Australian Critical Care

"There has to be an element of trust first": An exploratory descriptive study of caring for Indigenous Peoples, family, and the wider community in Australian intensive care units
Sundararajan K, Subramaniam A, Phelan C, Plummer M, Thompson C, Hanson-Easey S, Doherty S, Milera T, Cowling N, Mahmood MA and Bloomer MJ
Indigenous Peoples are distinct cultural and social groups in Australia, representing almost 4% of the Australian population. Health inequities and poorer social determinants of health contribute to a greater burden of disease and injury. In critical care contexts, patterns of admission and resultant outcomes are known. What is less well known is how intensive care unit (ICU) clinicians approach the care of Indigenous Peoples.
Differential impact of sex and age on the obesity paradox: A retrospective observational study of a binational registry
Plečko D, Modra L, Pilcher D and Bellomo R
An increased body mass index (BMI) is associated with improved outcomes in intensive care unit patients, known as the "obesity paradox".
Methodological series: Advancing statistical rigour in critical care research-A call for quantified collaboration and precision-based sample rationale
Cheng W
Writing and reasoning among intensive care nurses in coauthored digital diaries with real-time family access: A qualitative study
Schol CMA, Holman S, van Son-Kemmeren W, van Esch A, Berger E, Mol V, Gommers DAMPJ and van Mol MMC
Digital intensive care unit (ICU) diaries are used to support psychological recovery for ICU survivors and families. In the Dutch coauthored digital format, entries are visible to families in real time, creating not only opportunities for connection but also new challenges for nurses deciding what and how to write.
Optimising intermittent pneumatic compression for peripherally inserted central catheter-associated thrombosis prophylaxis: A call for a haemodynamic and stewardship bundle in traumatic brain injury
Zhuang Z, Huang Q, Zhu X, Liao D, Feng Y and Huang S
Half alive but still longing for death: Exploring the experiences of patients waking up in the intensive care unit after a suicide attempt-a qualitative study
Helme AE, Bjørnaas MA, Grimholt TK, Hofsø K, Rustøen T and Hagen J
Patients admitted to intensive care units (ICUs) after suicide attempts are in a vulnerable state and experience emotional distress simultaneously battling the suicidal crisis. Despite a notable rise in ICU admissions for serious suicide attempts, little research has explored the specific experiences of these patients. Existing literature highlights the influence of communication with healthcare personnel, indicating that empathetic and individualised care can foster hope and improve self-worth. This study seeks to fill the knowledge gap concerning the experiences of ICU patients post a suicide attempt.
Exploring Australian intensive care unit nurses' experiences, confidence, and knowledge in supporting breastfeeding women in the early postpartum period: A descriptive cross-sectional study
Zisin Y, Clarke A, Kloester J and Pollock W
The number of pregnant and postpartum women admitted to intensive care units (ICUs) in Australia and New Zealand has doubled over the past decade, creating unique challenges for ICU nurses, particularly in supporting breastfeeding. This study aimed to explore ICU nurses' experience, confidence, and knowledge in supporting breastfeeding women in the early postpartum period.
Treatment withdrawal and distress: Recognising the need for better support in critical care-A scoping review
Chartrand L, Nguyen-Lu T, Soliman L and Harder N
Intensive care units house critically acute patients requiring extensive treatments and specialised care. Highly trained healthcare providers work tirelessly to perform life-sustaining measures, but when all possible treatment options have been exhausted, it sometimes becomes necessary to withdraw treatment. This process places critical care nurses and the interprofessional teams at the centre of emotionally and ethically challenging end-of-life care.
Clinical practice guideline for nonpharmacological prevention and management of patient agitation in the adult intensive care unit (CALM ICU)
Adams AMN, Chamberlain D, Maiden MJ, Thorup CB, Nørgaard MW, Laugesen B, Grønkjær M, Bruce K, Waite C, Lamprecht C and Conroy T
Agitation affects 32-70% of adult patients in the intensive care unit (ICU) and is associated with disruption of life-saving treatment, prolonged hospitalisation, and psychological trauma. While nonpharmacological interventions are increasingly encouraged to reduce the reliance on sedatives, existing guidelines predominantly focus on pharmacological management. This contributes to inconsistent practices and underutilisation of effective person-centred nonpharmacological alternatives.
The interconnectedness of the post-intensive care syndrome domains: A qualitative study
Alrø AB, Svenningsen H, Overgaard R, Nedergaard HK, Jensen HI, Dreyer P and Holm A
Each year, more than 30 million people worldwide are admitted to intensive care units (ICUs) with life-threatening illness or injury. While advances in intensive care have improved survival, many continue to face long-term consequences after discharge. Post-intensive care syndrome (PICS), encompassing physical, cognitive, psychological, and social impairments, profoundly affects everyday life, family dynamics, and the ability to return to previous activity levels. Prevalence estimates vary, but more than half of individuals surviving an ICU admission remain affected 1 year after discharge. Although research has often focused on isolated symptoms, less is known about how these domains interact and shape recovery. Exploring this interconnectedness from the perspectives of individuals with a previous ICU admission and their relatives is essential for guiding person-centred rehabilitation strategies.
Pressure injury surveillance in the intensive care unit: Development, validation, and clinical application of a natural language processing algorithm
Pilowsky JK, Choi JW, Nguyen N, Williams L and Jones SL
Pressure injuries (PIs) are one of the most common hospital-acquired complications in patients admitted to an intensive care unit (ICU). Existing PI surveillance systems are known to have multiple limitations, including poor data quality. Previous studies investigating PI acquisition in critically ill populations have had relatively small sample sizes and have not considered when PIs occur during the ICU admission.
Comment on "The influence of sex on early postoperative opioid administration after cardiac surgery"
Liu S
Barriers to and facilitators for implementing a Care Partner program for adult patients with persistent critical illness
Istanboulian L, Gilding AJ, Hamilton L, Smith KM and Soldatić K
Family engagement is critical to patient and family wellbeing in critical care settings, including specialised units for the care of patients with persistent critical illness. Care Partner programs have been introduced in settings such as long-term care and include formal structures (e.g., policies and procedures) to support engagement and collaborative involvement in care among patients, family caregivers, and formal healthcare providers (HCPs). The complexity and acuity of critical care requires early attention to barriers to and facilitators for implementing a Care Partner program intervention to improve family engagement in these settings.
Psychological safety and mental health among intensive care unit nurses: A multi-institutional cross-sectional study
Sato T, Oyama Y, Aikawa G, Kakuda K, Fukunaga T, Yoshihara S, Fukushima A, Fukamachi Y, Sugishima K, Naya K, Okamoto S, Kaneko K and Sakuramoto H
The objective of this study was to examine the association between psychological safety and mental health outcomes among intensive care unit (ICU) nurses.
Adverse events during continuous renal replacement therapy in critically ill patients: A retrospective cohort study
de Melo Keller H, de Oliveira PC, de Sá Mendes A, Fernandes LC, Oliveira RA, Vattimo MFF and Coelho FUA
The objective of this study was to identify risk factors for adverse events (AEs) occurring during continuous renal replacement therapy (CRRT) in critically ill patients.
The use of large data sets in clinical research: Don't throw the baby out with the bathwater
Marshall AP
Recruitment strategies for family members in intensive care unit studies: A retrospective observational study
Udupa S, Beydoun S, Kifell J, Duong J, Abdallah JP, Ohana M and Goldfarb M
Family engagement in patient care has emerged as an important aspect of critical care delivery. There is a need for clinical trials to obtain robust evidence on family engagement interventions. However, limited evidence exists on effective strategies for recruiting family members of intensive care unit (ICU) patients in clinical trials.
Critical care nurses' lived experience of compassion fatigue in the intensive care unit: A phenomenological study
Guiriba GM, Hills D and Peck B
Compassion fatigue is the state of exhaustion that hinders the ability to engage in caring relationships. Nurses dealing with the complexities of the acute clinical environment and recurrent exposure to patient suffering are susceptible to compassion fatigue. When nurses have compassion fatigue, high-quality care is compromised. However, there is scarce literature examining the experiences of compassion fatigue among critical care nurses in the intensive care unit.
Contemporary structures, processes, and outcomes of critical care nursing education: An integrative review
Saghafi F, Grech C, Causby B, Clarke A, Jauncey-Cooke J, Massey D, Rolls K, Thompson K and Greenwood M
The critical care workforce requires nurses who are specialised, educated, and adaptable to manage complex situations, with the capability to make informed decisions for optimal patient care. The Australian College of Critical Care Nurses supports evidence-based practice through an education position statement, which is periodically updated to reflect evolving needs. In this review, our aim was to inform revisions to the position statement on critical care nurse education by examining the structure, processes, and outcomes of contemporary education programs designed to enhance the capability of registered nurses working in critical care environments internationally.
Reply regarding: "Optimizing non-pharmacological strategies for UEVT prevention: Standard care and IPC in TBI patients with PICCs-Letter on Liang et al."
Liang H and Liu L
Nurses' perspectives of COVID-19 medical emergency team responses: A mixed-method study
Lyons P, Omarit R and Wynne R
The COVID-19 pandemic had a sustained and profound impact on the nature and frequency of medical emergency team (MET) activation. Infection control measures in combination with heightened patient acuity increased the risk of delayed recognition of and intervention for deterioration. Evidence describing nurses' experience of triggering MET activation during the COVID-19 pandemic is scant.