Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621992
·
Publisher ↗
Critical illness is stressful for patients' families. This integrative review revealed a variety of family needs within 5 themes: communication, compassion and caring, support, cultural considerations, and family needs i...Critical illness is stressful for patients' families. This integrative review revealed a variety of family needs within 5 themes: communication, compassion and caring, support, cultural considerations, and family needs in a dynamic health care landscape. Families need frequent, consistent, and understandable communication and require assurance that the patient is receiving high-quality compassionate care. Many families experience significant stressors during critical illness and will need additional support from the interdisciplinary team. Family needs vary across cultures and with the changing health care system, and therefore, nurses should begin with an assessment of individual needs and preferences.
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621991
·
Publisher ↗
Family-centered care (FCC) emphasizes collaboration, dignity, respect, and shared decision-making between families and health care teams. In the ICU, FCC relies on family presence at the bedside, facilitated by open visi...Family-centered care (FCC) emphasizes collaboration, dignity, respect, and shared decision-making between families and health care teams. In the ICU, FCC relies on family presence at the bedside, facilitated by open visitation policies. However, the COVID-19 pandemic disrupted this model, as restrictive visitation policies eliminated family presence, leading to adverse outcomes such as loneliness and delirium in patients, distress and grief among families, and moral injury and burnout in staff. As health systems recover, there is a need to reestablish FCC by prioritizing open visitation while balancing infection control and operational demands.
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621990
·
Publisher ↗
When patients transition from curative to comfort-focused treatment, family-centered care at the end of life can improve outcomes for intensive care unit (ICU) families. Nurses make important contributions across 3 key p...When patients transition from curative to comfort-focused treatment, family-centered care at the end of life can improve outcomes for intensive care unit (ICU) families. Nurses make important contributions across 3 key phases: admission and the hope for recovery, realization of poor prognosis, and the active dying phases. Barriers such as conflicts and organizational constraints can be addressed through various strategies, including advocating for early palliative care, encouraging regular family meetings, involving spiritual care, and providing bereavement support. Finally, nurses must also attend to their own emotional well-being to sustain their work caring for patients and families during this challenging time.
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621989
·
Publisher ↗
Family-centered care (FCC) is an approach to health care delivery that recognizes the central role that family members play in patients' lives, emphasizing dignity and respect, information sharing, participation, and col...Family-centered care (FCC) is an approach to health care delivery that recognizes the central role that family members play in patients' lives, emphasizing dignity and respect, information sharing, participation, and collaboration. With ethical foundations in principlism, care ethics, and feminist ethics, FCC promotes the autonomy of the family unit. However, prioritizing the needs of the patient and the family in a mutually beneficial manner can be ethically complex, particularly when needs diverge. Attention to best practices in communication, collaboration from the outset, and ethics consultation can be useful in addressing ethical conflict and ensuring patients and families receive goal-concordant care.
McAndrew NS, Hetland B, Fortney CA
… +3 more, Bennett R, Schanock C, Lindroth H
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621988
·
Publisher ↗
Family-centered care (FCC) is a hallmark of high-quality care in intensive care units (ICUs), yet consistent implementation remains challenging. This umbrella review evaluated recent literature on FCC interventions and t...Family-centered care (FCC) is a hallmark of high-quality care in intensive care units (ICUs), yet consistent implementation remains challenging. This umbrella review evaluated recent literature on FCC interventions and their influence on patient outcomes across ICU settings. FCC interventions improved infant feeding, weight gain, and reduced length of stay (LOS); reduced complications in children; and decreased delirium and LOS in adults. However, evidence strength varied, with some studies reporting mixed or minimal effects. Variability in findings highlights the need for further research using standardized measures. Overall, FCC shows promise in improving ICU patient outcomes; policies supporting implementation are needed.
Crit Care Nurs Clin North Am
· 2026 Mar · PMID 41621987
·
Publisher ↗
This integrative review examines the important role of culturally sensitive care in critical care. As patient populations grow increasingly diverse, the review identifies key barriers, including communication challenges,...This integrative review examines the important role of culturally sensitive care in critical care. As patient populations grow increasingly diverse, the review identifies key barriers, including communication challenges, educational gaps, and insufficient organizational support, that restrict the delivery of equitable, patient-centered care. Six themes emerged: education and competency development, self-awareness, communication, spiritual and religious needs, interprofessional collaboration, and organizational support. The findings support the need for experiential learning, reflective practice, and organizational commitment to foster empathy, cultural humility, and effective communication. Integrating these elements is essential to improving outcomes for diverse patients and families in critical care.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193160
·
Publisher ↗
Sustaining healthy work environments is an ongoing process that requires interprofessional team engagement. Applying evidence-based practices, such as establishing staff-led healthy work environment committees, performin...Sustaining healthy work environments is an ongoing process that requires interprofessional team engagement. Applying evidence-based practices, such as establishing staff-led healthy work environment committees, performing purposeful leader rounding, and conducting stay interviews, enhance the sustainability of a healthy work environment. Continuously monitoring the environment offers teams a clear vision of their opportunities and successes. As the individuals who make up the team change over time, the interventions that sustain a healthy work environment will also evolve. Leaders must be central to this work and promote the most effective strategies that sustain a healthy work environment.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193159
·
Publisher ↗
Trust is the belief that people or organizations will act in others' best interests. Because it combines both cognitive and emotional elements, building trust requires patterns of accountability as well as relational ski...Trust is the belief that people or organizations will act in others' best interests. Because it combines both cognitive and emotional elements, building trust requires patterns of accountability as well as relational skills. This article reviews the literature on trust in health care work environments and demonstrates its correlation with improved outcomes for patients, nurses, and organizations. Given these benefits, critical care leaders and bedside nurses must prioritize strategies to build and sustain trust.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193158
·
Publisher ↗
Efforts to improve the work environment are supported by nurse scientists (NSs), doctorally prepared researchers who conduct, facilitate, and promote research in health care organizations. While decades of research demon...Efforts to improve the work environment are supported by nurse scientists (NSs), doctorally prepared researchers who conduct, facilitate, and promote research in health care organizations. While decades of research demonstrate the value of assessing and benchmarking clinician work environments, the nursing profession struggles to create and maintain healthy workplaces. Recognizing the need for improvement, national organizations have called for the advancement and promotion of healthy work environments to ensure better outcomes, and NSs are uniquely positioned to lead these efforts.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193157
·
Publisher ↗
Building and sustaining a healthy work environment is key to encouraging nurse engagement and retention. Leveraging generational differences can be a valuable tool to engaging nurse's strengths to achieve optimal patient...Building and sustaining a healthy work environment is key to encouraging nurse engagement and retention. Leveraging generational differences can be a valuable tool to engaging nurse's strengths to achieve optimal patient outcomes. Recognizing and supporting diverse priorities of the multigenerational workforce is foundational to authentic leadership. Fostering multigenerational collaboration is essential to facilitating each of the 6 pillars of American Association of Critical Care Nurses' healthy work environment.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193156
·
Publisher ↗
Acute care nurse practitioners (ACNPs) play a crucial role in the intensive care units (ICUs) staffing by addressing physician shortages, enhancing care continuity, and improving outcomes. Their presence enriches the wor...Acute care nurse practitioners (ACNPs) play a crucial role in the intensive care units (ICUs) staffing by addressing physician shortages, enhancing care continuity, and improving outcomes. Their presence enriches the work environment by fostering interdisciplinary collaboration and streamlining communication. However, the factors influencing a healthy work environment for ACNPs are poorly understood. Recognizing their impact and addressing workplace challenges are essential for sustaining their well-being and optimizing their effectiveness in critical care. This article synthesizes evidence on ACNPs' role in the ICU and emphasizes the need for strategies to support their professional environment.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193155
·
Publisher ↗
This article addresses critical challenges facing modern health care: increasing nursing shortages, the imperative of safe environments in nursing, burnout among existing staff, rapid technology integration, and predicti...This article addresses critical challenges facing modern health care: increasing nursing shortages, the imperative of safe environments in nursing, burnout among existing staff, rapid technology integration, and predictions of growing elderly populations requiring specialized care. This complex environment demands leaders skilled in Authentic Leadership to foster healthy workplaces by nurturing occupational belonging. These leaders create supportive, inclusive environments that improve retention and ultimately enhance patient care and outcomes.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193154
·
Publisher ↗
This article explores ethical decision making for critical care nurses, noting that ethical decisions occur every day at the patient level and at the systems level. This article emphasizes the impact of the work environm...This article explores ethical decision making for critical care nurses, noting that ethical decisions occur every day at the patient level and at the systems level. This article emphasizes the impact of the work environment on ethical decision making and also connects moral distress and mattering to ethical decision making. The article also explores the concept of moral community as an obligation of health care organizations to support ethical decision making, mitigate moral distress, reinforce mattering, and sustain a healthy work environment.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193153
·
Publisher ↗
This article presents an evidence-based framework for creating inclusive excellence in health care work environments through diversity, equity, inclusion, and belonging (DEIB) initiatives. Drawing from organizational psy...This article presents an evidence-based framework for creating inclusive excellence in health care work environments through diversity, equity, inclusion, and belonging (DEIB) initiatives. Drawing from organizational psychology and health care outcomes research, the author proposes a hierarchical model that demonstrates how DEIB principles create stackable benefits, from basic equality through human flourishing. Applying the framework addresses cultural congruence, implicit bias mitigation, health care hierarchy disruption, and the transition from traditional meritocracy to merit-equity approaches. Clinical applications include strategies for building psychological safety, promoting allyship, and creating sustainable organizational change that improves outcomes for all members of the health care teams.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193152
·
Publisher ↗
Workplace violence (WPV) in health care is rising and often underreported, especially in high-stress environments like critical care units. Nurses are the most affected, facing both patient-initiated violence-often due t...Workplace violence (WPV) in health care is rising and often underreported, especially in high-stress environments like critical care units. Nurses are the most affected, facing both patient-initiated violence-often due to delirium-and interpersonal aggression, such as bullying. WPV leads to burnout, job dissatisfaction, turnover, and compromised patient-care. Despite the high costs, there are no national mandates for prevention. Evidence including Occupational Health and Safety Administration, National Institute for Health and Care Excellence, and Registered Nurses Association of Ontario guidelines support a multifaceted approach that includes policy changes, staff training, and supportive workplace culture.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193151
·
Publisher ↗
The rapid integration of technology in health care has transformed the nursing work environment, impacting various aspects of nurses' well-being. Although technology promises enhanced efficiency and improved patient outc...The rapid integration of technology in health care has transformed the nursing work environment, impacting various aspects of nurses' well-being. Although technology promises enhanced efficiency and improved patient outcomes, acknowledging its impact on nurses and addressing the associated challenges are essential for creating a healthier work environment where nurses can thrive both professionally and personally.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193150
·
Publisher ↗
This article examines the evolution of nurse staffing models and work environments in critical care settings. It traces historical developments from early centralized care models to current evidence-based approaches focu...This article examines the evolution of nurse staffing models and work environments in critical care settings. It traces historical developments from early centralized care models to current evidence-based approaches focusing on optimized environments and flexible staffing. The discussion highlights initiatives such as the Magnet Recognition Program and American Association of Critical-Care Nurses Standards for Appropriate Staffing that have reshaped organizational policies and improved patient outcomes. The article demonstrates how staffing levels, unit design, and leadership collectively influence patient care quality and nurse well-being, while addressing the importance of ongoing education, technology integration, and policy development in critical care nursing.
Crit Care Nurs Clin North Am
· 2025 Dec · PMID 41193149
·
Publisher ↗
A healthy work environment (HWE) is a workplace that supports nurses and interprofessional partners in providing safe, high-quality care. Although no consensus exists on the definition of an HWE or its attributes, common...A healthy work environment (HWE) is a workplace that supports nurses and interprofessional partners in providing safe, high-quality care. Although no consensus exists on the definition of an HWE or its attributes, common characteristics include effective leadership, strong communication and collaboration, shared decision-making, adequate staffing and resources, and meaningful recognition. The effect of HWEs has been studied extensively across the globe. Strong evidence supports the positive impact of HWEs on hospital safety cultures, care delivery, and quality outcomes such as patient-centeredness, continuity of care, failure-to-rescue, nurse-sensitive indicators, and patient satisfaction.