PURPOSE:This study aimed to evaluate the effects of sensory stimulation (SS) on the level of consciousness, the incidence and duration of ICU delirium, the awakening time, and the length of mechanical ventilation in ICU patients. MATERIALS AND METHODS:Randomized controlled trials (RCTs) were identified through a comprehensive search across 7 digital databases. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Cochrane Risk-of-Bias Tool for Randomized Trials. In case of disagreement, a third author decided whether to include or exclude the article. Meta-analyses were conducted using RevMan V.5.3.5 software. RESULTS:A total of 22 RCTs involving 1,522 patients were included. Compared with routine care, SS improved the level of consciousness (MD: 2.09; 95% CI: 1.50 to 2.68; P < .001) and reduce the incidence (OR: 0.33; 95% CI: 0.18 to 0.62; P < .001) and duration of delirium (MD: -2.63; 95% CI: -3.32 to -2.03; P < .001) in ICU patients, shorten the Awakening time (MD: -7.39; 95% CI: -8.76 to -6.01; P < .001). CONCLUSION:SS may improve the level of consciousness, reduce the incidence of delirium, and shorten the Awakening time in ICU patients. For improvement in the level of consciousness, subgroup analyses suggest that SS delivered by family members is more effective than that delivered by nurses, multisensory stimulation (MSS) is more effective than single-modality stimulation, and an intervention period of at least 7 days is required to achieve a significant effect, with twice-daily SS appearing to be the optimal frequency.
Background: Breast milk is the preferred source of enteral nutrition for neonates and is particularly important for premature neonates because it promotes growth and development, and reduces the incidence of many diseases to which premature neonates are susceptible. Objectives: To assess the prevalence and duration of breastfeeding among very preterm infants (VPIs) with a gestational age <32 weeks admitted to the neonatal intensive care unit (NICU) of XiJing Hospital. Methods: A retrospective record review was conducted to collect data on clinical characteristics and feeding methods of 235 VPIs born in XiJing Hospital from January 2017 to December 2023 and admitted to the NICU within 24 hours of birth. Results: Of the 235 eligible VPIs, 177 (75.3%) were delivered by cesarean section, 102 (43.4%) did not receive any breast milk during their hospitalization, and 133 (56.6%) received a mixture of breast milk and formula. Compared with the cesarean-section group, the vaginal-delivery group was significantly more likely to breastfeed (12% vs. 0.3%; P =.004) and had a significantly higher median daily breast milk intake (5.81 vs. 0.17 mL/kg; P =.003) during hospitalization; however, the duration of parenteral nutrition did not differ significantly between groups. Discussion: Overall, these results indicate that measures are required to increase breastfeeding among VPIs, particularly those born by cesarean section.
Background: A newly opened Medical Intensive Care Unit identified variation in nursing documentation practices related to titratable medications, with underlying causes initially unclear. Objectives: The primary aim of this quality improvement initiative was to reduce variation in titratable medication documentation practices by identifying and addressing barriers to compliance. Methods: Using an improvement science approach informed by protocol-based care and iterative Plan-Do-Study-Act cycles, the project identified key barriers, including workflow inefficiencies, documentation complexity, and knowledge gaps. A targeted educational intervention was subsequently developed, and auditing tools were used to assess sustainability. Results: Following the intervention, compliance with titratable medication documentation improved from a baseline of 78.5% to 88.7%, as demonstrated by audits conducted 3 months postintervention. Pre- and postclass surveys also showed significant improvements in nurses’ confidence and competence in documenting and managing titratable medications. Discussion: This project provides insight into the development of collaborative, data-driven educational interventions that foster accountability, enhance clinical documentation practices, and ultimately improve patient safety and care quality in critical care settings. Future quality improvement efforts may benefit from incorporating simulation-based strategies.
