Research ArticleResearchWorkflow

Virtual reality did not reduce pain or anxiety during chest-drain removal after cardiac surgery

Enfermeria intensiva (PubMed)Jul 3, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

In an open-label randomized trial that analyzed 98 post-cardiac-surgery patients, virtual-reality distraction did not significantly reduce pain or state anxiety during chest-drain removal versus usual care, although satisfaction was high.

What NurseJet pulled from the source

This single-center randomized trial enrolled 101 spontaneously breathing, communicative patients in a cardiac surgery unit and analyzed 98. Patients underwent chest-drain removal with virtual-reality distraction or usual care, with pain and state anxiety assessed at baseline and after the procedure. The time-by-treatment interaction was not significant for pain (mean difference 0.16, 95% CI -0.70 to 1.03; p=0.71) or state anxiety (mean difference -1.83, 95% CI -4.50 to 0.88; p=0.18). Patients rated the virtual-reality experience highly, but satisfaction did not translate into measured analgesic or anxiety benefit.

Why this matters for nurses

Cardiac and critical-care nurses prepare patients for chest-drain removal and support procedural comfort. This trial matters because it found that a well-liked distraction tool did not improve the outcomes it was intended to change.

Bedside takeaway

Be aware that virtual reality was well liked but did not significantly reduce pain or anxiety during chest-drain removal in this cardiac-surgery trial.

How This Applies in Practice

Use this when: Reviewing comfort measures for chest-drain removal in a cardiac or critical-care unit.

On your shift

Continue the unit's approved pain and anxiety assessment around chest-drain removal rather than using satisfaction as a proxy for symptom relief.
If virtual reality is offered, evaluate it as an optional distraction tool and document clinical response alongside acceptability.

Keep in mind: This trial did not show pain or anxiety benefit. Follow facility protocol and patient-specific provider orders for procedural analgesia and comfort measures.

Explain this for my unit

Key takeaways

The open-label trial enrolled 101 post-cardiac-surgery patients and analyzed 98.
Virtual reality did not significantly reduce pain during chest-drain removal compared with usual care.
State-anxiety differences were also not statistically significant.
Mean satisfaction with the virtual-reality experience was high at 8.3 out of 10.

Practice implications

Do not assume that high patient satisfaction with virtual reality means it reduces procedural pain or anxiety. Continue facility-approved pain assessment and comfort measures for chest-drain removal, and evaluate any new distraction tool against clinical outcomes as well as acceptability.

Limitations & cautions

This was an open-label, single-center study limited to spontaneously breathing patients who could communicate. The analysis included 98 patients, and the study does not establish whether different virtual-reality content, patient selection, or use alongside other interventions would change outcomes.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Enfermeria intensiva (PubMed)

Enfermeria intensiva (PubMed). Virtual reality to reduce pain and anxiety during the removal of chest drains after cardiac surgery: A randomized controlled trial.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42398469/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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The Cochrane database of systematic reviews (PubMed)Jul 14, 2026Systematic ReviewPractice applicable

A Cochrane review of nine randomized trials involving 4,381 adults found that intensive systolic targets below 160 mmHg after ischemic-stroke reperfusion produced no clinically meaningful functional or hemorrhage benefit and probably increased all-cause mortality.

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This Cochrane review compared intensive systolic blood-pressure targets below 160 mmHg with conventional targets, generally below 180 mmHg, after thrombolysis or endovascular thrombectomy for ischemic stroke. Nine randomized trials included 4,381 participants. Intensive management produced little to no clinically meaningful difference in functional outcomes and did not change the risk of any intracranial hemorrhage (RR 0.99, 95% CI 0.87 to 1.14). It probably increased all-cause mortality (RR 1.19, 95% CI 1.08 to 1.32) and probably reduced the proportion of participants with favorable neurologic status, although the estimate included the possibility of little difference. The review does not support assuming that a lower post-reperfusion target is safer or more effective for every patient.

Key takeaways

The review included nine randomized trials and 4,381 adults after thrombolysis or endovascular thrombectomy.
Intensive systolic targets below 160 mmHg did not produce a clinically meaningful functional benefit.
Any intracranial hemorrhage was similar with intensive and conventional management.
Intensive management probably increased all-cause mortality, with a pooled risk ratio of 1.19.

Why this matters on shift

Stroke and critical-care nurses repeatedly measure blood pressure, assess neurologic status, administer ordered antihypertensives, and escalate deviations after reperfusion. This review matters because it challenges the intuitive assumption that pushing systolic pressure lower than conventional targets necessarily improves recovery.

Bedside takeaway

Be aware that intensive systolic targets below 160 mmHg after stroke reperfusion probably increased mortality without meaningful functional or hemorrhage benefit.

Nursing implications

Use the prescribed post-reperfusion target and the facility's stroke protocol rather than treating a lower systolic pressure as automatically better. Pair blood-pressure surveillance with neurologic reassessment and promptly communicate out-of-range values or clinical deterioration to the stroke team.

Limitations & cautions

The intensive targets varied across trials, including thresholds below 120, 140, and 160 mmHg; seven studies involved thrombectomy and two involved thrombolysis. Studies were mainly from upper-middle- and high-income countries, and certainty ranged from high to very low across outcomes.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

The Cochrane database of systematic reviews (PubMed). Blood pressure management in reperfused ischemic stroke.

Explain this for my unit

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AI-summarized from the linked source. Review the original article before applying to practice.

Frontiers in cardiovascular medicine (PubMed)Jun 30, 2026Research ArticlePractice applicable

In a single-center randomized trial of 122 adults with atrial fibrillation, a nurse-led WeChat and cloud follow-up program improved early INR compliance, INR monitoring, medication adherence, and knowledge, but detected no difference in complications or readmissions.

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This randomized trial enrolled 122 cardiology patients taking long-term warfarin and assigned 61 to routine discharge education or 61 to the same education plus an Internet Plus Nursing telehealth program using WeChat and cloud-based education and monitoring. At 10 days, INR compliance was 98.3% with telehealth and 86.5% with usual care; at 1 month it was 86.7% and 57.7%. INR monitoring rates were also higher at both time points. Medication adherence was 88.3% with telehealth and 48.1% with usual care, and knowledge and satisfaction scores were higher. No significant differences were detected in complications or readmissions during six months of follow-up, so the trial supports process and adherence benefits rather than improved clinical outcomes.

Key takeaways

The single-center trial randomized 122 adults taking long-term warfarin for atrial fibrillation.
The intervention combined routine education with WeChat and cloud-based nurse follow-up for six months.
INR compliance and monitoring were higher at 10 days and 1 month, and medication adherence was higher with telehealth.
The trial detected no significant difference in complications or readmissions.

Why this matters on shift

Cardiology and medication-safety nurses reinforce warfarin teaching, coordinate INR follow-up, and identify barriers after discharge. This trial matters because it tested a nurse-led digital pathway and measured both care-process outcomes and clinical outcomes instead of treating improved engagement as proof of fewer complications.

Bedside takeaway

Be aware that nurse-led warfarin telehealth improved INR follow-up and adherence, but the small trial detected no reduction in complications or readmissions.

Nursing implications

A structured, approved telehealth pathway may help reinforce INR follow-up and medication adherence after discharge. Teams should still monitor bleeding, thromboembolic events, complications, and readmissions because better process measures did not translate into detected clinical-outcome differences in this small trial.

Limitations & cautions

This was a single-center study of 122 patients in one Chinese cardiology department with six months of follow-up. The intervention combined education, WeChat contact, and cloud monitoring, and the study did not detect differences in complications or readmissions.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Frontiers in cardiovascular medicine (PubMed). Effect of internet plus nursing mode telehealth intervention on warfarin management in atrial fibrillation patients.

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Hospital Pediatrics (PubMed)Jul 14, 2026Systematic ReviewPractice applicable

A systematic review of 23 pediatric inpatient studies found that most alarm-reduction projects lowered monitor-alarm frequency and every study measuring nonactionable alarms reported a decrease, but study heterogeneity prevented comparison of individual strategies and safety balancing measures were inconsistent.

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This systematic review examined interventions intended to reduce pulse-oximeter and cardiorespiratory-monitor alarms in pediatric inpatient care. The 23 included studies comprised 12 NICU studies, two PICU studies, eight medical-surgical studies, and one spanning PICU and medical-surgical care; 16 were quality-improvement studies, five were nonrandomized, and two were randomized trials. Common approaches included staff education, universal or patient-specific parameter changes, longer alarm delays, and standardized communication about monitoring plans. Most studies reported fewer alarms, and every study that measured nonactionable alarms reported a decrease. However, heterogeneity prevented comparison of individual interventions, balancing measures were inconsistently reported, and the review found no standardized method for synthesizing quality-improvement studies.

Key takeaways

The review included 23 studies across neonatal, pediatric intensive-care, and pediatric medical-surgical settings.
Sixteen studies were quality-improvement projects, five were nonrandomized, and only two were randomized trials.
Most studies reported lower alarm frequency, and all studies measuring nonactionable alarms reported decreases.
The review could not compare individual interventions because of heterogeneity, and safety balancing measures were reported inconsistently.

Why this matters on shift

Pediatric nurses are exposed to repeated monitor alarms and are central to monitoring-plan communication and response. This review matters because it identifies recurring alarm-reduction approaches while warning that lower alarm counts alone do not establish that a change is safer.

Bedside takeaway

Worth knowing that pediatric alarm-reduction projects usually lowered alarm counts, but heterogeneous methods and inconsistent safety balancing measures prevent naming one best approach.

Nursing implications

Pediatric units can use the review to structure approved alarm-reduction work around clear monitoring plans, staff education, nonactionable-alarm measurement, and balancing outcomes. Alarm limits or delays should not be changed outside approved orders and unit protocols, and the review did not identify one superior approach.

Limitations & cautions

The evidence was dominated by heterogeneous quality-improvement and nonrandomized studies, with only two randomized trials. Intervention effects could not be compared, balancing measures were inconsistent, no pooled effect estimate was available, and methods for systematically reviewing quality-improvement studies are not standardized.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Hospital Pediatrics (PubMed). Interventions to Reduce Monitor Alarms Across Pediatric Inpatient Settings: A Systematic Review.

Explain this for my unit

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

Intensive blood-pressure lowering after stroke reperfusion probably increased mortality without meaningful functional benefit

Nurse-led warfarin telehealth improved early INR measures and medication adherence, but complication and readmission rates did not differ significantly

Pediatric monitor-alarm projects usually reduced alarm burden, but safety balancing measures were inconsistent