{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:52:31Z","timestamp":1792155151026,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adult ICU medication loss is reported using non\u2010equivalent forms and denominators, limiting interpretation and intervention design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine loss measurement, nursing mechanisms, intervention evidence and balancing outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Convergent segregated mixed\u2010methods systematic review. Three databases were searched to 1 July 2026, with citation searching, metadata checks and an uncapped rerun of two capped PubMed arms. Quantitative results remained in native units; qualitative findings were synthesised separately and integrated. MMAT 2018 was applied by design category; two reviewers checked screening, extraction and appraisal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 768 screened records (576 primary; 192 rerun), 79 reports were assessed with retained sources. Four reports could not be retrieved. Twenty\u2010five reports from 21 independent studies were included; the rerun added none. Categories were prepared\u2010unused medication (11), post\u2010order or post\u2010event loss (7), partial\u2010container residual (8), delivery\u2010system residual (3) and material\u2010flow loss (4); categories were nonexclusive. Denominators were explicit in 10 studies, partial in 5 and absent in 6. No studies met pooling criteria. Two qualitative studies generated six low\u2010confidence CERQual findings. Intervention evidence was uncontrolled, modelled or proposal\u2010based; balancing outcomes were uncommon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adult ICU loss comprised non\u2010equivalent quantities, not one waste prevalence, and no study related it to a patient outcome. Studies would need to specify loss form, numerator, denominator, observation window, workflow node, result origin and balancing outcomes alongside resource use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Order review before non\u2010urgent preparation, reconstitution and checking, storage and return pathways, and syringe, pump and line handling are candidate targets; no controlled adult ICU study has shown reduced loss without affecting access, dose delivery, sterility, compatibility or workload.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70743","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:10:17Z","timestamp":1792152617000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nursing Mechanisms of Intravenous Medication Loss in Adult Intensive Care: A Mixed\u2010Methods Systematic Review"],"prefix":"10.1111","volume":"31","author":[{"given":"Lijun","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine Mianyang Hospital Affiliated to University of Electronic Science and Technology of China (Mianyang Central Hospital)  Mianyang Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinlong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Mianyang Hospital Affiliated to University of Electronic Science and Technology of China (Mianyang Central Hospital)  Mianyang Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Mianyang Hospital Affiliated to University of Electronic Science and Technology of China (Mianyang Central Hospital)  Mianyang Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingwen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Mianyang Hospital Affiliated to University of Electronic Science and Technology of China (Mianyang Central Hospital)  Mianyang Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010025\u201005299\u20106"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2023.103403"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2024.103786"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejps.2023.106590"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010025\u201005434\u20103"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp140257"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/00185787221130229"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/cce.0000000000001450"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000730220.95371.4b"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010026\u201006163\u2010x"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.13150"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2025.101450"},{"key":"e_1_2_12_14_1","volume-title":"JBI Manual for Evidence Synthesis","author":"Aromataris E.","year":"2020"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643\u2010020\u201001542\u2010z"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6890"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201012\u2010181"},{"key":"e_1_2_12_19_1","unstructured":"Q. 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