assess the potential impact of unobserved mortality among dropouts. DISCUSSION: We hypothesise that ePRO-based repeated assessments of HRQoL will support the goal of optimised data collection methods, while ensuring resources control. Moreover, identification of a candidate approach to HRQoL characterisation may shed light into the full recovery trajectory of ICU survivors and improve the interpretation and clinical relevance of HRQoL outcome assessments.
PubMed2026
Ethical Concerns and Implementation Barriers to Early Mobilisation in Critically Ill Adult and Older Adult Patients: Perspectives of ICU Nurses.
BACKGROUND: Early mobilisation is central to contemporary critical care, yet implementation remains inconsistent and ethically complex, particularly when patient safety, autonomy and resource constraints must be balanced. AIMS: To examine ICU nurses' perceptions of ethical concerns and implementation barriers related to early mobilisation in critically ill adults, including older adults, and their associations with professional characteristics. DESIGN: A single-centre analytical cross sectional study. METHODS: A convenience sample of ICU nurses completed a self-administered questionnaire comprising demographic and professional data and the researcher-developed Ethical Issues in Early Mobilisation-Critical Care Scale and Early Mobilisation Barriers Scale. Data were analysed using descriptive statistics, independent-samples t-tests, one-way analysis of variance, Pearson's correlation and multiple linear regression. RESULTS: A total of 100 ICU nurses participated in the study. The mean ethical-concern score was 113.41/150 (75.6% of the maximum possible score), and the mean barrier score was 69.94/90 (77.7%). Beneficence and Patient Well-being had the highest ethical-domain score. Patient-related barriers had the highest descriptive domain score, although all four barrier domains were closely distributed (76.6%-79.2%). Ethical-concern and barrier scores were modestly correlated (r = 0.292, 95% CI 0.103-0.461; p = 0.003), indicating limited shared variance. In mutually adjusted models, education level, ICU experience and previous early-mobilisation training were associated with both outcomes. The coded ICU-type term was associated with ethical-concern scores only, whereas professional nursing classification was associated with neither outcome. Age and gender were not associated with either score. CONCLUSIONS: Early mobilisation emerged as an ethical and organisational challenge, not merely a technical task. Ethical concerns and implementation barriers were related but largely distinct. Associations with education, ICU experience and training should be interpreted as correlational rather than causal. Integrated, context-sensitive approaches combining graded safety assessment, ethical decision-making, role clarity and organisational support warrant prospective evaluation. RELEVANCE TO CLINICAL PRACTICE: The findings support the development of evidence-based protocols, targeted educational initiatives and organisational strategies that strengthen nurses' clinical decision-making and facilitate the safe and consistent implementation of early mobilisation in critical care settings.
PubMed2026
Evaluating Meaningful Patient and Public Involvement in Intensive Care Research-A PEIRS-22 Survey.
BACKGROUND: Patient and public involvement (PPI) is increasingly recommended in health research to enhance relevance, quality and implementation of findings. In intensive care research, involving patients, family members and healthcare professionals may help ensure that research addresses outcomes that are meaningful to those affected by critical illness. AIM: This study aimed to assess the level of meaningful PPI engagement during the development of a core outcome set (COS) for general intensive care unit (ICU) patients in Denmark. STUDY DESIGN: A cross-sectional survey using the Danish version of the Patient Engagement in Research Scale (PEIRS-22) was conducted between December 2024 and January 2025. We invited all members (patients, family, healthcare professionals and researchers) of five research panels, established in 2021 to support COS development across Danish university hospitals (N = 46). PEIRS-22 total scores range from 1 to 100, with higher scores indicating greater meaningful engagement (scores ≥ 70.1 were considered meaningful). Descriptive statistics, item-level analyses and non-parametric comparisons between participant roles were performed. RESULTS: Thirty-seven of 46 participants responded (80.4%): 27.0% (n = 10) were patients/family, 46.0% (n = 17) healthcare professionals and 27.0% (n = 10) researchers. The median PEIRS-22 total score was 78 (IQR 68-93), with 72.0% (n = 27) scoring ≥ 70.1. Engagement differed statistically significant by role (p = 0.004), with researchers reporting the highest scores (median 97), followed by patients/family (89), while healthcare professionals reported lower scores (74). CONCLUSION: PPI in COS development for general ICU patients was perceived as meaningful overall. However, differences across stakeholder groups and lower achievement of advanced engagement elements suggest opportunities to strengthen shared decision-making, role clarity and perceived relevance, particularly among healthcare professionals. Meaningful involvement of patients, families and clinicians may support the development of more patient-centred intensive care research and outcomes that better reflect the priorities of those affected by critical illness. RELEVANCE TO CLINICAL PRACTICE: Meaningful PPI can help ensure that intensive care research reflects the priorities of patients and families. Clear roles, clinical relevance, and opportunities to influence decisions may strengthen engagement, particularly among healthcare professionals. Critical care nurses may play an important role in facilitating collaboration between patients, families, clinicians, and researchers.
PubMed2026
Family Caregivers' Goals-of-Care Decisions for Critically Ill Older Adults: A Reflexive Thematic Analysis.
BACKGROUND: Family caregivers often act as surrogate decision-makers for critically ill older adults, but little is known about how goals-of-care decisions are experienced in Saudi intensive care units, where family hierarchy, Islamic values, restricted visiting and physician-led communication shape care. AIM: To explore family caregivers' experiences of goals-of-care decision-making for critically ill older adults admitted to intensive care units in Al-Ahsa, Saudi Arabia. STUDY DESIGN: A qualitative study using reflexive thematic analysis. Semi-structured face-to-face interviews were conducted in Arabic with 18 purposively sampled family caregivers across three adult intensive care units in two government hospitals. Data were analysed inductively using Braun and Clarke's six-phase approach, supported by reflexive journaling and peer debriefing. FINDINGS: Four themes were developed: Navigating the Unknown; The Weight of an Impossible Responsibility; Faith as a Compass, Community as a Gaze; and Present but Unheard. Together, they describe compounding vulnerability created by informational opacity, moral responsibility, family hierarchy, diverse Islamic ethical interpretations, and inconsistent professional support. CONCLUSIONS: Goals-of-care decision-making in the participating Saudi intensive care units was emotionally demanding, culturally embedded and relationally mediated. Nurses were trusted relational anchors, but their supportive potential was constrained by workload and unclear formal roles. RELEVANCE TO CLINICAL PRACTICE: ICU nurses can support values-aligned decision-making through plain-language communication, inclusive engagement of both the family spokesperson and primary caregiver, culturally sensitive opportunities for marginalised caregivers to contribute and coordination of spiritual and psychosocial support.
PubMed2026
How Evidence Has Transformed Paediatric and Neonatal Critical Care Nursing: Reflections From This Year's ESPNIC Congress.
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PubMed2026
How Families Become Able to Assume Surrogate Decision-Making Responsibility in Donation After Brain Death: An Interpretive Qualitative Study.
Donation after brain death requires families to assume surrogate decision-making responsibility while coping with sudden loss and uncertainty. The aim of this study was to explore how family members became able to assume this responsibility. Semi-structured interviews were conducted 3-7 years after donation with four family members who had participated in organ donation discussions in Japan. Data were analysed using Krippendorff's qualitative content analysis. Families described being assigned responsibility before feeling ready, regaining orientation through sustained interaction with healthcare professionals, developing moral authorisation to decide despite uncertainty and integrating the decision into their lives over time. These findings suggest that surrogate decisional agency develops through relational and temporal processes rather than through information provision alone. Relational continuity, sensitive timing and post-decision support may help critical care nurses support families facing surrogate decision-making.
PubMed2026
Intensive Care Nurses' Experiences and Attitudes Towards Family Involvement in Delirium Care: A Qualitative Descriptive Study.
BACKGROUND: Delirium is a common neuropsychiatric complication among critically ill patients, particularly those who are mechanically ventilated. Evidence suggests family involvement may improve delirium-related outcomes in adult intensive care units (ICUs). However, limited evidence exists on intensive care nurses' (ICNs) experiences and attitudes towards family involvement in delirium care in South Africa. AIMS: The study aimed to explore intensive care nurses' experiences and attitudes towards family involvement in the care of mechanically ventilated patients with delirium in adult ICUs. STUDY DESIGN: A descriptive qualitative study design was utilised. Four focus group discussions were conducted with 32 ICNs from two adult ICUs at a tertiary academic hospital in Johannesburg between April and August 2022. Participants who had at least 2 years of intensive care experience were purposively sampled. Data were analysed using inductive qualitative content analysis. The study adhered to Consolidated Criteria for Reporting Qualitative Studies guidelines. FINDINGS: Three categories were identified: emotional burden and psychological demands of delirium care, communication and psychosocial support for families in delirium care and barriers to effective family involvement in delirium care. While recognising the therapeutic value of family engagement, the nurses reported experiencing emotional stress related to family expectations and anxiety. They adopted strategies such as structured communication, empathetic listening and technology-assisted contact to support families. However, barriers such as time constraints, limited intensive care space, staffing shortages and restrictive policies limited sustained involvement. CONCLUSIONS: This study provides context-specific insight into how ICNs facilitate family involvement in the care of patients with delirium in a public tertiary ICU. ICNs recognise the therapeutic value of family involvement in the care of patients with delirium and are willing to facilitate engagement. However, systemic and environmental barriers limit consistent implementation. Therefore, strengthening institutional policies and supporting nurses through structured training and team-based approaches may enhance sustainable family-centred delirium care. RELEVANCE TO CLINICAL PRACTICE: This study's findings demonstrate the need for ICNs to adopt structured communication strategies, flexible visitation policies and empathy towards families and their patients in the ICU. Perhaps incorporating family-centred care into daily intensive care practices could strengthen family involvement in critical care, particularly for patients with delirium.
PubMed2026
Job Stress and Handover Competency Among Critical Care Nurses: The Mediating Role of Clinical Decision-Making in a Multicentre Cross-Sectional Study.
BACKGROUND: Effective nursing handover is essential for ensuring patient safety and continuity of care, particularly in critical care settings where patients are highly complex and clinical decisions must be made rapidly. Occupational stress is prevalent among critical care nurses and has been associated with impaired performance and communication failures. Clinical decision-making is a core professional competency that may influence how stress affects handover quality; however, limited evidence has examined its combined effects. AIMS: To examine the impact of job stress and clinical decision-making on handover competency among critical care nurses and to test the mediating role of clinical decision-making in this relationship. STUDY DESIGN: A multicentre cross-sectional descriptive study was conducted in six hospitals in Egypt. Using a convenience sampling approach, participants completed self-administered, self-report questionnaires. Data were analysed using descriptive statistics, correlation analysis, multiple linear regression and mediation analysis with Hayes' PROCESS Macro (Model 4). RESULTS: A total of 410 critical care nurses were recruited for the study. They reported moderate levels of job stress, strong clinical decision-making abilities and high handover competency. Job stress was negatively correlated with both clinical decision-making (r = -0.242, p < 0.001) and handover competency (r = -0.218, p < 0.001), while clinical decision-making was positively correlated with handover competency (r = 0.332, p < 0.001). Regression analysis showed that higher educational level, rotating shifts and stronger clinical decision-making predicted higher handover competency, whereas higher job stress predicted lower competency. Mediation analysis revealed that clinical decision-making partially mediated the relationship between job stress and handover competency, with significant direct, indirect and total effects. CONCLUSIONS: Clinical decision-making plays a pivotal mediating role in the relationship between job stress and handover competency among critical care nurses. Job stress directly and indirectly impairs handover performance by diminishing nurses' decision-making capacity. RELEVANCE TO CLINICAL PRACTICE: Interventions aimed at reducing job stress and strengthening clinical decision-making, such as stress-management programs, simulation-based training and structured handover protocols, may enhance communication quality and patient safety in critical care settings.
PubMed2026
Key Characteristics and Mechanisms in Ventilator Weaning of Adult Intensive Care Patients-A Qualitative Study With Healthcare Professionals.
BACKGROUND: Weaning from mechanical ventilation appears to be a complex intervention as defined by the Medical Research Council Framework. However, there is a lack of theoretical insights into ventilator weaning, and the underlying causal mechanisms have not yet been uncovered sufficiently. To understand its complexity in theory and develop it in practice, a program theory is currently being developed in a multi-method study. AIM: To identify key characteristics and mechanisms in ventilator weaning of adult intensive care patients. STUDY DESIGN: In this sub-study, we conducted semi-structured group discussions and workshops with 29 healthcare professionals in intensive care over 3 days in 2025 in Germany, using a qualitative design. The data were collected using audio recordings, field notes and photographs. After transcription, a deductive-inductive thematic analysis was performed. FINDINGS: The analysis revealed four principal themes: (1) complexity of ventilator weaning, (2) outcomes, (3) interventions and (4) links and relationships. The first theme combines factors such as definition and delimitation, dynamics, structure and individualization, which together describe the inherent complexity. The second theme covers different endpoints during the process, including preconditions and postconditions as well as intermediate, immediate and ultimate outcomes. The third theme comprises direct and indirect interventions, as well as nonprogram external factors. The fourth theme explores the connections between interventions, outcomes and contextual factors. CONCLUSION: The findings of this study support the understanding that ventilator weaning is a complex intervention. The identified interaction of the various interventions, outcomes and contextual factors needs to be theoretically organized and evaluated in future studies. RELEVANCE TO CLINICAL PRACTICE: Identifying the interactions between key characteristics in this process can improve HCPs' sensitivity to the effects of their own actions. A theoretical understanding of the mechanisms underlying ventilator weaning enables the targeted development and evaluation of a complex weaning intervention. TRIAL REGISTRATION: Open Science Framework YGJ3T; https://doi.org/10.17605/OSF.IO/YGJ3T, registered on 14 May 2025.
PubMed2026
Nurse-Administered and Nurse-Feasible Post-Extubation Dysphagia Screening in Adult Intensive Care Units: A Scoping Review of Test Performance, Implementation and Patient Outcomes.
BACKGROUND: Post-extubation dysphagia (PED) is common after invasive mechanical ventilation. Nurses can provide timely bedside risk screening, but instrument validity, performance in nurses' hands and implementation effectiveness are distinct questions. AIM: To map direct nurse-administered evidence, transferability of nurse-feasible tools, nursing implementation context, and reported patient outcomes in adult intensive care units (ICUs). METHODS: Literature searches were conducted in six databases, with the search updated in August 2026. Evidence was stratified according to the actual screening administrator and reference-standard assessment. Criterion-level MMAT and QUADAS-2 assessments were applied without summary scores. RESULTS: The source-verified map comprised 34 reports representing 31 study families. Instrumental-reference evidence with nurse or nursing-assistant administration included two complete-verification cohorts: modified Volume-Viscosity Swallow Test versus FEES in 44 extubated patients (sensitivity 89.5%, specificity 72%) and GUSS-IVA versus FEES in 51 of 56 enrolled patients (81.0%, 88.9%). A third nurse screen had optional FEES in 38 of 123 patients (86%, 21%). Other nurse-administered studies used clinical or proxy comparators or positive-only verification. SLP-administered FEES studies informed transferability, not nurse-administered accuracy. Implementation fidelity varied, and outcome studies were non-randomised. CONCLUSIONS: Nursing involvement in structured PED screening is feasible, but direct accuracy and patient-outcome evidence remain heterogeneous and at risk of selection, verification and confounding bias. ICUs may pilot governed pathways with competency assessment, documentation, specialist escalation and outcome audit; no single screen is established as standard care. RELEVANCE TO CLINICAL PRACTICE: Bedside screening is risk stratification rather than diagnosis. Failed, discordant or high-risk screens require prompt specialist assessment and, where indicated, FEES or VFSS.
PubMed2026
Nurses' Perspectives on a Communication Model Between Providers and Mechanically Ventilated Patients in the Intensive Care Unit.
BACKGROUND: Communication with mechanically ventilated patients in intensive care is complex. Decades of research demonstrate that communication barriers are commonly experienced and one of the most challenging experiences during an intensive care stay. Support for the health care providers in these situations could be a model for communication, guiding the interaction. AIM: The aim of this study was to examine critical care nurses' (CCNs') perspectives of the clinical relevance and applicability of a communication model for mechanically ventilated patients. STUDY DESIGN: Qualitative, explorative design in accordance with Im & Meleis' phases of development of situation-specific theories. We conducted six focus group interviews with CCNs from Denmark, Norway and the United States, two in each country, lasting between 58 and 90 min. The interviews were analysed by a content analytic approach with both inductive and deductive phases. FINDINGS: Twenty-nine CCNs participated in the focus group interviews. The main category was identified during the analysis, which was: 'Relationship-building as a starting point for meaningful communication'. The main category was further described by three subcategories: (1) Patients' abilities and challenges in communication while being mechanically ventilated. (2) Nurses' competencies and strategies for effective communication with mechanically ventilated patients and (3) Tools and resources in practice. CONCLUSIONS: The nurses' perspectives yielded a deeper understanding of how clinical practice both corresponds to and departs from a theoretical lens. Given that the interviews with nurses revealed the relational component as a critical starting point of communication, the model should highlight this specific element more explicitly. To understand the complexity occurring in the daily practice of an ICU, a situation-specific theory will be useful for providing examples of good practice. RELEVANCE TO CLINICAL PRACTICE: Communication in an ICU setting requires the establishment of a relationship to find effective ways to communicate. Integrating clinical perspectives can refine and adapt the preliminary model to the real communication encounters and improve care.
PubMed2026
Nursing Workload Assessment in a Stroke Unit at a Portuguese Hospital: A Prospective Observational Study.
BACKGROUND: The Nursing Activities Score is a promising tool to calculate nursing workload in Intensive and Intermediate Care Units of different typologies. AIM: To assess nursing workload in a Stroke Unit using the Portuguese version of the Nursing Activities Score. STUDY DESIGN: Prospective observational study conducted with patients admitted to a Stroke Unit from November 2024 to February 2025. The study was approved by the Ethics Committee and was reported in accordance with the STROBE guidelines. RESULTS: The study included 69 patients admitted to the Stroke Unit for more than 24 h. Each participant generated an average nursing workload of 45.30 ± 7.39 points/day. The Stroke Unit recorded a median nursing workload of 159.40 (IQR: 126.60-211.90) points/day and an average occupancy rate of 82.0%. The days of admission and discharge are periods that tend to generate greatest nursing workload. There were statistically significant differences between the first and the last nursing workload assessments. Altered state of consciousness and fibrinolysis in the Stroke Unit are associated with greater nursing workload on the admission day. CONCLUSIONS: This study revealed the potential of the Nursing Activities Score as a tool to assess nursing workload in Intermediate Care Units, such as Stroke Units. The Nursing Activities Score showed an imbalance between nursing resources and reported care needs. The nursing workload was higher in the first assessment than in the last, reflecting the trend towards recovery of autonomy and improvement of the participants' clinical condition throughout the length of stay. There are demographic and clinical characteristics present at the time of admission that may be associated with a higher nursing workload. RELEVANCE TO CLINICAL PRACTICE: Nursing workload assessment using the Nursing Activities Score enables identification of patients and periods with the greatest care needs, thereby supporting decision-making in complex environments such as Stroke Units.
PubMed2026
Olanzapine for the Prevention and Treatment of ICU Delirium: Protocol for a Systematic Review With Meta-Analysis.
BACKGROUND: Intensive care unit (ICU) delirium is a multifactorial acute brain dysfunction associated with prolonged hospitalization, increased morbidity and mortality, and higher healthcare costs. Despite these substantial negative impacts of delirium, the optimal prevention and treatment strategies are unclear. Olanzapine, an atypical antipsychotic drug, is commonly used for delirium management. We will perform an updated systematic review and meta-analysis to assess the benefits and harms of olanzapine for the prevention and treatment of ICU delirium. METHODS: This protocol is developed in accordance with the recommendations of The Cochrane Collaboration and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines. We will include all randomized clinical trials (RCTs) evaluating prophylactic or therapeutic olanzapine versus any comparator, including pharmacological, non-pharmacological, placebo, or routine care/no specific delirium-directed intervention (treated as a single comparator) in ICU patients. Observational studies will be included solely to address potential harms. We will systematically search the following databases: Embase, MEDLINE, The Cochrane Library, Web of Science, CINAHL, Scopus, and PsycINFO, as well as clinical trial registries. We will perform meta-analysis and trial sequential analysis (TSA) to investigate the risk of both Type I and II errors. We will assess the risk of bias using the Cochrane Risk of Bias tool (RoB-2). The quality of trials will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. The review is registered in the PROSPERO database (CRD420261474813). OUTCOMES: The primary outcome is days alive and out of the hospital. The secondary outcomes include all-cause mortality at 90 days, number of CAM-ICU (Confusion Assessment Method for the Intensive Care Unit) negative days at 30 days, number of days without pharmacological treatment for delirium other than study drug during the intervention period and serious intervention-related harms. DISCUSSION: This protocol outlines the methodology we will use in a systematic review with meta-analysis designed to evaluate the beneficial and harmful effects of olanzapine for prevention and treatment of delirium in ICU patients. The findings of the systematic review will be disseminated through peer-reviewed publication. We hope this review will inform future RCTs and improve clinical practice.
PubMed2026
Perceptions of Death Among Intensive Care Nurses: A Metaphor Study.
BACKGROUND: Intensive care nurses frequently encounter death as part of their clinical practice, which may evoke complex emotional and cognitive responses. Understanding how nurses perceive death is essential, as these perceptions can influence care delivery, decision-making processes and the quality of end-of-life care. Although previous studies have explored nurses' experiences with death, research examining these perceptions through metaphors remains limited. AIM: This study aimed to explore intensive care nurses' perceptions of death through the use of metaphors. STUDY DESIGN: This study was conducted using a qualitative design. Data were collected using a metaphor-based approach and analysed using content analysis to identify common themes and categories. FINDINGS: Intensive care nurses expressed their perceptions of death using a variety of metaphors, which were grouped into five main categories: 'End', 'Peace', 'Beginning', 'Uncertainty' and 'Unclassifiable'. The findings revealed that death was most commonly perceived as an 'End', often associated with inevitability and finality. However, some nurses described death as a peaceful transition or a new beginning, while others emphasized its uncertain and ambiguous nature. CONCLUSIONS: The findings suggest that intensive care nurses hold multidimensional perceptions of death, shaped by both emotional and experiential factors. These perceptions reflect not only the finality of death but also its potential meaning as a transition or a source of peace. RELEVANCE TO CLINICAL PRACTICE: Understanding nurses' perceptions of death may contribute to improving end-of-life care practices, supporting their emotional coping strategies, and enhancing communication with patients and families in intensive care settings. Addressing these perceptions through education and supportive interventions may strengthen nurses' ability to provide holistic and compassionate care.
PubMed2026
Perioperative Nursing Care of a Patient With 70% TBSA Second- To Third-Degree Flame Burns Complicated by Pseudomonas aeruginosa Infection: A Case Report.
This case report summarizes the surgical nursing experience of a patient with 70% total body surface area (TBSA) second- to third-degree flame burns complicated by Pseudomonas aeruginosa infection. Key nursing interventions included intraoperative temperature management, use of a turning bed for safe positional changes during back debridement, and prevention of pressure injuries at prone-position high-risk sites (forehead, chest, bilateral hips, lower limbs and toes). Following intensive treatment and meticulous nursing care, most of the patient's wounds healed and her physical function recovered satisfactorily. She was discharged after 63 days of hospitalization. This report systematically details standardized turning bed procedures and comprehensive warming strategies, providing quantitative operational guidance for surgical nursing in similar cases.
PubMed2026
Person-Centred Care Among Intensive Care Unit Nurses: The Role of Delirium Care Burden, Nursing Competency and Positive Organisational Culture.
BACKGROUND: Person-centred care (PCC) recognises patients as unique individuals and provides care through person-centred communications. AIM: This study aimed to examine the combined associations of nursing competency (prerequisite), positive organisational culture (care environment) and delirium care burden (contextual barrier) with PCC among intensive care unit (ICU) nurses, based on McCormack and McCance's Person-Centred Nursing Framework. STUDY DESIGN: This descriptive cross-sectional study included nurses working in the ICUs of a university hospital in South Korea. The data were collected between 30 June and 17 July 2023. The survey assessed general characteristics, nursing competency, positive organisational culture, delirium care burden and PCC. Data were analysed using descriptive statistics, independent t-tests, one-way analysis of variance, Pearson's correlation coefficients and multiple regression analysis. RESULTS: PCC was significantly and positively correlated with nursing competency (r = 0.37, p < 0.001) and positive organisational culture (r = 0.46, p < 0.001). Multiple regression analysis revealed that positive organisational culture (β = 0.39, p < 0.001) and nursing competency (β = 0.27, p < 0.001) were significantly associated with PCC, whereas delirium care burden was not significantly associated with it. CONCLUSIONS: To enhance PCC in ICUs, it is essential to strengthen nursing competency (prerequisite) and foster a positive organisational culture (care environment). The lack of a significant association between delirium care burden and PCC suggests that ICU nurses maintain person-centred practices despite care strains. RELEVANCE TO CLINICAL PRACTICE: To improve nursing competency and organisational culture, competency development programmes tailored to the professional characteristics of ICU nurses are necessary, along with adequate resource allocation and human resource management. Furthermore, organisational-level efforts such as improving policy and reward systems are required to create a supportive care environment.
PubMed2026
Postoperative Delirium in Intensive Care Units: A Bibliometric Analysis of Nursing Studies.
BACKGROUND: Delirium is a common and serious postoperative complication in intensive care units, associated with increased morbidity, mortality and long-term cognitive impairment, and despite the pivotal role of nurses in its assessment and management, variations in prevalence and gaps in intervention-focused nursing research persist, underscoring the need for a bibliometric evaluation of the literature. AIM: The aim of the study was to quantitatively analyse and visually map trends, citations, key terms and country contributions in nursing research on postoperative delirium in intensive care as well as to characterize the overall structure of the literature. STUDY DESIGN: This study was conducted as a retrospective and descriptive research using the bibliometric analysis method on December 1, 2025. No time restrictions were imposed on the literature. Data analysis was performed using R Studio software. RESULTS: The earliest study on postoperative delirium in intensive care units within the field of nursing was published in 2001, and the analysed publications covered the period from 2001 to December 2025. In addition, 55.96% of all publications have been released in the past 7 years. The journal with the highest number of publications is Nursing in Critical Care, while the United States stands out as the country with the highest research output. It can be suggested that topics such as 'cardiac surgery', 'nursing care', 'postoperative delirium', 'postoperative care' and the 'Confusion Assessment Method for the Intensive Care Unit' represent areas that warrant further investigation and development in future research. CONCLUSIONS: The analysis showed a marked increase in publications on postoperative delirium in intensive care nursing in recent years. The United States and the Journal Nursing in Critical Care were identified as the leading contributors to the literature. Thematic mapping indicated that the literature primarily focused on delirium assessment and intensive care nursing, with several interconnected research areas. RELEVANCE TO CLINICAL PRACTICE: The findings emphasize the critical role of nurses in delirium screening and management in intensive care units. While assessment tools are well represented in the literature, further research is needed to develop and evaluate nurse-led interventions aimed at delirium prevention and care. Enhancing nursing education and institutional support may contribute to improved patient outcomes and quality of postoperative intensive care.
PubMed2026
Protecting the Privacy of Patients With Impaired Consciousness in Intensive Care: A Qualitative Study.
BACKGROUND: Maintaining privacy in intensive care units (ICUs) is challenging because of high workload, invasive procedures, continuous monitoring and shared care environments. Patients with impaired consciousness may be particularly vulnerable because their ability to express privacy preferences, assert personal boundaries and advocate for themselves is limited. AIM: To explore intensive care nurses' experiences of protecting privacy when caring for patients with impaired consciousness. STUDY DESIGN: A descriptive qualitative study was conducted with 20 intensive care nurses in Türkiye between March and April 2026. Data were collected through semi-structured online interviews and analysed using inductive thematic analysis. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. FINDINGS: Four themes were identified: the marginalisation of privacy under clinical priorities; structural and process-related constraints on privacy in intensive care; loss of subjectivity and the mechanisation of care in patients with impaired consciousness; and ethical and psychosocial implications of privacy violations. CONCLUSIONS: Privacy in intensive care is shaped not only by individual ethical awareness but also by workload, environmental conditions, care routines and communication practices. Patients with impaired consciousness have the same rights to privacy and dignity as other patients; however, their reduced ability to express preferences, assert personal boundaries and advocate for themselves may make privacy violations less visible and increase their dependence on nurses for protection. RELEVANCE TO CLINICAL PRACTICE: Protecting the privacy of patients with impaired consciousness in ICUs requires structured care routines, standardised bedside communication, minimisation of unnecessary exposure during procedures and targeted ethical awareness training to support dignity in everyday practice.
PubMed2026
Research Priorities for Intensive Care Nursing: A Focus Group and Three-Round Delphi Consensus Study.
Research priorities for intensive care nursing have been set internationally but not in Japan. We aimed to identify national priorities and compare them with those reported elsewhere. Focus group interviews with 10 expert intensive care unit (ICU) nurses generated 65 categories, which 50 nurses rated over three modified Delphi rounds (consensus, median ≥ 70, then ≥ 80). Categories were restructured into 20 topics; 16 reached consensus. Five independent nursing researchers who had taken no part in the interviews or the Delphi rounds then appraised every topic for validity, applicability, utility and clarity; all 16 were endorsed, and one was reworded. Symptom management, post-intensive care syndrome prevention and ICU nurse education ranked highest, and education- and system-related topics formed about one-third of the agenda, suggesting workforce regulation shapes national research priorities alongside clinical need. The agenda gives Japanese academic societies, funders and post-graduate programmes an explicit basis for targeting research investment.
PubMed2026
The Application of Nurse-Led Bedside Critical Care Ultrasound in Paediatric and Neonatal Nursing Practice: A Scoping Review.
BACKGROUND: Point-of-care ultrasound (POCUS) is increasingly used in paediatric and neonatal critical care, but evidence on nurse-led bedside POCUS remains limited and fragmented. AIMS: This scoping review aimed to map the evidence on nurse-led bedside POCUS in paediatric and neonatal critical care nursing practice, examine implementation factors and identify evidence gaps relevant to nursing research, education and clinical practice. METHODS: Following JBI methodology and PRISMA-ScR guidance, we searched PubMed, Embase, CINAHL, Web of Science, Cochrane Library and CNKI from inception to October 2025. Eligibility followed the PCC framework. Two reviewers independently screened records and extracted data using a standardized form. Study characteristics were synthesized descriptively, and implementation factors were deductively analysed using the COM-B framework. RESULTS: Thirty-four studies were included, mainly from the United States and China. Nurse-led POCUS applications included vascular access, respiratory assessment, catheter localization, cardiac or hemodynamic evaluation, bladder assessment and education or competency development. Outcomes included clinical (procedural success and diagnostic accuracy), process (timeliness and workflow efficiency) and nurse-related (competency, confidence and role development). Safety-related outcomes were the least reported. Implementation was influenced by training, equipment, protected time, institutional support, collaboration and patient safety concerns. The automatic motivation domain, referring to unconscious drivers such as habits and emotional responses, was not addressed by any study. CONCLUSIONS: Nurse-led POCUS is an emerging but unevenly developed component of paediatric and neonatal critical care. Brief training may support initial competency, but sustained implementation is constrained by underdeveloped quality assurance, unclear career pathways and limited attention to motivational processes. RELEVANCE TO CLINICAL PRACTICE: Future nursing research and clinical programmes may look beyond short-term training outcomes to consider competency standards, longitudinal supervision, quality assurance, educational approaches combining foundational POCUS training with structured workplace supervision and sustainable integration into routine care delivery.
PubMed2026
The Role of Emotional Intelligence in Intensive Care Nursing: A Scoping Review.
BACKGROUND: Emotional intelligence (EI) is critical in intensive care unit (ICU) nursing, where nurses face high stress, clinical instability and emotionally demanding situations. EI helps nurses manage emotions, improve communication and support clinical performance. It has also been linked to lower burnout and more adaptive coping among ICU nurses. AIM: This scoping review aimed to map the available evidence on emotional intelligence among nurses working in ICUs, including its key dimensions, associated professional outcomes and current knowledge gaps. STUDY DESIGN: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A structured search was conducted in MEDLINE, CINAHL, PubMed and Scopus for studies published in the past 10 years in Portuguese, English or Spanish. RESULTS: In total, this review included nine studies. The evidence highlights the crucial role of EI in emotional regulation, communication and clinical performance among ICU nurses. Key dimensions of emotional intelligence, including empathy, emotional clarity and self-regulation, were consistently identified as important. Training programmes demonstrated significant improvements in EI and reduced burnout symptoms, and EI was also associated with more adaptive coping strategies and improved professional performance. CONCLUSIONS: Emotional intelligence is an important competency in ICU nursing and has been linked to improved communication, clinical decision-making and lower burnout among nurses. Despite these benefits, research still shows gaps, particularly in standardising EI assessment tools and in the need for longitudinal studies. Targeted emotional intelligence training programmes may strengthen ICU nurses' emotional resilience and enhance care quality. RELEVANCE TO CLINICAL PRACTICE: Integrating EI development into ICU nursing education and institutional policies can help reduce burnout, improve communication with patients and families, and enhance overall clinical performance, thereby supporting a healthier work environment and strengthening nurses' communication and professional performance in intensive care settings.
PubMed2026
The Transition to Critical Care: A Qualitative Study of New Nurses' and Mentors' Experiences and Challenges in the Intensive Care Unit.
BACKGROUND: During the orientation process in the intensive care unit (ICU), the experiences and challenges of new nurses and their mentor nurses often differ, leading to potential incompatibilities. AIMS: This descriptive qualitative research aimed to determine the opinions and experiences of newly recruited nurses and their mentor nurses on the adaptation to the ICU. STUDY DESIGN: Semi-structured interviews were conducted with 21 nurses (10 mentors and 11 mentees) who worked in an ICU. Data were collected between March and May 2025. Four focus group interviews were conducted with mentors and mentees. Data were analysed using content analysis. Consolidated Criteria for Reporting Qualitative (COREQ) was used for reporting. FINDINGS: In the mentor group, three themes emerged: (1) mentor challenges in mentee conflicts, (2) helpful or harmful: a mentor's dilemma and (3) double duty: the rising workload of nurse mentors; in the mentees group, two themes emerged: (1) mentee challenges in mentor conflictsand (2) a good system with operational gaps. CONCLUSIONS: The study reveals the complex challenges faced by both new nurses and their mentors in the ICU. Although mentorship supports professional growth and patient safety, issues such as poor communication, mismatched expectations and emotional strain can hinder its effectiveness. These findings highlight the need to view mentorship as both an educational and an emotional process that requires mutual support. RELEVANCE TO CLINICAL PRACTICE: The study demonstrates that ICU mentorship must be recognized as a high-intensity clinical responsibility, requiring dedicated time to prevent mentor burnout and ensure patient safety. By addressing the identified communication gaps and 'double duty' burdens, healthcare managers can create a more resilient orientation system that improves the retention of newly recruited nurses.