搜索结果：Intensive & critical care nursing

Early mobilization is a structured protocol designed to facilitate motor recovery in intensive care unit (ICU) patients with ICU-acquired weakness. This process is typically implemented by an interdisciplinary team of nurses, physical therapists, and other healthcare professionals. However, its application is often constrained by the patients' critical conditions, limited mobility, and the challenges of coordinating care within resource-intensive ICU environments. In this study, we developed a patient-centered virtual reality (VR) exergame through an interdisciplinary design process involving clinicians and therapists, tailored to the constraints of critical care. The exergame incorporates progressive mobility levels that mirror early mobilization practices, and includes an embodied avatar to provide guidance and motivation. Using Meta Quest 3 body tracking, the system captures and visualizes patients' movements, thereby providing motivational engagement and quantifiable mobility metrics. We evaluated the exergame in two stages: a dual-user study involving healthy participants and healthcare professionals or students (N = 13), and a subsequent study with cardiothoracic ICU patients

Excessive caregiver workload in hospital nurses has been implicated in poorer patient care and increased worker burnout. Measurement of this workload in the Intensive Care Unit (ICU) is often done using the Nursing Activities Score (NAS), but this is usually recorded manually and sporadically. Previous work has made use of Ambient Intelligence (AmI) by using computer vision to passively derive caregiver-patient interaction times to monitor staff workload. In this letter, we propose using a Multiscale Vision Transformer (MViT) to passively predict the NAS from low-resolution thermal videos recorded in an ICU. 458 videos were obtained from an ICU in Melbourne, Australia and used to train a MViTv2 model using an indirect prediction and a direct prediction method. The indirect method predicted 1 of 8 potentially identifiable NAS activities from the video before inferring the NAS. The direct method predicted the NAS score immediately from the video. The indirect method yielded an average 5-fold accuracy of 57.21%, an area under the receiver operating characteristic curve (ROC AUC) of 0.865, a F1 score of 0.570 and a mean squared error (MSE) of 28.16. The direct method yielded a MSE of 1

As the aging population increases and the shortage of healthcare workers increases, the need to examine other means for caring for the aging population increases. One such means is the use of humanoid robots to care for social, emotional, and physical wellbeing of the people above 65. Understanding skilled and long term care nursing home administrators' perspectives on humanoid robots in caregiving is crucial as their insights shape the implementation of robots and their potential impact on resident well-being and quality of life. This authors surveyed two hundred and sixty nine nursing homes executives to understand their perspectives on the use of humanoid robots in their nursing home facilities. The data was coded and results revealed that the executives were keen on exploring other avenues for care such as robotics that would enhance their nursing homes abilities to care for their residents. Qualitative analysis reveals diverse perspectives on integrating humanoid robots in nursing homes. While acknowledging benefits like improved engagement and staff support, concerns persist about costs, impacts on human interaction, and doubts about robot effectiveness. This highlights compl

For patients experiencing cancer, nurse navigation can ease the burden of complex care by enhancing coordination of health services and patient outcomes. However, in under-resourced areas, trained nurse navigators may be limited or non-existent. In the United States, artificial intelligence (AI)-enabled digital health tools are increasingly available and may help address gaps in care coordination; however, most are not designed to specifically support nursing. This perspective piece discusses a human-centered AI framework that integrates empathic and agentic approaches grounded in the American Nurses Association's code of ethics to support nurses in the United States in cancer care navigation. The framework could augment, not replace, human empathy and agency while improving nurse workflow, patient-clinician relationships, and care coordination services in under-resourced areas.

An emergent challenge in geriatric care is improving the quality of care, which requires insight from stakeholders. Qualitative methods offer detailed insights, but they can be biased and have limited generalizability, while quantitative methods may miss nuances. Network-based approaches, such as quantitative ethnography (QE), can bridge this methodological gap. By leveraging the strengths of both methods, QE provides profound insights into need-finding interviews. In this paper, to better understand geriatric care attitudes, we interviewed ten nursing assistants, used QE to analyze the data, and compared their daily activities in real life with training experiences. A two-sample t-test with a large effect size (Cohen's d=1.63) indicated a significant difference between real-life and training activities. The findings suggested incorporating more empathetic training scenarios into the future design of our geriatric care simulation. The results have implications for human-computer interaction and human factors. This is illustrated by presenting an example of using QE to analyze expert interviews with nursing assistants as caregivers to inform subsequent design processes.

The intensive care unit (ICU) is a specialized hospital space where critically ill patients receive intensive care and monitoring. Comprehensive monitoring is imperative in assessing patients conditions, in particular acuity, and ultimately the quality of care. However, the extent of patient monitoring in the ICU is limited due to time constraints and the workload on healthcare providers. Currently, visual assessments for acuity, including fine details such as facial expressions, posture, and mobility, are sporadically captured, or not captured at all. These manual observations are subjective to the individual, prone to documentation errors, and overburden care providers with the additional workload. Artificial Intelligence (AI) enabled systems has the potential to augment the patient visual monitoring and assessment due to their exceptional learning capabilities. Such systems require robust annotated data to train. To this end, we have developed pervasive sensing and data processing system which collects data from multiple modalities depth images, color RGB images, accelerometry, electromyography, sound pressure, and light levels in ICU for developing intelligent monitoring system

This paper explores the application of large language models (LLMs) in nursing and elderly care, focusing on AI-driven patient monitoring and interaction. We introduce a novel Chinese nursing dataset and implement incremental pre-training (IPT) and supervised fine-tuning (SFT) techniques to enhance LLM performance in specialized tasks. Using LangChain, we develop a dynamic nursing assistant capable of real-time care and personalized interventions. Experimental results demonstrate significant improvements, paving the way for AI-driven solutions to meet the growing demands of healthcare in aging populations.

There is a growing need to understand how digital systems can support clinical decision-making, particularly as artificial intelligence (AI) models become increasingly complex and less human-interpretable. This complexity raises concerns about trustworthiness, impacting safe and effective adoption of such technologies. Improved understanding of decision-making processes and requirements for explanations coming from decision support tools is a vital component in providing effective explainable solutions. This is particularly relevant in the data-intensive, fast-paced environments of intensive care units (ICUs). To explore these issues, group interviews were conducted with seven ICU clinicians, representing various roles and experience levels. Thematic analysis revealed three core themes: (T1) ICU decision-making relies on a wide range of factors, (T2) the complexity of patient state is challenging for shared decision-making, and (T3) requirements and capabilities of AI decision support systems. We include design recommendations from clinical input, providing insights to inform future AI systems for intensive care.

Latest advances in the field of natural language processing (NLP) enable new use cases for different domains, including the medical sector. In particular, transcription can be used to support automation in the nursing documentation process and give nurses more time to interact with the patients. However, different challenges including (a) data privacy, (b) local languages and dialects, and (c) domain-specific vocabulary need to be addressed. In this case study, we investigate the case of home care nursing documentation in Switzerland. We assessed different transcription tools and models, and conducted several experiments with OpenAI Whisper, involving different variations of German (i.e., dialects, foreign accent) and manually curated example texts by a domain expert of home care nursing. Our results indicate that even the used out-of-the-box model performs sufficiently well to be a good starting point for future research in the field.

Background: Telephone nursing is the first line of contact for many care-seekers and aims at optimizing the performance of the healthcare system by supporting and guiding patients to the correct level of care and reduce the amount of unscheduled visits. Good statistical models that describe the effects of telephone nursing are important in order to study its impact on healthcare resources and evaluate changes in telephone nursing procedures. Objective: To develop a valid model that captures the complex relationships between the nurse's recommendations, the patients' intended actions and the patients' health seeking behavior. Using the model to estimate the effects of telephone nursing on patient behavior, healthcare utilization, and infer potential cost savings. Methods: Bayesian ordinal regression modeling of data from randomly selected patients that received telephone nursing. Inference is based on Markov Chain Monte Carlo methods, model selection using the Watanabe-Akaike Information Criteria, and model validation using posterior predictive checks on standard discrepancy measures. Results and Conclusions: We present a robust Bayesian ordinal regression model that predicts 76% of

The flexibility level allowed in nursing care delivery and uncertainty in infusion durations are very important factors to be considered during the chemotherapy schedule generation task. The nursing care delivery scheme employed in an outpatient chemotherapy clinic (OCC) determines the strictness of the patient-to-nurse assignment policies, while the estimation of infusion durations affects the trade-off between patient waiting time and nurse overtime. We study the problem of daily scheduling of patients, assignment of patients to nurses and chairs under uncertainty in infusion durations for an OCC that functions according to any of the three commonly used nursing care delivery models representing fully flexible, partially flexible, and inflexible care models, respectively. We develop a two-stage stochastic mixed-integer programming model that is valid for the three care delivery models to minimize expected weighted cost of patient waiting time and nurse overtime. We propose multiple variants of a scenario grouping-based decomposition algorithm to solve the model using data of a major university oncology hospital. The variants of the algorithm differ from each other according to th

In this paper, we formulate a new vehicle dispatch optimization problem, called Nursing Care Taxi Dispatch, as a variant of the Vehicle Routing Problem, considering constraints related to wheelchair use, user compatibility, pick-up and drop-off times, and vehicle limitations. Previous neural-based methods for Vehicle Routing Problems have typically addressed a few simple constraints, while our new problem involves multiple complex constraints, resulting in having fewer destinations to select. This complexity makes it more difficult to obtain solutions that allow all nodes to be visited with a limited number of vehicles. To balance low violation rate, computational efficiency, and solution quality, we propose a supervised machine learning approach based on the Transformer architecture. We first obtain a set of high-quality solutions using an integer linear programming solver for given inputs and then train our learning model through supervised learning. Additionally, we introduce the post-processing of the paths generated by the learning model, ensuring that all constraints are satisfied. We compared each instance's objective function value (operating time), execution time, and cons

Relationship-centred care (RCC) recognises that healthcare quality depends not only on outcomes, but on how voice, responsibility, and emotional labour are negotiated among patients, caregivers, and providers. As AI systems enter sensitive care contexts, they introduce a new participant into these negotiations. Drawing on empirical work in Advance Care Planning (ACP) and peer support, we argue that AI's primary impact in high-subjectivity domains is not optimisation but redistribution: it reorganises who speaks, who decides, and who bears moral responsibility. Across both settings, participants were less concerned with technical accuracy than with relational consequences: whether AI would appropriately represent their decision, reduce burden, or blur accountability, scaffold connection, or subtly displace it. We identify three relational dimensions: authority, temporality, and visibility, through which AI reshapes care relationships, and propose design provocations centred on relational legibility, bounded agency, responsibility traceability, and non-substitutive scaffolding.

Consistent high-quality nursing care is essential for patient safety, yet current nursing education depends on subjective, time-intensive instructor feedback in training future nurses, which limits scalability and efficiency in their training, and thus hampers nursing competency when they enter the workforce. In this paper, we introduce a video-language model (VLM) based framework to develop the AI capability of automated procedural assessment and feedback for nursing skills training, with the potential of being integrated into existing training programs. Mimicking human skill acquisition, the framework follows a curriculum-inspired progression, advancing from high-level action recognition, fine-grained subaction decomposition, and ultimately to procedural reasoning. This design supports scalable evaluation by reducing instructor workload while preserving assessment quality. The system provides three core capabilities: 1) diagnosing errors by identifying missing or incorrect subactions in nursing skill instruction videos, 2) generating explainable feedback by clarifying why a step is out of order or omitted, and 3) enabling objective, consistent formative evaluation of procedures.

Recent advancements in large language models (LLMs) have significantly transformed medical systems. However, their potential within specialized domains such as nursing remains largely underexplored. In this work, we introduce NurseLLM, the first nursing-specialized LLM tailored for multiple choice question-answering (MCQ) tasks. We develop a multi-stage data generation pipeline to build the first large scale nursing MCQ dataset to train LLMs on a broad spectrum of nursing topics. We further introduce multiple nursing benchmarks to enable rigorous evaluation. Our extensive experiments demonstrate that NurseLLM outperforms SoTA general-purpose and medical-specialized LLMs of comparable size on different benchmarks, underscoring the importance of a specialized LLM for the nursing domain. Finally, we explore the role of reasoning and multi-agent collaboration systems in nursing, highlighting their promise for future research and applications.

The COVID-19 pandemic has had far-reaching consequences, highlighting the urgency for explanatory and predictive tools to track infection rates and burden of care over time and space. However, the scarcity and inhomogeneity of data is a challenge. In this research we develop a robust framework for estimating and predicting the occupied beds of Intensive Care Units by presenting an innovative Small Area Estimation methodology based on the definition of mixed models with random regression coefficients. We applied it to estimate and predict the daily occupancy of Intensive Care Unit beds by COVID-19 in health areas of Castilla y León, from November 2020 to March 2022.

We find ourselves on the ever-shifting cusp of an AI revolution -- with potentially metamorphic implications for the future practice of healthcare. For many, such innovations cannot come quickly enough; as healthcare systems worldwide struggle to keep up with the ever-changing needs of our populations. And yet, the potential of AI tools and systems to shape healthcare is as often approached with great trepidation as celebrated by health professionals and patients alike. These fears alight not only in the form of privacy and security concerns but for the potential of AI tools to reduce patients to datapoints and professionals to aggregators -- to make healthcare, in short, less caring. This infixated concern, we - as designers, developers and researchers of AI systems - believe it essential we tackle head on; if we are not only to overcome the AI implementation gap, but realise the potential of AI systems to truly augment human-centred practices of care. This, we argue we might yet achieve by realising newly-accessible practices of AI healthcare innovation, engaging providers, recipients and affected communities of care in the inclusive design of AI tools we may yet enthusiastically

Nursing notes, an important part of Electronic Health Records (EHRs), track a patient's health during a care episode. Summarizing key information in nursing notes can help clinicians quickly understand patients' conditions. However, existing summarization methods in the clinical setting, especially abstractive methods, have overlooked nursing notes and require reference summaries for training. We introduce QGSumm, a novel query-guided self-supervised domain adaptation approach for abstractive nursing note summarization. The method uses patient-related clinical queries for guidance, and hence does not need reference summaries for training. Through automatic experiments and manual evaluation by an expert clinician, we study our approach and other state-of-the-art Large Language Models (LLMs) for nursing note summarization. Our experiments show: 1) GPT-4 is competitive in maintaining information in the original nursing notes, 2) QGSumm can generate high-quality summaries with a good balance between recall of the original content and hallucination rate lower than other top methods. Ultimately, our work offers a new perspective on conditional text summarization, tailored to clinical app

Clinical decision making is challenging because of pathological complexity, as well as large amounts of heterogeneous data generated as part of routine clinical care. In recent years, machine learning tools have been developed to aid this process. Intensive care unit (ICU) admissions represent the most data dense and time-critical patient care episodes. In this context, prediction models may help clinicians determine which patients are most at risk and prioritize care. However, flexible tools such as artificial neural networks (ANNs) suffer from a lack of interpretability limiting their acceptability to clinicians. In this work, we propose a novel interpretable Bayesian neural network architecture which offers both the flexibility of ANNs and interpretability in terms of feature selection. In particular, we employ a sparsity inducing prior distribution in a tied manner to learn which features are important for outcome prediction. We evaluate our approach on the task of mortality prediction using two real-world ICU cohorts. In collaboration with clinicians we found that, in addition to the predicted outcome results, our approach can provide novel insights into the importance of diff