Delirium is an acute disorder characterized by changes in the patient’s cognitive function, which another neurocognitive or pre-existing disease cannot explain. It produces adverse outcomes for critically ill patients and their families related to adverse events associated with the accidental removal of medical devices that increase the risk of the patient and the length of stay at the hospital, manifested by agitation and confusion behaviors. Five reviewers conducted An Umbrella Review from May to August 2023 through research in the databases Medline, CINAHL, Scopus, Web of Science, Cochrane Database of Systematic Reviews and articles obtained through research in other sources. After verifying their eligibility, we obtained 22 systematic reviews and meta-analyses for data extraction and analysis. From the results obtained, the importance of the implementation of surveillance interventions and systematic evaluation of the presence of delirium is highlighted, with particular emphasis on the use of the scale, Confusion Assessment Method, followed by the implementation of multicomponent interventions, pharmacological or not, highlighting the use of dexmedetomidine and family as support, as well early mobilization for the management of delirium. Managing delirium in critically ill patients based on Meyer and Lavin's theory, is an area sensitive to nursing care with an impact on the prevention of complications and consequent promotion of the safety of these patients, which also translates into positive results for the family and health organizations, reducing morbidity, mortality, length of stay and health costs.

Corneal surface injuries occur frequently (59.4%) in critically ill patients, and the average time for their appearance is 8 days. Such injuries are primarily related to dry eye, which increases the risk of exposure injury in patients admitted to intensive care units. This can result in a severe ulcer or perforation that results in partial to total loss of vision, decreasing the quality of the patient's life. This is a sensitive nursing care area requiring further investigation. Thus, this review aims to analyse nursing interventions that aim to prevent ocular surface injuries. An integrative literature review was carried out from May to August 2023 in the Medline, CINAHL, Scopus, Web of Science, and PubMed databases using the Whittemore and Knafl methodology. Inclusion and exclusion criteria were subsequently applied to assess the results. After verifying result eligibility, seven documents were identified for data extraction and analysis. The results suggest the importance of recognizing risk factors for ocular injuries in critically ill patients, surveillance as a nursing competency, adequate ocular hygiene and effective lubrication, and managing environmental conditions to prevent corneal injuries. Implementing surveillance and intervention protocols for critically ill patients at risk of corneal injuries requires specialized training for critical care nurses. Specifically, environmental management, including temperature and humidity control, is highlighted as an area that merits further research.

BACKGROUND AND AIM: A healthy work environment is one in which workers and managers cooperate in the process of continuous improvement regarding the protection, and promotion of workers' health and well-being, for the sake of work sustainability. The current state of the art shows that an unfavourable work environment contributes to nurses' dissatisfaction, burnout and emotional exhaustion, and the intention to leave the workplace/service. This study aimed to identify the Nurses' Work Environment in a small Portuguese Hospital, diagnose the situation, and focus on a healthy work environment. METHODS AND MATERIALS: This is a quantitative, descriptive, and cross-sectional study, with a convenience sample of 90 nurses. The “Escala de Ambiente de Trabalho da Prática de Enfermagem” (Nursing Practice Work Environment Scale), validated and adapted by Ferreira & Amendoeira (2014) for the Portuguese population, was applied. The statistical treatment was performed using SPSS 27. RESULTS: The sample is mostly composed of female nurses (87%) with an average age of 26 years, and 75.5% are single. The dimension "Management and Leadership of the Head Nurse" had a mean value of x̅ =3.3 (out of 4) and σ=0.5, which was the dimension with the best assessment. The dimension with less encouraging results was "Nurses' Participation in Hospital Affairs" with x̅ =2.8 (out of 4) and σ=0.7. Overall, all domains assessed had a mean value above 2.5, which was considered a favourable work environment by the nurses. CONCLUSION The results, although generally satisfactory, show the need to carefully intervene and assess each dimension in an integrated perspective, to promote a healthy work environment and workers' well-being, since its imbalance may negatively affect quality of their work, impacting the quality of health care provided to the user . In addition, these results should be understood as an important factor to be considered in the design of future care teams. Regardind future research, it would be important to consider large samples and deepen the topic explored among different departments in the health care facilities.
Nurses ; Workplace ; Health Promotion