Enhancing Critical Thinking Competency and Nursing Quality in Critically Ill Patient Care

Taizhou Hospital

Status

Completed

Conditions

Training

Critically Ill Patient

Evidence-Based Nursing

Treatments

Other: evidence-based nursing group

Other: Conventional group

Study type

Interventional

Funder types

Other

Identifiers

NCT06997614

No. 20240625

Details and patient eligibility

About

The EBN-based nutritional management protocol effectively enhances junior nurses' specialized critical thinking competency and improves patient nutritional outcomes and satisfaction, demonstrating its potential to optimize critical care quality. However, further validation through multicenter studies with larger cohorts, extended follow-up periods, and additional outcome measures is warranted.

Full description

This study aims to develop an evidence-based nursing (EBN)-based nutritional management protocol for critically ill patients and assess its effects on junior nurses' specialized critical thinking competency and nursing quality. A quasi-experimental design was employed, involving 7 junior nurses and 84 critically ill patients in each of the study and control groups. The study group implemented the EBN-based protocol alongside structured training, while the control group adhered to conventional practices. Nursing quality outcomes included assessments of nurses' specialized critical thinking skills, patient nutritional biomarkers (serum albumin, prealbumin), complication rates (aspiration, diarrhea, abdominal distension), and patient satisfaction. Multivariate binary logistic regression analysis identified influencing factors.

Enrollment

84 patients

Sex

All

Volunteers

No Healthy Volunteers

Inclusion criteria

diagnosis of critical illness by attending physicians or higher-qualified specialists according to established critical care diagnostic standards
requirement for ICU admission with full access to standardized critical care and medical resources
preserved partial gastrointestinal function without severe intestinal obstruction or perforation confirmed by certified nutritionists or senior nurses, enabling potential enteral nutrition (EN) or combined EN-parenteral nutrition (PN) support.

Exclusion criteria

patients with severe cognitive impairment or psychiatric instability (e.g., advanced dementia, schizophrenia, status epilepticus) impairing capacity to engage in nutritional assessments or adhere to clinical protocols, which would jeopardize data collection reliability
terminal-stage conditions (malignancies, renal/hepatic failure) with life expectancy < 7 days or exclusively receiving palliative care, leading to misalignment between their palliative nutritional goals and the study's therapeutic intervention objectives
congenital metabolic disorders (e.g., phenylketonuria) or short bowel syndrome requiring specialized nutritional protocols, which were incompatible with conventional critical care nutritional protocols and could compromise the generalizability of study findings
pregnancy/lactation due to unique nutritional demands and potential risks to fetal/infant development inherent in the study design, contravening established ethical standards
cases involving transfer, voluntary discharge, or withdrawal of consent that compromised data completeness.