Ventilator-associated pneumonia (VAP) remains a common risk in mechanically ventilated patients. Different care bundles have been proposed to succeed VAP reduction. We aimed to identify the combined interventions that have been used to by ICUs worldwide from the implementation of “Institute for Healthcare Improvement Ventilator Bundle”, i.e., from December 2004. A search was performed on the PubMed, Scopus and Science Direct databases. Finally, 38 studies met our inclusion criteria. The most common interventions monitored in the care bundles were sedation and weaning protocols, semi-recumbent positioning, oral and hand hygiene, peptic ulcer disease and deep venus thrombosis prophylaxis, subglottic suctioning, and cuff pressure control. Head-of-bed elevation was implemented by almost all studies, followed by oral hygiene, which was the second extensively used intervention. Four studies indicated a low VAP reduction, while 22 studies found an over 36% VAP decline, and in ten of them, the decrease was over 65%. Four of these studies indicated zero or nearly zero after intervention VAP rates. The studies with the highest VAP reduction adopted the “IHI Ventilator Bundle” combined with adequate endotracheal tube cuff pressure and subglottic suctioning. Multifaced techniques can lead to VAP reduction at a great extent. Multidisciplinary measures combined with long-lasting education programs and measurement of bundle’s compliance should be the gold standard combination.

Background: Postoperative cardiac rehabilitation (CR) programs are increasingly recommended by clinicians, but only a minority of patients who have undergone open heart surgery participate in such programs. Participation rates in postoperative CR, if anything, appear to be declining. This systematic review examines the effectiveness of post-operative CR and reveals possible participation barriers. Methods: A search of two scholarly databases for primary research papers published in the last decade examining the impact of post-operative CR was conducted and the resultant papers reviewed. Results: The 21 resulting studies revealed physiological functioning improvement and a reduction in mortality and readmission rates, while highlighting an enhancement in mental status. Some of the studies recognized the need for nutritional support and suggested that age, gender, access to CR centers, and socioeconomic variables impact participation in CR. Conclusions: Post-operative CR participation rates continue to decline despite increasing evidence of the value of the approach.

Background: Evidence suggests that fluctuations of cortisol and vital signs can emerge during the course of mild Traumatic Brain Injury (mTBI). Objective: To investigate fluctuations of cortisol and vital signs during the acute phase of mTBI in hospitalised patients. Methods: 30 participants (19 patients with mTBI and 11 controls) were examined for saliva cortisol dynamics, heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and body temperature (BT) fluctuations for four consecutive days. Also, the participants completed the Athens Insomnia Scale and Epworth Sleepiness Scales, in order to check for sleep problems. Results: Patients showed elevated levels of cortisol relative to controls (peak at 8 am and lowest levels at 12 am), as well as for most physiological parameters. MAP was significantly higher for patients throughout the measurement period, and BT was elevated for patients relative to controls at almost all measurements of the first and second day. Mean HR tended to track at non-significantly higher levels for the mTBI group. Patients' sleepiness and insomnia values (ESS and AIS) were initially significantly higher relative to controls but the difference dissipated by day 4. Conclusion: The increase in absolute values of cortisol and vital signs measurements, indicates that in the acute phase of mTBI, a stressfulprocess is activated which may affect sleep quality as well.

Background: Pressure ulcers (PUs) remain a prevalent complication in intensive care unit (ICU) settings, especially among immobilized patients. The impact of structured, nursing-led mobilization protocols on PU prevention and recovery remains underexplored. Objective: To evaluate the impact of nursing-led mobilization protocols on the incidence and progression of PUs in critically ill patients. Methods: In this retrospective observational cohort study, 188 ICU patients were admitted during one of two consecutive periods of care: conventional care (6-hourly repositioning) and an advanced nursing-led protocol (3-hourly repositioning with support surfaces and specialized nurse training), which replaced conventional care as standard in our institution. The primary outcome included new PU development for patients with no pre-existing ulcers or worsening/non-progression of pre-existing ulcers at discharge; ICU mortality was evaluated as a secondary outcome. Results: Among patients without pre-existing ulcers (n = 155), new PU incidence did not significantly differ between groups, even after adjusting for SOFA score (OR 0.40, 95% CI: 0.05 TO 3.17; p = 0.374). However, in patients with pre-existing ulcers (n = 33), the advanced care group showed improvement (53.3% versus 0% in the conventional group, OR 0.07, 95% CI: 0.01–0.64; p = 0.012); this effect was independent of initial SOFA score. Mortality was associated with the SOFA score, but not with the type of care. Conclusions: While advanced nursing-led mobilization did not reduce PU incidence, it significantly improved existing ulcer outcomes. Findings support the integration of structured protocols for high-risk ICU patients, especially those with existing ulcers.

Cardiopulmonary resuscitation (CPR) is a vital skill for healthcare professionals, crucial in life-saving situations. More than 80% of cardiac arrest cases occur out of hospital. As the demand for competent CPR practitioners grows, the effectiveness of training methods becomes increasingly important, especially for undergraduate students preparing to enter the healthcare field. The primary objective of our study is to investigate the effectiveness of simulation-based teaching methods and by integrating innovative technologies, such as the OMNI2 stimulator, to improve the precision and objectivity of CPR instruction. A cohort of 144 undergraduate students from the Nursing School Department of the National Kapodistrian University of Athens participated in an 8-hour Basic Life Support Seminar. It consisted of 5 hours theoretical instruction followed by 3 hours of practical training using the OMNI2 simulator. Each student was tasked with identifying cardiac arrest and performing two cycles of CPR according to the 2021 guidelines. Metrics, including total session time, cycles performed, compression-to-ventilation ratio, compression depth, compressions and ventilations per minute, full recoil, peak inspiratory pressure, and ventilation duration, were measured and compared against the stimulator's specified targets. Statistically significant differences (p < 0.05) were observed across all parameters, except for peak inspiratory pressure. Concluding, while simulation-based teaching has conventionally been proven effective for CPR proficiency, real-time data collected in this study reveal a disparity between anticipated and actual performance. Our research underscores the necessity of refining instructional methods to enhance accuracy, potentially leading to improved patient outcomes in the future.

Cardiopulmonary resuscitation (CPR) is a vital skill for healthcare professionals, crucial in life-saving situations. More than 80% of cardiac arrest cases occur out of hospital. As the demand for competent CPR practitioners grows, the effectiveness of training methods becomes increasingly important, especially for undergraduate students preparing to enter the healthcare field. The primary objective of our study is to investigate the effectiveness of simulation-based teaching methods and by integrating innovative technologies, such as the OMNI2 simulator, to enhance practitioners’ performance and to improve the precision and objectivity of CPR instruction. A cohort of 144 undergraduate students from the Nursing School Department of the National Kapodistrian University of Athens participated in an 8 h Basic Life Support Seminar. It consisted of a 5 h theoretical instruction followed by 3 h of practical training using the OMNI2 simulator. Each student was tasked to identify cardiac arrest and to perform two cycles of CPR according to the 2021 guidelines. Metrics, including total session time, cycles performed, compression-to-ventilation ratio, compression depth, compressions and ventilations per minute, full recoil, peak inspiratory pressure, and ventilation duration, were measured and compared against the simulator’s preset targets. Statistically significant differences (p < 0.05) were observed for all outcomes. In conclusion, while simulation-based teaching has conventionally been proven effective for CPR proficiency, real-time data collected in this study reveal a disparity between anticipated and actual performance. Our research underscores the necessity of refining instructional methods to enhance skill acquisition, potentially leading to improved patient outcomes in the future.