New method for autonomous learning of BLS psychomotor skills: Pillow mannequin: Randomized controlled study.

BACKGROUND: Evidence supporting the benefits of autonomous learning of basic life support, such as rapid outcomes and cost-effectiveness, is increasing. Reports supporting the autonomous learning of cognitive skills in basic life support exist. However, there is currently no report supporting the autonomous learning of psychomotor skills in basic life support. AIM: This study aimed to assess how using a research-developed pillow-made mannequin affects autonomous learning of psychomotor skills in basic life support training. DESIGN: Randomized controlled trial. SETTING: This study was conducted in a nursing school in Turkey. PARTICIPANTS: Sixty-one (n = 61) third-year formal science undergraduate students. METHODS: At XXX University, 61 nursing students were divided into Intervention (n = 31) and Control Groups (n = 30). Students in both groups received basic life support training, including live demonstrations. Intervention Group students practiced with the mannequin for 15 days. Skill assessments were conducted by two independent evaluators using a real mannequin 15 days later and six months later. Researchers used a checklist to assess psychomotor skills. RESULTS: The sociodemographic characteristics of both student groups were similar. There was no significant difference in cognitive knowledge levels after the blended training (p > 0.05). However, at both post-intervention assessments, after 15 days and after 6 months, significant skill differences emerged in "placing the index finger on the ends of the sternum," "combining the thumbs in the middle," "defining the lower sternum as a massage point," "placing the base of the chest" "placing the weaker hand at the massage point," "placing the body perpendicular to the ribcage," and "performing 30 compressions." Cohen's kappa value was calculated as 0.932. CONCLUSION: Use of the mannequin facilitates autonomous learning of psychomotor skills and promotes accurate application. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05346003, 08/02/2022.

The Effects of Preoperative Video-Assisted Education on Anxiety and Comfort After Breast Cancer Surgery: Nonrandomized Controlled Study.

PURPOSE: This study aimed to determine the effects of video-assisted education given before breast cancer surgery on patients' anxiety and comfort. DESIGN: A nonrandomized, controlled, quasi-experimental model was used. METHODS: The study was conducted in the general surgery clinic of a public hospital. Seventy patients voluntarily participated in the study, 35 of them were in the Control (CG) and 35 of them were in the Experimental Group (EG). While routine treatment and care were given to CG, a video-assisted education was also provided to EG. The data were collected using the Personal Information Form, State-Trait Anxiety Inventory (STAI), and General Comfort Questionnaire (GCQ). The patients in both groups filled in the STAI and GCQ on the first day preoperatively, STAI-S and GCS on the second postoperative day and STAI-S on the tenth day after surgery. P < .05 was accepted as a statistical significance value. FINDINGS: The groups were similar in terms of descriptive features and preoperative anxiety scores (P > .05). Postoperative second and tenth-day anxiety scores were significantly higher in CG (43.97 ± 9.42 and 39.45 ± 3.88) compared to EG (33.29 ± 4.94 and 33.31 ± 3.01) (P < .05). In terms of the mean scores of the GCQ and its subscales of comfort, preoperative comfort was found to be lower than postoperative comfort level (P < .05). CONCLUSIONS: Preoperative video-assisted education decreased the anxiety level and increased the comfort level in EG. We conclude that the use of video-assisted education in reducing anxiety and increasing the perception of comfort in breast cancer surgery patients would be beneficial.

Designing and implementing a training program on surgical hand scrubbing, wearing surgical cap and surgical mask, gowning, and gloving using HMD-based virtual reality technologies for nursing students: an exploration of student perceptions.

Objective: The aim of this study is to determine the steps of a training program utilizing Head-Mounted Display (HMD) based Virtual Reality Technology to enhance nursing students' skills in surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving, and to evaluate students' perceptions toward the program. Methods: The study aimed to investigate the potential applications of HMD-Based Virtual Reality Technology in Surgical Hand Scrubbing, Wearing Surgical Cap and Surgical Mask, Gowning and Gloving Program for nursing students, as well as students' perceptions toward this technology. The research was conducted with a focus group consisting of second-year nursing students in Osmaniye/Turkey, between January and June 2022, and the training program was implemented in five stages: Analysis, Design, Development, Implementation, and Evaluation. The program was evaluated with a focus group of nursing students. Focus group discussions were conducted to provide insights into students' experiences, feedback, and perceptions of the program. Results: A vast majority of participants (92.5%) reported feeling fully immersed in the operating room environment during the virtual reality (VR) experience. Notably, all students acknowledged the potential of HMD-Based Virtual Reality Technology to enrich their understanding of surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving procedures, surpassing conventional instructional models. While many participants found the experience exhilarating (85.1%), a considerable portion reported a decline in engagement after repeated exposures (88.8%). Overall, participants welcomed the integration of VR technology into education, expressing optimism about its capacity to facilitate additional instructional modules (74.4%). Moreover, they conveyed satisfaction with the opportunity to engage with the VR application, emphasizing its significant educational value (81.4%). Conclusion: Based on these findings, we can suggest that virtual reality technology has the potential to have an impact on nursing students' education. The majority of students expressing a sense of presence in the operating room highlights the value of this method in education. However, the reported boredom after repeated experiences by most participants underscores the importance of diversifying the program and introducing innovative approaches to keep students engaged.

Meeting the Needs of Family Members of Trauma Patients in the Emergency Department.

BACKGROUND: While the needs of family members have previously been studied, the needs of families of trauma patients have received less attention. OBJECTIVE: This study aims to assess the needs of family members of trauma patients in the emergency department. METHODS: This cross-sectional survey study was conducted over 4 months (February-May 2022) with family members of trauma patients admitted to the emergency department of a state hospital in Istanbul, Turkey. The validated Critical Care Family Needs Inventory - Emergency Department survey was administered face-to-face to a convenience sample of consenting family members. RESULTS: A total of 248 family members participated, representing 84 patients. The mean age of the participants was 33 (8.18) years, with a gender distribution of 50% women. On average, 76.5% of the family members' needs were met. The most important needs reported as mean (SD) were as follows: communication, 3.52 (0.68); participation in care, 3.52 (0.68); comfort, 3.36 (0.65); and support needs, 3.21 (0.72). These needs were met to varying degrees: communication 85%, participation in care 81.2%, comfort 75.4%, and support needs 65.2%. CONCLUSION: The study findings indicate that the needs of family members of emergency department trauma patients are not fully met. Families report needing communication the most and comfort the least.

Family opinions on resuscitation and participation in end-of-life care in the emergency department: A cross-sectional study.

OBJECTIVE: The study looked into emergency department family members' (FMs) views on being present during resuscitation and contributing to end-of-life care. METHODS: A cross-sectional study with 467 FM volunteers of mildly injured or ill patients was conducted at a research hospital between October 2021 and May 2022. Data were collected using a questionnaire administered by a clinical psychologist. The analysis employed SPSS 22.0 with a significance threshold of P < 0.05. The study was conducted according to the STROBE criteria. Statistical significance was set at P < 0.05. RESULTS: The mean FMs' age was 34.3 ± 10.43; 64.2% were male, 62.1% were married, and 76.9% had nuclear families. About 61% wanted the option of being present during resuscitation, with 47.5% desiring participation in both resuscitation and end-of-life care. Significant differences were observed in opinions based on education, work status, and resuscitation training (P = 0.015, P = 0.001, P = 0.002). CONCLUSION: Many FMs sought the choice to be present during resuscitation, and nearly half preferred participation in both resuscitation and end-of-life care.

Assessing the impact of the COVID-19 pandemic on latex glove usage and latex allergy complaints among nurses: A descriptive study.

BACKGROUND: The coronavirus 2019 (COVID-19) pandemic has led to a significant increase in the use of latex gloves among nurses. However, concerns about the rise in latex allergies and related complaints due to this increase remain uncertain. OBJECTIVE: This study aims to assess the rates of latex glove usage and allergy-related complaints among nurses working in hospitals during the COVID-19 pandemic. METHODS: Between May 15 and June 15, 2021, ethical approvals were obtained for a cross-sectional study involving 448 volunteer nurses. Descriptive statistics were used to represent categorical values as counts (n) and percentages (%), while continuous values were represented as mean±standard deviation. The normal distribution of the data was assessed using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Comparative analyses were conducted using paired sample t-test, Pearson's chi-squared (x2) test, McNemar's chi-squared (x2) test, and Spearman correlation analysis. RESULTS: Before the pandemic, the average number of invasive procedures was 45.13±26.48, whereas during the pandemic, this rate increased to 50.23±29.14. The average glove usage duration went from 7.69±3.13 hours to 14.73±3.68 hours during the pandemic. Among nurses, the rate of allergic symptoms, which was previously at 31.5%, rose to 33.3% during the pandemic. CONCLUSION: This study revealed a significant increase in daily invasive procedures and the use of latex gloves among nurses during the pandemic period. Simultaneously, the frequency of allergic symptoms also rose. These findings underscore the importance of awareness and preventive measures, particularly regarding latex allergies, in the healthcare field.

Knowledge and Practices of Surgical Nurses on Inadvertent Perioperative Hypothermia.

AIM: This study aimed to determine surgical nurses' knowledge of the risk factors and complications of inadvertent perioperative hypothermia and the practices preferred to prevent inadvertent perioperative hypothermia and to provide normothermia. METHODS: This descriptive study was conducted on 122 volunteer nurses working in the surgical clinics of a state and a private hospital between August 1 and September 15, 2019. The data collection form included questions to determine the characteristics of nurses and the risk factors, complications, and preventive practices of inadvertent perioperative hypothermia. The data forms were distributed by visiting the nurses one by one and were retrieved after an appropriate time. For statistical analyses, Statistical Package for the Social Sciences 22.0 software was used. RESULTS: The most known risk factors for IPH were "excessive blood loss" (75.4%), "anemia" (73.0%), and "inadequate covering of the patient/ not enough clothing" (72.9%). The most known complications of inadvertent perioperative hypothermia were "increased oxygen consumption and need" (65.6%), "hypoxemia" (61.5%), and "hypoxia" (49.4%). The most preferred method to provide normothermia in the perioperative period was "covering the patient with a blanket" (80.3%). CONCLUSION: In this study, nurses did not have enough information about the risk factors and complications of Inadvertent perioperative hypothermia. In addition, it was determined that most of the nurses did not use the methods in the guidelines to prevent inadvertend perioperative hypothermia.

Evaluation of the relationship between individual workload perception and compliance with isolation measures of emergency and critical care nurses.

BACKGROUND: As a result of the coronavirus 2019 (COVID-19) pandemic, compliance with isolation measures has become challenging. OBJECTIVE: To evaluate the individual workload perception and compliance with isolation measures of nurses working in the emergency service and critical care unit during the COVID-19 outbreak. METHODS: This descriptive correlational study was carried out in the emergency service and critical care unit of a public hospital between April 20 and May 20, 2021. A total of 153 nurses working in the emergency service and critical care unit who agreed to participate in the study were included in the study. RESULTS: Nurses from a state hospital's emergency department and critical care unit (n = 153) were included in the study sample. The impression of overall individual workload by nurses and compliance with isolation (r = 0.153; p < 0.05) had a positive, weak, and significant relationship. The Isolation Measures Compliance Scale resulted in a mean score of 70.70±5.35. The mean score on the Individual Workload Scale for nurses was moderate (3.22±0.54). CONCLUSION: The low perception of individual workload of nurses working in the emergency service and critical care unit during the COVID-19 pandemic increased the compliance with isolation measures.

Exposure of Emergency Nurses to Workplace Violence and Their Coping Strategies: A Cross-Sectional Design.

INTRODUCTION: Violence against nurses working in the emergency department is a serious problem worldwide. METHODS: This descriptive study used a participant questionnaire and was conducted in-person, using semi-structured interviews with 120 emergency nurses (69 female, 51 male) working in the emergency department between September 1 and November 30, 2017. RESULTS: Overall, 90% of the study participants were exposed to workplace violence at least once while working in the emergency department, and 94.4% experienced verbal abuse, including insults, shouting, threats, and swearing. Most of such workplace violence came from the patients relatives. Most workplace violence incidents occurred during the 4 pm to midnight time slot and in the triage area. The most important perceived reasons for workplace violence were the long waiting period for treatment and care (79.6%) and not being prioritized for treatment (68.5%). The top 3 coping methods used were reporting to the nurse in charge (78.1%), followed by reaching out to the security personnel (72.8%) and filing lawsuits if exposed to physical violence (65.8%). CONCLUSIONS: Most emergency nurses had experienced workplace violence. Hospital administration should take more effective security measures, hospitals should provide education and training programs for dealing with workplace violence, and programs to support staff members on encountering workplace violence should be implemented.

Effect of family presence on stress response after bypass surgery.

BACKGROUND: Coronary artery bypass grafting (CABG) is a major surgery that may cause severe surgical stress response (SR). Although the presence of family members in intensive care unit (ICU) is known to benefit intensive care patients socially and emotionally, its effects on surgical SR are unknown. OBJECTIVES: To investigate the effect of an informed family member (IFM)'s presence in the awakening process in ICU on patients' SR after CABG. METHODS: A nonrandomized controlled clinical study was completed with a total of 73 patients: 37 patients in the control (CG) and 36 in the intervention group (IG) underwent CABG surgery. In the CG patients, no family members were taken into the ICU during the awakening process and routine care and treatment practices were continued. In the IG patients, besides routine care and treatment practices, an IFM was taken into the ICU during the awakening process in accordance with the research method. Groups were statistically compared in terms of serum cortisol level which is the one of the main indicators of surgical SR, state anxiety, sedative drug requirements, and duration of intubation, sedation, and ICU stay. A p value <0.05 was accepted as statistically significant. RESULTS: Presence of an IFM in the ICU was found to be effective in decreasing serum cortisol level, state anxiety, sedative drug requirements, and the duration of intubation, sedation, and ICU stay (p<0.05). CONCLUSIONS: In CABG, the presence of IFM in ICU is effective in reducing SR.

Determination of food intake and the factors affecting food intake in perioperative period in patients who undergo open heart surgery.

BACKGROUND: This study aims to investigate the factors affecting food intake in perioperative period of patients who undergo open heart surgery and the effects of body weight, albumin and hemoglobin values, nausea, vomiting and constipation on food intake. METHODS: This cross-sectional study was conducted between 4 February 2015 and 4 May 2015 in a cardiovascular surgery clinic. A questionnaire including 25 questions was applied to a total of 86 volunteer participants (62 males, 24 females; mean age 61.3±10.8 years; range 38 to 82 years). RESULTS: Patients consumed 38% of the food one day before the surgery and 51% one day after, 47% three days after, and 52% five days after the surgery. Factors affecting food intake were the procedure of discontinuing food intake for pre-surgery anesthesia preparation (84.9%), nausea (31.4%) one day after surgery, and constipation three (26.5%) and five (33.7%) days after surgery. Albumin levels decreased significantly in days after surgery compared to the day before surgery (p<0.05). There was a significant positive correlation between food intake rates and albumin levels on the first, third and fifth days after surgery (r=0.354, r=0.353, and r=0.521, respectively; p<0.05). CONCLUSION: Patients' body weight and albumin levels decreased in accordance with their nourishment status after surgery. Food intake was insufficient in the perioperative period.

Effectiveness of local cold application on skin burns and pain after transthoracic cardioversion.

BACKGROUND: Transthoracic cardioversion (TTC) is widely used in emergency departments and daily clinical practice. TTC may cause skin lesions on the application of apical and sternal paddle areas. The lesions are characterised by redness, erythema and blister(s), and can be defined as first degree burns locally causing pain and increased sensitivity. AIM: To evaluate the effectiveness of local cold application on reducing the incidence, severity and pain/sensitivity of skin burns in patients who underwent TTC. METHODS: The study was conducted in the intensive care unit of the cardiovascular surgery department. The patients were assigned to study (n=24) and control groups (n=24). Local cold application was performed for a 1 hour period on patients in the study group, whereas only clinical procedures were applied in the control group following TTC. Incidence and severity of burn was evaluated 2 h after TTC, and pain/sensitivity scores were evaluated at 2, 4 and 24 h after TTC. Results The incidence of burn was significantly lower in the study group (3/24) compared to the control group (21/24) (12.5% vs 83.3%, p<0.001). Pain/sensitivity scores were significantly lower in the study group compared to the control group (p<0.05). CONCLUSION: Local cold application following TTC is an effective means of reducing the incidence and severity of burns and pain/sensitivity. It is cost-effective and can easily be applied by nurses in medical/surgical units and emergency departments.

Tear clearance measurement in patients with dry eye syndrome using quantitative lacrimal scintigraphy.

OBJECTIVE: The aim of this study was to evaluate the tear clearance in patients with dry eye syndrome using quantitative lacrimal scintigraphy. MATERIALS AND METHODS: We investigated 21 patients (42 eyes; 18 women, 3 men; mean age, 63.19 +/- 13.33 years) with dry eye syndrome. Additionally, for the sake of comparison, 12 normal subjects of the same age group (24 eyes; 10 women, 2 men; mean age, 68.25 +/- 2.63 years) were included. Lacrimal scintigraphy, Schirmer-1 test, BUT, and rose bengal ocular surface vital staining were performed in these cases. RESULTS: According to the results of lacrimal scintigraphy, the mean value of T 1/2 was 4.16 +/- 1.22 minutes and the mean value of RI was 14.15% +/- 2.30% in normal subjects. However, in patients with dry eye syndrome, these values were 20.59 +/- 1.97 minutes and 55.64% +/- 6.90%, respectively. Consistent with the results of ophthalmologic tests, the mean Schirmer-1 value was 12.46 +/- 2.10 mm, the mean value of BUT was 14.36 +/- 3.40 seconds, and the mean staining value of the rose bengal was 1.98 +/- 0.80 in normal subjects, whereas these values were 1.36 +/- 0.49 mm, 5.46 +/- 1.33 seconds, 6.62 +/- 0.86, respectively, in patients with dry eye syndrome. When we compared the results of lacrimal scintigraphy and the results of ophthalmologic tests, an inverse correlation was noted between both the T1/2 and RI values and both the Schirmer-1 and BUT values in all subjects (p < 0.001). However, there was a greater positive correlation between the rose bengal ocular surface staining value and both the T1/2 and RI values in all cases (p < 0.001). CONCLUSION: In the current study, it was concluded that although the lacrimal drainage system was normal, tear clearance was significantly delayed in dry eye patients. With this study, we have shown that quantitative lacrimal scintigraphy, which is an objective, practical, and noninvasive method, appears to be useful for the assessment of the tear clearance in patients with dry eye syndrome.

The influence of post-exercise cardiac changes on thallium-gated myocardial perfusion scintigraphy findings in normal subjects.

BACKGROUND AND AIM: During recovery after exercise, the heart rate and blood pressure return to a resting state more rapidly than the end-systolic left ventricular dimensions and fractional shortening. The aim of this study was to assess how exercise-related cardiac changes affect the interpretation of myocardial perfusion images in normal subjects. Systolic cardiac parameters on gated stress and rest images were evaluated in healthy young and elderly subjects. METHODS: Twenty-six healthy young and 20 healthy elderly subjects participated in the study. An injection of 111-130 MBq of thallium-201 (201Tl) was given at peak exercise. Rest images were acquired 2.5 h after stress acquisition, 15 min after a second injection of 18.5-37 MBq of 201Tl. Data were analysed using automatic-processing software for quantitative gated single photon emission computed tomography (SPECT) (QGS). The parameters derived from QGS were the end-systolic volume (ESV), end-diastolic volume (EDV), left ventricular ejection fraction (LVEF), end-systolic surface area (ESSA) and end-diastolic surface area (EDSA). The difference between wall thickening in the basal and apical segments (Delta WT) was also calculated. Perfusion images were visually assessed for differences in cardiac size, evidence of reversible hypoperfusion and hot spots. RESULTS: In the young group, LVEF was approximately 6% higher at stress than at rest. EDV, ESV, ESSA and EDSA were all significantly lower, and Delta WT was significantly higher, at stress than at rest. In the elderly group, the mean LVEF at stress was slightly higher than the finding at rest (P<0.05). Visual evaluation of perfusion images revealed mild reversible stress hypoperfusion in the inferoseptal region in eight young male subjects. CONCLUSIONS: In healthy young subjects, post-exercise cardiac changes affect systolic functions detected on gated thallium myocardial perfusion scintigraphy, resulting in a smaller heart size during stress. This finding, accompanied by a significant difference in apex to base counts during stress, may cause basal portions of the heart to appear ischaemic. The absence of these findings in the elderly suggests a decrease in contractility with age.