Adaptation and validation of the Compliance with Standard Precautions Scale amongst nurses in Turkey.

AIMS: To adapt and psychometrically test the Compliance with Standard Precautions Scale for use by Turkish nurses. BACKGROUND: Measurement of standard precautions compliance is important to manage the safety of both patients and health care teams. METHODS: This two-phase methodological study employed a correlational design with repeated measures. In phase one, the scale's adaptation, including translation, semantic equivalence, content and face validity, was implemented. In phase two, internal consistency and stability were used to examine the reliability of the scale. Construct validity was tested using the Rasch rating scale model. This study was conducted by recruiting 411 nurses from three different hospitals between September 2015 and September 2016. RESULTS: Adaptation results showed that the Turkish version of the Compliance with Standard Precautions Scale (CSPS-T) is adequate for linguistic and content validation. The content validity index and comprehensibility of the scale were similarly satisfactory. The reliability of the CSPS-T was examined by Cronbach's alpha, corrected item-total correlations and intraclass correlation coefficient, and good results were obtained. The Rasch model showed that all items were compatible with the model. Whereas Item 4 was the most difficult, Item 10 was the easiest. CONCLUSION: The CSPS-T is a reliable and valid tool for assessing compliance with standard precautions amongst Turkish nurses.

Nurses' view of their work environment, health and safety: A qualitative study.

AIM: This study aims to determine the nurses' view of the work environment on nurses' health and safety. BACKGROUND: The creation of positive work environments has become one of the key determining factors to improve nurse outcomes. METHODS: The research, a qualitative descriptive design, was conducted between January and October 2017 with a total of 17 nurses. Nurses were selected for the study using the purposive sampling method, and in-depth interviews were carried out with these nurses under the guidance of a semi-structured interview form. Thematic analysis was conducted to analyse the interviews. RESULTS: In line with the views of nurses, two main themes as "physical environment regulations" and "administrative arrangements" and six sub-themes (room structures and plans, hygiene conditions, lack of materials, occupational precautions, the attitude of the managers, team collaboration and communication) were determined as the nurses' health and safety issues on their work environment. CONCLUSIONS: Personal, administrative and institutional improvements are needed, especially for the prevention of work accidents and injuries. IMPLICATIONS FOR NURSING MANAGEMENT: The study results will serve to guide legislators and upper-middle-sub-level managers in developing interventions to create supportive work environments for the health and safety of nurses.

Nurses' identification and reporting of medication errors.

AIMS AND OBJECTIVES: To investigate hospital nurses' involvement in the identification and reporting of medication errors in Turkey. BACKGROUND: Medication safety is an international priority, and medication error identification and reporting are essential for patient safety. DESIGN: A descriptive survey design consistent with the STROBE guidelines was used. METHODS: The participants were 135 nurses employed in a university hospital in Turkey. The survey instrument included 18 sample cases and respondents identified whether errors had been made and how they should be reported. Descriptive statistics were analysed using the chi-square and Fisher's exact tests. RESULTS: The sample case of "Patient given 10 mg morphine sulphate instead of 1.0 mg of morphine sulphate" was defined as a medication error by 97% of respondents, whereas the sample case of "Omitting oral/IV antibiotics because of the need to take the patient out for X-rays for 3 hr" was defined as a medication error by only 32.1%. It was found that eight sample cases (omitting antibiotics, diluting norodol drops with saline, giving aspirin preprandially, injecting clexane before colonoscopy, giving an analgesic at the nurse's discretion, dispensing undiluted morphine, preparing dobutamine instead of dopamine and administering enteral nutrition intravenously) were assessed as errors and reported, although there were significant statistical differences between the identification and reporting of these errors. CONCLUSION: Nurses are able to identify medication errors, but are reluctant to report them. Fear of the consequences was the main reason given for not reporting medication errors. When errors are reported, it is likely to be to physicians. RELEVANCE TO CLINICAL PRACTICE: The development of a commonly agreed definition of a medication error, along with clear and robust reporting mechanisms, would be a positive step towards increasing patient safety. Staff reporting medication errors should be supported, not punished, and the information provided used to improve the system.

The other side of the coin: nurses' views and behavior on physical restraint / El otro lado de la moneda: puntos de vista y comportamiento de las enfermeras en relación a la restricción médica / O outro lado da moeda: a visão e o comportamento dos enfermeiros na contenção física

Background: The physical restraint is a widely used practice that includes ethical problems. Analysis of the views and behaviors of nurses who apply physical restraint is important to determine the problems in the practice and to find solutions. Aim: To study the views and behaviors of the nurses who apply physical restraint. Research Design:The study was designed as a descriptive study. The data were collected using a questionnaire form and analyzed by chi-square tests. The study was conducted at a university hospital. The convenience sample consisted of 93 voluntary nurses. Findings: The decision to initiate/terminate the physical restraint is mostly (63.4%) made by the physician and the nurse together, and frequently (96.8%) wrist belts are used. While one-third of the nurses (33.4%) apply the restraint for more than 7 days, 21.4% never loosen the physical restraint. 28% of the nurses face resistance due to the restraint. 78.5% of the nurses obtain informed consent for the restraint whereas 51.6% believe that the consent is not necessary. Only 9.7% of the nurses record the practice to the patient observation chart. Additionally, there is a relationship between the unit, patients they cared for daily, years in the profession and the nurses' views on restraint (p≤0.05). Conclusion: It is necessary to improve the nurses' awareness and ethical sensitivity about physical restraint. Professional development of the nurses regarding physical restraint should be maintained continuously from the beginning of their undergraduate education. An institutional committee should be established to support decision-making and monitor the restraint processes.

Objetivo: Estudiar los puntos de vista y comportamientos de las enfermeras que aplican restricción física. Diseño de investigación: Estudio descriptivo realizado en un Hospital Universitario. Los datos se recolectaron usando un cuestionario y analizando los textos mediante chi-square. La muestra de conveniencia consistió en 93 enfermeras voluntarias. Resultados: La decisión de iniciar/terminar la restricción física corresponde mayoritariamente al médico y la enfermera en conjunto (63,4%), y frecuentemente se usa atadura de muñecas (96,8%). Mientras que un tercio de las enfermeras (33,4%) aplica la restricción por más de 7 días, 21,4% nunca afloja la restricción física. 28% de las enfermeras muestran resistencia a aplicar restricción. 78,5% obtienen consentimiento informado para restringir, mientras que 51,6% cree que no es necesario el consentimiento. Solamente 9,7% de las enfermeras registra la práctica en la hoja de observación del paciente. Además, existe relación entre la unidad, pacientes que cuidan diariamente, años en la profesión y puntos de vista de las enfermeras sobre la restricción (p≤0.05). Conclusión: Es necesario mejorar la conciencia y sensibilidad ética sobre la restricción física. Debiera mantenerse continuamente el desarrollo profesional de las enfermeras sobre la restricción física desde el comienzo de la educación de pregrado y establecer un comité institucional para asistir la decisión de monitorear los procesos de restricción.

Fundo: A contenção física é uma prática amplamente utilizada que inclui problemas éticos. A análise dos pontos de vista e comportamentos de enfermeiros que aplicam a contenção física são importantes para determinar os problemas na prática e para encontrar soluções. Objetivo: Estudar as visões e comportamentos de enfermeiro que fazem uso da contenção física. Projeto de pesquisa: O estudo foi concebido como um estudo descritivo. Os dados foram coletados utilizando um formulário de questionário e analisados pelos testes do qui-quadrado. O estudo foi realizado em um hospital universitário. A amostra de conveniência consistiu de 93 enfermeiros voluntários. Conclusões: A decisão de iniciar/encerrar a contenção física é principalmente (63,4%) feita pelo médico e enfermeiro juntos, e frequência de uso dos cintos de pulso (96,8%). Enquanto um terço dos enfermeiros (33,4%) aplicam a retenção por mais de 7 dias, 21,4% nunca soltam a contenção física. 28% dos enfermeiros encaram resistência devido a retenção. 78,5% dos enfermeiros obtém consentimento prévio para retenção, enquanto 51,6% acreditam que o consentimento não é necessário. Apenas 9,7% dos enfermeiros registram a prática na ficha de observação do paciente. Além disso, existe uma relação entre a unidade, os pacientes que eles cuidam diariamente, anos na profissão e visão dos enfermeiros a cerca da contenção (p ≤ 0,05). Conclusão: É necessário melhorar a consciência e sensibilidade ética dos enfermeiros sobre contenção física. O desenvolvimento profissional do enfermeiro considerando a contenção física deve ser mantido continuamente a partir do início de sua graduação. Uma Comissão institucional deve ser estabelecida para apoiar a tomada de decisão e acompanhar os processos de retenção.

Factors influencing nurses' perceptions of occupational safety.

To determine nurses' perceptions of occupational safety and their work environment and examine the sociodemographic traits and job characteristics that influence their occupational safety, we studied a sample of 278 nurses. According to the nurses, the quality of their work environment is average, and occupational safety is insufficient. In the subdimensions of the work environment scale, it was determined that the nurses think "labor force and other resources" are insufficient. In the occupational safety subdimensions "occupational illnesses and complaints" and "administrative support and approaches," they considered occupational safety to be insufficient. "Doctor-nurse-colleague relationships," "exposure to violence," and "work unit" (eg, internal medicine, surgical, intensive care) are the main factors that affect occupational safety. This study determined that hospital administrations should develop and immediately implement plans to ameliorate communication and clinical precautions and to reduce exposure to violence.