Bakgrund: Suicid är ett globalt folkhälsoproblem. I Sverige vårdades 2021 cirka 11 000 patienter som försökt begå suicid. Intensivvårdssjuksköterskor har en betydelsefull roll i vården och mötet med patienten som utfört ett suicidförsök. Människor som försökt begå suicid har ett lidande och behöver bemötas utifrån en helhet av kropp, själ och ande. Syfte: Att beskriva intensivvårdssjuksköterskors erfarenheter av att på en intensivvårdsavdelning vårda patienter som försökt begå suicid. Metod: Kvalitativ innehållsanalys med induktiv ansats. Tio intensivvårdssjuksköterskor med erfarenhet av att vårda patient efter suicidförsök intervjuades. Resultat: Analysen resulterade i fyra kategorier, Väcker känslor, Vårda både kropp och själ, Att skapa en trygg miljö och Att bemöta anhöriga. De fyra kategorierna är sedan uppdelade i nio subkategorier. Konklusion: Studiens resultat visar att intensivvårdssjuksköterskor erfar att omvårdnaden av patienter som försökt begå suicid är komplex. Olika uppfattningar framkommer angående om det ingår i intensivvårdssjuksköterskans roll att prata med patienten om suicidförsöket. Att intensivvårdssjuksköterskor har olika syn på detta kan eventuellt leda till att patienter inte får jämlik vård. Vidare forskning av ämnet behövs för att skapa riktlinjer och tydliggöra om det är intensivvårdssjuksköterskans uppgift att initiera samtal om suicidförsöket. / Background: Suicide is a global public health problem. In Sweden, approximately 11,000 patients who attempted suicide were treated in 2021. Intensive care nurses have an important role in the care and meeting with the patient who has attempted suicide. People who have attempted to commit suicide are suffering and the whole person needs to be treated, body, soul and spirit. Aim: To describe intensive care nurses' experiences of caring for patients who have attempted suicide in an intensive care unit. Method: A qualitative content analyses with an inductive approach. Ten intensive care nurses with experience from caring for patients after suicide attempt, where interviewed. Result: The analysis resulted in four categories, Evokes emotions, Caring for both body and soul, Creating a safe environment and Dealing with relatives. Conclusion: Intensive care nurses experience that the care of patients who have attempted suicide is complex. Different opinions emerge regarding whether it is part of the intensive care nurse's role to talk to the patient about the suicide attempt. Different views on this could potentially lead to patients not receiving equal care. Further research on the subject is needed to create guidelines and clarify whether it is the intensive care nurse's task to initiate conversations about the suicide attempt.

Preterm birth disrupts the development of the brain and other critical organs of the infant body. Since the brain is one of the last organs to finish developing during pregnancy, the risk for substantial neurological deficits increases as the gestational age decreases. One way to combat these deficits is to reconnect the preterm infant with the mother via skin-to-skin contact, also known as kangaroo care (KC). This intimate touch helps to replicate aspects of the environment that the preterm infant experienced in utero. The purpose of this literature review was to analyze the current literature to better understand the effects that KC may have on facilitating neurodevelopment of preterm infants in Neonatal Intensive Care Units (NICUs). Emphasis was placed on neurophysiologic functioning, autonomic functioning, and neurobehavioral functioning. A database search of CINAHL Plus with Full Text, PsycINFO, MEDLINE, Cochrane Central Register of Controlled Trials, and Health Source: Nursing/Academic Edition was conducted, and a total of six articles were reviewed based on their relevance and application towards this thesis. KC is a low-cost, relatively easy intervention to initiate that can have positive impacts on many aspects of preterm infant growth and maturation. There is limited research regarding the use of KC as an intervention to support neurodevelopment, especially with regards to long-term effects. Existing research supports the use of KC as an intervention to facilitate neurodevelopment in preterm infants in the NICU.

The purpose of this study was to conduct an integrated review of the literature examining the use of non-pharmacologic pain management strategies in premature neonates and to explore the relationship between health outcomes and time to discharge from the neonatal intensive care unit (NICU). Non-pharmacologic pain management strategies include human touch, facilitated tucking, non-nutritive sucking, and kangaroo care. A systematic review of the literature was conducted from multiple online databases. Peer reviewed, English-language articles containing the keywords ‘pain management’, ‘neonatal intensive care unit’, and ‘non-pharmacologic’ were included for synthesis. Exclusion criteria included articles with a focus on infants not admitted to the NICU and infants with a gestational age greater than 37 weeks. Results revealed positive outcomes when alternative pain-relieving methods, rather than drug therapy, were used in the NICU. A majority of articles suggest facilitated tucking is very successful in lowering a preterm infant’s pain. However, facilitated tucking alone was significantly less effective in relieving procedural pain compared to facilitated tucking in combination with oral sucrose administration. Kangaroo care and gentle human touch also proved to reduce physiologic and behavioral signs of pain in neonates. The literature reveled an overall positive outcome when non-pharmacologic pain interventions are used in the NICU, with some behavioral interventions showing better efficacy than others at relieving neonatal pain. None of the reviewed articles explored the relationship between reduced length of stay and parameters assessing health outcomes based on pain control in neonates. The literature indicated nurses play a significant role in the use of pain-relieving methods in neonatal populations. Implications for future research that focuses on successful behavioral based pain management strategies that assists in refining neonatal pain relief would be of great benefit to improving health outcomes related to infant survival after discharge from the NICU.

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Admission of an infant into the neonatal intensive care unit (NICU) is an experience that has been associated with a variety of both positive and negative health outcomes for parent and child. While both the setting name and the admitted population alludes to a sole focus on the affected infant, what often remains underrecognized is the impact on the ones who care for the newborn long before and longer after their NICU stay. Given the recency and unprecedented impact of the COVID-19 pandemic, very little research has examined the impact of COVID-19-specific stress on the experience of parents of infants requiring a NICU stay in the midst of the ongoing pandemic. As such, the current study aimed to gather electronic survey data from caregivers (both biological and non-biological) of infants across the United States admitted to a NICU on or after March 1, 2020. Major factors addressed in the survey included anticipation of the NICU, COVID-19-specific stress, NICU-specific stress, global health outcomes (physical, mental, and social health), parental bonding, and parental self-efficacy. It was hypothesized that (1) COVID-specific stress and would be associated with suboptimal NICU experiences; (2) COVID-specific stress would be associated with worse parental health (physical, mental, and social) and parent-child relational health (bonding, self-efficacy) outcomes; (3) NICU stress and parental health would serve as mechanisms through which COVID-specific stress impacts parental-relational outcomes; (4) These associations would vary depending on whether or not a caregiver was anticipating that their infant would need to go to the NICU. Hypotheses were partially supported such that COVID stress was associated with increased NICU stress and poorer caregiver physical and social health. Unique patterns were found depending on facets of caregiver health. Clinical implications and future directions are discussed.

Palliative care is of value to the quality of life in people with terminal conditions when initiated early. The purpose of this literature review was to identify barriers to early initiation of palliative care consultation. The secondary purpose was to examine characteristics that prompt palliative care consultation. The TLC model of palliative care was used to explore palliative care in the critical care setting in people with terminal conditions. The concepts of the model support optimal palliative care as collaborative and comprehensive, with shared decisions made by the patient, practitioners, and loved ones. A literature review was conducted to identify common barriers to early initiation of palliative care consults in the critical care setting for people with terminal conditions. Peer-reviewed articles were retrieved from the EBSCOhost, Medical Literature On-Line (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Elsevier databases to evaluate their relevance to palliative care in the critical care setting. Twelve preliminary studies were selected for review per the inclusion criteria. Eleven studies identified education and legal factors as barriers. Six studies identified patient and family perceptions as barriers. Five studies identified practitioner-related bias as a significant barrier to consultation. Of the twelve articles reviewed, ten articles referred to palliative care in the adult ICU setting. Two articles included in the review examined barriers to palliative care in the neonatal and pediatric settings. The analysis of the data identified three categories as barriers to initiation of end-of-life care: practitioner-related bias, patient and family perceptions, and education and legal factors after a synthesis of the relevant literature was performed. Analysis of the articles suggests early identification of potential diagnoses for palliative consultation beginning in the intensive care unit (ICU) can improve symptom management, support, patient- centered care, and quality of life for people with terminal conditions. Barriers related to all three categories dominated the literature, with the most prominent being barriers related to education and legal factors. Results indicate that development and implementation of a palliative care referral tool can increase consultation for patients in the critical care setting with terminal conditions. Further education on the topic can increase understanding of palliative care services and improve provision of palliative care through early referrals and consultation.

Yes / It is estimated that 5-10% of hospitalised patients in developed countries contract hospital acquired infections (HAI). Increasing levels of antimicrobial resistance manifested by many HAI-causing pathogens such as Acinetobacter spp in the intensive care unit (ICU) setting present a significant challenge to those managing these infections. Consequently, much attention has been focused on the prevention of HAIs. Particular emphasis has been placed on interventions intended to interrupt patient-to-patient transmission of pathogens, such as enhanced hand hygiene and identification of patients colonised with methicillin-resistant Staphylococcus aureus (MRSA) using rapid DNA-based screening techniques. However, comparatively little attention has been given to the hospital environment, including water supplies, as a source of nosocomial pathogens of importance for patients on the critical care unit. This article reviews the role of hospital water sources in the epidemiology of HAI and new technologies which can be employed in the prevention and control of such infections.

Thema: Ziel der Studie war die Evaluierung der mobilen CT im intensivmedizinischen Einsatz Methodik: Es wurde eine Prozessanalyse der mobilen CT in einem Interventionsraum auf der Intensivstation sowie der ortsfesten CT in der radiologischen Abteilung vorgenommen. Der klinische Teil richtete sich auf die Evaluierung des intensivmedizinischen Personals bezüglich der Bewertung der mobilen CT. Weiterhin wurden die mit der mobilen CT untersuchten Patienten hinsichtlich ihrer Transportfähigkeit anhand intensivmedizinischer Bewertungssysteme bewertet. Ergebnisse: Die CT-Untersuchungen mit der mobilen CT im Interventionsraum haben einen leichten zeitlichen Vorteil gegenüber denen in der radiologischen Abteilung (55 vs 65 Minuten). Die mobile CT wurde von der Mehrheit des intensivmedizinischen Personals positiv bewertet, z.B. empfanden sie 81 % der Ärzte sowie mehr als 50 % der Pflegekräfte als Arbeitserleichterung. Bei vier der 24 untersuchten Patienten hätte es keine Alternative zur mobilen CT gegeben. Schlussfolgerung: Die mobile CT hat sich im klinischen Einsatz bewährt. Sie gewährleistet eine kontinuierliche intensivmedizinische Umgebung bei der CT-Untersuchung. Darüber hinaus ermöglicht sie bei nicht transportfähigen Patienten eine adäquate radiologische Diagnostik. / Purpose: To evaluate portable CT in ICU settings. Methods: Assessment of workflow of portable and stationary CT. Evaluation of ICU staff by questionnaire. Risk of transportation Assessment of examined patients by ICU-scores). Results: Examination by portable CT is little less time consuming compared to CT-examination in the radiology department (55 vs. 65 minutes). There was a great acceptance of portable CT by ICU staff. 81 % of ICU physicians and more than 50 % of nurses assessed portable CT as a reduction of work load. Portable CT could not have been missed in four of 24 examined patients for examination by computed tomography. Conclusions: Portable CT enables ICU-care to be continued during CT-examination. By Bedside CT patients can be examined who otherwise would have to abandon advanced radiologic diagnostic.

Advances in science and technology have made nursing practice in acute care settings complex, rapid and demanding. Hospital visiting hours and rules are established for the comfort and safety of patients and their loved ones. In addition, there is the need to focus on the needs of 'the customer'. The researcher adopted a descriptive, exploratory approach to determine the perceptions and preferences of patients, family members/friends and nurses of visiting time in ICUs. The aim was to recommend mechanisms and measures with regard to the desired visiting schedule that would enhance patient-centred integrated care in ICUs. The study found that patients and family members/friends preferred extended visiting time and perceived this as beneficial to them, while the majority of the nurses preferred scheduled visiting time. / Health Studies / M. A. (Health Studies)