Exploring the relationship between pressure ulcer knowledge and self-efficiency among nursing students: A multicenter study.

AIM: To determine the relationship between the knowledge and self-efficiency regarding pressure ulcers of nursing students. METHODS: This descriptive and correlational study was conducted with 775 nursing students from three different universities in various regions of Turkey. The "Pressure Ulcer Knowledge Assessment Tool-Updated Version" and "Pressure Ulcer Management Self-Efficiency Scale for Nurses" tool were used to collect data between May and September 2023. The Strengthening the Reporting of Observational Studies checklist was followed to report this study. RESULTS: The mean knowledge score was 7.27 ± 3.09, and the mean self-efficiency on pressure ulcer management score was 35.5 ± 18.3. A statistically significant positive correlation was found between nursing students' knowledge and self-efficiency mean scores regarding pressure ulcers (p < 0.05). A significant difference was also found between the students' academic levels and gender and their knowledge and self-efficiency scores regarding pressure ulcers. CONCLUSION: In this study, where the data covers these three institutions, students' pressure ulcer knowledge and self-efficiency scores were lower compared to all academic years. Accordingly, it was also determined that students with more nursing practice experience showed higher knowledge and self-efficacy scores than students with less nursing practice experience. Additionally, the students' self-efficacy increased along with their knowledge level. Training courses may be suggested to improve students' knowledge and self-efficiency regarding pressure ulcers.

Assessment of nurses' respect for patient privacy by patients and nurses: A comparative study.

AIMS: To determine whether nurses respect or violate patient privacy by comparing nurses' and patients' opinions. BACKGROUND: Although nurses want to respect patient privacy, they can sometimes violate patient privacy or not pay enough attention. METHOD: This comparative and cross-sectional study was conducted with 357 patients and 305 nurses in 12 public hospitals in Trabzon, Turkey. Data were collected with an information form and the Patient Privacy Scale. Reporting is consistent with the STROBE checklist for cross-sectional studies. RESULTS: The total mean score of the patient privacy scale was 4.6 ± 0.39 for nurses and 4.5 ± 0.41 for patients, and no significant difference was found between their scores (U = 52999.0; p = .554). Further, the nurses (U = 14358.0; p = .000) and the patients (U = 13272.5; p = .006) in the public hospitals had statistically significantly higher overall privacy scores than those in the training and research hospitals. The overall privacy scale scores were higher and more statistically significant in the patients hospitalised in surgical clinics than those hospitalised in clinics for internal diseases (U = 8514.0; p = .005) and in single compared to married patients (U = 12364.5; p = .034). CONCLUSION: Nurses respected patient privacy highly according to both nurses and patients, and there was no significant difference between their views. However, nurses working in training and research hospitals and internal diseases clinics need to improve their approaches to patient privacy. RELEVANCE TO CLINICAL PRACTICE: The results of this study could be used to reduce patient privacy vulnerabilities in complex hospitals and clinics such as training and research hospitals and to improve institutional policies and activities regarding patient privacy. By comparing the results of patients and nurses, the study provided more consistent and accurate data about patient privacy.

Determination of perception levels of student nurses about nursing diagnosis.

OBJECTIVE: To determine perception levels of student nurses about nursing diagnosis. METHODS: The descriptive, comparative, cross-sectional study was conducted at the Nursing Department, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey, in December 2015, and comprised nursing students studying in the 2nd, 3rd and 4th grades. Data was collected using a personal information form and the Perceptions of Nursing Diagnosis Survey. Data was analysed using SPSS 18. RESULTS: Of the 386 students, 317(82%) were female and 321(83%) considered themselves competent enough to make diagnosis. Also, 268(69%) students thought that nursing diagnosis was useful in providing planned, correct and systemised diagnosis. Mean total score of perception of nursing diagnosis of female students was higher than males (p=0.005). CONCLUSIONS: The students' perception level of nursing diagnosis was positive.

Effects of organisational restructuring of hospitals on nurses.

AIM: The study aims to determine the thoughts, feelings and attitudes of nurses towards organisational change in hospitals, and the effects of organisational cynicism, job satisfaction, organisational commitment and work alienation on nurses' attitudes towards change. BACKGROUND: Changes and employees' thoughts, attitudes and behaviours can be mutually affected in the process of transformation. METHODS: The descriptive, correlative and cross-sectional study was conducted with 1,000 nurses in 52 public hospitals in Turkey. RESULTS: Of the nurses, 59% explained that their workload had increased, and 57% experienced uncertainty and confusion due to the organisational changes in the hospitals. Nurses' total scale scores were 2.86 ± 0.65 for attitude towards change, 2.98 ± 0.52 for work alienation, 2.97 ± 0.84 for organisational cynicism, 2.98 ± 0.70 for job satisfaction and 2.74 ± 0.92 for organisational commitment. Organisational cynicism had a significant effect on the attitude towards change of nurses (R2  = 0.486; F = 235.528; p < .001). CONCLUSION: The nurses had a moderate level of attitude towards change, organisational cynicism, job satisfaction, organisational commitment and work alienation. The primary influence on their attitude against change was their cynical thinking. IMPLICATIONS FOR NURSING MANAGEMENT: The findings of the study can be used to test strategies to reduce cynicism regarding effective management of change.

The effect of theoretical and simulation training on medical errors of nurse students in Karadeniz Technical University, Turkey.

OBJECTIVE: To assess the efficacy of theoretical training related to medical errors and patient safety and practical simulation training on students' knowledge and skill levels.. METHODS: This experimental study was conducted from March 28 to May 18, 2016, at nursing department of a university and comprised of students attending the third grade of the nursing school. The subjects were divided into two equal experimental and control groups. The experimental group, among other things, received simulation training that involved a demonstration and subsequent one-to-one practice. Data was collected on a proforma that included demographic information, pretest and post-test scores, checklists for pre-assessments and final assessments related to nursing practices. RESULTS: There were 62 nurses divided into two groups of 31(50%) each. The difference between post-test scores of the concerning theoretical training about medical errors and patient safety was statistically significant (p<0.05). Pre-assessment of the groups concerning practical training on nursing skills and medical errors revealed no statistically significant difference (p>0.05), while there was a significant difference between their final assessments (p<0.05). CONCLUSIONS: Theoretical education increased students' levels of knowledge regarding medical errors and patient safety, and the the practical simulation training reduced malpractices by improving skills.

The malpractices of student nurses in clinical practice in Turkey and their causes.

OBJECTIVE: The study was conducted to identify whether or not student nurses made the medical errors as well as the reasons for the errors. METHODS: A study was conducted with 1067 student nurses studying at 12 universities in Turkey. The data were collected by using medical error scale and a questionnaire on demographic characteristics and malpractices. RESULTS: Overall 28% of the student nurses performed malpractice during clinical practice. Medical errors included failure of complying with sterility and asepsis rules (32%), wrong identification of patient identity (19%), and administrating wrong dosage of medications (12%). They obtained a mean score of 4.19±0.62 from the overall scale and the lowest score was 3.9±0.78 for drug administrations. CONCLUSIONS: Nursing students perform considerable amount of malpractice and they should especially improve concerning administration of drugs.

Evaluating medical errors made by nurses during their diagnosis, treatment and care practices.

AIMS AND OBJECTIVES: The aim of this study was to determine whether the nurses committed medical errors and to identify the types of and reasons for the medical errors. BACKGROUND: Medical errors have recently emerged as a significant issue both in Turkey and around the world because they result in the death and disability of a number of people each year. DESIGN: This study was a descriptive study. METHOD: The study was conducted with 1092 nurses working at a university hospital, 12 public hospitals and a private hospital in Trabzon. RESULTS: Twenty-two per cent of the nurses stated that they had made medical errors endangering patient safety, and 4% stated that their medical errors had injured a patient. Of the nurses who made a medical error, 10% indicated that a patient's treatment was delayed and 6% stated that the patient experienced side effects. In addition, 23% of the nurses stated that they had committed medical errors such as delaying/not administering a patient's treatment and 20% stated that they had made medical errors such as using instruments without first checking them. Eighty-three per cent of the nurses stated that they had committed a medical error due to fatigue, 82% were reported to be caused by the hospital's administration due to the limited number of nurses on duty and 75% were caused by physicians and other medical personnel due to a lack of communication. CONCLUSION: Two of five nurses had committed a medical error throughout their career; these errors were due to fatigue, a limited number of nurses and communication problems, and patients were harmed because of these errors. RELEVANT TO CLINICAL PRACTICE: The results of this study could be used to take precautions against nursing medical errors in Turkey and to enhance institutional policies and activities regarding medical errors and patient safety.

Protection of nurses rights in Turkey: A study on nurses' opinions.

OBJECTIVE: To evaluate nurses' opinions on the violation and protection of their rights at public hospitals. METHODS: The descriptive study was conducted between May and November 2013 at 11 hospitals affiliated with the Association of Public Hospitals in Istanbul, Turkey. Data was gathered using a questionnaire consisting of 59 questions on demographic characteristics, professions, and rights of nurses. RESULTS: Of the 1,808 respondents, 1,374(76%) said nurse's rights were not protected and 994(55%) believed that their rights were not protected at public hospitals. However, 1,027(56.8%) of the nurses stated that their right to job security was protected, while 1,448(80.1%) reported violation of their right to adequate pay and 1,289(71.3%) reported violation or non-recognition of the right to participate in the political decision-making processes that directly affect the nursing profession. Those who were middle-aged and those who had bachelor's degree believed their rights were not protected, and considered nursing as a weak profession that was unable to protect its rights (p<0.001). CONCLUSIONS: Nurses believed their rights, especially those about salary, were not sufficiently protected.

The development of the patient privacy scale in nursing.

BACKGROUND: The developments in technology and communication channels, increasing workload, and carelessness cause problems regarding patient privacy and confidentiality in nursing services. RESEARCH OBJECTIVES: The study was conducted to develop a patient privacy scale to identify whether nurses observe or violate patient privacy at workplace. RESEARCH DESIGN: This research was a methodological and descriptive study. PARTICIPANTS AND RESEARCH CONTEXT: Participants were 354 nurses working at private hospitals and hospitals affiliated with the Ministry of Health in Istanbul/Turkey. Data were collected with a questionnaire about the demographic characteristics of nurses and their opinions about patient privacy and with patient privacy scale. ETHICAL CONSIDERATIONS: After getting permission from the top management of hospitals, information about the study was given to nurses. Those willing to participate were informed that participation was voluntary and invited to give written consent before data collection. FINDINGS: The content validity index of scale was 0.91, Cronbach's alpha was 0.93, Spearman-Brown and Guttman coefficients were 0.85, the upper and lower 27% test was -29.65, and item-total correlation values ranged from 0.47 to 0.71. The scale had five subscales. In addition, 49% of the nurses stated that patient privacy was always observed in their services/units. They appraised with a mean score of 4.51 ± 0.49 for the total scale, 4.39 ± 0.61 for confidentiality of personal information and private life, 4.39 ± 0.70 for sexual privacy, 4.56 ± 0.57 for the privacy of those unable to protect themselves, 4.60 ± 0.59 for physical privacy, and 4.60 ± 0.52 for ensuring a favorable environment. DISCUSSION: The findings of this study were in contrast with the results of some international studies which determined the violation of the patient privacy. CONCLUSION: The patient privacy scale is a valid and reliable tool to collect data on whether nurses observe or violate patient privacy, and the nurses generally reported observing or paying attention to patient privacy in all hospitals and especially private hospitals.

Development of an administrative ethical behaviour scale.

The aim of this study was to develop an Administrative Ethical Behaviour Scale (AEBS) and to determine whether nurses found their head nurses' behaviours ethical and to reveal head nurses' ethical and unethical administrative behaviour. It was conducted on 264 nurses working in five state hospitals in Trabzon, Turkey. Content validity index of the scale was 0.87, item-to-total correlations ranged from 0.50 to 0.81 and Chronbach Alpha was 0.98. The scale included five subscales, i.e. truthfulness and honesty, liabilities and supremacy of laws, rights and freedom, good human relationships and humanism, justice and equality. Overall, head nurses' behaviour was considered ethical by nurses; however, their behaviour in terms of justice and equality, good human relationships and humanism was not found ethical. Positions, satisfaction with head nurses' behaviour and frequency of contact with them affect nurses' opinions.

A psychometric assessment of nurses: Development of the innovative leadership scale.

PURPOSE: The study aims to develop a measurement tool that will determine the innovative leadership levels of nurses. METHODS: This methodological paper was conducted with 615 nurses. The content validity, factor analyses, and Cronbach's alpha test were used for psychometric assessment. FINDINGS: As a result of the exploratory factor analysis, the scale consists of 43 items and five subscales. Confirmatory factor analysis showed that the innovative leadership scale (ILS) is a valid model. PRACTICAL IMPLICATIONS: There is a need for innovative leading nurses in the healthcare field. The psychometric assessment showed the ILS is a valid and reliable scale.

Comparison of the effects of face-to-face and electronic peer mentoring on students' care plan preparation and motivation levels.

BACKGROUND: It is a basic requirement in professional nursing education that nursing students learn the process of caring as the entity at the center of nursing practice. Peer mentoring programs can be beneficial for the mutual growth of mentors and mentees and improve the care competencies of nursing students. OBJECTIVE: To compare the effects of face-to-face and electronic peer mentoring on students' nursing process-based patient care plan preparation and motivation levels for the course. DESIGN: The study used an experimental three-group design. SETTINGS AND PARTICIPANTS: This experimental study was conducted with 83 first- and 6 fourth-year nursing students. METHOD: The data were collected with the information and opinion form, the Instructional Materials Motivation Survey (IMMS), and the Nursing Care Plan Rubric (NCPR). In the study, conducted with three subgroups of each group, the experimental group received electronic peer mentoring (EPM), and the experimental group 2 received face-to-face peer mentoring (FPM), while the control group did not receive any intervention. RESULTS: It was statistically significant that the students in the EPM group had higher patient care plan preparation scores than the FPM and control groups, and the FPM group had higher patient care plan preparation scores than the control group (p < 0.05). Also, the students in the FPM group had statistically significantly higher confidence-satisfaction sub-dimension scores on the IMMS than those in the EPM and control groups (p < 0.05). CONCLUSION: While electronic peer mentoring was effective on the patient care plan preparation levels of first-year nursing students, face-to-face peer mentoring was more effective in increasing the students' confidence and attitude levels and thus their motivation levels.

Nursing students' classroom climate perceptions: A longitudinal study.

BACKGROUND: As a versatile and dynamic process, classroom climate directly affects the learning levels of students and their quality of life while in school. OBJECTIVES: The study was conducted to explore and compare nursing students' perceptions of classroom climate throughout four years of university education and to evaluate the influencing factors. DESIGN AND SETTINGS: The longitudinal study was conducted between 2017 and 2020 in the nursing department of a university in Turkey. PARTICIPANTS: The study was carried out with 134 nursing students who enrolled in their first year and agreed to participate in the study. METHODS: The data were collected at the end of the fall semester of each of the four years using the Student Information Form and the Classroom Climate Inventory. RESULTS: The mean score of students' perceptions of classroom climate was 2.88 ± 0.83 for all academic years. The classroom climate inventory mean scores of fourth-year students were statistically significantly higher than their scores in the first and third years (p = 0.000). The students' classroom climate levels were statistically significantly affected by the positive classroom communication among students in all academic years in a positive direction. Statistically significant effective factors in students' classroom climate perceptions by year were as follows: the sense of belongingness to the class in the second and third years (although significantly lower in the first year), socio-cultural activities organized at school the second and fourth years (p < 0.05), instructors' attitudes supporting classroom communication in the first year, and opportunities supporting communication in the school environment in the fourth year (p < 0.05). CONCLUSIONS: Students' perception of the classroom climate was moderate overall and affected by positive classroom communication among students in all academic years. School administrators and educators can develop strategies and organize activities to increase positive communication in the classroom.

Nursing and midwifery college students' expectations of their educators and perceived stressors during their education: a pilot study in Turkey.

Nursing and midwifery education is known to be negatively affected by several factors. Nevertheless, the present learning environments for students can be effectively altered to optimize their learning and practical training and decrease their stress levels. In order to minimize the stressors and to encourage the qualities needed of a competent educator, it would be important to first determine students' perceived stressors and the expectations they have of their educators. The main purpose of the study was to define the expectations that nursing and midwifery college students have of their educators as well as the stressors they perceive during their education. The present descriptive study was carried out with 474 students; there were 345 nursing students and 129 midwifery students at a college in northeastern Turkey. Data were obtained with a questionnaire and assessed with X(2) analyses. The findings of the study demonstrated that a majority of the students had some expectations of the educators and perceived stressors during their education. The students' most common expectations of the educators included their desire to be understood during their clinical education. In addition, students wanted the educators to make more use of visual materials during the theoretical part of their courses. The study also determined that the students felt very stressed when they were questioned by the educator on both clinical and theoretical aspects of their coursework.

Crisis management: the activities of nurse managers in Turkey.

Crisis management is the process of preventing the organization from getting into a crisis and taking the organization out of the situation with minimum costs and losses in sudden crisis situations. A descriptive study design was used to determine the activities of nurse managers regarding crisis management. The most common type of crisis encountered at hospitals was natural disasters such as earthquakes. To cope with stress regarding crises, 71.6% of nurse managers stated they leave the resolution of crises to the top management, 64.7% noted they increase the number of the staff members, and 58.1% said they ignore crises. It was concluded nurse managers were partially prepared for crises or crisis management. Activities of nurse managers for more efficient crisis management in hospitals can be restructured according to the results and suggestions of the research. Crises can be coped with, turned into opportunities, and negative effects of crises can be minimized.

The effect of mobile augmented reality application developed for injections on the knowledge and skill levels of nursing students: An experimental controlled study.

OBJECTIVE: To evaluate the effect of Mobile Augmented Reality (MAR) educational materials on the knowledge and skill levels of nursing students on injection practices. METHOD: This controlled experimental study was carried out with 122 first-year nursing students, 64 of whom were included in the experimental group and 58 in the control group. Data were collected between March and April 2018 using an information form, a pre-test, a post-test, a persistence test, and injection evaluation checklists. In the study, the experimental group used MAR applications and the control group used traditional teaching methods in learning injection practices. RESULTS: There was no statistically significant difference between the pre-test scores of the students in the experimental and control groups, which determined the knowledge level of subcutaneous, intramuscular, and intravenous injections before the lesson (p > 0.05). After the lesson, it was found statistically significant that the post-test and persistence test scores of students in the experimental group were higher than the control group (p < 0.05). In the first and second/persistence skill evaluations, the injection skill scores of the students in the experimental group were higher than the control group (p < 0.05), which was also statistically significant. In addition, the students in the experimental group stated that MAR applications increased their motivation and self-confidence and reduced their concerns. CONCLUSION: It was determined that MAR applications had a positive effect on the knowledge and skill levels of nursing students regarding injection practices and provided persistence in the learned knowledge and skills.

Development of a medical error scale for nurses in Turkey.

BACKGROUND: Medical errors can have an adverse effect on patients, health care providers and health care organizations. Determining the likelihood of such errors is important to implement appropriate and effective solutions to minimize errors. AIMS: The aim of this study was to develop a valid and reliable scale to evaluate the likelihood of medical errors by Turkish nurses. METHODS: The draft scale (with 94 items) was developed based on primary references and the opinions of nursing experts. Content validity was assessed using 15 nursing experts. Construct validity of the scale was assessed with exploratory and confirmatory factor analyses using 298 nurses at a university hospital in Trabzon, Turkey. To assess test-retest reliability of the scale, another group of 50 nurses were included. RESULTS: The content validity index of the scale was 0.82, Cronbach alpha was 0.89, and item-total correlation values ranged from 0.31 to 0.54. Kaiser-Meyer-Olkin was 0.81, Bartlett test was 5909.75, P < 0.0001, and the anti-image correlations ranged between 0.63 and 0.90. In the four rotations done with varimax rotation, 42 items were excluded because their factor loadings were less than 0.45. The final scale had 43 items and six subscales: falls, blood and blood products transfusion, medication practices, care practices, communication, and other controlled practices. The six-subscale structure was confirmed by confirmatory factor analysis, and the fit between the scale and its subscales was good. CONCLUSION: The scale is a valid and reliable tool to collect consistent data on medical errors in the patient-related practices of nurses.

A de novo complex chromosomal rearrangement involving chromosomes 2, 8 and 13 in a dysmorphic case with polysyndactyly.

We report herein a case with dysmorphic features, polysyndactyly and psychomotor mental retardation, who had an apparently balanced de novo translocation between chromosomes 8 and 13 as well as a de novo insertion within chromosome 2 itself. This case is worth mentioning in the sense that it bears two de novo rearrangements with five breakpoints. The correlation between the possible disrupted genes within the given breakpoints and the phenotype of the case will be discussed.

The occupational safety and health in hospitals from the point of nurses.

Hospitals have many forms of danger due to many different working conditions. Hospital personnel also take risks whilst providing health care which may cause health problems to themselves. The research, related to health and safety of nurses and other staff was carried out in order to compare and determine the occupational health problems and evaluate the occupational safety precautions and applications of a private hospital accredited with JCI (Joint Commission International) and also a university hospital. The research took place amongst 162 nurses of a university hospital and 150 nurses of a private hospital, both in Istanbul, Turkey. The data was gathered between March and July 2007 using a survey consisting of 7 questions to find out the socio-demographic characteristics and 17 questions related to the occupational safety precautions and the occupational health problems of health personnel. According to the nurses, the safety applications and precautions of the private hospital were better than the university hospital. It was found out that the university hospital was poor at providing an ergonomic working environment and the private hospital was poor at planning the timetables of the nurses. In addition to this,--in both hospitals--sharp or pointed devices, blood/blood fluids and infected material were discovered to cause occupational diseases and other problems. In conclusion, the precautions and applications regarding occupational health and safety in the private hospital accredited with JCI were better than the university hospital.

Nursing satisfaction and job enrichment in Turkey.

Survey research was conducted with the aim of better understanding nurses' perceptions of organizational factors which relate to their job satisfaction and motivation in Turkey. Nurses (N = 290) who were employed at a training and research hospital, part of the Turkish Republic Ministry of Health, were included. The questionnaire used was developed for this study based on Hackman and Oldman's job enrichment theory. The results showed that only one third of the nurse leaders and one in five of the staff nurses reported being satisfied with their job. The participants saw the five core job dimensions of Hackman and Oldman's work design model: skill variety, task identity, task significance, autonomy, and feedback as important for nurses. Nursing was described by the participants as hard and challenging, but they also found it meaningful and said that it gave them the opportunity to use their skills and abilities.