Effectiveness of breast milk in the healing of medical adhesive-related skin injuries in peripheral intravenous catheter securement: A randomized controlled trial.

BACKGROUND: Skin injuries, which are more prevalent among premature infants, can prolong the hospital stay of preterms in neonatal intensive care units. AIM: This study aimed to assess the effectiveness of breast milk in reducing the healing time of skin injuries caused using medical adhesive for securing peripheral intravenous catheters (PIVCs) in late preterm infants, which was evaluated using the Neonatal Skin Condition Scale (NSCS). A randomized controlled trial was conducted with two parallel groups in a 1:1 allocation ratio. STUDY DESIGN: It was conducted in the Neonatal Intensive Care Unit of a hospital in Karaman, Turkey between August and November 2022 with 72 preterm infants born at 35-36 weeks with stable health status and having intravenous catheter securement to the skin with medical adhesive tapes, with the tapes remaining on the skin for a minimum of 24 h and a maximum of 32 h. Preterm infants were randomly assigned to breast milk or routine care groups. The site of the skin injuries was evaluated by two independent observers using the NSCS once every 60 min until the injury was completely healed. A one-way ANOVA and repeated measures analysis of variance was used to analyse the data. RESULTS: The average postnatal age was 3.32 ± 0.99 days, and the total duration of medical adhesive tape on the skin was 28.21 ± 2.59 h. A significant difference was found between the mean skin condition scale scores of the infants in the breast milk group (F = 117.219, p < .001) and the routine care group (F = 122.247, p < .001) according to time within the group. The skin injuries of preterm infants in the breast milk group decreased significantly in the first 3 h after the procedure. CONCLUSION: Breast milk application was more effective than routine care in reducing the healing time of skin injuries. RELEVANCE TO CLINICAL PRACTICE: It can be recommended to use breast milk to heal skin injuries in preterm infants.

University Students' Gaming and Gambling Behaviors, Related Factors, and the Relationship Between Gaming and Gambling.

The purpose of this study was to investigate university students' gaming and gambling behaviors, the factors that relate to these behaviors, and the connection between gaming and gambling behaviors. The study was designed as survey research, which is one of the quantitative research methods. The sample for the study consists of 232 students who are continuing their education at a state university in Turkey. The data of the research were collected through the Student Information Form, the Game Addiction Scale, and the South Oaks Gambling Screen. While the rate of students with problematic gambling behavior was 9.1% (n = 21), the rate of students with problematic gambling behavior was 14.2% (n = 33). Gaming behavior showed significant differences according to gender, age, the feeling of success, leisure time sufficiency, sleep proficiency, smoking, and alcohol use. Gambling behavior showed significant differences according to gender, family type, family income, the feeling of success, level of happiness, the experience of psychological distress, social relationship satisfaction, smoking, and alcohol use, and the presence of an addicted person in the social environment. Gender, perception of success, leisure proficiency, and alcohol use were variables associated with both gambling and gaming. There was a positive and significant relationship between gaming and gambling behavior (r = .264, p < .001). As a result, it is seen that the variables related to gaming and gambling behavior differ rather than partnership. Considering the weak relationship between gaming and gambling behavior, it is difficult to put forward sharp views on the relationship between gaming and gambling.

The effect of lighted toy on reducing pain and fear during blood collection in children between 3 and 6 years: A randomized control trial.

BACKGROUND: This study was carried out as an experimental research to determine the effect of the light toy on reducing pain and fear during blood collection in children. METHODS: The data were obtained 116 children. The "Interview and Observation Form Children's Fear Scale, Wong-Baker Faces, Luminous Toy and Stopwatch" was used for data collection. The data were evaluated using percentage, mean, standard deviation, chi-square, t-test, correlation analysis and Krusskal Wallis test in SPSS 21.0 package program. FINDINGS: The fear score average of the children in the lighted toy group was 0.95 ± 0.80, while it was 3.00 ± 0.74 in the control group. The difference between the groups in terms of the fear score average of the children was found statistically significant (p < 0.05). When the difference between groups in terms of pain status of children is examined, the pain level of children in the lighted toy group (2.83 ± 2.82,) was found to be significantly lower than the pain level of the children in the control group (5.86 ± 2.72) (p < 0.05). DISCUSSION: As a result of the study, it was found that the lighted toy given to the children during blood collection reduces their fear and pain levels. In the light of these findings, it is recommended to increase the use of lighted toys in blood collection. APPLICATION TO PRACTICE: The use of lighted toys as a distraction method during blood collection in children is an effective, easy-to-access and low-cost method. This method demonstrates that there is no need for expensive methods of distraction.

Effectiveness of stress ball and relaxation exercises on polymerase chain reaction (RRT-PCR) test-induced fear and pain in adolescents in Türkiye.

PURPOSE: This study aimed to determine the effectiveness of stress balls and relaxation exercises in relieving PCR test-induced fear and pain in adolescents. DESIGN AND METHODS: A randomized controlled experimental study with a parallel-group design was conducted. The sample size was determined by G*Power analysis, and 32 adolescents were included in each group accordingly. The data were collected using the Adolescent and Parent Information Form, The Children's Fear Scale, and The Wong-Baker Faces Pain Scale. Descriptive statistics, t-test, paired t-test, ANOVA, and Tukey's forward analysis were used to analyze the data. RESULTS: The mean age was 14.93 ± 2.07 years for the adolescents, 43.58 ± 4.50 years for the mothers, and 48.25 ± 4.92 years for the fathers. Adolescents were stratified according to age, gender, and fear of invasive procedures, and homogeneity was ensured in their distribution to the groups. The pre-procedural level of fear was moderate in each group with no significant difference (p > 0.05). However, a significant difference was found between the groups in terms of both post-procedure levels of fear and pain. The pre-procedural fear of the adolescents in the control group (3.91 ± 0.29) did not change much after the procedure (3.91 ± 0.30), while there was a decrease in the other groups. The least post-procedure fear (0.09 ± 0.29) and pain (0.44 ± 0.67) were found to be in the relaxation exercise group. CONCLUSIONS AND PRACTICE IMPLICATIONS: Relaxation exercise is the most effective method to reduce fear and pain during the PCR procedure. It is recommended to use it during the PCR procedure for being easily accessible, applicable, and cost-effective. Clinical Trials ID: NCT05250544.

Effect of topical application of black pepper essential oil on peripheral intravenous catheter insertion: A randomized controlled study.

OBJECTIVE: The literature describes many techniques to increase vein visibility and palpability that facilitate peripheral intravenous catheter insertion. However, there is only one study examining the effect of topical essential black pepper oil on veins. We aimed to determine the effects of topical application of black pepper essential oil on peripheral intravenous catheter insertion success. METHODS: This randomized controlled trial was carried out on 60 patients randomly assigned to either the experimental group (n=30) or the control group (n=30) reporting to the endoscopy unit of the clinic between May 2019 and October 2019. The study results were evaluated using an information form, a catheter insertion form, and a visual analog scale (VAS). In the experimental group, black pepper essential oil was used to increase vein degree before the procedure, while in the control group, no extra interventions were applied. The time taken in determining an appropriate vein, time taken for successful catheter insertion, and the patient's and nurse's satisfaction after the process were recorded. RESULTS: Significant improvements in vein degree were detected after the experimental group's oil application (p1<0.001). The period of appropriate vein selection and successful catheter insertion showed a statistically significant decrease in the experimental group (p<0.05). The satisfaction levels of patients and nurses in the control group were significantly lower than those of the patients from the experimental group (p<0.05). CONCLUSION: Topical black pepper oil application can increase the vein degree and the success of the procedure.

The Effect of Distraction Cards on Reducing Pain and Anxiety During Intramuscular Injection in Children.

AIM: The aim of the present study was to evaluate the effectiveness of distraction cards in reducing pain and anxiety during intramuscular (IM) injection in children aged between 6 and 11 years. METHODS: Sixty children were randomized into two groups, the distraction group and controls. The children in the distraction group viewed distraction cards during the procedure. The children in the control group were allowed to have their family nearby when the routine injection procedure was performed, but no distraction techniques were employed. Children's Fear Scale was used to assess children's anxiety levels. Pain levels were assessed using the Wong-Baker FACES pain rating scale via self-reports, which were completed by the children and also by the parents and observer. RESULTS: There were significant differences in the self-, parent-, and observer-reported pain and parent- and observer-reported anxiety levels between the distraction and control groups. LINKING EVIDENCE TO ACTION: Distraction methods, such as distraction cards, should be used as a nursing intervention to reduce pain and anxiety during IM injection in children. This study contributes to the literature on nonpharmacologic pain relief methods during IM injection in children.

Effectiveness of Two Different Methods for Pain Reduction During Insulin Injection in Children With Type 1 Diabetes: Buzzy and ShotBlocker.

BACKGROUND: Repeated injections may prevent children from performing insulin administration (skip dosing) and may cause anxiety. AIMS: To compare the effect of ShotBlocker and the combination of vibration and cold application (Buzzy) in reducing pain during insulin administration in children. METHODS: This research was designed as a randomized controlled experimental study. The study sample consisted of 60 children aged between 6 and 12 years who were diagnosed as having type 1 diabetes and received insulin from the Child Endocrinology Department of the medical faculty in Eskisehir Osmangazi University between May 2015 and June 2017. The children were randomized into the Buzzy (n = 20), ShotBlocker (n = 20), and control (n = 20) groups. Three instruments were used to obtain the research data: Interview and Observation Form, Children's Anxiety and Pain Scale (CAPS), and Faces Pain Scale-Revised (FPS-R). RESULTS: The mean age of the children was 9.43 ± 2.18 years (range 6-12 years). There were no significant differences among preprocedural anxiety levels of the study groups in terms of self-, parent-, and observer-reported levels (p = .935, p = .374, and p = .680, respectively). Children in the control group had higher levels of pain than children in the Buzzy and ShotBlocker groups (p = .008, p = .007, and p > .001, respectively). There was a significant difference between the groups with procedural anxiety levels reported by the family and observer (p = .006 and p = .002, respectively), favoring the intervention groups. LINKING EVIDENCE TO ACTION: Nurses should be aware of pain during insulin injection and use methods for pain relief accordingly. ShotBlocker is recommended as a helpful option in cases where a pain control method is required.

Pain and factors that affect its definition as defined by preschool age children: a qualitative study

The aim of this study was to determine the definitions of pain by pre-school age children and factors that affect these definitions. The study was conducted on children aged between four and six years (N=146) in the city of Karaman in Turkey. Qualitative and quantitative research design were used together in this study. This study's qualitative tradition method was phenomenologic research. The data were assessed using descriptive statistics and thematic analysis. The children's definitions of pain were found to be affected by their hospital and daily life experiences. The preschool age children generally defined pain in similar ways, and everything that made children feel pain made them think about it. Sometimes their family members, hospital equipment, and health staff lead them to think about pain.

Physicians' and nurses' medical errors associated with communication failures.

OBJECTIVE: To determine medical errors associated with communication failures among physicians and nurses. METHODS: This cross-sectional, descriptive study was conducted at 20 state hospitals and 14 training and research hospitals affiliated with the Istanbul City Health Directorate in Turkey, and comprised physicians and nurses. Data were collected between August 2012 and February 2013. A 16-item questionnaire was used that included questions regarding socio-demographic features such as age, gender, educational status, institution, occupation and working years. Questions also aimed at determining medical errors related to communication failures. The questionnaire was completed by the participants during face-to-face interviews. RESULTS: Of the 2,273 participants, 1,654(72.8%) were nurses and 619(27.2%) were physicians. Besides, 340(54.9%) physicians and 811(49.03%) nurses worked in state hospitals. The mean age of the physicians was 37.76±9.20 years (range: 22-62 years), and that of the nurses was 32.61±7.38 years (range: 17-62 years). Moreover, 137(22.1%) physicians and 258(15.3%) nurses had previously experienced medical errors. Also, 74(54%) physicians and 135(52.3%) nurses had experienced medical errors due to some communication error. The most common medical errors by physicians were incorrect drug administration 45(32.8%), and delivery of drugs to the wrong patient by nurses 103(40.7%). In addition, 58(42.3%) physicians made medical errors in adult surgical clinic services while 102(39.5%) nurses made medical errors in adult internal medicine clinics. CONCLUSIONS: The majority of medical errors originated from communication failures.

Pediatric Nurses' Information and Applications Related To Ethical Codes.

BACKGROUND: Ethics is defined as the entirety of moral principles that form the basis of individuals' behavior; it can also be defined as "moral theory" or "theoretical ethics". OBJECTIVES: To determinate information and applications related to ethical codes of pediatric nurses. PATIENTS AND METHODS: Participants were nurses attending the Neonatal Intensive Care Unit Nursing Course and the Pediatric Nursing Course conducted in Istanbul between September 2011 and December 2012. A total of nurses attending the courses at the specified dates and who agreed to participate in the study were included in the analysis. Data were collected through a questionnaire that we developed in accordance with current literature on nursing ethics. RESULTS: 140 nurses participated in this study. Information and applications were related to ethical codes of nurses including four categories; autonomy, beneficence, nonmaleficence, justice. The principle of confidentiality/keeping secrets. Exactly 64.3% of nurses reported having heard of nursing ethical codes. The best-known ethical code was the principle of justice. Furthermore, while the rates were generally low, some nurses engaged in unethical practices such as patient discrimination and prioritizing acquaintances. CONCLUSIONS: We conclude that most nurses working in pediatric clinics act in compliance with ethical codes. We also found that the majority of nurses wanted to learn about ethical codes. For this reason, we recommended that nurses working in clinics and future nurses in training be informed of the appropriate ethical behavior and codes.