What's in this issue?

In the second issue of 2021, several papers around important issues such as survivorship from critical illness, follow up after impact Intensive Care Unit (ICU) environment on patients, and mental distress in nurses are collated. To introduce this issue, our guest editorial by Flaws Manning reviews current knowledge field post-ICU across life-span paediatrics to adulthood.1 The authors then emphasise need focus future work optimising outcomes, ensure diverse needs survivors illness all ages, their families, met. Picking one areas recommended editorial, et al discuss post-intensive care syndrome (PICS).2 This term was developed 2012 Society Critical Medicine,3 has promoted maximising recovery following illness. However, present two case studies demonstrate diversity experience clinical covered PICS. vast spectrum conditions poses a challenge both research management, argue that individualised within broad scope PICS is required optimise recovery. Following relationship between post-traumatic stress disorder (PTSD) memories ICU examined Askari Hossenini descriptive correlational study 100 Iran.4 They found 13% participants had PTSD discharge ICU, measured using Impact Event Scale-Revised (IES-R). also demonstrated mean IES-R scores were higher patients' who experienced delusional stay memory tool (ICU-MT), well those mechanically ventilated. highlights take measures minimize echoing Flaws, Manning's call modifiable risk factors support psychological recovery.1 implications for supporting long-term While highlighting importance screening survivors, Karanikola aimed validate modification Davidson Trauma Scale (the DTS-I-M) use telephone consultations with patients recovering illness.5 tested DTS-I-M sample 110 Cyprus, demonstrating valid population. 36% reported symptoms PTSD. explored some predictive characteristics sample. Like al,4 they mechanical ventilation be an factor, results suggesting longer durations length may at more immediate period, Tanner Cornish effect routine step-down services in-hospital outcomes international systematic review meta-analysis.6 Routine visits Outreach Practitioners recently discharged have been adopted many UK National Health Service trusts, supported Guidelines Provision Services adults.7 Eight included review, focused specifically delivered Practitioners. Despite widespread adoption, did not find statistically significant either mortality or readmission although quality meta-analyses assessed generally poor. Given adoption follow-up despite lack evidence, conclude exploring these broaden examine other than readmission, mixed methods benefit convey patients. last 12 months incredibly challenging staff disciplines. Wharton al8 commentary, describe value new well-being champion role can during COVID-19. champion, promotes encourages self-reflective practice peer-to-peer period acute stress, provide nursing team. now them through robust evaluation, key variables burnout, nurse retention, sickness. another paper related topic, Leng al9 influencing managing COVID-19 Wuhan, China. cross-sectional survey used validated instruments, evaluate 90 (83% response rate) selected go Wuhan (China) first wave pandemic. Interestingly, (who came different cities) “selected” because perceived high resilience performance levels. Unsurprisingly, fairly levels among nurses, concluding even highly skilled resilient exposed working pandemic conditions, unknown team, health suffered significantly. Moving on, next noise, light, pain sleep intensive renowned being noisy bright 24-hour shown.10 addition environmental often suffer anxiety, exacerbating problem impairing sleep. Lack (or adequate quality) contributory delirium.11 Bani Younis al12 design ICUs Jordan, noise light 10 pm 6 am (using Richards-Campbell Sleep Scale) 103 conscious extubated adults. correlations (P = <.001) self-reported These findings hardly surprising but serve remind us potentially factor positively Aydin Sayilan al13 pain, three adult Turkish hospital. descriptive, observational 126 awake adults 2 days. Scale, along State Anxiety Inventory (for anxiety) visual analogue scale pain. significantly negative dimensions <.001), patient anxiety .016) no .66). Both yet controlling modifying continues problematic. challenges especially when night really aware consciously strive reduce maximise whenever possible. may, however, Sundberg al14 physical incidence adverse events. report refurbishment rooms Swedish according principles Evidence-Based Design. events occurring admitted refurbished comparison rest cohort. Although difference groups, offers insight into Design consider rooms. Further needed capture changes environment, including impacts, which captured study, delirium ways, paediatric evidence lags behind part smaller nature specialty. Follow-up unit admission example this. Where United Kingdom time15 implemented ICUs, long way behind. al16 conducted web-based instrument adapted Danish “the Follow survey”) determine characteristics, content, PICUs republic Ireland late 2017. With rate 79%, less half surveyed provided any very few post-discharge up. hugely problematic survival PIC (at 96%)17 compared ICU. addition, children (most young <2 years age) whole life ahead them, (to identify problems early instigate support) lead (psychological, social, cognitive, physical) child family.18 Three survey, it would useful re-examine if progress made. 2021 promote consideration lifespan, support, post-hospital contribute increasing placed offer potential improvements practice.