Acute and Critical Care

Review Articles

Nursing
Nursing delirium management to promoting critically ill patients’ safety: an umbrella review: Daniela Carvalho Plácido, Maria do Rosário Pinto, Maria Cândida Durão, Helga Rafael Henriques, Joana Ferreira Teixeira; Acute Crit Care. 2025;40(3):373-392. Published online August 29, 2025; DOI: https://doi.org/10.4266/acc.005221

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Abstract PDF: Delirium is an acute disorder characterized by changes in the patient’s cognitive function, which another neurocognitive or pre-existing disease cannot explain. It produces adverse outcomes for critically ill patients and their families related to adverse events associated with the accidental removal of medical devices that increase the risk of the patient and the length of stay at the hospital, manifested by agitation and confusion behaviors. Five reviewers conducted An Umbrella Review from May to August 2023 through research in the databases Medline, CINAHL, Scopus, Web of Science, Cochrane Database of Systematic Reviews and articles obtained through research in other sources. After verifying their eligibility, we obtained 22 systematic reviews and meta-analyses for data extraction and analysis. From the results obtained, the importance of the implementation of surveillance interventions and systematic evaluation of the presence of delirium is highlighted, with particular emphasis on the use of the scale, Confusion Assessment Method, followed by the implementation of multicomponent interventions, pharmacological or not, highlighting the use of dexmedetomidine and family as support, as well early mobilization for the management of delirium. Managing delirium in critically ill patients based on Meyer and Lavin's theory, is an area sensitive to nursing care with an impact on the prevention of complications and consequent promotion of the safety of these patients, which also translates into positive results for the family and health organizations, reducing morbidity, mortality, length of stay and health costs.

Nursing
Promoting patient safety in critically ill patients: nursing interventions in surveillance and prevention of ocular injuries: Anabela Carvalho Raposo, Maria Candida Durao, Maria do Rosário Pinto, Helga Rafael Henriques, Joana Ferreira Teixeira; Acute Crit Care. 2025;40(1):10-17. Published online February 12, 2025; DOI: https://doi.org/10.4266/acc.005014

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254 Download
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2 Crossref

Corneal surface injuries occur frequently (59.4%) in critically ill patients, and the average time for their appearance is 8 days. Such injuries are primarily related to dry eye, which increases the risk of exposure injury in patients admitted to intensive care units. This can result in a severe ulcer or perforation that results in partial to total loss of vision, decreasing the quality of the patient's life. This is a sensitive nursing care area requiring further investigation. Thus, this review aims to analyse nursing interventions that aim to prevent ocular surface injuries. An integrative literature review was carried out from May to August 2023 in the Medline, CINAHL, Scopus, Web of Science, and PubMed databases using the Whittemore and Knafl methodology. Inclusion and exclusion criteria were subsequently applied to assess the results. After verifying result eligibility, seven documents were identified for data extraction and analysis. The results suggest the importance of recognizing risk factors for ocular injuries in critically ill patients, surveillance as a nursing competency, adequate ocular hygiene and effective lubrication, and managing environmental conditions to prevent corneal injuries. Implementing surveillance and intervention protocols for critically ill patients at risk of corneal injuries requires specialized training for critical care nurses. Specifically, environmental management, including temperature and humidity control, is highlighted as an area that merits further research.

Citations

Citations to this article as recorded by

Lens on eye care in intensive care units: deficiencies, training, and improvement recommendations – a descriptive observational study
Ayşegül Tuğba Yıldız, Özlem Ceyhan
BMC Nursing.2025;[Epub] CrossRef
Ocular Surface Disorders in ICU Patients: Evidence-Based Nursing Prevention Strategies
Weiwei Ni, Xinwei Jiao
Translational Vision Science & Technology.2025; 14(12): 21. CrossRef

Original Article

Nursing
Differences in the psychological preparedness of emergency nurses for caring for victims of violence against women according to nurse gender: a nationwide cross-sectional questionnaire survey in Japan: Akane Kato; Acute Crit Care. 2024;39(4):630-639. Published online October 23, 2024; DOI: https://doi.org/10.4266/acc.2024.00654

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1 Web of Science
1 Crossref

Abstract PDF

Background
With the increasing incidence of violence against women (VAW), emergency department (ED) nurses should be trained to respond appropriately to victims of VAW (VVAW). However, the psychological preparedness of nurses caring for VVAW and its relationship to nurse gender remains unclear in Japan.
Methods
A nationwide self-administered questionnaire survey was conducted among 430 randomly selected certified emergency nurses. The questionnaire was a Japanese translation of the evaluation tools from the World Health Organization (WHO) curriculum "Caring for women subjected to violence: a WHO curriculum for training healthcare providers."
Results
The final sample included 104 participants, and the effective response rate was 24.2%. More than 60% of nurses had experience in caring for VVAW; however, only 10% had received training concerning VAW. The mean number of VVAW cared for by these nurses was 6.2 (standard deviation, 6.1) with no significant difference in nurse gender (P=0.52, effect size [ES]=0.09). Male nurses had a higher mean score of psychological preparedness than female nurses (22.6 vs. 20.4; P=0.03, ES=0.22); moreover, female nurses scored lower than male nurses on all items of the psychological preparedness evaluation. Less than half of the participants reported having institutional support systems.
Conclusions
Establishing an education program for all emergency nurses, providing support to ensure the psychological preparedness of female emergency nurses, and ensuring improvement of facilities nationwide are essential for enhancing nursing care for VVAW in Japanese EDs.

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Measurement of Dehumanization, Self-Dehumanization, and Empathy as Mediating Factors Among Healthcare Professionals
Aikaterini Roupa, Athina Patelarou, Konstantinos Giakoumidakis, Kyriaki Fousiani, Marianna Miliaraki, Eirini Stratidaki, Evridiki Patelarou
Healthcare.2025; 13(1): 75. CrossRef

Review Article

Nursing
Specialized nursing intervention on critically ill patient in the prevention of intubation-associated pneumonia: an integrative literature review: Daniela Fradinho Almeida, Maria do Rosário Pinto, Maria Candida Durao, Helga Rafael Henriques, Joana Ferreira Teixeira; Acute Crit Care. 2024;39(3):341-349. Published online August 12, 2024; DOI: https://doi.org/10.4266/acc.2024.00528

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Abstract PDF: Healthcare-associated infections are adverse events that affect people in critical condition, especially when hospitalized in an intensive care unit. The most prevalent is intubation-associated pneumonia (IAP), a nursing-care-sensitive area. This review aims to identify and analyze nursing interventions for preventing IAP. An integrative literature review was done using the Medline, CINAHL, Scopus and PubMed databases. After checking the eligibility of the studies and using Rayyan software, ten final documents were obtained for extraction and analysis. The results obtained suggest that the nursing interventions identified for the prevention of IAP are elevating the headboard to 30º; washing the teeth, mouth and mucous membranes with a toothbrush and then instilling chlorohexidine 0.12%–0.2% every 8/8 hr; monitoring the cuff pressure of the endotracheal tube (ETT) between 20–30 mm Hg; daily assessment of the need for sedation and ventilatory weaning and the use of ETT with drainage of subglottic secretions. The multimodal nursing interventions identified enable health gains to be made in preventing or reducing IAP. This area is sensitive to nursing care, positively impacting the patient, family, and organizations. Future research is suggested into the effectiveness of chlorohexidine compared to other oral hygiene products, as well as studies into the mortality rate associated with IAP, with and without ETT for subglottic aspiration.

Original Articles

Nursing
Sleep, anxiety, depression, and stress in critically ill patients: a descriptive study in a Portuguese intensive care unit: Rui Domingues Silva, Abílio Cardoso Teixeira, José António Pinho, Pedro Marcos, José Carlos Santos; Acute Crit Care. 2024;39(2):312-320. Published online May 30, 2024; DOI: https://doi.org/10.4266/acc.2023.01256

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239 Download
4 Web of Science
7 Crossref

Abstract PDF

Background
Sleep disorders are common among patients admitted to intensive care units (ICUs). This study aimed to assess the perceptions of sleep quality, anxiety, depression, and stress reported by ICU patients and the relationships between these perceptions and patient variables.
Methods
This cross-sectional study used consecutive non-probabilistic sampling to select participants. All patients admitted for more than 72 hours of ICU hospitalization at a Portuguese hospital between March and June 2020 were asked to complete the “Richard Campbell Sleep Questionnaire” and “Anxiety, depression, and Stress Assessment Questionnaire.” The resulting data were analyzed using descriptive statistics, Pearson’s correlation coefficient, Student t-tests for independent samples, and analysis of variance. The significance level for rejecting the null hypothesis was set to α ≤0.05.
Results
A total of 52 patients admitted to the ICU for at least 72 hours was recruited. The mean age of the participants was 64 years (standard deviation, 14.6); 32 (61.5%) of the participants were male. Approximately 19% had psychiatric disorders. The prevalence of self-reported poor sleep was higher in women (t[50]=2,147, P=0.037) and in participants with psychiatric problems, although this difference was not statistically significant (t[50]=–0.777, P=0.441). Those who reported having sleep disorders before hospitalization had a worse perception of their sleep.
Conclusions
Sleep quality perception was worse in female ICU patients, those with psychiatric disorders, and those with sleep alterations before hospitalization. Implementing early interventions and designing nonpharmacological techniques to improve sleep quality of ICU patients is essential.

Citations

Citations to this article as recorded by

Effectiveness of psychological nursing interventions for depression, anxiety and mental health resilience: A systematic review and meta-analysis
Xiaodong Wang, Rongfang He, Jiacheng Long, Juan Chen, Monica Karunakaran, Vishnu Shankar Hariharan, Rajan Rushendar, Luwei Xiang
Archives of Psychiatric Nursing.2026; 60: 152042. CrossRef
The Impact of Environmental Stressors on Sleep Quality and Patient Experience in the Intensive Care Unit
Meyreme Aksoy, Zeliha Büyükbayram Genç, Muhammed Ismail Güner
Nursing in Critical Care.2026;[Epub] CrossRef
Frailty and fear of death among geriatric patients in critical care units: A mixed methods study
Eman Arafa Hassan, Shimmaa Mohamed Elsayed, Heba Hashem Monged, Basma Taher Abdelwahab
Nursing in Critical Care.2025;[Epub] CrossRef
Effects of a Multimodal Intervention on Sleep Quality and Duration in Intensive Care Unit Patients
Jieun Nam, Sukhee Ahn
Journal of Korean Critical Care Nursing.2025; 18(1): 70. CrossRef
Sleep Quality and Its Associated Factors among Adult Patients Admitted in the Intensive Care Units of Public Hospitals in Addis Ababa, Ethiopia
Taye Mezgebu Ashine, Birehanu Melaku Kassaye, Asefu Woldestadik, Kasie Gebeyehu Tiruneh, Tadesse Sahle Adeba, Edmialem Getahun Mesfin, Tamrat Alate Woldeyohannis, Asaminew Habtamu Sane
Sage Open Nursing.2025;[Epub] CrossRef
Environmental Factors Affecting Sleep Quality in Intensive Care Unit Patients in Southern Morocco: An Assessment Study
Abdelmajid Lkoul, Keltouma Oumbarek, Youssef Bouchriti, Asmaa Jniene, Tarek Dendane
Advances in Respiratory Medicine.2025; 93(3): 14. CrossRef
Prevalence of poor sleep quality among critical care unit nurses: a systematic review and meta-analysis
Neda Sanaie, Sogand Sarmadi, Akbar Zare-Kaseb
BMC Nursing.2025;[Epub] CrossRef

Nursing
The effect of time management education on critical care nurses’ prioritization: a randomized clinical trial: Fatemeh Vizeshfar, Mahnaz Rakhshan, Fatemeh Shirazi, Roya Dokoohaki; Acute Crit Care. 2022;37(2):202-208. Published online April 28, 2022; DOI: https://doi.org/10.4266/acc.2021.01123

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733 Download
14 Web of Science
23 Crossref

Abstract PDF

Background
Nurses are at the forefront of patient care, and time management skills can increase their ability to make decisions faster. This study aimed to assess the effect of a time management workshop on prioritization and time management skills among nurses of emergency and intensive care units.
Methods
This randomized clinical trial was performed with 215 nurses. The educational intervention about time management was held in the form of a workshop for the intervention group. The time management questionnaire was completed by both groups before, immediately after, and 3 months after the intervention.
Results
Most participants were female (n=191, 88%), with a mean age of 31.82 years (range, 22–63 years). Additionally, the participants’ work experience ranged from 1 to 30 years (mean±standard deviation, 8.00±7.15 years). After the intervention, the mean score of time management increased significantly in the intervention group, but no significant difference was observed in this regard in the control group. The results also revealed a significant difference between the intervention and control groups regarding the mean score of time management 3 months after the intervention (P<0.001).
Conclusions
Time management training helped nurses adjust the time required to perform and prioritize various tasks.

Citations

Citations to this article as recorded by

Coping Mechanism and Resilience Strategies of Nurses in the Provincial Government of Albay: Strengthening Well-Being and Professional Performance amidst Workplace Stressor
Ailyn Oliquiano, Rowena Cuevillas
JPAIR Multidisciplinary Research.2026;[Epub] CrossRef
Nursing student reflections on a research internship: A reflective discussion following the Gibbs' reflective cycle
Francine Antoinette Ocampo, Brianne Genevieve McIntyre, Debbie Massey, Rosemary Saunders
Nurse Education Today.2025; 145: 106481. CrossRef
Barrierer for tilførsel av enteral ernæring til intensivpasienten – en deskriptiv tverrsnittsstudie
Espen Løver Thu, Stian Voldsund, Kristoffer Sand
Sykepleien Forskning.2025; (98756): e. CrossRef
The impact of emotional intelligence on work performance among ICU nurses in Palestine: a cross-sectional study
Imad H. Fashafsheh, Faeda A. Eqtait, Bahaaeddin M. Hammad, Ahmad J. Ayed, Basma S. Salameh
BMC Nursing.2025;[Epub] CrossRef
Transforming nursing education: the power of educational leadership in optimizing time management and competency
Shaimaa Mohamed Amin, Ahmed Abdelwahab Ibrahim El-Sayed, Ahmed Abdellah Othman, Ahmed Salah Ali, Nagwa Ibrahim ELfeshawy, Hanan Hosni El-Sherbini, Abeer Abdel Fattah Mahmoud, Mohamed Hussein Ramadan Atta
BMC Nursing.2025;[Epub] CrossRef
The novelty effect impacts evaluation when implementing a new communication tool
Mia Moreno, Maxine Adegbola, Donald E. Stout, Lisa M. Smith, Emerson B. Nairon, Maria E. Denbow, Daiwai M. Olson
Nursing.2025; 55(8): 56. CrossRef
Impacts of 21st‑Century Time Traps, Time Management, and Mental Well‑Being on Job Performance in Nurses
Rabia Arpacı, Zehra Can Karabörklü, Derya Tanriverdi
Scandinavian Journal of Caring Sciences.2025;[Epub] CrossRef
Hemşirelerin Zaman Yönetimine İlişkin Tutumlarının İncelenmesi: Tanımlayıcı Bir Çalışma
Semanur Kumral Özçelik, Kadriye Özkol Kılınç, Zülfünaz Özer, Havva Öztürk, Ayşe Nefise Bahçecik
Sağlık Bilimleri Üniversitesi Hemşirelik Dergisi.2025; 7(2): 137. CrossRef
Barriers to the delivery of enteral nutrition in intensive care unit patients – a descriptive cross-sectional study
Espen Løver Thu, Stian Voldsund, Kristoffer Sand
Sykepleien Forskning.2025; (98756): e. CrossRef
Time management training and its effect on head nurses’ work-family conflict
Mansoura Aid Abed El Salam, Samah Faisal Fakhry, Samah Mohamed Elsayed
BMC Nursing.2025;[Epub] CrossRef
Hemşirelerin Kronemik (Zamansal İletişim) Algıları ve Etkileyen Faktörlerin İncelenmesi
Emek Bakanoğlu Kalkavan, Elif Nur Şahin, Esranur Dilek
Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi.2025; 14(4): 1527. CrossRef
Nursing core competencies for postresuscitation care in Iran: a qualitative study
Mahnaz Zali, Azad Rahmani, Kelly Powers, Hadi Hassankhani, Hossein Namdar-Areshtanab, Neda Gilani
BMJ Open.2024; 14(1): e074614. CrossRef
Critical care nurses’ experiences of caring challenges during post-resuscitation period: a qualitative content analysis
Mahnaz Zali, Azad Rahmani, Hadi Hassankhani, Hossein Namdar-Areshtanab, Neda Gilani, Arman Azadi, Mansour Ghafourifard
BMC Nursing.2024;[Epub] CrossRef
Exploring Burnout among Nursing Students in Bangalore: A t-Distributed Stochastic Neighbor Embedding Analysis and Hierarchical Clustering in Cross-Sectional Data
Michael Sebastian, Maddalena De Maria, Rosario Caruso, Gennaro Rocco, Cristina Di Pasquale, Arianna Magon, Gianluca Conte, Alessandro Stievano
Nursing Reports.2024; 14(3): 1693. CrossRef
A Systemic Model for Resilience and Time Management in Healthcare Academia: Application in a Dental University Setting
Maria Antoniadou, Rallis Antoniadis
Applied Sciences.2024; 14(11): 4918. CrossRef
Impact of Time Optimization Intervention on Work Execution and Burnout among Nurses Working at Intensive Care Unit
H Angelin Santhakumari , Annamalai Manjula, Arjunan Porkodi , Adithya. A. Venkat
Salud, Ciencia y Tecnología.2024; 4: 1115. CrossRef
Nurse managers’ managerial innovation and it’s relation to proactivity behavior and locus of control among intensive care nurses
Loly Mohamed Shawky Elbus, Mohamed Gamal Mostafa, Fatma Zaghloul Mahmoud, Mostafa shaban, Seham Aly Mahmoud
BMC Nursing.2024;[Epub] CrossRef
Nurses and Managers’ Time Management Skills Assessment: A National Survey in the Italian Healthcare Setting
Lucia Filomeno, Yassin Chaoui, Antonietta Scinicariello, Andrea Minciullo, Sofia Di Mario
Nursing Reports.2024; 14(3): 2107. CrossRef
Prioritization skills for nurses
Kelly Moseley, Lori Hammond
Nursing Made Incredibly Easy!.2024; 22(5): 45. CrossRef
Exploring the association between internet addiction and time management among undergraduate nursing students
Heba Fakieh Mansy Ali, Marwa Abd-El-Gawad Mousa, Mohamed Hussein Ramadan Atta, Shadia Ramadan Morsy
BMC Nursing.2024;[Epub] CrossRef
Impact of time management program on stress and coping strategies adopted by nursing students with regard to academic performance
Juby Mary Chacko, Achamma Varghese, Nirmala Rajesh
IP Journal of Paediatrics and Nursing Science.2023; 6(1): 48. CrossRef
Perceived clinical competence and predictive role of time management in nursing students
Maryam Behdarvand, Mehrnaz Ahmadi, Nasrin Khajeali
Nurse Education in Practice.2023; 72: 103789. CrossRef
Examining the impact of time management and resilience training on work-family conflict among Iranian female nurses: a randomized controlled trial
Sedigheh Peykar, Hakimeh Vahedparast, Tayebeh Gharibi, Razieh Bagherzadeh
BMC Nursing.2023;[Epub] CrossRef

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