@article{ author = {Kaviani, Melika and Sharif-Nia, Hamid and Barzegari, Saeed and Nazari, Roghieh}, title = {Comparison of Pain Behaviors of Brain-Injured Patients Based on Clinical Characteristics: A Cross-Sectional Study}, abstract ={Background & aim: Most of the brain-injured patients hospitalized in the Intensive Care Unit (ICU) are not able to report their pain. In order to assess their pain, the CPOT-Neuro has been developed. Actually they may indicate different pain behaviors according to clinical conditions. Therefore, this study was conducted with the aim of comparing pain behaviors in brain-injured patients based on their clinical characteristics. Methods: This cross-sectional study was carried out on 132 brain-injured patients in Amol city, Iran who were enrolled in the study from December 2023 to March 2024. Data were collected using a demographic checklist and a Critical-Care Pain Observation Tool Neuro (CPOT-Neuro). Patients' behaviors were evaluated before, during and after change position (nociceptive procedure). Results: According to the frequency of pain behaviors observed during nociceptive procedure, a total of 105 patients indicated changes in facial expression, 13 patients in autonomic response, 88 patients in body movements, 46 patients in vocalization/ventilator tolerance and 31 patients indicated changes in muscle rigidity. By comparing the frequency of these behaviors during nociceptive procedure based on clinical characteristics, the chance of observing body movements during nociceptive procedure in non-traumatic patients was 60% lower than in traumatic patients (P<0.05). The probability of observing the autonomic response, vocalization/ ventilator tolerance and muscle rigidity during the nociceptive procedure decreased with the improvement of the level of consciousness (P<0.05). In addition, the chance of observing the autonomic response, body movements, vocalization/ ventilator tolerance and muscle rigidity during nociceptive procedure increased with the change in patients' sedation (P<0.05). The possibility of observing a change in muscle rigidity during nociceptive procedure in patients under mechanical ventilation was 74% lower than in patients without mechanical ventilation (P<0.05). Conclusion: This study showed that pain behaviors in brain-injured patients were different based on the type of brain-injury, the level of consciousness, the level of sedation and the way of breathing. These findings highlight consideration of clinical characteristics when evaluating and managing pain in these patients.}, Keywords = {Brain Injury, Pain, Behaviors, Pain Measurement, Intensive Care Units.}, volume = {17}, Number = {1}, pages = {1-8}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.1.1}, url = {http://jccnursing.com/article-1-770-en.html}, eprint = {http://jccnursing.com/article-1-770-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Abadi, Ehsan and Rahmani, Ali and Abbaszadeh, Nasim}, title = {Correlation of D-dimer Level with Severity of COVID-19 Disease in Hospitalized Patients: A Cross-Sectional Study}, abstract ={Background & aim: D-dimer levels have been recognized as significant markers for assessing disease severity and mortality in patients with COVID-19. This research aims to examine the correlation between D-dimer levels and disease severity in hospitalized COVID-19 patients. Methods: Conducted over an eight-month period from March 2023 to January 2024, this cross-sectional study evaluated 231 confirmed COVID-19 patients admitted to Chamran Hospital. D-dimer levels, along with clinical and Para clinical data, were collected and analyzed. Disease severity was assessed through pulse oximetry and measurements of blood oxygen saturation (SpO2). Results: The present study was carried out on 134 males (58%) and 97 females (42%), with a mean age of 61 years. Elevated D-dimer levels were correlated with decreased SpO2 levels. Patients with SpO2 below 90% exhibited significantly higher mean D-dimer levels compared to those with SpO2 above 90% (2589 vs. 517 Nano grams per milliliter, P>0.001). Additionally, a moderate negative correlation was found between D-dimer levels and SpO2 (r=-0.624). Conclusion: The inverse correlation between D-dimer levels and SpO2, indicative of disease severity in COVID-19 patients, suggests that D-dimer levels can serve as a predictive biomarker in these patients.}, Keywords = {Coronavirus, D-Dimer, COVID-19, Prognostic Biomarker}, volume = {17}, Number = {1}, pages = {9-14}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.1.9}, url = {http://jccnursing.com/article-1-768-en.html}, eprint = {http://jccnursing.com/article-1-768-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Joukar, Enayatalah and Tayebi, Ali and Einollahi, Behzad and Rahimi, Abolfazl and Tayebi, Mehdi}, title = {The Effect of using Easy Workout Kit on Hemodialysis Outcomes: An Interventional Study}, abstract ={Background & aim: Hemodialysis significantly alters the daily life and health of patients with kidney failure, impacting their quality of life and sleep. This study aimed to assess the impact of an easy exercise regimen on hemodialysis outcomes. Methods: This cross-sectional interventional study utilized a pre-post design involving 42 hemodialysis patients selected via census. Demographic data were recorded, and baseline assessments of quality of life and sleep quality were conducted using the Kidney Patients Quality of Life Questionnaire (KDQOL-SFTM) and the Richard Campbell Sleep Quality Questionnaire, respectively. Additional measures included KT/V and biochemical tests. Participants engaged in the Easy Workout program three times per week during dialysis sessions over a 12-week period, after which post-intervention assessments were conducted. Results: After the interventions, the sleep quality of the patients increased significantly (P<0.001). The adequacy of dialysis compared to before the intervention showed a statistically significant increase (P = 0.039). The general dimension and the specific dimension of the quality of life of the patients increased significantly after the interventions (P<0.001). Conclusion: Easy exercises during hemodialysis improve sleep quality, quality of life and dialysis adequacy of hemodialysis patients. It is suggested to use easy exercises to improve the health status of patients during hemodialysis.}, Keywords = {Easy Workout, Hemodialysis, Sleep Quality, Quality of Life, Dialysis Adequacy.}, volume = {17}, Number = {1}, pages = {15-24}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.1.15}, url = {http://jccnursing.com/article-1-764-en.html}, eprint = {http://jccnursing.com/article-1-764-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {MirEbarhimi, Mir Akbar and Moayed, Malihe sadat and Ebadi, Abbas and Saeed, Yaser}, title = {Person-Centered Care Approach in the Intensive Care Unit: A Systematic Review}, abstract ={Background & aim: Person-centered care is of great importance in nursing due to its wide application and increasing importance. Therefore, it is considered as a quality indicator in the health system. This review study was conducted with the aim of investigating the person-centered care approach. Methods: This article is a systematic review that targeted search without time limitation using the keywords person-centered care, nursing, intensive care unit and its English equivalent in the English language databases Web of Science, Scopus, PubMed and Persian SID, Iran Medex, Magiran and Google Scholar search engine. This search was conducted until March 2023. Results: Out of 67 initial studies, 14 studies were included in the final analysis. In most of the studies, four factors of individuality, kindness, respect and comfort were reported as the main dimensions of person-centered care in Intensive Care Units (ICUs). Heavy workload and lack of cooperation between nurses were introduced as the main obstacles to the implementation of person-centered care and high work experience as an effective factor in improving the quality of person-centered care in the special care department. The provision of suitable clinical spaces for the family was also reported as one of the effective factors in improving the quality of person-centered care. Conclusion: Person-centered care, as a new approach, has been investigated in various studies. Paying attention to the patient as a whole person, emphasizing the individual's personality, participation in decision-making processes, respecting the wishes of the patient and his family can be effective factors in providing person-centered care in the special care department. Limited studies have been conducted in the field of person-centered care in the ICU, which is suggested to be further investigated in future studies.}, Keywords = {Patient-Centered Care, Family-Centered Care, Person-Centered Care, Critical Care, Systematic Review.}, volume = {17}, Number = {1}, pages = {25-34}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.1.25}, url = {http://jccnursing.com/article-1-760-en.html}, eprint = {http://jccnursing.com/article-1-760-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Aein, Mojtaba and Mahmoudi, Hosein and Latifi, Ali Mohammad and Jafari-Oori, Mehdi}, title = {Investigating the Effectiveness of Education on the Entrepreneurial Attitude and Intention of Nursing Students: A Semi-Experimental Study}, abstract ={Background & aim: In the field of nursing, there are many entrepreneurship and innovative opportunities, however, its education in nursing, especially nursing students, has been less. For this reason, the present study was conducted with the aim of determining the effectiveness of education on the attitude and entrepreneurial intention of nursing students. Methods: In this semi-experimental study, 102 nursing students were randomly divided into intervention and control groups. In order to collect data, a questionnaire that included a demographic section and a section to measure Linan and Chen's entrepreneurial intention and attitude, which was based on the planned behavior model, was used before and immediately after the intervention. The intervention was implemented as a one-month entrepreneurship training workshop for the intervention group. Data analysis was carried out with a significance level of 0.05. Results: Before the intervention, there was no significant difference between the control and intervention groups (P>0.05). However, after the intervention, except for the attitude variable (P>0.05), there was a significant difference in other variables in the intervention group (P<0.05). The mean scores of intention variables (P = 0.001) and behavioral control (P = 0.003) were significant, but for attitude (P = 0.16) and subjective norm (P = 0.052) was not significant. Conclusion: These findings show that entrepreneurship education can improve the intention and behavioral control of nursing students regarding entrepreneurship. This study can help administrators and educational planners in the field of entrepreneurship to design appropriate educational programs for the development of entrepreneurship in nursing students.}, Keywords = {Entrepreneurship Education, Nursing Students, Planned Behavior Model, Entrepreneurial Intention and Attitude.}, volume = {17}, Number = {1}, pages = {35-44}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.1.35}, url = {http://jccnursing.com/article-1-767-en.html}, eprint = {http://jccnursing.com/article-1-767-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Aziznejhad, Ebrahim and Dadashzadeh, Abbas and Sarbakhsh, Parveen and Asghari, Elnaz and Jabbarzadeh, Faranak}, title = {The Presence of Women in Pre-Hospital Emergency Medical Services from the Perspective of the Staff: A Cross-Sectional Feasibility Study}, abstract ={Background & aim: Women have been present in pre-hospital emergency in most countries; but recently such a decision has been made in Iran. Therefore, it is necessary to examine the opinion of the employees regarding the feasibility of the presence of women in order to meet the needs of the service recipients. The present study was conducted with the aim of assessing the feasibility of women's presence in pre-hospital emergency missions from the staff's point of view. Methods: This research was a cross sectional study. The research community was the employees working in the emergency departments of the medical system in the East Azerbaijan province, Iran. Sampling was done by stratified random method and random sampling was done from all cities in proportion to the volume of each stratify on the entire population. Finally, 326 employees were included in the study. A researcher-made tool with three subscales was used to collect data. Results: According to the findings, the acceptance rate of women's presence in the pre-hospital emergency was high from the staff's point of view. However, the current conditions and facilities are considered to be not enough. In addition, according to the findings, having a strong spirit, crisis management in difficult and heartbreaking conditions, covering gender differences and being in harmony with cultural, religious and social principles were declared as the most important expectations of the employees from the role of women in the pre-hospital emergency system. Conclusion: Based on the findings, the staff consider the presence of women in the pre-hospital emergency as necessary, but first special facilities should be provided for their presence and reasonable expectations should be considered for them. Based on these findings, it is recommended that policymakers focus on the level of the society's culture, the conditions for hiring female personnel, adding specialized equipment, modifying and changing work rules, so that the presence of female personnel in the pre-hospital emergency system is possible.}, Keywords = {Ambulances, Emergencies, Emergency Medical Technicians, Women}, volume = {17}, Number = {1}, pages = {45-54}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.1.45}, url = {http://jccnursing.com/article-1-769-en.html}, eprint = {http://jccnursing.com/article-1-769-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Masoudi, Saeideh and Abedini, Zahra and Khoramirad, Ashraf and Akhoundzadeh, Kobr}, title = {Risk Factors, Clinical Manifestations, and Para-Clinical Findings of Patients with ST-Elevation Myocardial Infarction: A Cross-Sectional Study}, abstract ={Background & aim: Despite significant advancements in the treatment of cardiovascular diseases, the prevalence of these diseases is on the rise in developing countries. Knowing the risk factors and other aspects related to these diseases can help to prevent the occurrence, and to also treat these patients faster and with a more efficient diagnosis. The present study aimed to investigate the risk factors, clinical manifestations and the para-clinical findings in patients with ST-segment elevation myocardial infarction in Shahid Beheshti Hospital, Qom, in 2022 and 2023. Methods: This cross sectional descriptive and analytical study was carried out using patients' files. The study included 208 patients with ST-segment elevation myocardial infarction referred to Shahid Beheshti Hospital, Qom. The data collection form included four sections: demographic variables, risk factors, clinical manifestations, and para-clinical findings. A P<0.05 was considered statistically significant in this study. Results: Most patients were male (78.4%) with a mean ± SD age of 58.05 ± 12.06. The most common clinical manifestation was chest pain (80.8%), and the most common risk factors were overweight and obesity, history of hypertension and smoking. Elevations in the levels of troponin and creatine phosphokinase as cardiac markers for myocardial infarction, and blood glucose and blood pressure were observed. The mean ± SD of the left ventricle ejection fraction was reported as 39.54 ± 10.05%. Conclusion: Understanding the higher incidence of myocardial infarction in men, and in the sixth decade of life, can help to identify the main target groups for comprehensive planning in the prevention and control of myocardial infarction. In addition, identifying overweight, obesity, hypertension, and smoking as the most common risk factors for heart attacks could play an important role to establish an efficient prevention program.}, Keywords = {Myocardial Infarction, Clinical Manifestations, Para-Clinical Evidence, Risk Factors.}, volume = {17}, Number = {1}, pages = {55-64}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.1.55}, url = {http://jccnursing.com/article-1-762-en.html}, eprint = {http://jccnursing.com/article-1-762-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Ghanbari, Alireza and Sharif-Nia, Hamid and Mousazadeh, Noushin and Nazari, Roghieh}, title = {Development and Validation of a Scale for Assessing Factors Influencing Nurses\' Intention to Use a Manometer for Endotracheal Tube Cuff Pressure Monitoring}, abstract ={Background & aim: Effective management of endotracheal tube cuff pressure is crucial in preventing complications such as pneumonia and airway trauma. Despite recommendations for using a manometer to, cuff pressure monitoring, adherence remains suboptimal. Since intention is the most significant predictor of actual behavior, understanding the factors influencing it through a valid tool can help identify barriers and facilitators more accurately. Therefore, this study aimed to develop and psychometrically evaluate of a Scale for Assessing Factors Influencing Nurses' Intention to Use a Manometer for Endotracheal Tube Cuff Pressure Monitoring. Methods: This methodological study was conducted in 2024 on 186 nurses working in the Intensive Care Units (ICUs) of public hospitals in Amol, Iran. The tool was developed based on the Theory of Planned Behavior using the framework and examples provided by Ajzen, and the psychometric process followed Eccles' guidelines. First, the target behavior was defined. Then, an initial set of items was generated through a literature review and clinical experience of the researchers. The content and face validity of the tool were evaluated using both qualitative and quantitative approaches. The construct validity of the tool was assessed through exploratory factor analysis, and its internal consistency was examined using Cronbach's alpha and McDonald's omega coefficients. The test-retest method was used to assess stability. Results: During the item generation phase, 41 items were developed based on a review of relevant literature. After qualitative and quantitative assessments of face and content validity, the number of items was reduced to 25. Exploratory factor analysis indicated an acceptable fit for the data, with a Kaiser-Meyer-Olkin (KMO) sampling adequacy index of 0.853 and a significant Bartlett's test. Four factors with eigenvalues greater than one were identified, accounting for 22.50%, 10.95%, 9.30%, and 10.60% of the total variance, respectively (53.35% cumulatively). In the final stage, six items with factor loadings less than 0.3 were removed, resulting in 19 items categorized under four factors: "Positive Behavioral and Control Beliefs," "Normative Beliefs," "Perceived Control Beliefs Strength," and "Motivation to Comply. Cronbach’s alpha and McDonald’s omega coefficients ranged from 0.827 to 0.900, with ICC = 0.95. Conclusion: The tool demonstrated acceptable validity and reliability for assessing factors influencing the intention of ICU nurses to use manometers. Therefore, its application in future research could help identify additional barriers and facilitators in nurses' behavior, leading to the development of more effective training programs. It is also recommended that this tool be tested among different groups of nurses and in various hospital settings to further refine and improve it.}, Keywords = {Critical Care Nursing, Intention, Intratracheal Intubation, Psychometrics, Theory of Planned Behavior.}, volume = {17}, Number = {1}, pages = {65-75}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.1.65}, url = {http://jccnursing.com/article-1-774-en.html}, eprint = {http://jccnursing.com/article-1-774-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Javadinejad, Mohammad and Bahramnezhad, Fatemeh}, title = {Investigating Nurses’ Views of the Quality of Dying and Death in Intensive Care Units of Hospitals Affiliated with Tehran University of Medical Sciences in 2023: A Cross Sectional Study}, abstract ={Background & aim: Thinking about death is a human cognitive activity which affects a dying patient and the individuals who take care of them, especially nurses. Considering the high mortality rate in ICUs, the present study aims to determine the views of the nurses of ICUs regarding patients’ quality of dying and death. Methods: This descriptive-cross-sectional study was conducted in 2023 in hospitals affiliated with Tehran University of Medical Sciences. The research population consisted of 176 ICU nurses in hospitals affiliated with Tehran University of Medical Sciences, who were selected via a convenient sampling method. The data was collected using a demographic survey and the Quality of Dying and Death (QODD) Questionnaire —Version 3.2a by Cho et al. (2017). Results: In evaluating the quality of dying and death and its three components (patient’s experience at the end of life, end-of-life medical care, and quality of the moment of death experience), it can be stated that all of these components were lower than the mean scores. Therefore, from the nurses’ viewpoints, the quality of dying and death and its components are lower than mean scores. Regarding the demographic characteristics (gender and marital status), there was no significant difference in the quality of dying and death of terminally ill patients in ICUs of hospitals affiliated with Tehran University. In regards to nurses’ education and their received training in the field of quality of dying and death, a significant difference was observed (P<0.05). Conclusion: Regarding nurses' understanding of the quality of dying and death in ICUs, planning can be done to help preserve the human dignity of dying patients and the peace of their families by creating supportive measures. Through this process, families can also be assured that by maintaining the patient's human dignity, their death can be more convenient, and can be a foundation for knowledge in this field.}, Keywords = {Quality of Dying and Death, ICU, Nurse}, volume = {17}, Number = {2}, pages = {1-9}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.1}, url = {http://jccnursing.com/article-1-759-en.html}, eprint = {http://jccnursing.com/article-1-759-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Farahdel, Mahdi and Inanlou, Mehrnoosh and Haresabadi, Mahdi and Poorbarat, Salar and Khorashadizadeh, Fatemeh}, title = {Exploring Factors related to the Stress Caused by Patients\' Delirium Experience in Nurses Working in Intensive Care Units of the Selected Educational and Medical Centers in North Khorasan Province and Khorasan Razavi Province: A Cross Sectional Study}, abstract ={Background & aim: Nursing is a stessful perofesion due to its nature of the job. This study was designed and conducted in order to determine the stress caused by patients' delirium experience in nurses of Intensive Care Units (ICUs) of selected educational and medical centers in North Khorasan and Razavi provinces in 2018. Methods: This descriptive- analytic research was conducted on 170 nurses working in adult ICUs using the convenience sampling method. Stress caused by delirium in this study was examined applying the Delirium-induced experience and stress (CEDD'S) instruments of ICUs. Results: In this study, most participants were women (79.4%) and had a mean age of 35 years (33%). The research findings explaines that most nurses (75.88%) expressed their stress in the medium range. The results of statistical tests revealed that a statistically significant relationship was only observed between the work experience of nurses and the stress produced by patients' delirium experience (P = 0.020). Conclusion: Considering the existence of moderate stress in special department nurses and its significant relationship with work experience, it seems that nursing managers should reduce the stress of special department nurses with proper planning and stress management training.}, Keywords = {Stress, Delirium, Nurses, Intensive Care Unit}, volume = {17}, Number = {2}, pages = {10-16}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.10}, url = {http://jccnursing.com/article-1-766-en.html}, eprint = {http://jccnursing.com/article-1-766-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Babaei, Keivan and Abdi, AliReza and Ghesmati, Faezeh and Nowzari, Amir Hossein and Goodarzi, Afshi}, title = {Explanation of the Organizational Dimensions Affecting the Resuscitation Process: A Qualitative Study}, abstract ={Background & aim: Despite the ever-increasing number of patients with cardiopulmonary arrest, the survival rate of patients has decreased. On the other hand, this index has been reported differently in different countries. The difference in the outcomes of resuscitation, despite following a single guideline, indicates that several factors are effective in the optimal performance of the resuscitation process and its outcomes. This study aimed to explore the perceived organizational dimensions effective on cardiopulmonary resuscitation from the perspective of the members of the resuscitation team. Methods: The present study was conducted with a qualitative approach. The sample of our study included 23 members of the resuscitation team who were selected purposefully from February 2024 to May 2024 with maximum diversity. In-depth semi-structured interviews were used to collect data. Data were analyzed using qualitative content analysis with the conventional approach of Graneheim and Lundman (2004). Results: The organizational dimensions effective on cardiopulmonary resuscitation were developed in three main categories and eight subcategories. Perceived convergence and divergence in the resuscitation team members with three subcategories, organizational ambiguity in the resuscitation process with two subcategories and the importance of support organization for proper resuscitation with three subcategories, were the three main extracted categories in the present study. Conclusion: The managers should put an all-round approach based on the perception of the rescuers in the promotion of this process. Creating grounds for promoting convergence between resuscitation team members, developing clear guidelines for do-not-resuscitate, clinical or simulator-based training, re-engineering of the resuscitation room along with motivational approaches for resuscitation team members can be considered in planning to improve the resuscitation process in organizations.}, Keywords = {Cardiopulmonary Resuscitation, Qualitative Study, Rescuer, Organization}, volume = {17}, Number = {2}, pages = {17-26}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.17}, url = {http://jccnursing.com/article-1-781-en.html}, eprint = {http://jccnursing.com/article-1-781-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Heydarian, Mohammadhossein and VahedianAzimi, Amir and Mahmoodi, Hossein and Vafadar, Zohreh}, title = {Effect of Adaptive Support Ventilation on the Outcomes of Intensive Care Unit Patients: A Systematic Review Study}, abstract ={Background & aim: A large number of patients are admitted to Intensive Care Units (ICUs) due to the need for mechanical ventilation. In mechanical ventilators, various modes and settings are used according to the patients' needs, which can significantly impact patient outcomes. One of these modes is Adaptive Support Ventilation (ASV), for which more evidence is needed regarding its effects. This study aims to elucidate the impact of ASV on the outcomes of patients admitted to ICUs. Methods: This systematic review study was conducted by searching relevant sources from the beginning up to April 5, 2023, in both English and Persian, with no time limitations on articles. The literature search was performed using Persian keywords including 'adaptive support ventilation,' 'intensive care,' 'patient outcomes,' 'mechanical ventilation,' and their English equivalents: 'adaptive support ventilation,' 'ASV,' 'intensive care,' 'critical care,' 'mechanical ventilation,' 'patients outcomes' in Persian-language databases such as SID, MagIran, IranMedex, and IranDoc, as well as English-language databases including Scopus, Web of Science, PubMed, Cochrane, EMBASE, ScienceDirect, and ProQuest, along with the first 30 pages of the Google Scholar search engine using the AND and OR operators. The selected articles were then categorized and entered the final stage for data extraction. Results: Out of 492 retrieved articles, 130 were included in the final stage of the study. A total of 107 studies reported outcomes on the impact of ASV, including reduced weaning time, lung protection and safe ventilation, reduced hospital stay duration, less clinical intervention, and reduced manpower requirements. Two studies examined the weaning duration and the impact of this mode on children and adolescents. Eleven studies did not observe any effects on weaning or the protective impact of this mode, and finally, ten studies reported complications associated with ASV. Conclusion: According to findings it can be stated that the use of ASV can reduce the patient's need for a ventilator and the number of breaths, while increasing tidal volume to prolong exhalation time in patients with Chronic Obstructive Pulmonary Disease (COPD) and reduce air trapping. This mode is recommended for patients in ICUs after heart surgery that needs rapid extubation. However, caution is advised when using it in children, infants, and obese patients who have undergone open-heart surgery. In addition, ASV can be used as an effective intervention for patients in ICUs.}, Keywords = {Adaptive Support Ventilation, Intensive Care Unit, Mechanical Ventilation}, volume = {17}, Number = {2}, pages = {27-45}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.27}, url = {http://jccnursing.com/article-1-761-en.html}, eprint = {http://jccnursing.com/article-1-761-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {AlirezaeiDiziche, Maryam and Salmani, Fatemeh and Jouzi, Mi}, title = {The Effect of Nursing Counseling on the Family Syndrome of a Patient Hospitalized in an Intensive Care Unit: A Semi-Experimental Study}, abstract ={Background & aim: A patient's admission to the Intensive Care Unit (ICU) is a stressful experience for the patient's family. One of the problems that arise for the family members of patients hospitalized in ICUs is the occurrence of a series of psychological and non-psychological symptoms called syndrome of the patient's family in the ICU. This study was conducted with the aim of determining the effect of nursing counseling on the family syndrome of a patient admitted to the ICU. Methods: This semi-experimental study was conducted in 2023 in the city of Isfahan. For this purpose, 60 family members of patients admitted to the ICU were included in the study as available sampling. Then, by random allocation using the case number, they were placed in two intervention and control groups of 30 people. In the intervention group, nursing counseling in the form of getting to know the department, receiving an information booklet and holding two to three face-to-face meetings according to the needs of the family were included. They were given to family members individually and at most for half an hour. The control group only received routine ward care. Dass 21 Stress, Depression and Anxiety Questionnaires, FOA post-traumatic stress disorder, Petersburg sleep disorder, Chalapi and Amirkafi social isolation were completed by the samples in three stages (before the intervention, after the intervention, and one month after the intervention). Results: The findings of the study showed that nursing counseling has important changes on family syndromes including depression, anxiety, stress and post-traumatic stress disorder, and sleep disorders (P<0.001). However, there was no significant difference between the intervention and control groups on social isolation (P>0.001). Conclusion: According to findings, conditions should be provided to allocate appropriate time for nursing consultation for the family members of ICU patients.  It is also suggested to health managers that in ICUs, special attention should be paid to the patient's family as a unit of care.}, Keywords = {Nursing Consultation, Family Syndrome, Patient, Intensive Care Unit}, volume = {17}, Number = {2}, pages = {46-57}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.46}, url = {http://jccnursing.com/article-1-776-en.html}, eprint = {http://jccnursing.com/article-1-776-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Mahmoudilerd, Fateme and Navab, Elham and Haghani, Hamid and Shali, Mahboobe}, title = {Nurses\' Perception of their Role in the Active Participation of Family Caregivers in the Care of Patients Hospitalized in the Intensive Care Unit: A Cross-Sectional Study}, abstract ={Background & aim: The role of family caregivers is recognized as an important principle in advancing care goals. Knowing the importance of the role of nurses in the participation of family caregivers in the matter of care is important in achieving the goals of family-centered care. The present study was conducted with the aim of determining the nurses' understanding of their role regarding the active participation of family caregivers in the care of patients hospitalized in the Intensive Care Unit (ICU). Methods: In this cross-sectional study in 2024, 150 nurses working in ICUs affiliated to Tehran University of Medical Sciences were selected using proportional stratified sampling. In order to collect information, two questionnaires were used, including demographic information and a questionnaire on the nurses' understanding of their role towards family caregivers. Results: The nurses participating in the research had an average age of 34.6±7.88, and most of them were female (77.3%) and 62% were married. The average score of nurses' understanding of their role was 40.79 ± 6.87 (moderate understanding). Based on the statistical analysis, the nurses' understanding had a statistically significant relationship with the participation of family caregivers in patient care (P = 0.004). Conclusion: The results of the study showed that nurses had a moderate understanding of their role towards family caregivers in active participation in patient care. Given the importance of nurses' understanding of the active participation of family caregivers, it is recommended to carry out managerial and organizational interventions and provide the necessary conditions to promote a family-centered care culture in the care system.}, Keywords = {Family-Centered Care, Family Caregivers, Intensive Care Units, Nurses}, volume = {17}, Number = {2}, pages = {58-65}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.58}, url = {http://jccnursing.com/article-1-787-en.html}, eprint = {http://jccnursing.com/article-1-787-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Yavari, Mahdieh and Bahrampouri, Saiede and Nejat, Nazi and Javaheri, Jav}, title = {The Relationship between Apache 2 and PSI Scores with Length of Hospitalization and Mortality Rate of Covid-19 Patients Hospitalized in Intensive Care Unit: A Cross-Sectional Study}, abstract ={Background & aim: In Intensive Care Units (ICUs), several systems are used to predict patient mortality. In this study, the relationship between the Apache 2 and PSI scores with the length of stay and mortality rate of Covid-19 patients admitted to the ICU was investigated. Methods: This cross-sectional analytical study was conducted on patients admitted to the ICU. In order to collect information, the PSI and Apache 2 tools were used. After obtaining a referral from the university's research vice chancellor, the hospital archives unit was referred. Then, the data required for the Apache 2 tool, the PSI tool, and demographic characteristics related to the first 24 hours of admission to the ICU were collected from the hospital's files and HIS. Information related to the time of death, length of stay, and patient transfer were also recorded. Results: Of the 486 investigated patients, the mean and standard deviation of age was 62.76 ± 18.1. In addition, 46.7% of patients were female (227 patients) and 53.3% (259 patients) were male. The mean duration of hospitalization in the ICU was 7.15 ± 4.6 days (minimum 1, maximum 27 days). Furthermore, 21% (102 patients) were intubated at the time of examination. Finally, 51.9% (252 patients) were discharged from the ward and 48.1% (234 patients) died. In a recent evaluation, it was observed that the Apache 2 score had a statistically significant relationship with patient mortality, and the mean and standard deviation of the score were higher in deceased patients (P = 0.000). This tool can also predict the mortality rate of Covid-19 patients by 72.4%. The Apache 2 score was related to the patient's age and intubation status (P = 0.001), but it was not statistically significantly related to gender and length of hospitalization (P = 0.905). The PSI score had a statistically significant relationship with patient mortality, and the mean and standard deviation of the score were higher in deceased patients (P = 0.001). The PSI score also had no statistically significant relationship with length of hospitalization (P = 0.581). This tool can predict the mortality rate of Covid-19 patients by 66%. Also, according to the results of the recent evaluation, length of hospitalization was not related to the patient's age, gender, intubation status, and initial level of consciousness. Conclusion: According to findings, the use of the Apache 2 tool in the admission of patients with Covid-19 to the ICU had a more accurate prediction than other tools and could greatly contribute to the optimal use of ICU beds.}, Keywords = {Keywords: Apache 2, Pneumonia Severity Index, Length of Hospitalization, COVID-19}, volume = {17}, Number = {2}, pages = {66-75}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.66}, url = {http://jccnursing.com/article-1-783-en.html}, eprint = {http://jccnursing.com/article-1-783-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {AbasiNiasar, Alireza and Mahmoudi, Hosein and Moradian, ُSeyed Tayeb and Vafadar, Zohreh}, title = {Evaluation of the Intra-Hospital Transfer Process for Critically Ill Patients in an Emergency Department of a Univesitiy\'s Hospital in Tehran: A Cross Sectional Study}, abstract ={Background & aim: Intrahospital patient transfer, particularly for critically ill patients in the emergency department, plays a crucial role in patient recovery and reducing mortality rates. Numerous factors, including coordination and time management, influence this process. A thorough examination of patient transfer procedures within hospitals can significantly contribute to identifying challenges and enhancing healthcare services. This study aimed to investigate the process of transferring critically ill patients within the emergency department. Methods: A descriptive-analytic study was conducted in 2023. The study population consisted of critically ill patients requiring admission to Intensive Care Units (ICUs). A sample size of 100 patients was selected using a convenience sampling method, considering the sample size formula and previous studies. Data was collected using a patient transfer safety and demographic questionnaire through observation and patient records. Results: An evaluation of the physiological parameters of critically ill patients during the transfer process revealed significant changes in blood pressure (P<0.05), while changes in other physiological parameters such as respiratory rate and heart rate were not significant (P>0.05). Out of 100 transfers, adverse events were observed in 12 patients. The most common adverse event reported was hemodynamic instability in 12 cases (12%). A significant correlation was found between the occurrence of intra-transfer disturbances and the implementation of standards for transferring critically ill patients. Non-compliance with transfer standards at certain stages of the transfer process, such as checking patients' blood pressure medications and using infusion pumps, led to adverse events and unfavorable changes in the health status of critically ill patients. Conclusion: The process of transferring critically ill patients in the emergency department was associated with adverse events that have a significant impact on patient outcomes. These findings highlight the importance of evaluating the transfer of critically ill patients in the emergency department. Strategies such as transferring critically ill patients by a trained team, using appropriate equipment and checklists, and avoiding the transfer of patients with unstable clinical conditions are effective.}, Keywords = {Adverse Events of Transfer, In-Hospital Patient Transfer Standards, Critically Ill Patients, Transfer to Intensive Care Unit}, volume = {17}, Number = {2}, pages = {76-84}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.76}, url = {http://jccnursing.com/article-1-794-en.html}, eprint = {http://jccnursing.com/article-1-794-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Tavakolizadeh, Reza and Abdolmohamadian, Sevil}, title = {Preparation of Intravenous Insulin Solution in the Treatment of Diabetic Children}, abstract ={Dear Editor Insulin-dependent diabetes mellitus is the most common form of diabetes in children and adolescents. Many of these patients are diagnosed with a condition called Diabetic Ketoacidosis (DKA), which has a mortality rate of approximately 1%. In children, DKA is typically characterized by reduced levels of consciousness, deep and rapid breathing, blood acidification, high blood glucose levels, and severe dehydration. Due to these critical conditions, treatment is preferably conducted in Intensive Care Units (ICUs), or, when necessary, in Emergency Rooms (ER). A key treatment for (DKA) is the administration of intravenous insulin. Since the method of preparing and administering intravenous insulin in children is somewhat different from that in adults, it is crucial to be well-versed in the standard principles of preparing intravenous insulin solutions in children, and to ensure clear communication between physician orders and nursing actions for successful treatment. This article aims to explain the method of insulin preparation for treating children, as well as some important and practical aspects of the process.}, Keywords = {Keywords: Diabetes, Ketoacidosis, Insulin.}, volume = {17}, Number = {3}, pages = {1-4}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.3.1}, url = {http://jccnursing.com/article-1-803-en.html}, eprint = {http://jccnursing.com/article-1-803-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Rashti, Babak and - Asgharzadeh, Ali and Teimourpour, Amir and Jadid-Milani, Maryam}, title = {The Role of Spiritual Intelligence in Predicting the Job Performance of Nurses in Intensive Care Units of Selected Hospitals of Tabriz University of Medical Sciences in 2024: A Cross- Sectional Study}, abstract ={Background & aim: Nursing in Intensive Care Units (ICUs) is one of the most important and sensitive professional area in the health system. Nurses' job performance is effective and ensures the quality of health services in performing activities and responsibilities related to direct patient care. Spiritual intelligence is among the important issues that is of great importance in the performance of nurses in ICUs. Therefore, the present study aimed to determine the role of spiritual intelligence in predicting the job performance of nurses in ICUs of selected hospitals of Tabriz University of Medical Sciences in 2024. Methods: The present study was carried out by using a cross-sectional method on 259 nurses working in ICUs in 2024.In this research, a multi-stage sampling method was used. As available, four hospitals (Imam Reza (AS), Sinai, Shahid Madani and Razi) that had special care units were selected. According to the number of nurses in special care units, the share of each hospital was determined in proportion to the eligible people to enter the study. Within each center, sampling of special care nurses was done as available. Data collection tools included Abdullahzadeh's Spiritual Intelligence Questionnaire, and Paterson's Job Performance Questionnaire. Results: The findings revealed that the spiritual intelligence level of the majority of nurses (45.6%) was high with a mean 119.96 ± 15.068. The majority of nurses (93.8%) had strong job performance with a mean 37.54 ± 7.579. There was a significant and direct mean relationship between spiritual intelligence and job performance (r = 0.373, P>0.001). The regression model for predicting job performance was significant by spiritual intelligence (P>0.001) and 15% of the variance in job performance was explained by spiritual intelligence. Conclusion: The results of the present study can be used to provide practical strategies to improve the level of awareness of policymakers, officials and nurses in order to improve the level of spiritual intelligence and their effects on the level of job performance of nurses in ICUs.}, Keywords = {Spiritual Intelligence, Job Performance, Intensive Care Unit.}, volume = {17}, Number = {3}, pages = {5-14}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.3.5}, url = {http://jccnursing.com/article-1-775-en.html}, eprint = {http://jccnursing.com/article-1-775-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Rahmani, Ali and abadinia, ehsan and sagahfi, abdollah and Jafari-Oori, Mehdi and Mahmoudi, Hosein and Shojafard, Javad and Abbaszadeh, Nasim}, title = {Essential Preparedness Measures for Healthcare Centers in Chemical, Biological, Radiological, and Nuclear Crises: A Systematic Review}, abstract ={Background & aim: Wars have always posed a significant threat to human societies. With the advancement of technology, more complex conflicts, including Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNe) incidents have emerged, causing irreparable harm to public health and the environment. This study investigates the preparedness of hospitals and healthcare centers to respond to such incidents, aiming to identify measures for improvement. Methods: This study was conducted as a systematic review following PRISMA guidelines. A comprehensive literature search was performed in databases including PubMed/MEDLINE, EMBASE, Web of Science, Scopus, Cochrane Library, Science Direct, and ProQuest to identify articles related to hospital preparedness for CBRNe incidents. Articles published between January 2010 and December 2023 were reviewed. The inclusion criteria focused on studies addressing hospital preparedness for responding to CBRNe incidents, while articles centered on prehospital preparedness or unrelated events were excluded. Study selection followed the systematic review steps proposed by Tawfik et al. for disaster research. Additionally, the PICO framework was employed to formulate research questions regarding the target population, interventions, and outcomes. Results: The findings of this study revealed that hospital preparedness for CBRNe incidents depends on three main domains: equipment and infrastructure, personnel training, and management and protocols. Key factors for improving critical response include ensuring the availability of appropriate equipment, providing specialized training and regular drills, and developing updated protocols. These results align with previous studies, underscoring the importance of continuous advancements in these areas. Conclusion: The results of this research highlight the need to enhance hospital preparedness for CBRNe incidents, particularly in terms of improving protective equipment, staff training, and managerial protocol development. Continuous education and operational drills can play a crucial role in improving skills and reducing casualties in crisis situations. Considering the importance of health system preparedness in addressing these incidents, future studies are recommended to comprehensively assess prehospital preparedness as well.}, Keywords = {Hospital Preparedness, Emergency Preparedness, Disasters, CBRNe Incidents, Systematic Review.}, volume = {17}, Number = {3}, pages = {15-26}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.3.15}, url = {http://jccnursing.com/article-1-785-en.html}, eprint = {http://jccnursing.com/article-1-785-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Bigdeli, Kimia and Valiee, Sina and ZandKarimi, Eghbal and Vatandost, Salam}, title = {Investigating Nurses\' Vigilance in Caring for Patients in Intensive Care Units in Educational Hospitals of Kurdistan University of Medical Sciences in 2023: A Cross-Sectional Study}, abstract ={Background & aim: Nursing in Intensive Care Units (ICUs) requires constant vigilance, close monitoring, and rapid interventions in order to provide appropriate care and intervention by collecting complete and timely information from the patient and to prevent preventable negative outcomes. The present study was conducted with the aim of determining the vigilance of nurses in caring for patients in ICUs. Methods: The present study was a descriptive-analytical type that was conducted with a cross-sectional method with the participation of 203 ICU nurses who were selected by census method. Data were collected using a demographic information form and the Nurses' Vigilance Standard (NVS) questionnaire with a five-choice Likert response and a total score range of 40-200. Results: The mean total vigilance score of ICU nurses was 147.91 ± 15.73. Nurses' alertness was statistically significantly different based on gender, age group, work experience, average working hours per month, shift type, interest in nursing profession, history of written warning from the medical center, and history of reprimand from the medical center (P<0.05). Conclusion: Nurses vigilance was higher than the expected average. However, implementing effective corrective measures to improve nurses' alertness in patient care is essential to provide better quality care to patients and prevent complications.  }, Keywords = {Nurse, Nursing Vigilance, Intensive Care Unit, Care}, volume = {17}, Number = {3}, pages = {27-36}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.3.27}, url = {http://jccnursing.com/article-1-799-en.html}, eprint = {http://jccnursing.com/article-1-799-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Bahmaniar, Sadaf and Amirfakhraie, Azita and mohamadisoliemani, mohammadreza and Zarei, Eghbal}, title = {The Development and Validation of a Job Burnout Questionnaire for Iranian Nurses: A Case Study of Nurses Working in Hormozgan Province}, abstract ={Background & aim: Evaluating burnout among nurses is critical as a preventive strategy for enhancing mental health and improving their quality of life. Given the intense work pressures during the COVID-19 pandemic, there was a perceived need for a specialized instrument to assess nurses’ burnout. This study aimed to design and validate a new questionnaire for evaluating burnout among nurses working in Hormozgan province. Methods: This research employed a sequential exploratory mixed-method approach, combining qualitative and quantitative techniques. The statistical population included nurses working in Hormozgan Province in 2022. Initially, the preliminary questionnaire items were developed through interviews. Subsequently, 590 nurses were randomly selected. Among them, 100 participated in concurrent validity analysis, 290 in exploratory factor analysis, 150 in confirmatory factor analysis, and 40 in reliability testing. The tools used in this study included a researcher-developed burnout questionnaire and the Maslach Burnout Inventory. The validity of the instrument was assessed through face validity, content validity, exploratory and confirmatory factor analyses, and convergent validity. Reliability was evaluated using internal consistency, split-half reliability, and test-retest methods. Results: The designed questionnaire demonstrated acceptable results in evaluating face validity (both qualitative and quantitative), although two items were revised. Content validity was also confirmed, with modifications made to certain items. Exploratory factor analysis identified five main factors explaining 74.23% of the total variance, and the structure of the questionnaire was confirmed with 29 items. Confirmatory factor analysis validated the five-factor model with indices of χ²/df=2.30, GFI=0.91, CFI=0.91, IFI=0.91, NFI=0.87, AGFI=0.87, PNFI=0.79, and RMSEA=0.93. Convergent validity analysis showed a strong correlation (r=0.71). Cronbach's alpha coefficient was 0.93 for the entire questionnaire and over 0.80 for subscales. Test-retest reliability with a correlation coefficient of 0.91 further confirmed the reliability of the questionnaire (P<0.01). Conclusion: The newly designed burnout questionnaire is a valid and reliable tool for assessing burnout among nurses in Hormozgan province, and it can serve as a scientific and practical instrument in both research and clinical settings.}, Keywords = {Burnout, Nurses, Psychometrics, Questionnaire, Factor Analysis}, volume = {17}, Number = {3}, pages = {37-48}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.3.37}, url = {http://jccnursing.com/article-1-789-en.html}, eprint = {http://jccnursing.com/article-1-789-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Gholampour, Mohammad Hashem and Hajihosseini, Fatemeh and Nazari, Roghieh and Sharif-Nia, Hami}, title = {Investigating the Relationship Between Physician and Nurse in Predicting Missed Nursing Care in Intensive Care Unit Nurses: A Cross- Sectional Study}, abstract ={Background & aim: Delayed or Missed nursing care can be associated with serious complications, mortality, and dissatisfaction among patients, family members, and managers. The nurse-physician relationship plays an important role in managing missed nursing care. This study aimed to investigate the relationship between the physician and nurse in predicting missed nursing care in intensive care unit nurses. Methods: This descriptive-cross-sectional study was conducted using census sampling in 2024 on 180 nurses working in the Intensive Care Units (ICUs) of public hospitals in a city in northern Iran. The research tool was a two-part questionnaire including, the MISSCARE survey for missed nursing care, the Practice Environment Scale of the Nursing Work Index (PES-NWI) and demographic characteristics form. The dimensions of the PES-NWI included nurse participation in hospital affairs, nursing foundations for quality of care, nurse manager ability, leadership, and support of nurses, staffing and resource adequacy, and nurse-physician relationships. The validity of the questionnaires has been confirmed in previous studies in Iran, and their reliability was also acceptable. Data were analyzed using multiple and simple linear regression analysis. Results: A total of 180 nurses working in intensive care units with a mean age of 32.99 ± 7.37 years, most of whom were women and had bachelor's degrees, participated in the study. Adjusted regression analysis showed that, considering the remaining variables in the model, the variables "nursing foundations for quality of care" (B = -0.955, P = 0.019) and "Collegial nurse-physician relations" (B = 3.740, P<0.001) explained 19.3% of the missed nursing care among intensive care unit nurses. Conclusion: The results of this study showed that a good professional relationship between a doctor and a nurse can increase the incidence of missed nursing care. The findings suggest that healthcare management and policy should focus on the professional relationship between a doctor and a nurse, improving work environments to reduce missed nursing care, and improving patient outcomes. Further study is needed to explore possible causes.}, Keywords = {Missed Nursing Care, Relationship, Physician, Nurse, Intensive Care Unit.}, volume = {17}, Number = {3}, pages = {49-58}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.3.49}, url = {http://jccnursing.com/article-1-786-en.html}, eprint = {http://jccnursing.com/article-1-786-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Ostovar, Ayoub and Vatandost, Salam and Aghaei, Abbas and Salehi, Kamal}, title = {The Second Victim Experiences and its Relation to the Safety Culture Among Nurses in Critical Care Units: A Cross-Sectional Study}, abstract ={Background & aim: Considering the consequences of the second victim experience for nurses, further understanding of this phenomenon and identifying its related factors are essential to develop appropriate strategies for mitigating its negative effects. This study aimed to determine the relationship between the second victim experience among nurses and patient safety culture in the Critical Care Units (CCUs). Methods: In this cross-sectional study, 250 nurses were recruited via census sampling based on inclusion criteria: willingness to participate, a minimum Bachelor’s degree in nursing, at least one year of ICU work experience, and a history of medical errors in the past year. Data were collected using a demographic form, the "Patient Safety Culture" questionnaire, and the "Second Victim Experience and Support" questionnaire. Data were analyzed using independent t-test, Mann-Whitney U-test, one-way ANOVA, Pearson correlation coefficient, and linear regression. A significance level of less than 0.05 was considered. Results: The mean score of the second victim experience was 108.16 ± 14.30, indicating a moderate level. Among the dimensions of the second victim experience, "desired supportive measures" and "family support" scored highest (3.48/5 and 3.42/5, respectively), while "colleague support" and "physical strain" scored lowest (2.64/5). The overall patient safety culture score was moderate, with 36.72% reporting high, 30.05% moderate, and 33.21% low safety culture. Linear regression revealed a significant positive correlation between the second victim experience and patient safety culture (r = 0.434, P = 0.000). Conclusion: Enhancing safety culture may reduce the negative impacts of the second victim experience. Therefore, prioritizing safety culture in organizational planning, fostering a non-punitive safety culture, and improving nurses’ work environments could mitigate the second victim phenomenon.}, Keywords = {Second Victim Experience, Safety Culture, Critical Care Units, Nurses}, volume = {17}, Number = {3}, pages = {59-67}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.3.59}, url = {http://jccnursing.com/article-1-779-en.html}, eprint = {http://jccnursing.com/article-1-779-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Safarabadi, Mohsen and Heydari, Mohammad Reza and Haghani, Shim}, title = {Effects of Early Showering after Coronary Artery Bypass Surgery on Pain and Patient Comfort: A Clinical Trial}, abstract ={Background & aim: Showering after coronary artery transplant surgery is a procedure that the way and time of doing it is one of the problems of patients.  Taking a shower or bathing early causes the patient to move early, which prevents deep vein thrombosis, and on the other hand, encourages the patient to take deep breaths, which can prevent chest infection. This study aims to reveal the effects of early showering after coronary artery bypass surgery on pain and patient comfort. Methods: This research is a randomized clinical trial study in which 88 patients who underwent coronary artery bypass surgery and were hospitalized in the special care department of Valiasr Hospital were divided into two control and experimental groups using a block randomization method. Three patients from the intervention group due to tamponade, radial artery thrombosis and delirium and three from the control group (two patients due to prolongation of chest tube removal time more than 72 hours and one patient because of death due to heart failure and cardiorespiratory arrest) were excluded from the study. As the patients in the control group did not take a shower until they were in the hospital, but their showering time was at home on the day of discharge and on a daily basis. According to the protocol, the test group took a shower once a day from 48 to 72 hours after the operation, and the bathing process and evaluations continued daily until discharge. At the time of discharge, the patients were asked to continue bathing daily and on the 14th day after the operation (one week after the discharge), they were asked to visit their surgeon at the clinic for follow-up wound examination, adjustment of medications and continuation of treatment. The first evaluation of pain and comfort was done 48 to 72 hours after the operation and then daily 30 minutes after showering by the researcher. Pain was assessed using a Visual Analogue Scale (VAS). Results: There was a significant relationship between early showering and the level of pain and comfort of the patients. Pain was lower in all evaluations in the intervention group than in the control group. Comfort was higher in all evaluations in the intervention group than in the control group. Conclusion: Early showering after coronary artery bypass surgery has a direct effect on patient pain and comfort. The results showed that early showering after coronary artery bypass surgery reduces pain and increases patient comfort.}, Keywords = {Coronary Artery Bypass, Pain, Patient Comfort, Taking an Early Shower}, volume = {17}, Number = {3}, pages = {68-77}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.3.68}, url = {http://jccnursing.com/article-1-777-en.html}, eprint = {http://jccnursing.com/article-1-777-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Karami, Ata and Majedi, Mohammad azad and Kamyari, Naser and Vatandost, Salam}, title = {Knowledge and Practice of Nurses in Preventing Catheter Associate Urinary Tract Infection (CAUTI) in ICU: A Cross Sectional Study}, abstract ={Background & aim: Urinary tract infection is one of the most common hospital associate infections in the intensive care unit (ICU). The way nurses care for urinary tract catheters is one of the most important factors affecting the prevalence of urinary tract infection. Therefore, the present study was conducted to determine the knowledge and performance of nurses in preventing catheter associate urinary tract infection (CAUTI) in ICU. Methods: The study was conducted cross-sectional. Number of 105 ICU nurses were enrolled in the study using a complete census method. Nurses' knowledge and performance in preventing CAUTI were collected using standard questionnaires in a self-report manner. The knowledge questionnaire consists of 27 questions that are reported with correct and incorrect answers. The average percentage of correct answers of 80 and above is interpreted as good knowledge. The performance questionnaire consists of 23 questions with four-choice Likert-type responses ranging from completely agree (score 4) to completely disagree (score 1). An average score of 3 and above is considered good performance. Results: The mean age of the participants were 27.3 ± 3.03 years. Only 16.2% had a history of participating in a UTI prevention workshop. The results showed that only 38.1% of the knowledge and 33.3% of the performance of nurses in preventing CAUTI were at a good level. The highest incorrect response in the knowledge section was observed in the question "Does the placement of a urinary catheter help to heal bedsores in female patients with bedsores" (68.6%) and in the performance section was observed in the question "While caring for a female patient, I wash the perineum from back to front" (1.68 ± 0.68). Conclusion: The majority of nurses had poor knowledge and performance in preventing catheter-related urinary tract infection. Also, the majority of nurses did not have experience in specific training on UTI prevention in refresher courses. Given the importance of nurses' role in preventing catheter-related urinary tract infections, it is necessary to improve nurses' knowledge and performance based on standard protocols in academic training and refresher courses.  }, Keywords = {Urinary Tract Infection, Urinary Catheter, Nurse, Knowledge, Performance}, volume = {17}, Number = {4}, pages = {1-8}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.1}, url = {http://jccnursing.com/article-1-804-en.html}, eprint = {http://jccnursing.com/article-1-804-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Fazljoo, Seyede Elham and Azizadini, Seyed Shahabadin and Dehghani, Abasali and Salmani, Ebrahim and Nasiriani, KHadijeh}, title = {Explaining the Challenges of the CCU Department in Non-Specialized Hospitals in Small Cities in the Face of the Covid-19 Pandemic: A Qualitative Study}, abstract ={Background & aim: The COVID-19 pandemic has affacted a challenge to all healthcare systems. Crises put a lot of pressure on healthcare staff, especially in small towns where hospitals are not specialized. Therefore, the present study aimed to explain the challenges of the CCU department in non-specialized hospitals in small towns in the face of the COVID-19 pandemic from the perspective of service providers. Methods: The present study is qualitative and of the conventional content analysis type. Participants were selected purposively. Semi-structured interviews were used to collect data, and the interview process continued until complete data saturation. The qualitative data analysis process was carried out based on the Granheim and Landman method. Results: In this study, from 326 open codes, ten subcategories and three themes were extracted, including: structural environmental changes (transformation of the CCU ward into a COVID ICU, transformation of the general ward (one room) into a CCU, lack of equipment and facilities in the CCU ward, and change in the method of programming nurses' shifts from monthly to daily), personnel challenges (doctors' dissatisfaction, nurses' dissatisfaction with the ward, dissatisfaction with the lack of attention to non-COVID nurses' services, nurses' dissatisfaction with the lack of experience and knowledge of working with ICU patients), and inadequate management of cardiovascular patients (loss of cardiac patients and problems of cardiac patients in the CCU alternative ward). Conclusion: This study showed that sudden changes in the structure and management of human resources in the CCU department led to various challenges in the field of services provided to cardiovascular patients. Therefore, it is necessary for health system officials to pay serious attention to examining and improving the working conditions of nurses and providing appropriate equipment and space for treating patients.}, Keywords = {COVID-19, Health Challenges, Nursing, Cardiac Patient Management, CCU}, volume = {17}, Number = {4}, pages = {9-18}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.9}, url = {http://jccnursing.com/article-1-805-en.html}, eprint = {http://jccnursing.com/article-1-805-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Rezaei, Golestaneh and Salmani, Fatemeh and Hajsadegian, Mi}, title = {Investigating the Relationship between Death Anxiety and Perceived Social Support in CABG Patients Admitted to the Cardiac Intensive Care Unit: A Cross-Sectional Study}, abstract ={Background & aim: Coronary artery bypass grafting surgery is still known as the first and most important choice in the treatment of heart patients in some patients. Death anxiety is the most common psychological complication of patients who are candidates for coronary artery bypass grafting surgery, which can be affected by factors such as support from others and the community. The aim of the present study was to determine the relationship between death anxiety and perceived social support in CABG patients hospitalized in the cardiac intensive care unit. Methods: This study was conducted as a descriptive correlation. 100 CABG patients hospitalized in the cardiac intensive care unit referred to Shariati Hospital in Isfahan in 1402 were included in the study through convenience sampling. After receiving informed consent from the research units, the researcher explained to the patients how to complete the questionnaire. The data collection tool consisted of a questionnaire that included three parts: the first part was the demographic characteristics of the research samples, the Templer Death Anxiety Questionnaire, and the Perceived Social Support Scale questionnaire. Results: The study findings showed that the total score of death anxiety was moderate. And the total score of patients' perceived support was 68.4 ± 11.9, the social support score was 22.7 ± 4.1, family support was 23.2 ± 3.5, and the score of friends' support was 22.4 ± 4.6. And there is an inverse and significant relationship between perceived social support and death anxiety. Conclusion: The results of the present study indicate the importance of perceived social support in reducing death anxiety in these patients, therefore, it is necessary to take measures in line with support resources and pay attention to it and recognize the factors affecting it by nurses working in cardiac special wards, and it is recommended that this issue be included in the training for caring for these patients.}, Keywords = {Death Anxiety, Perceived Social Support, Coronary Artery Bypass Graft}, volume = {17}, Number = {4}, pages = {19-27}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.19}, url = {http://jccnursing.com/article-1-791-en.html}, eprint = {http://jccnursing.com/article-1-791-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Ganji, Mohammad and Navab, Elham and Esmaeili, Maryam and haghani, Shima and Shali, Mahboubeh}, title = {Evaluation and Comparison of Diagnostic Accuracy of Early Warning Scores in Trauma Patients for Determining the Need for Intensive Care Unit Admission: A Prospective Study}, abstract ={Background & aim: Predicting the need for intensive care in patients requires predicting the level of risk. Determining the amount of risk that threatens patients can lead to making correct treatment decisions. The present study aimed to determine and compare the diagnostic accuracy of early warning scores in trauma patients to determine the need for intensive care unit admission. Methods: This prospective study was conducted from December 2024 to January 2025 in hospitals affiliated with Tehran University of Medical Sciences. Using the convenience sampling method, 250 trauma patients were enrolled in the study. To collect data, a demographic information questionnaire and warning scores of the National Early Warning Score 2, the Modified Early Warning Score, the Triage Early Warning Score, and the Modified Emergency Medicine Score were used. Results: The mean age of the patients was 40.90 ± 15.78. Accident (56.8%) was the most common mechanism of trauma and multiple trauma (56%) was the most common type of trauma. The National Early Warning Score 2 showed the highest diagnostic accuracy with sensitivity (82.2%), specificity (81.1%), and area under the curve (0.889). Conclusion: While all four early warning scores had good ability to detect ICU admission, there were significant differences in their performance measures. The higher diagnostic accuracy of the National Early Warning Score 2 makes it a valuable tool in identifying patients who may require ICU admission.}, Keywords = {Early Warning Score, Trauma Nursing, Intensive Care Units}, volume = {17}, Number = {4}, pages = {28-36}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.28}, url = {http://jccnursing.com/article-1-807-en.html}, eprint = {http://jccnursing.com/article-1-807-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Samieipoor, Farkhondeh and Eydizadeh, Zahra and Akbari, Leil}, title = {Assessment of the Adherence to Infection Control Standards during the Insertion of Peripheral Venous Catheters: A Descriptive-Analytical Study}, abstract ={Background & aim: Standard precautions are designed to protect patients and hospital staff from potential exposure to contaminated blood and body fluids. This is possible by applying standard principles for infection prevention. In addition, bloodstream infections associated with peripheral venous catheters are a common problem in hospitalized patients. This study was conducted to determine the extent to which infection control standards are followed when inserting peripheral venous catheters. Method: This descriptive-analytical study was conducted using convenience sampling method on 86 nurses of surgical ward and Invasive Care Units (ICU) of Al-Zahraa subspecialty Hospital of Isfahan in 2024. The research tool was a researcher-made questionnaire including demographic characteristics and a checklist to check the level of compliance with standard precautions when inserting intravenous catheters. Results: The findings showed that the mean and standard deviation of the score of compliance with standard precautions was 83.56 ± 16. There was no significant relationship between age and experience in the ICU or surgery with the score of compliance with standard precautions during insertion of intravenous catheters in the studied units (P < 0.05). However, overall work experience had a direct relationship with compliance with standard precautions during the insertion of intravenous catheters (P < 0.001). Conclusion: According to the findings of this study, despite the fact that there was no relationship between the level of compliance with standard precautions and the age and work experience of personnel, the role of retraining courses in updating personnel information was insignificant, which requires further studies in order to improve the quality of standard precautions.}, Keywords = {Infection Control Standards, Catheter Insertion, Peripheral Vein}, volume = {17}, Number = {4}, pages = {37-46}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.37}, url = {http://jccnursing.com/article-1-800-en.html}, eprint = {http://jccnursing.com/article-1-800-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Neichi, Sara and Vatandost, Salam and Nouri, Bijan and Valiee, Si}, title = {The Relationship between Family Satisfaction and Engagement in the Care of Intensive Care Units Patients: A Cross-Sectional Study}, abstract ={Background & aim: In today’s world, satisfaction is considered an important indicator in evaluating the quality-of-care services. Due to limitations such as low level of consciousness of patients in the Intensive Care Unit (ICU), family members play an important role in assessing satisfaction and participating in treatment decision making. As a result, the present study was conducted with the aim of investigating the level of satisfaction of family members and its relationship with their engagement in the care of patients hospitalized in ICUs. Methods: This cross-sectional study was conducted in 2023 with the participation of 70 family members of patients admitted to the ICU of Tohid Hospital in sanandaj, who were selected through convenience sampling. Data were collected through Family satisfaction questionnaire and Family engagement questionnaire and analyzed using Spearman, Mann-Whitney, and Kruskal-Wallis nonparametric statistical tests. Results: The mean age of the participants was reported as 39.54 ± 9.91 years. The overall mean satisfaction score was 70.58 ± 18.77, which was above the median score. The highest score was related to satisfaction with the care provided being 73.13 ± 18.06, while satisfaction with decision-making was 67% ± 22.34. Family members' engagement in patient care was measured at 76.76 ± 17.78. Spearman’s correlation test revealed a statistically significant relationship between overall satisfaction and its subscales with family engagement, indicating that higher engagement was associated with greater satisfaction. Conclusion: Given the direct and significant correlation between family members’ satisfaction and their engagement, it is recommended that appropriate interventions be designed and implemented to enhance family involvement in treatment process and clinical decision-making, thereby improving the quality-of-care services. Additionally, health system managers are encouraged to adopt specific policies that enable greater family engagement through nursing staff.}, Keywords = {Intensive Care Units, Nursing care, Family, Patient Satisfaction}, volume = {17}, Number = {4}, pages = {47-57}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.47}, url = {http://jccnursing.com/article-1-809-en.html}, eprint = {http://jccnursing.com/article-1-809-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Salehinia, Jalal and Khajeaminian, Mohammad Reza and ZareReshkouie, Mohammad and Nasiriani, Khadijah}, title = {The Level of Compliance with National Standards in Resuscitation Trolleys in Teaching Hospitals in Yazd in 2024: A cross-Sectional Study}, abstract ={Background & aim: Effective and safe management of cardiopulmonary arrest in hospitals relies on immediate access to emergency drugs, equipment, and supplies. A resuscitation trolley is a set of drawers and shelves on wheels that are intended for transporting and distributing drugs and equipment in emergency situations. Periodic inspection and completion of the resuscitation trolley to comply with the standard is very important to ensure that the trolley is ready in emergency situations. The present study was conducted to determine the compliance of the resuscitation trolley with national standards in Yazd teaching hospitals in 1403. Methods: This study was a cross-sectional research. The study samples included 71 emergency trolleys in hospital wards. The researcher randomly visited all departments of university teaching hospitals in Yazd city in different shifts and evaluated the quality and quantity of medicines, consumables and equipment of the trolleys with a checklist compiled based on the latest standard guidelines for resuscitation trolleys. Results: According to findings, in terms of compliance with the national guidelines, medicines were not available in the first drawer 11.27% and the second drawer 19.72%, and the equipment in the third drawer 14.09%, the fourth drawer 40.84% and the fifth drawer 37.62%. In terms of the number of medicines in the first drawer 52.11%, the second drawer 66.20% and the equipment in the third drawer 25.59%, the fourth drawer 20.32% and the fifth drawer 43.26% were insufficient. In terms of the expiration date of the drugs in the first drawer 11.27% and the second drawer 19.72% and the expiration date of the equipment and devices in the third drawer 14.56%, the fourth drawer 23.74% and the fifth drawer 39.83% were not valid. Also, in terms of the presence and readiness of the oxygen capsule or central oxygen system 12.7% and 29.8%, suction 29.6% and 45.1%, defibrillator 8.5% and 8.5%, external pad 47.9%, the response was negative. The quality of the trolley was examined with 24 items, and in most cases, structural or quality problems were not found in the resuscitation trolleys. Conclusion: In comparing the resuscitation trolleys with the national standard, it can be concluded that the resuscitation trolleys are acceptable but are not maintained completely in accordance with the latest national guidelines. Therefore, in order to follow the latest resuscitation trolley guidelines, measures such as developing and reviewing the policy for periodic control of resuscitation trolleys and replacing drugs and devices, reviewing the resuscitation trolley standard based on the treatment department, and training staff on the latest resuscitation trolley guidelines are being implemented.}, Keywords = {Resuscitation Trolley, Emergency Trolley, Emergency Drugs, Emergency Equipment, Airway Managemen}, volume = {17}, Number = {4}, pages = {58-65}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.58}, url = {http://jccnursing.com/article-1-808-en.html}, eprint = {http://jccnursing.com/article-1-808-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Arabfard, Masoud and Maher-Sultan, Hosny and vahedian-azimi, Amir}, title = {AI Taxonomy and Statistical Paradigms in Intensive Care: Transforming Diagnosis, Management, and Outcomes: Invited Review Paper}, abstract ={Background & aim: The intensive care unit (ICU) is among the most critical hospital departments, requiring rapid and precise decision-making based on vast amounts of data. Artificial intelligence (AI), by providing advanced analytical tools, is playing an increasingly prominent role in enhancing diagnostic, therapeutic, and management processes in this setting. The primary aim of this review article is to present a systematic classification of different types of AI and their associated statistical methods, with a focus on their applications in critical care. This classification is intended to facilitate a clearer and more practical understanding of these technologies within the ICU. Methods: This narrative review was designed and conducted in accordance with established standards for narrative review articles. The research process was structured into four main phases. First, a comprehensive literature search was performed across major scientific databases, including PubMed, Scopus, Web of Science, and IEEE Xplore. The search strategy employed a combination of keywords related to artificial intelligence, intensive care, machine learning, early diagnosis, and resource management in critical care, along with their English equivalents. The search was limited to articles published between 2010 and 2024. In the second phase, clear inclusion and exclusion criteria were established. Cohort studies, clinical trials, meta-analyses, and review articles focusing on the application of artificial intelligence in intensive care were included. Animal studies, non-systematic case reports, and articles without full-text availability were excluded. During the data extraction and analysis phase, key information from each study was collected, including the type of artificial intelligence approach (symbolic AI, machine learning, deep learning, fuzzy systems), the specific models used (neural networks, support vector machines, decision trees), the domain of application (diagnosis, risk prediction, treatment management), and measures of effectiveness (accuracy, sensitivity, improvement in clinical outcomes). The final phase involved the development of an analytical framework based on two main axes: first, the classification of AI approaches by capability, distinguishing between rule-based systems (symbolic AI) and data-driven systems (deep learning); and second, a performance-based classification encompassing diagnostic applications (such as radiological image analysis), predictive modeling (risk models), and decision-making (optimization of treatment protocols). Specialized models were further evaluated for their practical utility in intensive care settings, including the use of convolutional neural networks for physiological data analysis and fuzzy systems for resource management. Ultimately, the findings were organized in a comparative matrix structured by model type, domain of application, and level of supporting evidence. Interdisciplinary overlaps, such as the integration of reinforcement learning with clinical decision support systems, were also identified. This methodology was developed in accordance with best practices for narrative reviews, emphasizing transparency and rigor in reporting. Results: The results of this review indicate that AI in critical care encompasses a wide range of approaches, including symbolic AI, machine learning (supervised, unsupervised, and reinforcement learning), deep learning, evolutionary AI, fuzzy systems, and swarm intelligence. Each of these approaches, utilizing specific statistical methods, offers unique capabilities in areas such as early disease detection, risk prediction, treatment optimization, and resource management. Conclusion: While the proposed classification can enhance understanding of AI applications in critical care, it is important to note that these categories are not always mutually exclusive, and there is overlap between different approaches. The choice of the appropriate AI method and corresponding statistical technique depends on the specific characteristics of the problem and the available data. Nevertheless, a thorough understanding of AI types and their statistical foundations enables critical care professionals to take effective steps toward improving care quality and patient outcomes. The intersection of AI and critical care opens new horizons for advancing patient health and improving therapeutic results. AI, with its broad spectrum of approaches and techniques, holds transformative potential for critical care. Deep knowledge of these methods empowers specialists to select optimal strategies for improving patient health. The integration of AI and critical care is set to reshape the future of medicine. Responsible development requires attention to ethical challenges and ensuring equitable use of these technologies.}, Keywords = {Artificial Intelligence, Specialized Models, Critical Care, Diagnosis, Care, Treatment}, volume = {17}, Number = {4}, pages = {66-80}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.66}, url = {http://jccnursing.com/article-1-811-en.html}, eprint = {http://jccnursing.com/article-1-811-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} }