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This study aimed to investigate the incidence and identify risk factors of stress hyperglycaemia among patients who received enteral nutrition (EN) in the intensive care unit (ICU).
Stress hyperglycaemia is common among ICU patients receiving EN and is related to worse outcomes. However, the factors associated with stress hyperglycaemia during EN remain unclear, especially among patients who are not diagnosed with diabetes.
A retrospective cohort study.
Electronic medical records of 614 non-diabetic patients receiving EN at two ICUs in Guizhou Provincial People's Hospital were reviewed. Patients were classified into hyperglycemic and non-hyperglycemic groups. Social demographics, clinical characteristics, treatment regimens, nutrition therapy, and point-of-care blood glucose values were collected. Univariate and multivariable analyses identified risk factors for stress hyperglycaemia. This study followed the STROBE guideline.
The incidence of stress hyperglycaemia among ICU patients without diabetes receiving EN was 35.50%. Multivariable analysis revealed that obesity (BMI ≥ 28 kg/m2), high carbohydrate intake (> 5.0 g/kg/day), and the use of semi-elemental EN solutions were independent risk factors for stress hyperglycaemia. In contrast, a moderate carbohydrate intake (3.0–3.9 g/kg/day) was associated with a significantly lower risk of stress hyperglycaemia.
The 35.50% of ICU patients without diabetes experienced stress hyperglycaemia during EN. Potential risk factors included BMI ≥ 28 kg/m2, high carbohydrate intake (> 5.0 g/kg/day), and the use of semi-elemental EN solutions. A moderate carbohydrate intake (3.0–3.9 g/kg/day) was protective. Future research should explore optimal carbohydrate intake ranges and personalised nutrition protocols to reduce stress hyperglycaemia in critically ill patients.
Reducing stress hyperglycaemia in ICU patients without diabetes receiving EN is crucial. Recommendations include monitoring patients with BMI ≥ 28 kg/m2 and considering moderate carbohydrate intake (3.0–3.9 g/kg/day), and reasonably selecting the type of enteral nutrition solution based on the patient's individual condition.
This study investigated the relationship between clinical nurses' critical thinking ability and medication safety competence, as well as the factors related to medication safety competence.
Nurses can have an active role in promoting medication safety. However, the main factors associating with nurses' competence in medication safety are uncertain.
This was a descriptive, multicenter cross-sectional survey study.
A total of 1196 nurses from four different tertiary hospital in China were included in this study. A demographic information questionnaire, the Critical Thinking Diagnostic for nurses, and the Medication Safety Competence Scale for nurses were used to survey. Descriptive statistics, comparisons, correlation and regression analysis of the collected data were performed using SPSS 26.00 software. The study was reported using STROBE checklist.
Included nurses obtained satisfactory scores on the critical thinking and medication safety scales and subscales. There was a strong statistically significant positive correlation between critical thinking ability and medication safety competence.
Multiple linear regression analysis indicated that personal critical thinking scores and working years were positively associated with nurses' medication safety scores, accounting for 62.50% of the variance.
Clinical nurses' critical thinking ability is positively associated with medication safety competence.
As critical thinking ability positively predicts nurses' medication safety competence, hospitals and nursing administrators should consider continuing nursing education and training to improve critical thinking skills, thereby promoting medication safety competence among clinical nurses.
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