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Background: In intensive care, mechanical ventilation is a common treatment for critically ill patients. Patients are often treated with both sedative and pain-relieving drugs, which together with invasive mechanical ventilation puts the patient in a particularly vulnerable situation as the ability to verbally communicate is limited. This makes it difficult for both the intensive care nurse and relatives to know what the patient remembers and how they have experienced their time with mechanical ventilation. Aim: To review and synthesize qualitative studies that have explored adult patients' memories of their time with invasive mechanical ventilation in an intensive care unit. Method: A structured literature review with qualitative design. Structured searches were conducted in the databases PubMed, CINAHL and Psychinfo, which resulted in 18 articles of qualitative design and mixed method and published between the years 2009-2024. Included articles are quality reviewed according to Caldwell's review template and the results of the articles are analyzed using an inductive thematic analysis. Results: The results present two main themes with associated subthemes. The main theme In the shadow of suffering had associated subthemes Pain and discomfort and An unreal existence. The main theme Abandoned in a strange environment had associated subthemes Voiceless in a world of sound and Seeing yourself fragile through the eyes of others. Conclusion: Patients' memories of the time in the intensive care unit with invasive mechanical ventilation vary, but overall the period is described as heavy and psychologically stressful. Communication and information from relatives and healthcare professionals is crucial for patients' well-being, and intensivecare nurses have an important role in supporting and including relatives in care. A professional approach to nursing care, regardless of whether the patient is sedated or awake, is essential for as pleasant an experience as possible.

Background: Delirium is a common condition in intensive care patients with symptoms such as confusion,hallucination, and insomnia. About 80% of patients admitted to the intensive care unit suffer fromdelirium, with an increased risk of mental and physical ill-health as a result. Identifying delirium in goodtime is a good prerequisite for both the care provider and the care recipient to reduce suffering incare. Purpose: The purpose of the literature study is to shed light on intensive care nurses' experience ofcaring for adult patients with delirium.Method: Literature study with a qualitative structured approach based on scientific articles. Results: Emerged from five subcategories and two categories describing the following: experience ofinadequacy and the time for recovery. Conclusion: Caring for delirious patients is time-consuming and stressful for intensive care nurses.Opportunities and conditions to be able to provide optimal care require an extent of less work-relatedstress and various trainings that identify delirium.

Nursing Muslim patients in the Kingdom of Saudi Arabia (KSA) poses challenges for expatriate non-Muslim nurses. Caring for Muslim patients in a cardiac intensive care unit, catering for patients who underwent open heart surgery, poses unique challenges to non-Muslim nurses. Semi-structured interviews were conducted with 63 non-Muslim nurses who cared for Muslim patients who had undergone cardiac surgery. Factors that influenced non Muslim nurses’ experiences of working with Muslim patients in the KSA, included culture shock, language barriers and a lack of understanding of Islam as a religion. In-service education sessions, addressing these issues, could enhance non-Muslim nurses' abilities to render culture competent care to Muslim patients in a cardiac intensive care unit in the KSA. Arabic-English translators could facilitate communication between the expatriate nurses and the Muslim patients. / Health Studies / M.A. (Health Studies)

The purpose of this study was to explore and describe the knowledge that a cohort of 40 intensive care unit nurses had of evidence-based practice. It was assumed that they lacked the knowledge to locate, evaluate understand and apply research findings. Quantitative, non-experimental descriptive research was conducted to explore their knowledge and to formulate recommendations for promoting it. Data collection involved administering a structured questionnaire administered to the cohort in an intensive care unit. The findings revealed that, although they were familiar with the basic concept of evidence-based practice, they were reluctant and lacked the skills to adopt it in their practice. It is recommended that they be trained and empowered to develop research expertise from within their own ranks. Finally it is recommended that nursing management should play a more proactive role in identifying cost-effective strategies in overcoming barriers to finding, promoting and integrating evidence-based practice / Health Studies / M.A. (Health Studies)

Bakgrund: Ångest är vanligt förekommande inom intensivvården. Det finns flera orsaker till att intensivvårdade patienter uppleva ångest. Ventilator, sedering, potenta läkemedel, miljö, rädsla, smärta och sömnbrist är ångest utlösande faktorer för patienten. Dessa upplevelser kan förlänga och komplicera patientens återhämtning process. Hur sjuksköterskor känner igen patientens symptom av ångest inom intensivvården är av intresse då rätt behandling kan minska ångest och därigenom minska patientens lidande. Syfte: att belysa intensivvårdssjuksköterskor erfarenheter av hur ångest symptom visar sig hos patienter inom intensivvården. Metod: Studien genomfördes med en kvalitativ design och datainsamlingen skedde genom sju intervjuer med semistrukturerade frågor. Intervjutexten analyserades via induktiv innehållsanalys. Resultat: Sjuksköterskor erfarenheter av hur ångest visar sig hos patienter inom intensivvården beskrevs av två kategorier: Kommunikations ångest och Existentiell ångest och sex subkategorier Slutsats: Ångest visar sig genom fysiologiska parametrar, desorientering, kroppsligt uttryck, onormal kontroll, patienten avskärmar sig och söker inre lugn och patienten anpassar sig genom att hitta meningen i sitt lidande. Det är viktigt att intensivvårdspersonal har erfarenheter om hur ångest visar sig. Intensivvårdssjuksköterskans erfarenheter om ångest hos patienterna ökar möjligheter att upptäcka den i en tidig fas och möjligtvis hjälper patienten att släppa alla komplikationer som följer efter. / Background: Anxiety is common among patients in intensive care. There are several reasons why intensive care patients experience anxiety. Use of ventilator, sedation, potent drugs, environment, fear, pain and lack of sleep are anxiety triggers for the patient. These experiences can prolong and complicate the patient's recovering process. How do intensive care nurses recognize the patient's symptoms of anxiety in intensive care are of interest as proper treatment can reduce anxiety and thereby reduce the patient’s suffering. Purpose: to highlight intensive care nurses' experiences about signs of anxiety among patients in intensive care. Method: The study was conducted with a qualitative design and data was collected through seven interviews with semi-structured questions. The data was analysed with inductive content analysis. Result: Nurses’ experience about symptoms of anxiety among patients in intensive care was described in two categories: Communications anxiety and existential anxiety and sex sub-categories. Conclusion: Anxiety is manifested by physiological parameters, disorientation, bodily expression, abnormal control, patient isolated himself and looking for inner calm and patient conform by finding meaning in their suffering. It is important to intensive care staff to have experience about symptoms of anxiety. Experience increases the possibilities to detect anxiety at an early phase and possibly reduce the patient’s complications.

Bakgrund: Under de senaste åren har det blivit allt mer uppmärksammat i media om patienters rättigheter i vården och att patientsäkerheten hotas på grund av bristen på sjuksköterskor. Det framhävs att det är särskilt stor brist på specialistutbildade sjuksköterskor och att arbetsbelastningen på intensivvårdsavdelningarna ökar, vilket kan leda till allvarliga konsekvenser för bedrivandet av intensivvård och för att upprätthålla en god patientsäkerhet.   Syfte: Syftet med studien var att undersöka statistiskt samband mellan intensivvårdssjuksköterskans arbetsbelastning och patientsäkerhet.   Metod: Studien genomfördes med en kvantitativ metod med deduktiv ansats och en tvärsnittsstudie gjordes med hjälp av webbenkäter. Alla allmänna intensivvårdsavdelningar i Sverige inkluderades och intensivvårdssjuksköterskorna var tvungna att ha arbetat minst två år. Sammanlagt distribuerades 372 enkäter och 258 svar erhölls vilket gav en svarsprocent på 69.4 procent. Dataanalys utfördes med deskriptiv statistik och korstabulering. Med hjälp av en bivariat analys kunde vi jämföra om det fanns statistiskt samband mellan patientsäkerhet och arbetsbelastning.   Resultat: Resultatet visar att det finns statistiskt samband mellan patientsäkerhet och arbetsbelastning. Patientsäkerheten påverkas negativt av en högre arbetsbelastning. Intensivvårdssjuksköterskorna uppger att de tvingas utföra ett sämre jobb relaterat till tidspressen och att arbetsbelastning är för hög. Resultatet visar att intensivvårdssjuksköterskorna anser att det finns välfungerande system för rutiner och avvikelser men på grund av en hög arbetsbelastning kan inte systemen och rutinerna följas vilket påverkar patientsäkerheten negativt.   Slutsats:Den här studien ger belägg att lyfta intensivvårdssjuksköterskornasarbetsbelastning i förhållande till patientsäkerhet och underlag för att vidta åtgärder inom berörda verksamheter. Åtgärder i form av en attraktivare, hälsosammare och patientsäkrare arbetsplats. Exempelvis arbetstidsförkortning som ger möjlighet till återhämtning mellan arbetspassen.Det är nödvändigt att se över arbetsbelastningen på intensivvårdsavdelningar nationellt för att inte mer omfattande patientsäkerhetsbrister ska ske. / Background: In recent years there has been increasing attention in the media about the right of patients in health care and that the safety of a patient is threatened because of the shortage of nurses. In particular, the current lack of specialized nurses and the increased workload in the intensive care units could lead to serious consequences regarding the provision of intensive care and maintaining high patient safety.   Objective: The objective of this study was to investigate the statistical connection between the workload of an intensive care nurse and the patient safety.   Method: The study was performed by a quantitative method with a deductive approach and a cross-sectional study was done using surveys on the web. All general intensive care units in Sweden were included and the intensive care nurses needed to have worked for at least two years. A total of 372 surveys were distributed and 258 responses were received giving a response rate of 69.4 percent. Data analysis was performed by descriptive statistics and cross tabulation. Using a two-dimensional analysis, the authors could compare whether there was a link between the patient safety and the workload.   Result: The result indicates that there is a statistical connection between patient safety and workload. Patient safety is negatively affected by a higher workload. The intensive care nurses state that they are forced to do a worse job related to time pressure and because of that the workload is too high. The result shows that today it is felt that there is a well functioning system of procedures and divergences but because of a high workload, the system and the procedures cannot be followed which affect patient safety negatively.   Conclusion: This study demonstrates proof to highlight critical care nurses' workload in relation to patient safety and evidence to take action within the relevant business. Arrangements such as an attractive, healthier and safer workplace for the patient. For an example, shorter working hours that allows recovery between shifts. It is a necessity to revise the workload in the intensive care units nationwide for not more extensive patient safety defects to occur.

M.Cur. / Nursing practitioners working in the critical care unit are responsible for quality nursing care of the patient on pressure-controlled ventilation. Pressure-controlled ventilation is a high-risk interaction, with potential life-threatening complications, for example barotrauma.There are, however, in the South-African context no standards for pressure-controlled ventilation with which quality nursing of the patient on pressure-controlled ventilation can be evaluated. The following question is then asked in this study: Which standards should be formulated for the adult patient on pressure-controlled ventilation incritical care units? The goal of this study is then to formulate standards for the adult patient on pressure-controlled ventilation in critical care units. An explorative, descriptive and modified standard-generating research design is followed in this study. The research methodology as suggested by Muller (1998a:606-609; 1998b:636-637) for standard development during the quality improvement process is used in this study. Standard formulation consists out of three phases, namely a development phase, a quantifying-/ validation phase and a testing phase. During the development phase of this study, a literature study is conducted after which concept standards for the adult patient on pressure-controlled ventilation in critical care units are formulated. During the validation phase of this study, the concept standards are validated by means of a consensus debate session with clinical domain experts. Seventeen standards in total were formulated. Standard one to fifteen are structure standards. These standards address the ethico-legal, philosophical and management framework according to which the nurse practitioner functions during the nursing of the adult patient on pressure controlled ventilation in critical care units. It also includes the fascilitating context, as well as facilities, equipment, stock and medication, procedures and protocols and aspect of personnel development necessary to nurse the patient on pressure-controlled ventilation. Lastly in this group of standards the knowledge and skills which the critical care nurse requires for nursing the patient on pressurecontrolled ventilation are described. Standard sixteen is the process standard for nursing the patient on pressure-controlled ventilation.This standard is described as one comprehensive standard to facilitate easy use in practice and to address the nursing process holistically. Standard seventeen can be described as the outcome standard for the nursing of the adult patient on pressure-controlled ventilation and describes the expected aspects of quality improvement.