Medical device-related pressure injuries in intensive care patients: A prospective and descriptive study.

BACKGROUND: Treatment and care of patients in intensive care units require the use of many medical and technological instruments. Pressure injuries occur when medical devices, which are used more in intensive care patients and are in direct or indirect contact with the skin, cause focal and localized forces on the superficial or deep tissues. OBJECTIVE: In this study, it was aimed to examine the risk factors, incidence and characteristics of medical device-related pressure injuries in intensive care patients. METHODS: This study has a prospective and descriptive design. The study was carried out in the adult intensive care unit of a healthcare institution located in the western Turkey. 138 intensive care patients treated in the level 3 adult intensive care unit were enrolled in the study. The first observations and evaluations of intensive care patients in terms of pressure injuries were made within the first 24 h after admission to the clinic. Observations continued daily during the hospitalization period of the patient. Data were collected with the Intensive Care Patient Information Form, Glasgow Coma Scale, Braden Pressure Ulcer Risk Assessment Scale and Identification Form for Medical device-related Pressure Ulcers. Analysis of data was performed with descriptive statistical methods, Shapiro-Wilk Test, Mann-Whitney U Test and Chi-Square analysis. RESULTS: Medical device-related pressure injury developed in 11.6% (n = 16) of intensive care patients. Anatomically, pressure injury occurred most frequently on the lip (37.5%) and most frequently due to the intubation tube (37.5%). Most of the developed wounds (75.0%) were found to be stage 2. Multinominal logistic regression analysis, which was performed to determine the effect of independent variables on medical device-related pressure injuries in intensive care patients, was found to be statistically significant (X2 = 37.098, p < 0.001). When the regression coefficients were examined, it was found that total hospitalization time in the intensive care unit (ß = 0.948, p < 0.01) and PaCO2 level (ß = 0.923, p < 0.01) had a positive, and duration of aerobic respiration with nasal cannula or mask (ß = -0.920, p < 0.01) and Braden score (ß = -0.948, p < 0.01) had a negative and significant effect on medical device-related pressure injuries. CONCLUSIONS: In this study found that the MDRPIs development rate was lower than other studies. It was observed that pressure injuries due to medical devices developed more frequently in patients with longer hospitalization days, higher PaCO2 levels, shorter duration of oxygenated breathing with nasal cannula or mask, and lower Braden scores.

Nurses' self-efficiency levels in safe blood and blood component transfusion: The case of Turkey.

OBJECTIVE: The study aimed to determine nurses' self-efficacy levels for safe transfusion of blood and blood components. METHOD: The design of this study is descriptive and cross-sectional. Before starting the study, ethics committee approval and institution approval was obtained. The participants were informed about the purpose of the study, and their written consent was obtained. The research was conducted between the dates 01 March 2022 and 01 May 2022, a private hospital in Turkey. The study sample consisted of 482 nurses. Data were collected using descriptive characteristics form and the Safe Blood and Blood Products Transfusion Self-Efficacy Scale (SBT-SES). RESULTS: The total SBT-SES scores of the nurses were high (202.7 ± 50.1), and the behavioral sub-factor self-efficacy scores were moderate (48.2 ± 19.5). When the SBT-SES scores were analyzed based on demographic characteristics, it was found that those who had received previous safe blood transfusion training scored higher than those who had not, and women scored higher than men (p < 0.05). In addition, no relationship was found between age, working time, number of weekly blood transfusions, and self-efficacy levels. DISCUSSION: As a result, nurses' self-efficacy levels towards blood transfusion are high. However, the behavioral sub-factor self-efficacy level is not sufficient. CONCLUSION: Based on these results, in order to increase the behavioral self-efficacy levels of nurses, our recommendations are as follows: investigating appropriate training methods, considering the sex factor when choosing training methods and techniques, investigating the barriers to safe transfusion behaviors, and measuring self-efficacy levels at regular intervals.

Missed nursing care: A cross-sectional and multi-centric study from Turkey.

AIM: The aim of this study is to explore the extent of missed nursing care in Turkey and identify its predictors. DESIGN: This was a descriptive, cross-sectional, multicentre study. METHODS: A total of 477 nurses working in seven public hospitals participated in this study from March to July 2019. The survey included two components: a personal and professional characteristics data form and the MISSCARE survey. RESULTS: The study revealed that emotional support, patient bathing and ambulation were the most frequently missed nursing care activities. An inadequate number of assistive personnel and staff, along with an unexpected increase in patient volume, were identified as the primary reasons for missed nursing care. Of the 21 missed nursing care activities, nine predictive models showed statistical significance (p < 0.05). Factors such as the type of unit, years of work experience, working hours, number of patients cared for in a shift and intention to leave the unit were found to be significant predictors of seven missed nursing care activities (p < 0.05). CONCLUSION: This study found that numerous variables influence each care activity, which suggests the need to devise more targeted and specific strategies to minimize missed nursing care. Thorough investigation into the impact of these strategies on each care activity is essential.

Evaluation of the Impacts of Reiki Touch Therapy on Patients Diagnosed With Fibromyalgia Who Are Followed in the Pain Clinic.

The aim of this study is to investigate the effects of Reiki application on pain, anxiety, and quality of life in patients with fibromyalgia. The study was completed with a total of 50 patients: 25 in the experimental group and 25 in the control group. Reiki was applied to the experimental group and sham Reiki to the control group once a week for 4 weeks. Data were collected from the participants using the Information Form, Visual Analog Scale, McGill-Melzack Pain Questionnaire, State-Trait Anxiety Inventory, and Short Form-36. There was a significant difference between the mean Visual Analog Scale pain scores during and before the first week (P = .012), second week (P = .002), and fourth week (P = .020) measurements of the individuals in the experimental and control groups, after application. In addition, at the end of the 4-week period, the State Anxiety Inventory (P = .005) and the Trait Anxiety Inventory (P = .003) were significantly decreased in the Reiki group compared with the control group. Physical function (P = .000), energy (P = .009), mental health (P = .018), and pain (P = .029) subdimension scores of quality of life in the Reiki group increased significantly compared with the control group. Reiki application to patients with fibromyalgia may have positive effects on reducing pain, improving quality of life, and reducing state and trait anxiety levels.

The Effect of Video-Assisted Training and Visual Feedback With UV Germ Technology on Nursing Students' Hand Hygiene Beliefs, Practices, and Compliance: A Randomized Controlled Study.

BACKGROUND: Hand hygiene (HH) is the most effective way to prevent health care-associated infections; however, HH compliance rates continue to be suboptimal. PURPOSE: To determine the effectiveness of video-assisted training and visual feedback with ultraviolet (UV) germ technology on nursing students' HH beliefs, practices, and compliance. METHODS: This study used a double-blind, posttest randomized controlled design. The experimental group received training, visual feedback with UV germ technology, and instructional videos. RESULTS: A total of 46 students were included in the study (experimental 21 and control 25). The mean score of the HH skills checklist of the experimental group was significantly higher than that of the control group ( P = .0001). The HH compliance rate was also higher in the experimental group (52.62%) compared with the control group (39.1%). CONCLUSIONS: The training, visual feedback with UV germ technology, and instructional videos increased HH compliance rates in nursing students.

The effect of laughter therapy on nursing students' anxiety, satisfaction with life, and psychological well-being during the COVID-19 pandemic: Randomized controlled study.

Background: Changes in routine due to the pandemic have increased nursing students' anxiety about clinical learning. The inadequacy experienced before graduation caused them to experience high levels of anxiety characterized by feelings of insecurity and unhappiness and negatively affected their life satisfaction. Methodological studies are needed to confirm the efficacy of laughter therapy, which is effective in reducing anxiety and stress, on the online platform. The current study protocol was designed to evaluate the effect of online laughter therapy on anxiety, life satisfaction, and psychological well-being. Methods: Forty students were selected for the intervention group and forty students for the control group by assigning 1:1 with a real random number selector among 140 senior nursing students who made up the universe. The intervention group received ten sessions of online laughter therapy two days a week for five weeks. Participants in the control group did not receive any intervention during the study. Data were obtained at the beginning of the study and after five weeks with the 'State-Trait Anxiety Inventory', 'Satisfaction with Life Scale' and 'Psychological Well-Being Scale'. Results: After laughter therapy, the intervention result showed a significant increase in life satisfaction and psychological well-being scores (p < 0.001) and a significant decrease in anxiety scores (p < 0.001) in the intervention group compared to the control group. Conclusion: The study reveals that online laughter therapy significantly positively affects nursing students' anxiety, life satisfaction, and psychological well-being.

The effect of aromatherapy and Su Jok interventions on post-cesarean pain.

OBJECTIVE: The aim of this study was to determine the effect of aromatherapy and Su Jok interventions as nonpharmacological methods of relieving pain after cesarean section. MATERIALS AND METHODS: This randomized controlled trial was conducted with 120 women who had cesarean delivery in the gynecology and obstetrics department of a training and research hospital between February 9 and October 2, 2019. The participants were allocated to the aromatherapy group, Su Jok group, Su Jok and aromatherapy group, or control group using block randomization based on parity. Su Jok was performed using buckwheat seed; aromatherapy was applied using lavender, eucalyptus, or rose oil. Data were collected using a participant information form and pain was assessed using the Visual Analog Scale. RESULTS: There was no significant difference between the groups in mean pain levels before or after the intervention, although the control group had less initial pain compared to the intervention groups. However, all three intervention groups showed significant decreases in pain levels immediately and 30 min after the intervention compared to pre-intervention levels (p < 0.05). The intervention in all three groups reduced the level of pain. In particular, the pain level of the Su Jok group reached from moderate to mild. There was no significant change in the control group. CONCLUSIONS: Aromatherapy and Su Jok interventions performed separately and simultaneously in addition to routine hospital care were more effective in reducing post-cesarean pain than routine care alone.

Do Patient Experiences Have Mediating Roles on Patient Loyalty?

The study aimed to evaluate the mediating roles of patient experiences on patient loyalty. The data were collected through an electronic questionnaire regarding feedback from 5732 patients received outpatient clinics. Patient loyalty was evaluated using the Net Promoter Score (NPS11) that patients were asked whether they would like to recommend the hospital to their relatives or friends. Patient experiences with physicians, nurses, and waiting times were also asked in the questionnaire. After preliminary analysis, mediation analyses were performed to evaluate direct and indirect causal effects among variables for NPS11. While patient experiences are used as possible mediators, Branch Groups in the first and Admission Time in the second model are independent variables. In the analyses, Surgical Medical Science (p = 0.019) and Day Shift (p = 0.000) have a direct mediating effect on NPS11. Nursing care experiences were found to be a mediator variable for NPS11 in both models (p = 0.000 for both). Patient loyalty was associated with Surgical Medical Science and Day Shift primarily whereas Nursing care experience had a mediating role.

Development and Validation of the Safe Parenteral Medication Administration Self-Efficacy Scale.

BACKGROUND: This study aimed to develop a valid and reliable measurement instrument for determining the self-efficacy perceptions of nurses concerning safe medication practices. METHOD: The study was conducted at the hospital of a state university in Istanbul, Turkey, between August and December 2016. The sample consisted of 278 nurses. RESULTS: The exploratory factor analysis indicated the scale had a single-factor structure that explained 47.92% of the total variance. The remaining 76 items had factor loads ranging from .50 to .87. The item-total correlations varied between .49 and .86, and Cronbach's alpha coefficient for the scale was .98. CONCLUSION: The results of the analysis show the items constituting the scale have validity and reliability criteria that can measure the self-efficacy of nurses related to parenteral medication administration. [J Contin Educ Nurs. 2021;52(6):267-273.].

Scale for maternity role perceptions.

The purpose of this study was to develop and test the psychometric properties of the Maternal Role Perception Scale, a measure of motherhood, based on the perceptions of women. The 5-point Likert draft scale with 61 items was used. The data of 610 mothers were analyzed in the study. In the validity-reliability analysis of the scale, exploratory factor analysis and Cronbach's alpha coefficients were used. As a result of the factor analysis, the scale consists of 28 items and two factors explaining 55.741% of the total variance. The internal consistency coefficient (Cronbach's alpha) of the scale was calculated as 0.952. The Maternity Role Perception Scale (MRPS) is a reliable and valid scale developed for Turkish women. Maternal role is affected by physical, psychological, social status and the life of the woman. It is recommended to apply MRPS on different samples.

Development, reliability, and validity of the Insulin Treatment Self-Management Scale.

AIM: The aim of this study was to develop a valid and reliable measuring tool to determine the level of self-management of insulin treatment by individuals with diabetes. METHODS: This was a methodological instrument development study. This study was conducted in a training and research hospital in Istanbul, Turkey, between January and June 2014.The sample of the study included 311 individuals with diabetes. The item pool was formed with 63 items. The content validity was assessed by 14 experts. The draft scale with 58 items was formed with a five-point Likert type scale. The structural validity of the scale was assessed via exploratory factor analysis. In the context of reliability analyses, the item-total score correlation, the split-half method, and the test-retest application were used. RESULTS: The scale had 32 items and three subscales. The first factor was called "behavioral subdimension," the second as "cognitive subdimension," and the third, "affective subdimension." The total Cronbach alpha value of the scale was 0.91. CONCLUSION: Preliminary validity and reliability was demonstrated for a newly developed scale for measuring insulin treatment self-management of adult individuals with diabetes.

Treatment of partial-thickness burns with a tulle-gras dressing and a hydrophilic polyurethane membrane: a comparative study.

OBJECTIVE: The purpose of this revisited study was to compare the clinical efficacy and long-term scar evaluation of a hydrophilic polyurethane membrane (HPM), Omiderm (Omikron Scientific Ltd., Rehovot, Israel) and an antimicrobial tulle-gras dressing (TGD), Bactigras (Smith & Nephew) in the management of partial-thickness burns. METHOD: Patients with partial-thickness burns were enrolled in this prospective study. Burn areas were divided into two areas and both dressings were applied to each field at the same time. Time to full re-epithelialisation and scar evaluation were compared using the Vancouver Scar Scale (VSS). RESULTS: A total of 21 patients, mean age 36.8 years, with 22 burns areas participated. The results showed that there is no statistically significant difference in terms of full epithelialisation time in the application of either dressing (p>0.05). However, with deep dermal burns, the HPM provided slightly faster epithelialisation (p>0.05). A VSS assessment showed no statistically significant difference (p>0.05) between applying either dressing materials. CONCLUSION: This study indicated that both dressings had the same effectiveness in treatment of partial-thickness burn wounds. However, the use of the HPM, especially in deep dermal second-degree burns, should be one of the first-line clinical choices, based on the advantages discerned by this study.

Effect of Web-based diabetes training program on diabetes-related knowledge, attitudes, and skills of health professionals: A randomized controlled trial.

AIM: To determine the effect of a Web-Based Diabetes Training Program (WB-DTP) on the diabetes-related knowledge, attitudes, and skills of health professionals. METHODS: This was an experimental pretest-post-test with a 1 month follow-up study design that included a control group. The results of the power analysis suggested that 50 individuals with diabetes should be in both the intervention and the control groups. The WB-DTP was developed in accordance with the Effective Teaching Instruction Model.. Measures included the information form, Achievement Test (AT), Diabetes Attitudes Scale (DAS), and skill observation forms. The Wilcoxon's Signed Rank test, Mann-Whitney U-test, and Friedman test were used to analyze group differences on these measures. RESULTS: There was a significant difference between the AT post-test and the follow-up test scores of the intervention and control groups. No significant difference was present for the DAS post-test and follow-up scores between the intervention and control groups. A significant difference emerged on the Insulin Injection Skill Observation Form score between the intervention and control groups. In addition, there was a significant difference in the measurement level of blood glucose by the Glucometer Skill Observation Form between the intervention and control groups. CONCLUSIONS: As a result, it was determined that the WB-DTP is effective in increasing the diabetes-related knowledge and skills of healthcare professionals. However, the program was not adequate at increasing the diabetes-related attitudes of health professionals.

Development of a Web-Based Diabetes Education Program for Health Care Professionals.

This study developed a Web-based type 2 diabetes education program (WB-DEP) for health care professionals. The methodology consisted of a pretest-posttest quasi-experimental approach. The study group consisted of 44 nurses and six midwives who volunteered for the study. The WB-DEP was developed in accordance with the effective teaching design model of Morrison, Ross, and Kemp. Data for the study were collected using the Information Form, The Section Evaluation Tests, the Web-Based Teaching Material Evaluation Scale, and the WB-DEP Opinion Form. In the statistical evaluation of the data, the averages, percentages, frequencies, and mean values were calculated, and the Wilcoxon signed-rank test was also used. According to the results, the study group believed that the WB-DEP was generally useful, successful, beneficial, informative, and understandable. In addition, the WB-DEP was found to significantly increase participants' knowledge about diabetes. J Contin Educ Nurs. 2016;47(10):464-471.

The Use of the Braden Scale in Assessing Pressure Ulcers in Turkey: A Systematic Review.

OBJECTIVE: The goal of this systematic review was to reach scientific generalizations regarding the assessment of risk for pressure ulcers based on the results of previous studies that made use of the Braden Scale. DATA SOURCES: This research was performed by using a retrospective screening of studies relevant to the subject. In Turkey, the first validity and reliability study for the Braden Scale was performed by Oguz and Olgun in 1998. For this reason, the authors' research was conducted between March 2, 2012, and August 4, 2012, as a systematic review analysis by evaluating studies in Turkey that made use of the Braden Scale between 1998 and 2012. Screening was performed by using different combinations of 8 keywords in Turkish and English to scan a total of 10 national and international databases. A total of 2375 studies were evaluated, and 16 studies were included and considered within the context of this research. RESULTS AND CONCLUSIONS: It was determined that the studies considered within the context of the current research were conducted between 1998 and 2012; 5 of these studies were experimental and 11 were descriptive; the sample size varied between 22 and 422; the majority were performed in intensive care units; and the study samples were mostly composed of patients. The Braden Scale was used in these studies for forming samples by identifying high-risk patients. Two studies evaluated the reliability of the Braden Scale, whereas 7 other studies calculated the reliability coefficient. Only 1 study included results for sensitivity, specificity, positive predictive value, and negative predictive value (which represent the predictive criteria of assessment tools). Four studies indicated cutoff values, which varied between 14 and 18. A general evaluation of these studies' results revealed limited evidence of effective risk assessment by the Braden Scale.

Preoperative education and use of analgesic before onset of pain routinely for post-thoracotomy pain control can reduce pain effect and total amount of analgesics administered postoperatively.

The purpose of this study was to investigate the efficiency of preoperative pain management education and the role of analgesics administration before the onset of pain postoperatively. The study was a prospective, randomized, and single-blind clinical trial, which was conducted January 1, 2008 through October 1, 2008 in the Thoracic Surgery Unit of Akdeniz University Hospital. A total of 70 patients who underwent thoracotomy (35 in the control group and 35 in the study group) were included in the study. Of the patients, 70% (n = 49) were male and 30% (n = 21) were female. Mean age was 51 ± 10 years (range = 25-65). The same analgesia method was used for all patients; the same surgical team performed each operation. Methods, including preemptive analgesia and placement of pleural or thoracic catheter for using analgesics, that were likely to affect pain level, were not used. The same analgesia medication was used for both patient groups. But the study group, additionally, was educated on how to deal with pain preoperatively and on the pharmacological methods to be used after surgery. An intramuscular diclofenac Na 75 mg was administered to the study group regardless of whether or not they reported pain in the first two postoperative hours. The control group did not receive preoperative education, and analgesics were not administered to them unless they reported pain in the postoperative period. The routine analgesics protocol was as follows: diclofenac Na 75 mg (once a day) intramuscular administered upon the complaint of pain following extubation in the postoperative period and 20 mg mepederin intravenously (maximum dose, 100 mg/day), in addition, when the patient expressed pain. Pain severity was assessed during the second, fourth, eighth, 16th, 24th, and 48th hours, and marked using the Verbal Category Scale and the Behavioral Pain Assessment Scale. Additionally, the total dose of daily analgesics was calculated. The demographic characteristics showed a homogeneous distribution in both patient groups. The rate of pain, which was defined as sharp, stabbing, and exhausting, was higher in the control group than in the study group, and the difference between the two groups was statistically significant (p < .05). As the doses of analgesics used for pain management in both groups were compared, it was determined that analgesic consumption was lower in the study group than in the control group, and the difference was statistically significant (p < .05). As a result, it was determined that preoperative thoracic pain management education and analgesics administered postoperatively, before the onset of pain, reduced the amount of analgesics used in the first postoperative 48 hours.

Developing scale for colleague solidarity among nurses in Turkey.

There is a need for an appropriate instrument to measure colleague solidarity among nurses. This study was carried out to develop a Colleague Solidarity of Nurses' Scale (CSNS). This study was planned to be descriptive and methodological. The CSNS examined content validity, construct validity, test-retest reliability and internal consistency reliability. The trial form of the CSNS, which was composed of 44 items, was given to 200 nurses, followed by validity and reliability analyses. Following the analyses, 21 items were excluded from the scale, leaving an attitude scale made up of 23 items. Factor analysis of the data showed that the scale has a three sub-factor structure: emotional solidarity, academic solidarity and negative opinions about solidarity. The Cronbach's alpha reliability of the whole scale was 0.80. This study provides evidence that the CSNS possesses robust solidarity among nurses.

Image of nursing held by nursing students according to gender: a qualitative study.

This paper is a report of a study to determine the nursing images of female and male nursing students. The study used a qualitative research design to determine nursing images of male (n = 20) and female (n = 20) nursing students. To analyse the data, the method used content analysis. Statements were organized under three categories and seven themes after content analysis. The first category, nursing concept, incorporates the two themes of: (i) female or sister; (ii) job definition. The second category, choosing, incorporates the four themes of: (i) Desire of Others; (ii) Guarantee of Work; (iii) Being Helpful to Others; and (iv) Limited to Academic Achievement. The third category, Gender, incorporates the one theme of: (i) Gendered Approach. Male students have started to take part in nursing programs relatively recently; therefore, more research is needed in the fields of academic accomplishments of male students.

[Approaches taken by nurses in treating postoperative pain]. / Postoperatif agri ve hemsirelik uygulamalari.

OBJECTIVES: Surgery is recognized as an important cause of pain. Expression of pain differs according to age, developmental stage, previous pain experiences, and other modifying environmental factors. The degree of postoperative pain should be reduced using different techniques, both pharmacological and non-pharmacological. This study aimed to determine the effects of various actions taken by nurses for the purpose of pain management. METHODS: One hundred eighty-nine nurses working in the surgical ward were included in this study. A questionnaire was used to investigate demographic data and the actions taken by the nurses in the study group to alleviate pain. RESULTS: The results showed that 146 of 189 nurses (77.2%) administered analgesic medication more often than employing other techniques for pain management. CONCLUSION: The other applications in pain management included patient-controlled analgesia (PCA), massage, visual analog scale (VAS), and teaching relaxation techniques, helping with mobilization, and assessing vital signs.

The relationship among pressure ulcers, oxygenation, and perfusion in mechanically ventilated patients in an intensive care unit.

PURPOSE: We examined the relationships among oxygenation, tissue perfusion, and other comorbid conditions not incorporated into the Norton Scale, and pressure ulcer (PU) development in subjects receiving mechanical ventilation. DESIGN: Descriptive, observational study. SETTING AND SUBJECTS: The setting was our university hospital's surgical/emergency intensive care unit in Istanbul province, Turkey. The sample comprised 30 patients who were older than 18 years, did not have a PU on admission, and had been mechanically ventilated for more than 24 hours when data collection began. METHODS: Skin integrity and a PU risk, using the Norton Scale, were administered twice daily. In addition, serum blood testing, vital signs, and data regarding ventilation and oxygenation status were obtained from the patient's electronic medical records. RESULTS: Slightly less than half of subjects were women (n = 14, 46.7%). Their mean age was 54.36 years (SD = 20.68). Pressure ulcers developed in 5 patients (16.7%); all PUs were located on the heel. All ulcers were initially observed as stage I lesions; 1 progressed to a stage II ulcer and 1 progressed to a stage III ulcer. Patients who developed pressure ulcers have higher serum glucose levels (z = -2.198; P = .028), higher serum pH levels (z = -2.031; P = .028), and lower diastolic blood pressures (z = 0.055; P = .057) than those who remained ulcer free. CONCLUSION: Our results demonstrate that mechanically ventilated patients who develop PUs were more likely to have significantly higher blood glucose levels, significantly lower diastolic blood pressure values, and significantly higher serum pH values than were patients who remained free of PUs. Nurses who care for mechanically ventilated patients should recognize these factors and initiate preventive interventions as indicated.