Stewart Carolyne, Bench Suzanne, Malone Mary
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK.
Nurse and Midwife Led Research and Academic Leadership, ACORN -A Centre Of Research for Nurses & Midwives, St Thomas Hospital, UK; Director of Nurse and Midwife led Research: Guys and St Thomas NHS Foundation Trust and Professor of critical care nursing, London South Bank University, UK.
Intensive Crit Care Nurs. 2024 Apr;81:103613. doi: 10.1016/j.iccn.2023.103613. Epub 2024 Jan 9.
Recruitment and retention of qualified nurses in critical care is challenging and has been further exacerbated by the COVID-19 pandemic. Poor staff wellbeing, including sickness absence and burnout contribute to a high staff turnover and staff shortages. This scoping review charts wellbeing interventions targeting nurses who work in adult critical care.
Following the Joanna Briggs Institute scoping review methodology, five databases were searched: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ovid Embase, Ovid PsycINFO, and the Cochrane Library alongside a search for grey literature targeting national and international critical care nurse organisations. Primary research studies (qualitative, quantitative and mixed methods), as well as quality improvement studies and policy frameworks published from January 1997 to September 2022 were included. Studies conducted outside an adult critical care setting or not including adult critical nurses were excluded. Extracted data were charted using a series of tables.
26 studies met the inclusion criteria. Most of the interventions targeted personal rather than organisational strategies, focusing on resilience training, mindfulness-based interventions, and other psychological approaches. One intervention was not evaluated. Most of the rest of the studies reported their interventions to improve wellbeing. However, only one study evaluated the intervention for longer than six months.
Current evidence identified that critical care nurse wellbeing is an international concern affecting recruitment and retention. Most available wellbeing interventions take a psychological, personal approach. However, these may not address the complex interaction of organisational factors which impact adult critical care nurses.
Further work is needed to identify and evaluate organisational approaches to improving wellbeing and to evaluate wellbeing interventions over a longer period of time. Critical care nurses should be included in the design of future wellbeing interventions.
在重症监护领域招聘和留住合格护士具有挑战性，而新冠疫情进一步加剧了这一问题。员工健康状况不佳，包括病假和职业倦怠，导致员工流动率高和人员短缺。本综述旨在梳理针对成人重症监护病房护士的健康干预措施。
按照乔安娜·布里格斯研究所的综述方法，检索了五个数据库：医学索引数据库（Medline）、护理学与健康相关文献累积索引数据库（CINAHL）、Ovid循证医学数据库（Embase）、Ovid心理学文摘数据库（PsycINFO）以及Cochrane图书馆，同时检索了针对国内外重症监护护士组织的灰色文献。纳入了1997年1月至2022年9月发表的主要研究（定性、定量和混合方法）以及质量改进研究和政策框架。排除在成人重症监护环境之外进行的研究或未纳入成人重症监护护士的研究。提取的数据使用一系列表格进行整理。
26项研究符合纳入标准。大多数干预措施针对个人而非组织策略，重点是恢复力训练、基于正念的干预措施和其他心理方法。一项干预措施未进行评估。其余大多数研究报告其干预措施改善了健康状况。然而，只有一项研究对干预措施进行了超过六个月的评估。
现有证据表明，重症监护护士的健康是一个影响招聘和留用的国际问题。大多数现有的健康干预措施采用心理、个人层面的方法。然而，这些措施可能无法解决影响成人重症监护护士的组织因素的复杂相互作用。
需要进一步开展工作，以确定和评估改善健康的组织方法，并在更长时间内评估健康干预措施。未来的健康干预措施设计应纳入重症监护护士。
