Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103425
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This article explores the evolution of the Certified Registered Nurse Anesthesiologist (CRNA) profession, from its origins during wartime medicine to its current role in high-acuity, technology-driven health care environ...This article explores the evolution of the Certified Registered Nurse Anesthesiologist (CRNA) profession, from its origins during wartime medicine to its current role in high-acuity, technology-driven health care environments. It examines historical milestones, legal and educational developments, and the expanding scope of CRNA practice. The review also considers future trends, including artificial intelligence, data-driven anesthesia management, and global advocacy. By highlighting both the historical context and modern advancements, the article underscores the CRNA's role as a clinically proficient, autonomous, and forward-facing anesthesia provider.
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103424
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The authors sought to examine the literature for evidence of shared similar cellular impacts between sepsis and aging. There is much available literature about shared immunologic dysregulation of toll-like receptor 4 (TL...The authors sought to examine the literature for evidence of shared similar cellular impacts between sepsis and aging. There is much available literature about shared immunologic dysregulation of toll-like receptor 4 (TLR4) activity in both conditions. Based on these findings, the authors propose a model of aging inspired by the recently published (2024) OO(H)NO! model of dysregulated immune and metabolic impacts of sepsis, which directionally maps out TLR4 dysregulation in sepsis.
Peterson B, Fong T, Gill T
… +2 more, Grant S, Guarnieri M
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103423
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TeleCritical Care (TCC) programs have the capability for early detection, rapid response, greater efficiency, and improved patient outcomes. Given high clinician-to-patient ratios and a hybrid environment, effective comm...TeleCritical Care (TCC) programs have the capability for early detection, rapid response, greater efficiency, and improved patient outcomes. Given high clinician-to-patient ratios and a hybrid environment, effective communication between team members is essential. We describe the development, design, and implementation of a web-based software program for intensive care unit call intake in a Situation, Background, Assessment, and Recommendation format. After implementation in our large TCC program, we observed multiple benefits, including high-quality communication, collaboration with bedside providers, timely response, and quality reporting. Finally, team-based call intake facilitated collaboration between providers in different hubs, supporting a hybrid coverage model.
Gary JC, Hamilton DK, Oczkowski SJ
… +1 more, Cadenhead CD
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103422
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The 2024 Society of Critical Care Medicine Intensive Care Unit (ICU) Design Guidelines offer evidence-based recommendations for ICU environments, addressing layout, infection control, infrastructure, and staff spaces. De...The 2024 Society of Critical Care Medicine Intensive Care Unit (ICU) Design Guidelines offer evidence-based recommendations for ICU environments, addressing layout, infection control, infrastructure, and staff spaces. Developed by a multidisciplinary task force, the guidelines emphasize high patient visibility, single-patient rooms, natural lighting, and flexible surge capacity. Despite low-certainty evidence, logical design strategies are proposed to enhance safety and efficiency. The paper underscores the importance of including nurses in design processes to improve care delivery and staff well-being. These guidelines aim to future-proof ICUs by integrating research, clinical insight, and innovation to meet evolving health care demands.
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103421
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Moyamoya disease is a rare progressive cerebrovascular disorder involving stenosis of major intracranial arteries and the formation of fragile collateral vessels. Patients face lifelong risks of ischemic and hemorrhagic...Moyamoya disease is a rare progressive cerebrovascular disorder involving stenosis of major intracranial arteries and the formation of fragile collateral vessels. Patients face lifelong risks of ischemic and hemorrhagic stroke. Surgical revascularization is the definitive treatment, aimed at restoring cerebral perfusion and reducing neurologic injury. Postoperative care is among the most complex in neuroscience nursing. Critical care nurses play a vital role in managing cerebral perfusion, conducting frequent neuro assessments, regulating blood pressure, and preventing seizures. Success requires individualized hemodynamic targets, early detection of complications like hyperperfusion or ischemia, psychosocial support, and close interdisciplinary collaboration.
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103420
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Hardiness-a personality trait defined by commitment, control, and challenge-is crucial for night shift nurses facing disrupted circadian rhythms, high stress, and fatigue. Research shows hardiness helps nurses perceive s...Hardiness-a personality trait defined by commitment, control, and challenge-is crucial for night shift nurses facing disrupted circadian rhythms, high stress, and fatigue. Research shows hardiness helps nurses perceive stress as manageable, leading to better mental health, lower burnout, and improved shift work tolerance. Emotional intelligence and supportive work environments further enhance hardiness, while anxiety and poor support diminish it. Despite its importance, studies specifically on night shift nurses are limited. Fostering hardiness through self-care, leadership, and resilience training can improve nurse well-being, job satisfaction, and retention, addressing the unique demands of night shift nursing.
Fazio SA, Doroy AL, Williams C
… +1 more, Adams JY
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103419
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ICU early mobility improves some patient outcomes, yet practice adoption remains inconsistent owing in part to variable terminology, documentation and measurement. This article describes a decade-long learning health sys...ICU early mobility improves some patient outcomes, yet practice adoption remains inconsistent owing in part to variable terminology, documentation and measurement. This article describes a decade-long learning health system approach to the study and practice of ICU early mobility measurement, leading to the development of the Out-of-Bed Mobility Eligible Index (OOB-E Index), an automated metric quantifying the frequency of out-of-bed events per mobility-eligible ICU day. Integrated into a mobility dashboard alongside other key metrics, the OOB-E Index supports supports standardized assessment, benchmarking and quality improvement. Measuring the OOB-E Index may enable more effective timing and dosing of ICU mobility.
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103418
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Falls occur infrequently in critical care where the risk must be balanced against the advantages of physical therapy. Many falls risk assessment tools are not designed for use in critical care and often categorize all pa...Falls occur infrequently in critical care where the risk must be balanced against the advantages of physical therapy. Many falls risk assessment tools are not designed for use in critical care and often categorize all patients as "high risk" and thus their usefulness is limited. The Tyndall-Bailey Falls Risk Assessment Tool was specifically designed to be used in the intensive care unit. This tool demonstrated good reliability in an early evaluation and was associated with a reduction in the fall rate. There is ongoing work, some international, to test the psychometrics and opportunities to extend its use to other jurisdictions.
Nydahl P, Eggmann S, Ewens B
… +3 more, Jones C, Karnatovskaia LV, Needham DM
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103417
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Modern patient-centered rehabilitation for critically ill patients focuses on physical, cognitive, psychological, and social recovery to reduce long-term impairments after critical illness. Core strategies include the AB...Modern patient-centered rehabilitation for critically ill patients focuses on physical, cognitive, psychological, and social recovery to reduce long-term impairments after critical illness. Core strategies include the ABCDEF (A2F) bundle/ICU Liberation, humanization programs, and symptom management. Based on the capabilities of individual patients, frequent assessments in these dimensions are performed to develop person-centered goals and interventions. Early mobilization, cognitive stimulation, delirium prevention and nonpharmacological management, empathic communication, ICU diaries, and family involvement should begin within 24 to 72 hours after ICU admission. The dosage and delivery of these interventions should be adapted to the capabilities and needs of individual patients.
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103416
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Contemporary rapid response systems have evolved from crisis-reactive teams into intelligent, predictive intervention programs that orchestrate comprehensive patient safety through precision health care delivery. This ar...Contemporary rapid response systems have evolved from crisis-reactive teams into intelligent, predictive intervention programs that orchestrate comprehensive patient safety through precision health care delivery. This article explores revolutionary advances in cognitive computing-enhanced detection systems, ambient monitoring networks, dynamic communication architectures, and precision-guided response protocols. Emerging evidence validates that integrated digital transformation strategies combining predictive intelligence with augmented decision-making frameworks substantially reduce mortality trajectories, optimize resource utilization, and deliver exceptional value propositions while dismantling conventional barriers to optimal therapeutic outcomes.
Martinez VA, Sulit R, Bertrand L
… +1 more, Buckley J
Crit Care Nurs Clin North Am
· 2026 Jun · PMID 42103415
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Virtual nursing uses technology to deliver remote care, address workforce challenges, and improve patient outcomes. This paper article explores the competencies required of virtual nurses-such as fostering healing, trust...Virtual nursing uses technology to deliver remote care, address workforce challenges, and improve patient outcomes. This paper article explores the competencies required of virtual nurses-such as fostering healing, trust, and authenticity-and examines the evolution, opportunities, and challenges, and future of virtual care. Health care organizations are leveraging technology to build virtual teams and adopt patient-centered, innovative care models. Although full integration of virtual teams into hospital operations is growing rapidly, role clarity and best practices have not been widely shared and validated. Virtual nursing as a nursing specialty is still in its infancy.
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621997
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Family-centered care (FCC) promotes participation of families in the care of patients, particularly in the pediatric environment. Pediatric intensive care units (PICUs) are the perfect environment for FCC, nurturing coll...Family-centered care (FCC) promotes participation of families in the care of patients, particularly in the pediatric environment. Pediatric intensive care units (PICUs) are the perfect environment for FCC, nurturing collaborative relationships between families and health care providers. Open communication and shared decision-making are emphasized in FCC. Families are active team members, and emotional, psychological, and cultural needs are considered within FCC. Studies have shown that FCC, in the PICU, reduces parental anxiety and stress in addition to enhancing communication, trust, and satisfaction with care.
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621996
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Neonatal intensive care unit (NICU) stays can be long, and parents can become an integral part of the team for their infants by being involved in family integrated care (FICare). The purpose of this review was to answer...Neonatal intensive care unit (NICU) stays can be long, and parents can become an integral part of the team for their infants by being involved in family integrated care (FICare). The purpose of this review was to answer the question, how does FICare in the NICU influence neonatal outcomes and parental confidence in neonatal care upon discharge? This integrative review followed the 5 stages outlined by Whittemore and Knafl. The 4 themes identified were neonatal outcomes, parental confidence, communication, and barriers to FICare. The findings provide insight into how FICare influences neonatal outcomes and parental confidence.
Leone-Sheehan D, Cronin A, McMahon A
… +1 more, Carnevale J
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621995
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Family connection and engagement are an essential part of care in the intensive care unit (ICU). For patients and their families experiencing ICU care stress of critical illness, the fast pace of decision-making and chan...Family connection and engagement are an essential part of care in the intensive care unit (ICU). For patients and their families experiencing ICU care stress of critical illness, the fast pace of decision-making and changes in patient condition necessitate a high level of engagement with the health care team. Family engagement emphasizes communication, information sharing, honoring of the dignity of the patient, trust and relationship building with the care team, and active engagement on the part of the family.
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621994
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Since its introduction to healthcare almost 40 years ago, family presence during resuscitation (FPDR) has faced continued pushback. Healthcare professionals' fears of litigation and concerns for family members' emotional...Since its introduction to healthcare almost 40 years ago, family presence during resuscitation (FPDR) has faced continued pushback. Healthcare professionals' fears of litigation and concerns for family members' emotional state led to slow and inconsistent adoption of FPDR. Yet, the desire of families to be present during resuscitative efforts has remained strong, consistently aligning with principles of family-centered care. As FPDR is increasingly integrated into clinical practice, it is crucial to focus on best practices for implementation. Adopting the family support role, creating policies and protocols, and educating the healthcare team are recommended strategies for equitable and effective FPDR implementation.
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621993
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Family caregivers of intensive care unit (ICU) patients face significant psychological challenges due to the sudden and uncertain nature of critical illness. This review synthesizes current literature on post-intensive c...Family caregivers of intensive care unit (ICU) patients face significant psychological challenges due to the sudden and uncertain nature of critical illness. This review synthesizes current literature on post-intensive care syndrome-family, summarizing prevalence, risk factors, assessment tools, and interventions. Caregivers frequently experience anxiety, depression, and posttraumatic stress disorder, with symptoms often persisting long after patient discharge. Although interventions have been implemented across both ICU and post-ICU phases, evidence remains inconsistent and limited in scalability. The review underscores the need for standardized protocols, long-term outcome tracking, and caregiver-centered strategies to improve psychological outcomes and support caregivers throughout the critical care continuum.