Replacing Monitoring Electrodes on Infant Skin Every 12 Versus 24 Hours.

OBJECTIVE: To examine the effect of varying the frequency of monitoring electrode replacement on skin moisture and condition of infants hospitalized in the pediatric ICU. METHODS: The population of the study consisted of 1- to 12-month-old infants receiving treatment in the pediatric ICU. The control group of the study (n = 33) included infants whose monitoring electrodes were replaced every 24 hours during monitoring, and the experimental group (n = 33) included infants whose monitoring electrodes were replaced every 12 and 24 hours during monitoring. Before assessment, the skin moisture of the monitoring areas was measured and evaluated with the Skin Condition Assessment Scale. RESULTS: When the difference in skin moisture was compared for all measurement areas of the infants before monitoring and at the 24-hour mark, an increase in moisture was seen in both groups, and the difference in the experimental group was greater than that in the control group. Increased moisture is a risk factor for medical device-related pressure injuries. When comparing between-group differences in skin condition, the researchers noted a greater increase in skin condition score in the experimental group. An increased score indicates that the infant's skin condition is worsening. CONCLUSIONS: Replacing the monitoring electrodes every 24 hours positively affected skin moisture and condition, whereas replacing them every 12 hours negatively affected skin moisture and condition.

The effect of "pediatric peripheral intravenous access (PPIVA) pathway" on the success of vascular access in children.

PURPOSE: Determine the affects of the developed "Pediatric Peripheral Intravenous Access (PPIVA) Pathway" on the success of the vascular access in children. DESIGN AND METHODS: A quantitative approach was used using a quasi-experimental single-group post-test design involved pediatric patients. The patients who were first attempted for peripheral vascular access were subjected to the procedure in accordance with the "PPIVA Pathway". The data was collected via a form on which we recorded down the patients' characteristics alongside their procedural data, as well as the Difficult Intravenous Access (DIVA) Score. For statistical analysis, the R vers. 2.15.3 program was utilized. RESULTS: The patients who applied to the pediatric observation clinic had a mean age of 8.14 ± 5.01 years. The DIVA total mean score of the patients was 1.73 ± 1.79. 89.1% (n = 163) of pediatric peripheral intravenous procedures were successfully completed on the first access. The logistic regression analysis model was found to be statistically significant to identify the factors that affect pediatric peripheral intravenous success on the first attempt (χ2 = 24.701; p < 0.001). A one-point increase in the DIVA score was found to reduce the likelihood of success on the first attempt by 56.1% [OR (95% CI) = 0.439 (0.280, 0.686), p < 0.001]. CONCLUSIONS: Using an algorithm to perform a peripheral intravenous intervention in children increases the likelihood of success on the first attempt. PRACTICE IMPLICATIONS: Using PPIVA Pathway shall improve the provision of atraumatic care for children, as the success rate of pediatric peripheral intravenous access on the first attempt is high.

Use of simulation from high fidelity to low fidelity in teaching of safe-medication practices.

OBJECTIVE: To evaluate the effects of simulation techniques on learning outcomes in the teaching of safe drug applications to first year nursing students. METHODS: The semi-experimental study was conducted from February to April 2017, and comprised nursing students of Acibadem Mehmet Ali Aydinlar University. This student satisfaction and selfconfidence in learning scale, medication practice via oral route checklist, and pre- and post-test for safe drug application knowledge Assessment were used for data collection. Following the theoretical lectures, case studies, task trainer practices and scenario with standardised patient were carried out. Baseline knowledge, during-the-scenario performanceand post-scenario level of student's satisfaction and self-confidence were evaluated. Data was analysed using SPSS 18. RESULTS: Of the 58 subjects, 51(87.9%) were female. The overall mean age of the sample was 20.69±1.02 years. There was a statistically significant difference between students' knowledge levels before and after the scenario (p<0.05). Mean performance scoreon safe medication practice was 65.70±5.83. A significant weak positive correlation was found between the students' scores on satisfaction with the simulation and knowledge levels as well as the performance and self-confidence scores (p<0.05 each). Also, there was a strong correlation between the scores on self-confidence scale and the knowledge levels (p<0.01). CONCLUSIONS: Simulation had a positive effect on learning outcomes..

Prevalence of cancer pain in outpatients registered to a cancer therapy center in Turkey.

INTRODUCTION: Although the World Health Organization (WHO) has stated that cancer pain can be controlled in 85-97% of cases with knowledge and technology available today, effective pain control is about 40%. This situation emphasizes the necessity of discussing cancer pain again. OBJECTIVE: This descriptive study was conducted with the aim of determining prevalence, severity, region and frequency of cancer pain in patients registered to a cancer treatment center. MATERIALS AND METHODS: A total of 256 patients who were treated in the outpatient clinic of a cancer center in Istanbul in 2010 constituted the study population and 99 cancer patients who agreed to participate in the study and could be reached constituted study sample. The study was completed with 49 (49.5%) patients as 50 (50.5%) out of 99 patients who were reached did not report pain. RESULTS: Of the patients with cancer pain, 30.6% (n=15) had colon/rectum cancer, 24.5% (n=12) had lung cancer and 51% (n=25) had metastasis. Pain was in lower extremities in 34.3% (n=35), 57.1% (n=28) had moderate pain, 24.5% (n=12) had severe pain and pain was constant in 28.6% (n=19). Additionally, 20.4% (n=10) were not receiving pain treatment. Usually opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) and adjuvant analgesics were being used in combination for pain treatment. CONCLUSION: The fact that 20.4% (n=10) of 49 patients were not receiving pain treatment and half of the cancer patients under control are experiencing pain is bothersome and thought provoking.