Clinical trial NCT06997614: Enhancing Critical Thinking Competency and Nursing Quality in Critically Ill Patient Care
Official title: Enhancing Critical Thinking Competency and Nursing Quality in Critically Ill Patient Care: A Quasi-Experimental Study of an Evidence-Based Nutritional Management Protocol
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Evidence-Based Nursing
Critically Ill Patient
Training
Lead sponsor: Taizhou Hospital
Sponsor class: OTHER
First posted: 2025-05-30
Enrollment: 84
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: 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.

Detailed 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Improvement in Junior Nurses' Specialized Critical Thinking Competency
timeFrame: Baseline: Before training (Day 0). Post-intervention: 3 months after protocol implementation.
Secondary outcomes:
measure: Serum Albumin Levels
timeFrame: ICU admission (Day 0) and Day 14.
measure: Serum Prealbumin Levels
timeFrame: Day 0 and Day 14.
measure: Patient Satisfaction
timeFrame: Day 15.
Other outcomes:
measure: Incidence of Aspiration
timeFrame: Daily monitoring until Day 14
measure: Incidence of Diarrhea
timeFrame: Daily monitoring until Day 14.
measure: Incidence of Abdominal Distension
timeFrame: Daily monitoring until Day 14.
measure: Body Weight Changes
timeFrame: Day 0 and Day 14.
measure: Blood Glucose Fluctuations Description: Time Frame:
timeFrame: Daily until Day 14
Locations:
city: Taizhou
country: China
facility: Taizhou Hospital of Traditional Chinese Medicine
state: Jiangsu
Study officials:
References: