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Nursing Care in the ICU—2nd Edition
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Nursing Care in the ICU—2nd Edition

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Clinical Care".

Deadline for manuscript submissions: 10 April 2027 | Viewed by 16259

Editor

Dr. Christina Alexopoulou

E-Mail Website
Guest Editor
1. Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
2. University General Hospital, 68100 Alexandroupolis, Greece
Interests: critical care; intensive care; sleep medicine; nursing/sleep in ICU
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The ICU environment is challenging for both patients and staff. The management of critically ill patients is extremely demanding, and the workload and knowledge level required of staff are high. ICU nurses are responsible for the care and treatment of patients in an unstable and/or critical clinical situation, assessing therapies and high-intensity interventions. ICU nursing practice includes crucial clinical decisions based on the best available scientific evidence, clinical experience, and patient preferences. ICU nurses carry out specific, autonomous, or complementary interventions of a technical–scientific, managerial, relational, and educational nature; plan healthcare assistance through scientifically validated tools; and identify, analyze, calculate, and treat risks related to care provision by systematically evaluating healthcare outcomes.

This Special Issue of Healthcare is dedicated to offering an overview of these activities. Topics that will be included are:

  • Nursing care protocols (sedation, pain, nutrition, etc.);
  • Delirium;
  • Sleep;
  • Infections;
  • Pressure ulcers;
  • Mobilization;
  • Recording;
  • Relatives;
  • Oncology ICU patients;
  • Elderly patients.

Experts from all specialties are encouraged to submit original research, project reports, short reports, reviews, and opinion papers.

Dr. Christina Alexopoulou
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ICU nursing
  • critical care
  • intensive care
  • delirium
  • sleep
  • infections
  • pressure ulcers mobilization
  • recording
  • relatives
  • oncology ICU patient
  • elderly patient

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Further information on MDPI's Special Issue policies can be found here.

Related Special Issue

Published Papers (6 papers)

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13 pages, 220 KB  
Article
The Psychosocial Dimension of Electrical Burns Related to Work Accidents—A Phenomenological Study on the Experiences of Patients Fighting for Their Lives in Intensive Care in Turkey
by Serpil Çelik Durmuş and Sevda Uzun
Healthcare 2026, 14(4), 542; https://doi.org/10.3390/healthcare14040542 - 22 Feb 2026
Cited by 1 | Viewed by 610
Abstract
Background: Electrical injuries occur when an electric current comes into contact with or passes through the body. Electrical injuries can result from contact with faulty electrical appliances and machinery or from contact with open household wiring or electrical power lines. Aim: The aim [...] Read more.
Background: Electrical injuries occur when an electric current comes into contact with or passes through the body. Electrical injuries can result from contact with faulty electrical appliances and machinery or from contact with open household wiring or electrical power lines. Aim: The aim of this study was to evaluate the psychosocial difficulties experienced by individuals who suffered electrical burns due to work accidents, using a phenomenological approach. Study Design: This phenomenological study was conducted with semi-structured in-depth interviews with 15 electrical burn survivors living in different regions of Turkey via the WhatsApp mobile application. The snowball sampling method was used to reach the sample group. Interviews continued until data saturation was achieved. All interviews were audio recorded and then transcribed. The data were analyzed using Colaizzi’s phenomenological analysis method. The study was conducted and reported according to the COREQ checklist. Results: In the analysis of the data, two categories and five themes were identified: the effects of electrical burn at the time of occurrence and during the hospital process (psychological, social and physical), and adaptation to life after electrical burn treatment (emotions experienced, difficulties experienced and coping). Conclusions: This study revealed the life experiences, psychosocial difficulties and coping experiences of individuals with electrical burns. According to the results of the research, it is understood that individuals experienced negative emotions such as depression, helplessness and hopelessness as a result of electrical burns, could not cope with the psychosocial difficulties experienced and received psychological support. It was determined that social appearance anxiety due to deterioration in body image was very important in individuals. Full article
(This article belongs to the Special Issue Nursing Care in the ICU—2nd Edition)
12 pages, 249 KB  
Article
An Effect of Smelled Breast Milk During and After Venous Blood Drawing on Newborn Infants’ Pain and Comfort Level
by Feyza Kübra Albayram, Selver Guler and Melike Yavas Celik
Healthcare 2025, 13(16), 2005; https://doi.org/10.3390/healthcare13162005 - 14 Aug 2025
Viewed by 1289
Abstract
Background/Objectives: This study was conducted as a randomized controlled trial to evaluate the effect of breast milk odor on pain and stress levels during venous blood sampling. Method: Data were collected from 60 newborn infants consisting of a total of 30 infants in [...] Read more.
Background/Objectives: This study was conducted as a randomized controlled trial to evaluate the effect of breast milk odor on pain and stress levels during venous blood sampling. Method: Data were collected from 60 newborn infants consisting of a total of 30 infants in the experimental group and 30 in the control group who were hospitalized in the Intensive Care Unit between 7 December 2022 and 25 September 2023. The data were collected using the Newborn Infant Pain Scale and Premature Infant Comfort Scale forms. Results: It was observed that there was a statistically significant difference between the groups in terms of the Newborn Infant Pain Scale and Premature Infant Comfort Scale when comparing the measurements taken during the procedure and 5 min after the procedure. A strong correlation was found between the Newborn Infant Pain Scale and Premature Infant Comfort Scale scores measured 5 min after the venous blood collection procedure (r = 0.86, p = 0.01). Conclusions: Based on the results of this study, it was determined that smelling breast milk, which is one of the non-pharmacological methods that can be used in invasive or non-invasive painful procedures on newborn infants, positively affects the pain and comfort level of babies. Full article
(This article belongs to the Special Issue Nursing Care in the ICU—2nd Edition)
11 pages, 1159 KB  
Article
Pressure Ulcers and Nursing-Led Mobilization Protocols in ICU Patients: A Retrospective Observational Cohort Study
by Anna Korompeli, Eleni Karakike, Petros Galanis and Pavlos Myrianthefs
Healthcare 2025, 13(14), 1675; https://doi.org/10.3390/healthcare13141675 - 11 Jul 2025
Cited by 4 | Viewed by 6990
Abstract
Background: Pressure ulcers (PUs) remain a prevalent complication in intensive care unit (ICU) settings, especially among immobilized patients. The impact of structured, nursing-led mobilization protocols on PU prevention and recovery remains underexplored. Objective: To evaluate the impact of nursing-led mobilization protocols on the [...] Read more.
Background: Pressure ulcers (PUs) remain a prevalent complication in intensive care unit (ICU) settings, especially among immobilized patients. The impact of structured, nursing-led mobilization protocols on PU prevention and recovery remains underexplored. Objective: To evaluate the impact of nursing-led mobilization protocols on the incidence and progression of PUs in critically ill patients. Methods: In this retrospective observational cohort study, 188 ICU patients were admitted during one of two consecutive periods of care: conventional care (6-hourly repositioning) and an advanced nursing-led protocol (3-hourly repositioning with support surfaces and specialized nurse training), which replaced conventional care as standard in our institution. The primary outcome included new PU development for patients with no pre-existing ulcers or worsening/non-progression of pre-existing ulcers at discharge; ICU mortality was evaluated as a secondary outcome. Results: Among patients without pre-existing ulcers (n = 155), new PU incidence did not significantly differ between groups, even after adjusting for SOFA score (OR 0.40, 95% CI: 0.05 TO 3.17; p = 0.374). However, in patients with pre-existing ulcers (n = 33), the advanced care group showed improvement (53.3% versus 0% in the conventional group, OR 0.07, 95% CI: 0.01–0.64; p = 0.012); this effect was independent of initial SOFA score. Mortality was associated with the SOFA score, but not with the type of care. Conclusions: While advanced nursing-led mobilization did not reduce PU incidence, it significantly improved existing ulcer outcomes. Findings support the integration of structured protocols for high-risk ICU patients, especially those with existing ulcers. Full article
(This article belongs to the Special Issue Nursing Care in the ICU—2nd Edition)
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12 pages, 809 KB  
Article
Factors Influencing Pressure Injury Development and Survival Duration in Adults Admitted to the ICU: A Retrospective Cohort Study Following the STROBE Guidelines
by Warantorn Potarin, Santisith Khiewkhern, Thidarat Somdee, Chitkamon Srichompoo, Kemika Sombateyotha, Jirarat Ruetrakul, Le Ke Nghiep and Kukiat Tudpor
Healthcare 2025, 13(12), 1411; https://doi.org/10.3390/healthcare13121411 - 12 Jun 2025
Cited by 2 | Viewed by 4886
Abstract
Background: Individuals receiving intensive care are particularly vulnerable to developing pressure sores. This heightened risk necessitates a thorough understanding of relevant risk factors and the time at which these injuries manifest, facilitating effective prevention. Objective: This investigation, structured as a retrospective cohort study, [...] Read more.
Background: Individuals receiving intensive care are particularly vulnerable to developing pressure sores. This heightened risk necessitates a thorough understanding of relevant risk factors and the time at which these injuries manifest, facilitating effective prevention. Objective: This investigation, structured as a retrospective cohort study, aimed to assess the duration until pressure sore onset and identify contributing risk factors among 50 adult patients in an intensive care unit (ICU), observed over 12 weeks. Methodology: Our analysis employed the Kaplan–Meier approach for survival analysis. We then used the log-rank test to determine significant differences in survival curves. We utilized COX proportional regression analysis to explore the associations between various factors and the development of pressure injuries during the ICU stay. Results: Data from 50 adult ICU patients showed that 29 patients developed pressure sores. Coccyx (44%) and back (6%) were most affected. The median survival time from ICU admission to the final skin examination for pressure sore development was 3 days. The multivariable Cox regression analysis revealed that males with a high BMI, increased systolic blood pressure, elevated albumin levels, and a more extended ICU stay were at a significantly higher risk of developing pressure ulcers (p-value < 0.05). Conclusions: The research highlights the need to prioritize males with high BMI, high blood pressure, and high albumin patients in preventing pressure sores in the ICU, with an extended ICU stay significantly increasing the risk. This information can be utilized to develop clinical guidelines for reducing pressure sore incidence and improving patient care. Full article
(This article belongs to the Special Issue Nursing Care in the ICU—2nd Edition)
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12 pages, 482 KB  
Protocol
Preoperative Risk Assessment and Shared Decision-Making in Older Patients Eligible for Cardiac Surgery: Protocol for a Non-Randomized Prospective Study
by Milou S. H. van Dieën, Fredrike Blokzijl, Michiel Kuijpers, Wolter Paans, Maria Agustina Bayon, Suzanne Festen, Willem Dieperink, Wobbe Bouma, Michiel Rienstra and Massimo A. Mariani
Healthcare 2026, 14(13), 1900; https://doi.org/10.3390/healthcare14131900 - 30 Jun 2026
Viewed by 235
Abstract
Background: The number of older patients undergoing cardiac surgery is increasing, and a substantial proportion of these patients are frail. Frailty is associated with increased mortality, psychological complications, functional decline, and reduced health-related quality of life, complicating treatment decision-making. Currently, treatment recommendations [...] Read more.
Background: The number of older patients undergoing cardiac surgery is increasing, and a substantial proportion of these patients are frail. Frailty is associated with increased mortality, psychological complications, functional decline, and reduced health-related quality of life, complicating treatment decision-making. Currently, treatment recommendations are formulated by the multidisciplinary Heart Team and are mainly based on disease-related parameters. To better integrate patient preferences, geriatric assessment, and shared decision-making into routine cardiothoracic practice, a nurse-led preoperative outpatient pathway was developed: the Preoperative RIsk assessment and shared decision-Making in patients Eligible for cardiac surgery (PRIME) clinic. This study aims to evaluate whether the implementation of PRIME consultation influences Heart Team treatment recommendations and to assess its cost-effectiveness. Methods: This single-center, non-randomized prospective study is conducted in the Netherlands. Patients aged ≥70 years who are eligible for cardiac surgery and have two or more risk factors for adverse postoperative outcomes are included. All patients are initially discussed in the Heart Team, resulting in a treatment recommendation. Patients in the intervention group subsequently visit the PRIME clinic, where a comprehensive geriatric assessment and a shared decision-making consultation are performed. Following this visit, patients are re-evaluated by the Heart Team. The primary outcome is the comparison between the initial and subsequent Heart Team treatment recommendations. Secondary outcomes include health-related quality of life and cost-effectiveness. Discussion: This prospective exploratory study evaluates the implementation of a novel, patient-centered preoperative care model integrating geriatric assessment and shared decision-making into routine cardiac surgical practice. By focusing on outcomes meaningful to older patients and their relatives, the study contributes to the development of value-based, individualized surgical care. Trial registration: The PRIME study was registered in ClinicalTrials.gov (trial registration number: NCT06616129). Full article
(This article belongs to the Special Issue Nursing Care in the ICU—2nd Edition)
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20 pages, 1682 KB  
Case Report
Maternal Corporeal Support in Terminal Stage Brain Astrocytoma: A Case Report and Literature Review
by Eleni N. Sertaridou, Emmanouela Tsouvala, Vasilios E. Papaioannou and Christina Alexopoulou
Healthcare 2026, 14(8), 1055; https://doi.org/10.3390/healthcare14081055 - 15 Apr 2026
Viewed by 774
Abstract
Background: The care and management of a pregnant woman suffering from end-stage brain cancer is surrounded by medical, legal, and ethical controversies. When this brain pathology leads to brain death (BD), continuation of life-sustaining treatments has been considered futile and unethical. An [...] Read more.
Background: The care and management of a pregnant woman suffering from end-stage brain cancer is surrounded by medical, legal, and ethical controversies. When this brain pathology leads to brain death (BD), continuation of life-sustaining treatments has been considered futile and unethical. An exception could be the case of pregnancy, in order to deliver a healthy neonate. Aim: The presentation of a pregnant woman with a terminal stage brain astrocytoma, admitted in the intensive care unit (ICU) to support the pregnancy, until optimal fetal viability, after she had neurological deterioration and confirmed BD, and a brief literature review of previously relevant published cases. Case Presentation: A 36-year-old woman with a medical history of brain astrocytoma in the last 2 years was admitted in ICU for the first time due to status epilepticus, six months after she stopped anticonvulsant therapy. Her epilepsy was controlled, and a pregnancy of 14 weeks was confirmed. Two weeks later, she deteriorated. After a multidisciplinary approach, it was decided to mechanically ventilate the patient and support the pregnancy. Brain death was determined after a couple of days. Results: A cesarean section was performed 11 weeks after BD diagnosis (at 27 weeks of gestational age) resulting in the delivery of a live, premature infant, weighing 549 gr. Conclusions: Maternal corporeal support can maximize the chances for survival in the neonate by prolonging the pregnancy of a brain-dead woman. Full article
(This article belongs to the Special Issue Nursing Care in the ICU—2nd Edition)
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