Nursing in critical care · 2026
A Multicentre Survey of Paediatric Critical Care Nurses' Awareness, Knowledge and Practice of Intra-Abdominal Hypertension and Abdominal Compartment Syndrome.
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Li ZhiRu, Lu FangYan, Dai YanHong, Ji Li, Huang HaiLi, He PanPan, Zhang WanYing, Wang HuaFen
Аннотация
BACKGROUND: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are potentially life-threatening complications in critically ill children, yet nursing awareness, knowledge and management of these syndromes remain poorly understood.
AIM: To assess paediatric critical care nurses' awareness, knowledge and management of IAH/ACS and intra-abdominal pressure (IAP) measurement, identifying gaps and barriers to guide training and protocol standardisation.
STUDY DESIGN: This is a descriptive cross-sectional study. Paediatric critical care nurses (convenience sample) from nine settings in six Zhejiang Province hospitals were surveyed online (April-May 2025). The survey evaluated IAH/ACS awareness/knowledge (13 items) and IAP measurement practices (12 items).
RESULTS: In this study, 235 nurses from nine centres responded (response rate: 61.8%). The survey revealed significant deficiencies in nurses' awareness and implementation of World Society of the Abdominal Compartment Syndrome (WSACS) guidelines: 52.8% were unaware of them, 12.3% reported familiarity, and 44.7% indicated non-adoption in their hospitals. Knowledge of IAH/ACS was limited: 54.9% had never heard of ACS, and 62.6% were unfamiliar with IAH's impact on organ function. Notably, 68.9% had never managed paediatric IAH/ACS cases. In practice, only 23.8% received IAP measurement training, and 26.0% had performed it. Transbladder measurement was most common (96.7%) but lacked standardisation. Main barriers were procedural skill deficits (61.5%), inadequate indication recognition (52.9%) and clinical inexperience (50.6%). Key facilitators included educational training (88.5%), simplified/standardised IAP techniques (88.1%) and evidence-based guidelines (80.4%).
CONCLUSIONS: Substantial knowledge-practice gaps exist in paediatric IAH/ACS management, characterised by low guideline awareness, insufficient clinical knowledge and inadequate/unstandardised IAP monitoring. To address these gaps, efforts should prioritise enhancing stratified training, standardising technical practices and implementing guidelines.
RELEVANCE TO CLINICAL PRACTICE: There is an urgent need for paediatric critical care nurses to receive standardised training on IAP monitoring, to adopt unit-specific protocols and to lead or participate in the implementation of evidence-based guidelines at the bedside.
AIM: To assess paediatric critical care nurses' awareness, knowledge and management of IAH/ACS and intra-abdominal pressure (IAP) measurement, identifying gaps and barriers to guide training and protocol standardisation.
STUDY DESIGN: This is a descriptive cross-sectional study. Paediatric critical care nurses (convenience sample) from nine settings in six Zhejiang Province hospitals were surveyed online (April-May 2025). The survey evaluated IAH/ACS awareness/knowledge (13 items) and IAP measurement practices (12 items).
RESULTS: In this study, 235 nurses from nine centres responded (response rate: 61.8%). The survey revealed significant deficiencies in nurses' awareness and implementation of World Society of the Abdominal Compartment Syndrome (WSACS) guidelines: 52.8% were unaware of them, 12.3% reported familiarity, and 44.7% indicated non-adoption in their hospitals. Knowledge of IAH/ACS was limited: 54.9% had never heard of ACS, and 62.6% were unfamiliar with IAH's impact on organ function. Notably, 68.9% had never managed paediatric IAH/ACS cases. In practice, only 23.8% received IAP measurement training, and 26.0% had performed it. Transbladder measurement was most common (96.7%) but lacked standardisation. Main barriers were procedural skill deficits (61.5%), inadequate indication recognition (52.9%) and clinical inexperience (50.6%). Key facilitators included educational training (88.5%), simplified/standardised IAP techniques (88.1%) and evidence-based guidelines (80.4%).
CONCLUSIONS: Substantial knowledge-practice gaps exist in paediatric IAH/ACS management, characterised by low guideline awareness, insufficient clinical knowledge and inadequate/unstandardised IAP monitoring. To address these gaps, efforts should prioritise enhancing stratified training, standardising technical practices and implementing guidelines.
RELEVANCE TO CLINICAL PRACTICE: There is an urgent need for paediatric critical care nurses to receive standardised training on IAP monitoring, to adopt unit-specific protocols and to lead or participate in the implementation of evidence-based guidelines at the bedside.