The Effect of QR Code-Supported Patient Training on Total Knee Arthroplasty-Related Problems and Emergency Department Admission Rate.

Knee arthroplasty surgery, which is increasingly performed due to increased life expectancy, has positive outcomes, although it can also cause serious health problems following surgery. This study was conducted to evaluate the impact of patient-related education via a QR code on total knee arthroplasty problems and emergency department referral rates. Participants were randomly assigned to intervention (n = 51) and control (n = 51) groups. The intervention group received QR code-supported training. The outcomes were assessed at baseline (preoperative), discharge, and postoperative sixth week. In the intervention group, significantly fewer problems related to total knee arthroplasty occurred at discharge and in week 6, and a higher level of functionality was noted ( P < .05). In week 6, the rate of emergency department admissions was lower, and mean scores for satisfaction with patient training were higher in the intervention group ( P < .05). In conclusion, QR code-supported patient training was effective in reducing the physiological and psychosocial problems related to total knee arthroplasty and the emergency department referral rates. In addition, it provided functional improvement and increased satisfaction with patient training.

The Effect of Education Planned According to Health Literacy Level on Functionality, Problems Experienced, and Quality of Life in Patients Undergoing Total Knee Replacement: A Nonrandomized Comparison Group Intervention Study.

Total knee arthroplasty procedures significantly improve quality of life for persons with debilitating pain. It is essential to plan patient education according to the level of health literacy. This nonrandomized comparison group intervention study examines the effect of education planned according to health literacy level on functionality, postoperative problems (pain and anxiety), and quality of life in patients who undergo total knee replacement. During the study, patients in the intervention group (n = 51) were provided with the planned patient education according to their health literacy level, whereas patients in the comparison group were given routine care (n = 51). Patients in the postoperative intervention group experienced fewer problems (p < .05). Education tailored to patients' health literacy levels had a positive effect on their functionality and quality of life (p < .05). Our findings suggest planning education according to patient health literacy levels may have a positive influence on functionality, postoperative problems, and quality of life among patients undergoing total knee replacement.

The Effect of Simulation Method on Nursing Students' Burn Patient Care Planning: A Randomized Controlled Trial.

In nursing education, the rate of students to practice for burn patient care is low. This research was carried out as a single-blind randomized control group intervention trial to determine the effectiveness of simulation method performed using high-fidelity human patient simulator in nursing students' burn patient care planning. The research was conducted with randomly selected 61 students including 31 in intervention and 30 in control groups. In the application process of the research, knowledge tests were administered as a pretest, second test, and posttest, and the first and second applications of burn patient care plans were performed with all students. In the research, the application of burn patient scenario was performed only with the intervention group. As a result of the research, it was found that the posttest knowledge scores of the students in the intervention group increased significantly compared with the control group (P < .05). According to the intergroup evaluations, there was no significant difference between the intervention and control groups in terms of care plan scores (P > .05), whereas the scores for the second burn patient care plan of the intervention group were higher compared with those of the control group. The simulation method was found to increase students' knowledge levels, and the employment of the method in nursing education is recommended.

Surgical nurses' knowledge and practices about informed consent.

BACKGROUND: Informed consent involves patients being informed, in detail, of information relating to diagnosis, treatment, care and prognosis that relates to him or her. It also involves the patient explicitly demonstrating an understanding of the information and a decision to accept or decline the intervention. Nurses in particular experience problems regarding informed consent. RESEARCH QUESTION AND DESIGN: This descriptive study was designed to determine nurse knowledge and practices regarding their roles and responsibilities for informed consent in Turkey. The research was performed using 92 nurses who work at the surgical clinics. Data collection form was prepared by the researchers with assistance from the literature, and the data were evaluated by the SPSS 12.0 data analysis program. ETHICAL CONSIDERATION: This study was approved by the Medicine and Health Sciences Research and Ethics Committee of the university. Written consent was received from the nurses. FINDINGS: Among the nurses who participated in this study, 39.1% indicated that they were responsible for obtaining informed consent. It was also found that 90.2% of the nurses informed patients before providing nursing interventions and 32.6% of the nurses obtained consent from patients, and 90.0% of the nurses who indicated that they obtain patient consent only obtain verbal consent. Among all of the nurses, 21.7% agreed that informed consent needs to be obtained in order to protect the medical staff legally. DISCUSSION: It is argued that a lack of official procedures at hospitals regarding informed consent and insufficient information being provided to healthcare providers has caused problems regarding informed consent. CONCLUSION: The nurses in this study lacked information regarding their role in obtaining informed consent from patients and they often performed incomplete and/or incorrect practices within the framework of their required role. It is believed that an increased level of education along with the creation of official policies and procedures would contribute towards solving these problems.

Cross-cultural adaptation, validity, and reliability of the Turkish version of revised American Pain Society patient outcome questionnaire for surgical patients.

OBJECTIVE: This study aims to investigate the validity and reliability of the Turkish Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR). METHODS: A methodological and cross-sectional design was used. This study included a total of 250 surgical patients (98 males, 152 females) between January 2015 and January 2016. Data were collected using a demographic questionnaire and the APSPOQ-R. Language equivalence, content and construct validity, and reliability of the scale were evaluated. RESULTS: The Pearson correlation coefficient of the scale for parallel test reliability was 0.362, and the Cronbach's alpha value was determined as 0.88 in the APS-POQ-R-TR. According to fit indexes of the confirmatory factor analysis [x2/SD=362.53/125=2.90; RMSEA=0.087 (90% CI: 0.077-0.098); CFI=0.95; IFI=0.95; NNFI=0.94], three factors were found to be appropriate for the APSPOQ-R-TR. CONCLUSION: The adaptation of the translated APS-POQ-R in Turkey is reliable and valid to measure and evaluate the quality of postoperative pain management in the Turkish population.

Effects of Case Studies and Simulated Patients on Students' Nursing Care Plan.

PURPOSE: The aim of this study is to determine the effects of using case studies and simulated patients in teaching students to plan their nursing care. METHODS: The study sample consisted of 70 second-year nursing students. Study data were collected using a questionnaire and by evaluating students' nursing care plans. RESULTS: The highest percentages of diagnoses identified were altered oral mucous membrane, ineffective breathing pattern, disturbed sleep pattern: less than body requirement, impaired tissue integrity, pain, and risk for infection. CONCLUSIONS: The use of simulated patients in nursing education appears to help students evaluate realistic medical cases and clinical problems, and plan their nursing care.

Determining nursing student knowledge, behavior and beliefs for breast cancer and breast self-examination receiving courses with two different approaches.

BACKGROUND: This study aimed to determine nursing student knowledge, behavior and beliefs for breast cancer and breast self-examination receiving courses with a traditional lecturing method (TLM) and the Six Thinking Hats method (STHM). MATERIALS AND METHODS: The population of the study included a total of 69 second year nursing students, 34 of whom received courses with traditional lecturing and 35 of whom received training with the STHM, an active learning approach. The data of the study were collected pre-training and 15 days and 3 months post-training. The data collection tools were a questionnaire form questioning socio-demographic features, and breast cancer and breast self-examination (BSE) knowledge and the Champion's Health Belief Model Scale. The tests used in data analysis were chi-square, independent samples t-test and paired t-test. RESULTS: The mean knowledge score following traditional lecturing method increased from 9.32 ± 1.82 to 14.41 ± 1.94 (P<0.001) and it increased from 9.20 ± 2.33 to 14.73 ± 2.91 after training with the Six Thinking Hats Method (P<0.001). It was determined that there was a significant increase in pre and post-training perceptions of perceived confidence in both groups. There was a statistically significant difference between pre-training, and 15 days and 3 months post-training frequency of BSE in the students trained according to STHM (p<0.05). On the other hand, there was a statistically significant difference between pre-training and 3 months post-training frequency of BSE in the students trained according to TLM. CONCLUSIONS: In both training groups, the knowledge of breast cancer and BSE, and the perception of confidence increased similarly. In order to raise nursing student awareness in breast cancer, either of the traditional lecturing method or the Six Thinking Hats Method can be chosen according to the suitability of the teaching material and resources.

Determining health personnel's application trends of new guidelines for preoperative fasting: findings from a survey.

INTRODUCTION: For over a century, the discontinuation of oral food intake preoperatively after midnight has been routinely applied. Although routine fasting during the night before elective surgery has been abandoned by many modern centers, preoperative fasting after midnight continues as a routine practice. PURPOSE: The purpose of this study was to determine trends in health personnel's application of new guidelines for preoperative fasting. MATERIALS AND METHODS: The research sample of this descriptive study consisted of 73 nurses and physicians who were working in the surgical clinics during the time when the study was conducted and who agreed to participate in the study. The data of the study were collected using a questionnaire designed by the researchers. FINDING: Of the health personnel included in the study group, 43.8% routinely kept adult patients fasting after midnight, 34.2% discontinued solid food intake 8 hours preoperatively, 5.5% discontinued solid food intake 6 hours preoperatively, and 34.2% discontinued the intake of clear and particulate liquids 4 to 8 hours preoperatively. Compliance of the American Society of Anesthesiologists' "2-4-6-8 rule" by health staff was very low. CONCLUSIONS: This study was carried out in a hospital and based on the statements of health staff. Therefore, the findings of the study are suggestive in nature and cannot be generalized. We recommend that the study should be conducted with larger sample groups and that actual preoperative fasting periods of the patients should be determined.

Occupational exposure to blood and body fluids among a group of Turkish nursing and midwifery students during clinical practise training: frequency of needlestick and sharps injuries.

AIM: To ascertain the number of needlestick and sharps injuries (NSSIs) in nursing and midwifery students and to assess the use of universal precautions among injured and non-injured students. METHODS: A survey of a representative sample of nursing and midwifery students who did clinical practise in a hospital was conducted. In total, 203 students met the inclusion criterion of the study. Of these, 141 (69.46%) provided useable data. The survey form was designed by the researcher after reviewing the relevant literature. The data frequency, percentages, and χ(2) -values were examined. RESULTS: According to the data, 35.5% of the participating students had experienced a NSSI, 54% of the students had received one NSSI, and 36.0% had two NSSIs. Sixty-six percent of the injured students had been injured by an ampoule and the majority of injuries occurred in the treatment room. Most of the students had washed their injury with antiseptic solution and 84% had not told anyone about their injury. While 86.5% of the students threw away used needles in the special sharps containers disposal box, 89.4% also stated that they always recapped used needles. Almost all the students had received the hepatitis B vaccine. Only 14% of the students stated that they always wore gloves. CONCLUSIONS: This study shows that a significant percentage of nursing and midwifery students receive NSSIs. It is very important to frequently review information about preventive measures so that the students practise them during clinical practise every semester. Moreover, the instructors should monitor if the students are taking the necessary preventive measures without fail.

School for health sciences university students' opinions about male nurses.

This study was conducted after the new nursing law was passed in Turkey in May 2007. According to the old nursing law in Turkey, only women could legally work as nurses. However, the new law made it possible for men to work as nurses as well. The researchers who conducted this study developed a survey for determining university nursing and midwifery students' opinions about the concept of a male nurse. No sampling method was used in this research, and the survey was administered to all students who came to school on the dates it was administered and agreed to participate voluntarily. A total of 331 students (88.7%) were administered the survey personally by the researchers. Of the participants in the study, 53.5% were in nursing and 46.5% were in midwifery schools. The majority (82.2%) of the students thought that nursing should be done by both genders, 74.0% thought that having male members of the profession would have a part in the advancement of the profession, 72.8% thought that male nurses should be admitted to schools, 61.3% thought that male nurses could give care to male and female patients, and 80.7% thought that they could work in harmony with male and female nurses. In general, the students at our university have a positive attitude toward male nurses.

The incidence of pressure ulcers in surgical patients: a sample hospital in Turkey.

AIM: This research was conducted for the purpose of determining the incidence of surgery-related pressure ulcer formation. BACKGROUND: Patients undergoing surgery are prone to develop pressure ulcers during surgery. Pressure ulcer incidence in surgery population is reported between 3.5% and 29.5%. Some of these factors that occur during surgery are being under pressure for a long time, remaining wet, and metabolic and circulatory changes related to the surgery and anaesthesia. DESIGN: The research was conducted as a prospective-analytic-descriptive study with 84 patients who agreed to participate in the study and who were 20 years old or older, having elective surgery, having a surgical procedure lasting two or more hours under general anaesthesia, and who had no risk for pressure ulcer development before surgery according to the Braden Pressure Ulcer Risk Assessment Scale. Research data were obtained using a Data Collection Form that has places for pre-, intra- and postoperative factors that may be related to surgery-related pressure ulcer development; a Body Mass Index Data Form and the Braden Pressure Ulcer Risk Assessment Scale. The Braden Pressure Ulcer Risk Assessment Scale was used to determine that patients had no risk for pressure ulcer development pre- and postoperatively and it was used for the purpose of establishing the patients risk status and areas at risk. Patients were monitored for pressure ulcers until the sixth postoperative day and risk status and areas at risk were determined. Data obtained in the research were analysed using percentage, chi-squared, McNemar and Cohen's Kappa tests for reliability between dependent groups. RESULTS: At the conclusion of the research, the findings obtained showed that 54.8% of the patients (n = 46) were observed to have Stage 1 pressure ulcers. A total of 41.3% of the patients had pressure ulcers in more than one region and 56.5% of these were of the erythema type. During the six-day postoperative monitoring, 97.9% of the pressure ulcers were observed in the first three days. CONCLUSION: The study made clear that surgery-related pressure ulcers are an important problem. RELEVANCE TO CLINICAL PRACTICE: (i) Determining the incidence of pressure ulcers during surgery in Turkey; (ii) For nurses to be able to prevent surgery-related pressure ulcers, it is necessary for them to direct their care by knowing factors that have a role in the development of pressure ulcers during surgery therefore this study will be to call Turkish nurse's attention to pressure ulcers during surgery.