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Aust Crit Care 2021 Jun 18. Epub 2021 Jun 18.

Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Outcomes After Surgery and Critical Illness Research Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Background: A multicentre randomised trial demonstrated improved outcomes for intensive care unit (ICU) patients using early, goal-directed mobility implemented by nurses.

Objectives: The aim of the study was to evaluate barriers to nursing mobility, using a validated survey, during an ongoing quality improvement (QI) project (2019) in a medical ICU and determine changes from the pre-QI (2017) baseline.

Methods: Nurses, nurse practitioners, physician assistants, and clinical technicians completed the 26-item Patient Mobilization Attitudes and Beliefs Survey for the ICU (PMABS-ICU). Read More

Aust Crit Care 2021 Jun 17. Epub 2021 Jun 17.

Department of Intensive Care Medicine, The Prince Charles Hospital, 627 Rode Road, Chermside, Queensland, 4032, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia.

Background: Patients treated in Australian intensive care units (ICUs) have an overall mortality rate of 5.05%. This is due to the critical nature of their disease, the increasing proportion of patients with multiple comorbidities, and advanced age. Read More

Aust Crit Care 2021 Jun 15. Epub 2021 Jun 15.

Nursing Research and Practice Development Centre, The Prince Charles Hospital, Rode Road, Chermside, Queensland, Australia 4032; School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, 1100 Nudgee Road, Banyo, Queensland, Australia 4014. Electronic address:

Objective: The aim of the study was to investigate the effectiveness of interventions to prevent pressure injury in adults admitted to intensive care settings.

Review Method Used: This is a systematic review and meta-analysis of randomised controlled trials.

Data Sources: Five databases (CINAHL, MEDLINE, Scopus, Web of Science, and Embase) were searched in mid-2019. Read More

Aust Crit Care 2021 Jun 15. Epub 2021 Jun 15.

Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia. Electronic address:

Background: Ineffective intervention for patients with blunt chest wall injury results in high rates of morbidity and mortality. To address this, a blunt chest injury care bundle protocol (ChIP) was developed, and a multifaceted plan was implemented using the Behaviour Change Wheel.

Objective: The purpose of this study was to evaluate the reach, fidelity, and dose of the ChIP intervention to discern if it was activated and delivered to patients as intended at two regional Australian hospitals. Read More

Aust Crit Care 2021 May 11. Epub 2021 May 11.

Dept. Mechanical Engineering, University of Melbourne, Melbourne, Australia.

Background: Healthcare workers (HCWs) have frequently become infected with severe acute respiratory syndrome coronavirus 2 whilst treating patients with coronavirus disease 2019 (COVID-19). A variety of novel devices have been proposed to reduce COVID-19 cross-contamination.

Objectives: The aim of the study was (i) to test whether patients and HCWs thought that a novel patient isolation hood was safe and comfortable and (ii) to obtain COVID-19 infection data of hospital HCWs. Read More

Aust Crit Care 2021 Jun 15. Epub 2021 Jun 15.

Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. Electronic address:

Background: Ventilator-associated pneumonia (VAP) is a common complication of mechanical ventilation in the intensive care unit. The incidence, patient characteristics, and outcomes have not been described in a regional Australian setting.

Objectives: Τhe primary objective was to establish the incidence of VAP in a regional intensive care unit using predetermined diagnostic criteria. Read More

Aust Crit Care 2021 Jul;34(4):301-302

Australian Critical Care, Australia.

Aust Crit Care 2021 Jun 11. Epub 2021 Jun 11.

Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia. Electronic address:

Background: Burnout in neonatal intensive care unit (NICU) nurses has been correlated with personality proneness to shame. However, the structural validities of the one-factor Burnout Measure (BM) and the two-factor Personal Feelings Questionnaire-2 (PFQ-2) used to assess burnout and shame-proneness, respectively, in these nurses were not evaluated.

Objectives: The aim of the study was (i) to perform factor analyses of the BM and the PFQ-2 and (ii) to determine the relationships of burnout dimensions retrieved by factor analysis with similarly validated dimensions of shame- and guilt-proneness in NICU nurses. Read More

Aust Crit Care 2021 Jun 10. Epub 2021 Jun 10.

Research Department of Emergency and Critical Care, HAN University of Applied Science, Nijmegen, the Netherlands; Radboud University Medical Centre, Radboud Institute for Health Sciences IQ Healthcare, the Netherlands; Foundation Family and Patient Centered Intensive Care, Alkmaar, the Netherlands.

Objective: The aim of the study was to assess the effectiveness of intensive care unit (ICU)-initiated transitional care interventions for patients and families on elements of post-intensive care syndrome (PICS) and/or PICS-family (PICS--F).

Review Method Used: This is a systematic review and meta-analysis SOURCES: The authors searched in biomedical bibliographic databases including PubMed, Embase (OVID), CINAHL Plus (EBSCO), Web of Science, and the Cochrane Library and included studies written in English conducted up to October 8, 2020.

Review Methods: We included (non)randomised controlled trials focussing on ICU-initiated transitional care interventions for patients and families. Read More

Aust Crit Care 2021 Jun 10. Epub 2021 Jun 10.

Department of Intensive Care, Nambour General Hospital, 26 Hospital Road, Nambour, Sunshine Coast, Queensland, 4560, Australia; Department of Intensive Care, Sunshine Coast University Hospital, 6 Doherty Street, Birtinya, Sunshine Coast, Queensland, 4575, Australia. Electronic address:

Background: Nasogastric tube insertion in the intensive care setting is common. Placement verification is required to avoid complications of bronchotracheal misplacement that range from aspiration of infused contents to death from associated causes. The gold standard of practice is chest radiography. Read More

Aust Crit Care 2021 Jun 9. Epub 2021 Jun 9.

Department of Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: Critically ill patients often experience coexisting symptoms. Thirst, in particular, appears to be an important symptom, having the highest prevalence, intensity, and induction of distress, and is significantly correlated with other symptoms. However, thirst and dry mouth are not usually assessed or treated. Read More

Aust Crit Care 2021 Jun 1. Epub 2021 Jun 1.

Clinical and Health Sciences, University of South Australia, PO Box 2471, South Australia, 5000, Australia. Electronic address:

Introduction: Adverse events associated with umbilical catheters include malposition, bloodstream infections, thrombosis, tip migration, and extravasation, resulting in loss of vascular access and increased risk of morbidity and mortality. There is a need for greater understanding of risk factors associated with adverse events to inform safe practice.

Objectives: The aim of the study was to summarise the existing evidence regarding risk factors for umbilical catheter-related adverse events to inform the undertaking of future research. Read More

Aust Crit Care 2021 Jun 1. Epub 2021 Jun 1.

University of Eastern Finland (UEF), Department of Nursing Science, POBox 1627, 70211, Kuopio, Finland; Kuopio University Hospital, Kuopio, Finland. Electronic address:

Background: Nurses' clinical competence involves an integration of knowledge, skills, attitudes, thinking ability, and values, which strongly affects how deteriorating patients are managed.

Objectives: The aim of the study was to examine nurses' attitudes as part of clinical competence towards the rapid response system in two acute hospitals with different rapid response system models.

Methods: This is a comparative cross-sectional correlational study. Read More

Aust Crit Care 2021 May 26. Epub 2021 May 26.

Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Queensland, Australia; Intensive Care Unit, Princess Alexandra Hospital, Queensland, Australia.

Background/objective: Endotracheal suction is one of the most common and harmful procuedres performed on mechanically ventilated children. The aim of the study was to establish the feasibility of a randomised controlled trial (RCT) examining the effectiveness of normal saline instillation (NSI) and a positive end-expiratory pressure recruitment manoeuvre (RM) with endotracheal suction in the paediatric intensive care unit.

Methods: Pilot 2 × 2 factorial RCT. Read More

Aust Crit Care 2021 May 26. Epub 2021 May 26.

Providence Health Care, Vancouver, Canada. Electronic address:

Background: The current coronavirus disease 2019 (COVID-19) pandemic is creating unprecedented and unchartered demands on critical care units to meet patient needs and adapt the delivery of health services. Critical care nurses play a pivotal role in developing models of care that are effective, flexible, and safe.

Objectives: We report on the accelerated development of a critical care nursing surge model responsive to escalating needs for intensive care capacity. Read More

Aust Crit Care 2021 May 25. Epub 2021 May 25.

Department of Nursing Science, University of Turku, FI-20014 TURUN YLIOPISTO, Finland; Turku University Hospital, PO Box 52, FI-20521 TURKU, Finland. Electronic address:

Background: Sleep is vital to our wellbeing. Critically ill patients are vulnerable with effects of sleep deprivation including weakened immune function, decreased glucose tolerance, and increased sympathetic activity. Intensive care unit (ICU) patients' sleep evaluation is difficult and often not reliable. Read More

Aust Crit Care 2021 May 25. Epub 2021 May 25.

Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland; Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland. Electronic address:

Background: Transition to parenthood is a wonderful yet stressful period especially when it involves the newborn's hospitalisation. To support and facilitate this transition, it is essential to understand parental beliefs and needs. The father's perspective remains an understudied yet fundamental question. Read More

Aust Crit Care 2021 May 22. Epub 2021 May 22.

Department of Intensive Care Medicine, Bendigo Health, Bendigo, Victoria, Australia; Department of Intensive Care Medicine, Goulburn Valley Health, Shepparton, Victoria, Australia; Department of Medicine University of Queensland, Australia; Department of Medicine University of Melbourne, Australia.

Background: Postextubation dysphagia (PED) has been shown to occur in 41% of critically ill patients requiring endotracheal intubation. With one-third of patients with PED experiencing silent aspiration, it is reasonable to anticipate negative health outcomes are likely, although this has not yet been systematically explored in an Australian context.

Objectives: The aim of the study was to determine the impact of PED, in a regional Australian intensive care unit (ICU), on rates of pneumonia, the length of stay in the ICU and hospital, and healthcare expenditure. Read More

Aust Crit Care 2021 May 20. Epub 2021 May 20.

School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia.

Objectives: The aim of the study is to understand the concept of disaster preparedness in relation to the intensive care unit through the review and critique of the peer-reviewed literature.

Review Method Used: Rodgers' method of evolutionary concept analysis was used in the study.

Data Sources: Healthcare databases included in the review were Cumulative Index to Nursing and Allied Health Literature, Public MEDLINE, Scopus, and ProQuest. Read More

Aust Crit Care 2021 May 12. Epub 2021 May 12.

School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Brisbane, Australia; Nursing Research & Practice Development Centre, The Prince Charles Hospital, Brisbane, Australia; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address:

Background: Pressure injuries are a ubiquitous, yet largely preventable, hospital acquired complication commonly seen in critically ill patients in the intensive care unit.

Objectives: The objectives of this study were to implement targeted evidence-based pressure injury prevention strategies and evaluate their effect through measurement of patient pressure injury observations.

Methods: A prospective multiphased design was used in the intensive care unit of an Australian tertiary referral hospital using three study periods (period 1, weeks 1-18; period 2, weeks 19-28; and period 3, weeks 29-52). Read More

Aust Crit Care 2021 May 12. Epub 2021 May 12.

Department of Nutrition and Dietetics, Royal Adelaide Hospital, South Australia, Australia; Intensive Care Unit, Royal Adelaide Hospital, South Australia, Australia; Allied and Scientific Health Office (ASHO), Department for Health & Wellbeing, Adelaide, South Australia, Australia.

Background: Malnutrition rates for critically ill patients being admitted to the intensive care unit (ICU) are reported to range from 38% to 78%. Malnutrition in the ICU is associated with increased mortality, morbidity, length of hospital admission, and ICU readmission rates. The high volume of ICU admissions means that efficient screening processes to identify patients at nutritional or malnutrition risk are imperative to appropriately prioritise nutrition intervention. Read More

Aust Crit Care 2021 Mar 10. Epub 2021 Mar 10.

Frankston Hospital, Monash University, Frankston, VIC, Australia. Electronic address:

Background: Personal-protective equipment (PPE)-preparedness, defined as adherence to guidelines, healthcare worker (HCW) training, procuring PPE stocks and responding appropriately to suspected cases, is crucial to prevent HCW-infections.

Objective: To perform a follow-up survey to assess changes in PPE-preparedness across six Asia-Pacific countries during the COVID-19 pandemic.

Methods: A prospective follow-up cross-sectional, web-based survey was conducted between 10/08/2020 to 01/09/ 2020, five months after the initial Phase 1 survey. Read More

Aust Crit Care 2021 May 4. Epub 2021 May 4.

Intensive Care Clinical Unit, University Hospital Virgen Macarena, Dr. Fedriani St., 3, 41009, Seville, Spain.

Background: Hyperglycaemia is a very common complication in post-cardiac surgical patients, and as such, it must be properly managed. For this purpose, the enhanced Model Predictive Control algorithm for glycaemia control has been implemented into a nurse-led device called Space GlucoseControl (SGC) that aims to achieve a safe and effective blood glucose control in a better way than the traditional "paper-based" protocols.

Purpose: The aim of the study was to know the effectiveness and safety of the SGC in glycaemia control in cardiosurgical adult patients in the immediate postoperative period in the intensive care unit. Read More

Aust Crit Care 2021 Apr 30. Epub 2021 Apr 30.

Evidence in Practice Unit, Mater Misericoridae Limited, Raymond Terrace, South Brisbane, QLD, 4101, Australia.

Background: Being able to visit a critically ill relative provides comfort to family members and has recognised benefits to the patient. Limited research has been conducted on demographic characteristics and visiting behaviours of family members with a relative in the intensive care unit (ICU).

Objectives: The objective was to provide an overview of local ICU visitor behaviours and practices across four metropolitan units in Australia. Read More

Aust Crit Care 2021 Apr 26. Epub 2021 Apr 26.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 3, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore.

Background: Nurses' role in vital signs monitoring places them in an ideal position to recognise and respond to clinical deterioration in general wards. However, enrolled nurses (ENs) and registered nurses (RNs) do not always work collaboratively, and this can lead to delays in recognition and escalation of clinical deterioration in general wards.

Objectives: The aim of the study was to explore the collaboration experiences between ENs and RNs in recognising and responding to clinical deterioration in general ward settings. Read More

Aust Crit Care 2021 Apr 26. Epub 2021 Apr 26.

Department of Acute Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address:

Background: Initial fluid resuscitation is presumed to be important for treating shock in the resuscitation phase. However, little is known how quickly and easily a physician could perform a rapid infusion with a syringe.

Objectives: We hypothesised that using a high-flow three-way stopcock (HTS) makes initial fluid resuscitation faster and easier than using a normal-flow three-way stopcock (NTS). Read More

Aust Crit Care 2021 05 21;34(3):226-234. Epub 2020 Oct 21.

Paediatric Critical Care Research Group, Centre for Children's Health Research, Brisbane, Australia; Paediatric Intensive Care Unit, Queensland Children's Hospital, Brisbane, Australia; Menzies Health Institute Queensland, Griffith University, Australia.

Objectives: The objectives of this study was to explore the accuracy of the Cornell Assessment for Pediatric Delirium (CAP-D), Pediatric Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU), and Preschool Confusion Assessment Method for the Intensive Care Unit (psCAM-ICU) when implemented in routine care as delirium screening tools, and to assess patient characteristics and clinical variables that may affect their validity.

Design: This is a prospective observational study.

Setting: The study was conducted in a 36-bed, mixed paediatric intensive care unit (PICU) at an Australian tertiary hospital. Read More

Aust Crit Care 2021 Apr 23. Epub 2021 Apr 23.

Centre for Medicines Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.

Background: Medical emergency teams use medications to rescue deteriorating patients. Medication management is the system of steps and processes, including prescribing, distribution, administration, and monitoring, to achieve the best outcomes from medication use. Systems or standards for medication management by medical emergency teams have not been defined. Read More

Aust Crit Care 2021 Apr 23. Epub 2021 Apr 23.

Burns Unit, Concord Repatriation General Hospital, NSW, Australia; Faculty of Medicine, University of Sydney, NSW, Australia.

Introduction: Impaired respiratory and swallow function in patients with intensive care unit-acquired deconditioning, such as associated with massive tissue loss, is not uncommon and can require prolonged rehabilitation.

Aim: The aim of the study was to examine the effect of combined inspiratory and expiratory respiratory muscle strength training (RMST) on respiratory and swallow function in two critical care patients with marked deconditioning after massive tissue loss.

Methods: Case 1 was a 19-year-old male patient with 80% body surface area burns; case 2 was a 45-year-old man with group A streptococcus myositis necessitating quadruple amputation. Read More

Aust Crit Care 2021 Mar 22. Epub 2021 Mar 22.

Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Clinical Sciences Building, Rode Road, Chermside 4032, Brisbane, Australia; Northside Medical School, University of Queensland, The Prince Charles Hospital, Rode Road, Chermside 4032, Brisbane, Australia. Electronic address:

Introduction: Delirium, a common complication of an intensive care unit (ICU) admission, is inconsistently diagnosed by clinicians. Current screening tools require specialist expertise and/or training. Some are time-consuming to administer, and reliability in routine clinical practice is questionable. Read More