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Nursing documentation based on the Clinical Care Classification (CCC) system has positive results and is an excellent model to follow. This study investigated the compliance of nursing care documentation of acute coronary syndrome (ACS) patients with the CCC system. In a directed content analysis study based on the CCC system, the degree of compliance with nursing care records in patients with ACS was assessed. In the first phase, the files of all patients (108 cases) with ACS admitted to the emergency ward for 18 months were included. In the study's second phase, by purposeful sampling, verbal reports of nursing care during shift handovers were analyzed. Several new meaning units emerged in the analysis of patients' records. The most widely used new meaning unit was the patient referral method, and the next item was the site of the IV line. The overall compatibility between our findings and CCC was 27.3% in the cardiac component. The compatibility in nursing diagnosis, nursing interventions, and evaluation of nursing interventions was 25%, 33.3%, and 25%, respectively. While our study revealed a low degree of compatibility of nursing diagnosis, interventions, and evaluation with the cardiac component of the CCC system, it also highlighted the potential for improvement.

Obsessive-compulsive disorder (OCD) is a prevalent psychiatric issue, particularly among critical care nurses who face intense emotional demands. This descriptive correlational study employed a cross-sectional design to assess the prevalence and characteristics of OCD among 175 registered critical care nurses in Oman, utilizing the Obsessive-Compulsive Inventory-Revised (OCI-R) for data collection. Recruitment occurred via online surveys distributed through social media in May-June 2023. The findings indicated that 88% of participants reported OCD, with the majority at low levels (45.45%). Significant differences in OCD were associated with marital status (t = 10.108, P = .002) and clinical experience (F = 3.275, P = .022), while age, gender, nationality, and education showed no significant differences. The high prevalence of OCD among critical care nurses underscores the psychological toll of their work environment. Factors, including single marital status and less clinical experience, contribute to the increase in OCD. This study emphasizes the urgent need for targeted mental health interventions to support critical care nurses in Oman. Establishing supportive resources and policies can improve their mental well-being and enhance patient care quality.

This article reports the results of a cross-sectional study aiming to assess how critical care nurses evaluate and support their patients' individuality and to determine how it changes in relation to different predictors. Data were obtained through an online survey with the ICN-Nurse questionnaire which was administered to a sample of Polish nurses working in a critical care setting. Data analysis included factor analysis, descriptive statistics, and linear model building. The levels of nurses' views on how they support their patients' individuality and for the way nurses perceive the maintenance of patients' individuality were moderate. The significant predictors for higher scores in both outcome measures included fewer years of experience in current unit, higher evaluations of care quality, and greater job satisfaction. Even though individualized care in critical care has been globally recommended, there are still places where it has not been implemented. This study several factors related to work organization and nurse characteristics that may explain why this approach to care remains underutilized. Based on the results, nurses can reflect on how they support the individuality of their patient, as well as acknowledge and address possible barriers to this approach.

Sleep disturbances and fatigue are significant concerns among critical care nurses due to the demanding nature of their work, which includes long shifts, high patient acuity, and constant exposure to stress. This study explores the prevalence and correlation between sleep disturbances and fatigue among critical care nurses. Using a cross-sectional design, data were collected from 104 nurses across 6 government hospitals through validated self-reported measures, including the Richards-Campbell Sleep Scale and the Fatigue Assessment Scale. Findings revealed moderate sleep disturbance, with an average sleep quality (SQ) score of 57.57 (SD = 23.90). Fatigue levels were also notable, particularly physical exhaustion. While demographic factors such as experience and work shifts showed no significant effect on SQ, age and gender were significantly associated with fatigue levels. Additionally, a negative correlation (R = -0.234, P = .017) was found between SQ and fatigue, indicating that poorer SQ was linked to higher fatigue levels. These results highlight the urgent need for targeted interventions to improve sleep hygiene and reduce fatigue among critical care nurses. Implementing structured shift schedules and fatigue management strategies could enhance nurses' well-being and ultimately improve patient safety and health care outcomes.

Moral resilience plays a key role in providing quality care to patients. The way nurses view ethical issues directly affects their decision-making. This study aimed to investigate the relationship between the ethical ideology and moral resilience of nurses working in critical care units. The present study is a cross-sectional, correlational study. The study sample included 196 nurses working in critical care units. In addition to the demographic questionnaire, Forsyth's Ethics Position Questionnaire was used to examine ethical ideology, and Rushton Moral Resilience Scale (RMRS-16) questionnaire was employed to assess moral resilience. The relationship between ethical ideology and the moral resilience of nurses was examined via Spearman's correlation coefficient. The total RMRS-16 score was 2.67 (median: 2.69). Per quartile analysis, 75% of nurses achieved scores beyond 2.44, with 50% reaching beyond 2.69 and 25% above 2.88. The results revealed that most nurses tended toward idealism. The overall level of moral resilience of nurses was also assessed as moderate to high. There was a significant positive correlation between the mean score of relativism and the total score of the RMRS-16. The results of this study indicate that ethical ideology can affect nurses' ability to maintain moral values and cope with job pressures. Additionally, relativistic nurses showed significantly higher moral resilience, suggesting their context-dependent approach may better navigate complex ethical decisions. Our findings show that critical care nurses' ethical beliefs directly influence their moral resilience and clinical decisions. To support idealist nurses facing systemic barriers, units should implement ethics consultations and structured debriefings. Simultaneously, units can leverage relativist nurses' resilience by adopting flexible decision frameworks that balance contextual needs with core principles. These targeted improvements will help nurses navigate ethical challenges more effectively.

Considering the importance of self-care in hemodialysis patients and the lack of comprehensive evaluation of the effects of interventions on self-care in patients undergoing hemodialysis, the present study provides evidence to review the interventions and strategies that promote self-care behaviors in hemodialysis patients. This narrative review study was conducted to identify interventions to promote self-care in hemodialysis patients. To find evidence related to the study objective, the databases such as PubMed, Embase, Scopus, Web of Science, SID, Magiran, and the Google Scholar search engine were searched without time limitation until 2025. The keywords that were used to search were "Self-care, Dialysis, Hemodialysis, Renal Replacement Therapy." A checklist was used to extract data from the studies. After screening studies and removing duplicates, 14 studies remained. Of the studies, 6 were quasi-experimental, 7 were randomized clinical trials, and 1 was a mixed-method study. The total number of hemodialysis patients studied in these studies was 1020. Interventions focused on several educational approaches to improve self-care behaviors in hemodialysis patients. These approaches included the following: video-based training, structured intervention programs, educational pamphlets and booklets, Orem's self-care theory, self-efficacy theory, health and nursing belief models, 5A self-management program model, PRECEDE-based training, behavioral training sessions, interactive multimedia approach and mobile applications, and peer and nurse education. The results of the review of studies indicated that educational methods had significant effects on improving self-care behaviors of hemodialysis patients (P&#x2009;<&#x2009;.05). Educational interventions, especially those that use structured programs, multimedia tools, and theoretical frameworks, can improve self-care behaviors, knowledge, and self-efficacy in hemodialysis patients. Therefore, health care providers are suggested to use these strategies to increase self-care in hemodialysis patients.

The Danish Nursing Home Resident Database is a comprehensive resource addressing critical gaps in understanding nursing home residents in Denmark. Maintained by the Danish Health Data Authority, it offers national coverage, integrates high-quality data sources, and enables longitudinal tracking of nursing home dynamics. The aim of this paper is to describe the content, structure, strengths, and limitations of the database to facilitate future research and policy use. The database includes all nursing homes registered in plejehjemsoversigten.dk (PLOV), with formal data collection starting in 2019. Retrospective reconstruction using manual compilations from 2011 and 2014 extends coverage back to 2011, creating a continuous dataset spanning over a decade. Resident demographics are sourced from the Civil Personal Register (CPR), while PLOV provides data on nursing home addresses, facility capacity, and care types. The CPR is updated daily, allowing near real-time resident tracking, while PLOV undergoes quarterly updates to reflect changes in nursing home facilities. Secure access to anonymised data ensures compliance with privacy regulations. By enabling linkages to other healthcare registers via CPR numbers, the database supports analyses of comorbidities, healthcare utilisation, and mortality outcomes, offering valuable insights into geriatric care and public health policy. The Danish Nursing Home Resident Database provides a comprehensive, high-quality resource that supports population-based research and evidence-based policymaking in geriatric care and public health.

Decompensated cirrhosis is a critical stage of liver disease associated with high morbidity and mortality. Significant variability in care exists, potentially impacting patient outcomes. This study aimed to evaluate the effectiveness of a standardized admission care bundle in improving outcomes for patients with decompensated cirrhosis. Quasi-experimental research design was utilized in the study. Gastroenterology intensive care unit (ICU) at Al-Rajhy Liver Hospital at Assiut University, Assiut, Egypt. The study included 180 patients with decompensated cirrhosis, comparing outcomes between a control group (received routine hospital care, n =&#xa0;90) and study group (received admission care bundle, n =&#xa0;90) of a standardized admission care bundle. The bundle comprised early risk stratification, timely antibiotics administration, prompt fluid assessment, variceal bleeding prophylaxis, and hepatic encephalopathy management. Primary outcomes included mortality rate and length of gastroenterology ICU stay. Secondary outcomes included the occurrence of specific complications. Compared to the control group, the post-implementation cohort demonstrated a significant reduction in mortality (38% vs. 18.9% respectively) (P < .05). Also observed was a statistically significant decrease in the average length of hospital stay and occurrence of complication (P < .01). Implementation of a standardized admission care bundle for decompensated cirrhosis is associated with improved patient outcomes, specifically a reduction in 90-day mortality and length of stay, highlighting the potential of standardized care to enhance the management of this complex condition.

Extracorporeal membrane oxygenation (ECMO) is a critical life-support therapy for patients with severe cardiac and/or respiratory failure, but it carries a significant risk of neurological complications. This narrative review evaluates neuromonitoring techniques, including electroencephalography, near-infrared spectroscopy, transcranial Doppler, somatosensory evoked potentials, and pupillometry, highlighting their clinical utility, limitations, and relevance for nursing practice. Findings indicate that a multimodal neuromonitoring approach improves early detection and management of neurological deterioration, ultimately enhancing patient outcomes. Standardized protocols and specialized nursing training are essential to optimizing neuromonitoring in ECMO patients.

Continuous renal replacement therapy (CRRT) is crucial for managing acute kidney injury in critical care settings, particularly when traditional dialysis is unsuitable. In resource-limited regions like Palestine, intensive care unit (ICU) clinicians' knowledge, attitudes, and practices (KAP) significantly impact patient outcomes. This study assessed the KAP of ICU clinicians in southern Palestine to identify gaps and propose improvements. A cross-sectional study in 6 hospitals across Hebron and Bethlehem involved 250 ICU clinicians. Data were collected using a structured questionnaire and analyzed using SPSS. All 250 questionnaires were completed (100% response rate). Participants' ages ranged from 23 to 59&#xa0;years (mean&#xa0;=&#xa0;31.56, standard deviation [SD]&#xa0;=&#xa0;6.48); 64.4% were male, and 70% held bachelor's degrees. Knowledge was moderate (mean score&#xa0;=&#xa0;0.50, SD&#xa0;=&#xa0;0.14); 52.4% had adequate knowledge, while 30% showed gaps. Attitudes were positive overall, but 30% viewed peritoneal dialysis negatively. Practice scores averaged 3.26, with ICU nurses outperforming others. Age (B =&#xa0;0.217, P =&#xa0;.004) and clinical role (B =&#xa0;-0.211, P < .001) significantly predicted practice. ICU clinicians exhibit moderate knowledge and positive attitudes toward CRRT, but gaps persist in practice. Targeted training is recommended to enhance patient outcomes in ICUs across Palestine.

Unique scientific contributions are made by the discipline of nursing every year. There is a growing call to action among professional nursing organizations to recognize nursing as a science, technology, engineering, and mathematics (STEM)-designated discipline. To elevate the practice of nursing to the accepted disciplines of STEM, nurse scientists must curate a body of scientific knowledge exploring and amplifying aspects of care that no other discipline can have command over. With an abundance of literature to support it, this article aims to define clinical surveillance, as an aspect of science that no discipline outside of nursing has absolute command of Clinical surveillance is known to be a concept within the discipline of nursing. This article argues that it is not only a concept but also that the discipline of nursing holds a distinct command of clinical surveillance science over any other discipline.

Pressure injuries represent a significant healthcare challenge in ICUs, particularly among older adults with diabetes. This study examined the relationship between hemoglobin levels and hospital-acquired pressure injury (HAPrI) development. This retrospective cohort study analyzed MIMIC-IV database data from 10,468 ICU patients aged &#x2265;65 years with stays of 2-14 days. Primary outcome was HAPrI development during ICU stay. Clinical and laboratory factors were compared between diabetic and non-diabetic patients. Among 10,468 patients (mean age 77.56&#xb1;8.05 years), 366 (3.5%) developed HAPrIs. Diabetes patients (n=1,513, 14.5%) had significantly higher HAPrI rates than non-diabetic patients (6.3% vs 3.0%; P<0.001). Diabetic patients who developed HAPrIs had markedly lower minimum hemoglobin levels than those without HAPrIs (7.94&#xb1;2.07 vs 10.00&#xb1;1.73 g/dL; P<0.001). Among diabetic patients with HAPrIs, those developing multiple injuries had lower hemoglobin levels than those with single injuries (7.22&#xb1;2.06 vs 8.30&#xb1;2.00 g/dL; P=0.02). Low hemoglobin levels are strongly associated with HAPrI development in older ICU patients with diabetes, with anemia severity correlating with multiple injury occurrence. Hemoglobin optimization may represent an important targeted prevention strategy for high-risk ICU patients.

Stroke is a leading global health concern and a primary cause of death and disability. Nurses play an essential role in stroke care, significantly influencing patient outcomes. This study aimed to assess the predictors of nurses' practice in caring for patients with stroke. A cross-sectional study was conducted among 167 nurses working in medical departments between January 1, 2023 and March 15, 2024. Data were collected using a structured questionnaire evaluating nurses' knowledge, attitudes, and practices. The study revealed that 138 (82.6%) nurses had moderate knowledge, 77 (46.1%) displayed positive attitudes, and 91 (54.4%) demonstrated good practice levels regarding stroke care. Multivariable regression analysis showed that education level (bachelor's degree), stroke care training, and knowledge were significant predictors of effective nursing practice (P < .01). This study highlights that while nurses generally have moderate knowledge and positive attitudes, only half exhibit good practices in stroke care. Tailored educational and training programs focusing on evidence-based stroke care can significantly enhance nursing practices, ultimately improving patient outcomes. Prioritizing ongoing professional development and structured stroke care protocols in resource-constrained settings like Palestine is essential to address these gaps effectively.

This study was conducted with a descriptive qualitative design to reveal the opinions and experiences of intensive care nurses who care for bariatric surgery patients. The study was conducted with 11 nurses working in hospitals' general surgery intensive care units caring for bariatric surgery patients. The data were collected using the interview method, which is one of the qualitative data collection methods. In the study, intensive care nurses expressed both positive and negative perspectives on bariatric surgery. They also reported challenges in patient care, particularly related to high-weight patients, in-pain patients, and fearful patients. Additionally, hospital-related difficulties, such as lack of staff and lack of equipment, were highlighted as key barriers to providing care. However, nurses identified facilitating factors, including patient characteristics and procedural aspects which contributed to more manageable care experiences. The findings of this study illuminate the diverse views and experiences of intensive care nurses caring for bariatric surgery patients.

During early months of the COVID-19 pandemic, presentations for acute myocardial infarction (AMI) declined significantly, and outcomes worsened. However, the full extent and long-term sequelae of changes in AMI epidemiology during the pandemic remain uncertain, as does whether these patterns differed by rurality. To describe the epidemiology of AMI-related hospitalizations, interventions, and outcomes among Medicare beneficiaries throughout the COVID-19 pandemic, focusing on differences in urban and rural populations. This retrospective cohort study included all Medicare fee-for-service beneficiaries with AMI between January 1, 2018, and December 31, 2023, in the analysis. Data were analyzed from March 19 to July 9, 2025. Time period (prepandemic [January 1, 2018, to December 31, 2019], pandemic [January 1, 2020, to December 31, 2021], and postpandemic [January 1, 2022, to December 31, 2023]) and beneficiary-level rurality. The primary outcome was in-hospital death, defined as death within 1 day of discharge from the index episode of AMI. Secondary outcomes included death within 90 days of the index admission date and postdischarge outcomes. AMI episodes were defined as any emergency department (ED), observational, or inpatient stay with a primary ST-segment elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) diagnosis or a primary cardiogenic shock and secondary STEMI or NSTEMI diagnosis. Generalized estimating equations clustering on hospitals were used to compare pandemic and postpandemic outcomes with the prepandemic period, adjusting for beneficiary characteristics. A total of 1&#x202f;152&#x202f;851 AMI episodes among 1&#x202f;032&#x202f;212 beneficiaries were identified between 2018 and 2023, of which 75.6% were NSTEMI. Most AMI episodes were among male (57.6%) beneficiaries aged 65 to 80 years (56.8%). The unadjusted quarterly incidence of AMI decreased from 17.2 to 13.0 episodes per million beneficiary days at risk (quarter 1 of 2018 to quarter 4 of 2023). In-hospital (adjusted odds ratio [AOR], 1.09; 95% CI, 1.07-1.11]) and 90-day mortality (AOR, 1.10; 95% CI, 1.09-1.12) increased during the pandemic and then returned to baseline or lower (AORs, 0.99 [95% CI, 0.97-1.01] and 0.96 [95% CI, 0.95-0.98], respectively). After the pandemic, beneficiaries were less likely to discharge to a skilled nursing facility (AOR, 0.67; 95% CI, 0.66-0.68), utilize the ED (adjusted incidence rate ratio [AIRR], 0.93; 95% CI, 0.92-0.94), or experience readmission (AIRR, 0.90; 95% CI, 0.90-0.92) within 90 days of their index episode of AMI. Patterns were largely similar by rurality. In this retrospective cohort study of fee-for-service Medicare beneficiaries, the incidence of AMI decreased during and after the pandemic. Beneficiaries experienced greater in-hospital and 90-day mortality during the pandemic. After the pandemic, in-hospital and 90-day mortality returned to baseline among micropolitan and rural beneficiaries and was lower than baseline among urban beneficiaries.

This study aims to assess critical care nurses' knowledge of blood transfusion safety in a university hospital in Jordan. A descriptive cross-sectional study was conducted among 200 critical care nurses who completed a questionnaire assessing knowledge of transfusion procedures, safety protocols, and management of transfusion reactions. Of the participants, 58% were female, with a mean clinical experience of 9.37&#xa0;years (SD&#xa0;=&#xa0;5.4); 68% had more than 10 years of experience. The mean blood transfusion safety score was 18.9 (54%) out of 35 (SD&#xa0;=&#xa0;5.92), indicating poor overall knowledge. Major gaps were noted in recognizing acute transfusion reactions (86.5%) and identifying drug restrictions during transfusion (74.5%). In contrast, most nurses were knowledgeable about informed consent (90.5%) and blood cross-matching (87%). Knowledge levels differed significantly by gender, education, experience, and workplace (P < .05), with intensive care unit nurses scoring lower than those in emergency, burn, or dialysis units. Multiple linear regression showed that the workplace was the only significant predictor, explaining 10.3% of the variance. Significant knowledge gaps in transfusion safety were identified, underscoring the need for targeted education and training to improve nurses' competency, enhance patient safety, and reduce transfusion-related adverse outcomes.

This study aimed to assess nurses' experiences in preventing or reducing sensory deprivation and sensory overload in intensive care unit (ICU) patients, utilizing a phenomenological approach. The qualitative research involved face-to-face, semi-structured, in-depth interviews with 15 nurses working in a general ICU in the southern region of our country. Data collection continued until data saturation was achieved, and all interviews were audio recorded and transcribed. Colaizzi's phenomenological analysis method was employed for data analysis, and adherence to the COREQ checklist was ensured throughout the study. The data analysis revealed 2 main categories (reflection on situations that may cause sensory deprivation and sensory overload in intensive care units and practices and coping experiences of nurses to avoid sensory deprivation and overload) and 6 themes (environment, disease, and its effects, being separated from the family environment and loved ones, challenges encountered, coping, and psychosocial applications). The results indicated that patients undergo sensory deprivation or sensory overload in the intensive care environment, with nurses playing a pivotal role in addressing these situations. It was observed that nurses encountered challenges in coping with sensory deprivation or sensory overload issues in patients. Nurses are advised to regularly assess training programs to ensure the ongoing promotion of safe nursing practices aimed at minimizing sensory deprivation or sensory overload in patients.

Chronic heart failure significantly impacts patients' quality of life and self-management. Enhancing self-efficacy is crucial for improving treatment adherence and health outcomes. This study aimed to evaluate the impact of telenursing-specifically through telephone training and follow-up-on the self-efficacy of patients with chronic heart failure. A quasi-experimental study was conducted with patients diagnosed with chronic heart failure at Shafa Hospital in Kerman, Iran in early 2024. The study involved the following: (1) patient education and consent, (2) weekly follow-up calls by trained nurses to provide self-care guidance and support, and (3) pre- and post-intervention assessments using the Sullivan Cardiac Self-Efficacy Scale. Fifty-five patients participated, with a mean age of 66.24&#xa0;years. Post-intervention, the percentage of patients with low self-efficacy decreased from 21.8% to 1.8%, while those with high self-efficacy increased from 3.6% to 90.9% (P < .0001). Clinical symptoms, such as weakness (P =&#xa0;.016) and fatigue (P =&#xa0;.031), were also significantly reduced. Structured telephone follow-up and education effectively enhance self-efficacy and reduce symptoms in patients with chronic heart failure, indicating the potential of telenursing in chronic care management.

Interdisciplinary collaboration is a vital part of patient care. One of the most important aspects of care in the intensive care unit is the handoff process. Guided by the principles of High-Reliability Organizations, this process allows intra-professional and inter-professional sharing of critical patient information that can influence patient outcomes. The purpose of this project was to develop, implement, and evaluate the impact of a structured handoff process in the immediate postoperative recovery phase in the adult cardiothoracic intensive care unit (CTICU) in an academic medical center (AMC). The project focused on patients being transferred directly from the operating room (OR) to the CTICU with the goal of promoting efficiency, effectiveness, and optimizing the work environment. This was a nurse-led quality improvement project that took place over a 5-month period in a CTICU in an AMC. The project utilized the development of a comprehensive handoff process that included a staff position map and a handoff tool. Pre-post implementation unit-specific data were analyzed that includes staff workflow satisfaction surveys and financial savings to evaluate the outcomes of the handoff process. The CTICU handoff process helped reduce perceived OR patient turnover times and improved handoff efficiency, effectiveness, and readiness of providers at the point of care. The department will save a projected $25.5&#xa0;K/annually by not interrupting the patient's arterial pressure monitoring system that was utilized in the OR. This CTICU handoff process has been shown to provide a seamless transition for the adult immediate postoperative patient. By providing standardized guidelines on communication, clarity of individual roles, and elimination of waste there is greater team member confidence in safety, completeness, and adaptability during handoff. Maintaining these improvements has required ongoing re-evaluation of the process including ongoing multidisciplinary education during the onboarding process. Overall, the implementation of this nurse-driven handoff process has proven to help efficiency, effectiveness and optimize the work environment and patient outcomes in a CTICU.