Experiences of perioperative nurses with robotic-assisted surgery: a systematic review of qualitative studies.

To determine the experiences of perioperative nurses with robotic-assisted surgery is needed to improve the robotic-assisted surgery practices. This study systematically reviewed and analysed the qualitative studies concerning perioperative nurses' experiences of robotic-assisted surgery. This systematic literature review included studies up to December 2020. The study data were analysed using inductive content analysis. This systematic review included six articles. There were a total of 71 nurses who participated in the included articles (min = 6, max = 17). Their mean age was 35.7, and their experience in robotic-assisted surgery ranged from 8 months to 10 years. Content analysis generated six categories: adaptation to robotic-assisted surgery technology, the importance of teamwork in robotic-assisted surgery, changing tasks and responsibilities in robotic-assisted surgery, training requirements for robotic-assisted surgery, the effects of robotic-assisted surgery on patients and patient safety, and difficulties with robotic-assisted surgery. A variety of themes and sub-themes emerged in these categories. The review highlights the importance of developing new ways of thinking about the assessment and management of disruptions, developing different teamwork patterns and communication skills, and overcoming the challenges involved in technologically advanced surgeries. Nurses' roles in robotic technology should be redefined in healthcare. Nurses should learn how to adapt to advancing technology and how to supplement and enhance their skills.

Factors Affecting Immunosuppressive Medication Adherence in Liver Transplant Recipients with Poor Adherence: A Qualitative Study.

Purpose: Preserving graft functions and preventing rejection is closely related to immunosuppressive medication adherence in liver transplant recipients. Therefore, it is essential to determine factors affecting immunosuppressive medication use positively or negatively in liver transplant recipients. This study aimed to explore the use of immunosuppressive medication experience in liver transplant recipients with poor adherence and reveal the factors affecting the medication adherence. Material and Methods: The study was conducted as a qualitative study with phenomenological approach. Seven adult liver transplant recipients were included in this study, who had poor adherence to immunosuppressive medication. Data was collected via in-depth personal interviews. Data analysis was conducted through inductive content analysis with three steps of preparation, organization, and reporting phases. Results: Content analysis revealed four main categories, nine categories and 31 sub-categories. Four main categories emerged from the interview data: medication adherence perception, types of medication non-adherence, factors affecting medication adherence negatively and factors affecting medication adherence positively. Conclusion: This study explored that there are several factors affecting immunosuppressive medication adherence among liver transplant recipients, both positively and negatively. In order to achieve liver transplant recipients' total adherence to immunosuppressive medication, the factors affecting medication adherence positively and negatively should be understood. The study results are expected to contribute developing strategies to improve immunosuppressive medication adherence in liver transplant recipients.

Cardiovascular nurses' experiences of working in the COVID-19 intensive care unit: A qualitative study.

BACKGROUND: Cardiovascular nurses' skills and experiences of cardiac critical care, management of cardiovascular emergencies, and mechanical circulatory support have been considered vital in providing nursing care for COVID-19 patients in intensive care units during the COVID-19 pandemic. To our knowledge, there are no studies have focused on the contribution and experiences of cardiovascular nurses in the critical care of COVID-19 patients. OBJECTIVES: To explore the experiences of cardiovascular nurses working in a COVID-19 intensive care unit during the pandemic. METHODS: The study was conducted as a qualitative study with phenomenological approach in June-December 2020. Study data were gathered from ten cardiovascular nurses through semi-structured interviews. RESULTS: Six themes emerged from the interview data: the duties and responsibilities in a COVID-19 intensive care unit; the differences of COVID-19 intensive care unit practices from cardiovascular practices; the transferrable skills of cardiovascular nurses in a COVID-19 intensive care unit; the difficulties encountered working in a COVID-19 intensive care unit; the difficulty of working with personal protective equipment; and the psychosocial effects of working in a COVID-19 intensive care unit. CONCLUSION: Cardiovascular nurses made an important contribution to the management of nursing services with their experiences and skills in the COVID-19 pandemic.

Experiences of adult extracorporeal membrane oxygenation patients following discharge: A mixed methods study.

BACKGROUND: Survival and discharge rates after extracorporeal membrane oxygenation are gradually increasing. More research is warranted to investigate extracorporeal membrane oxygenation patients' post-discharge experiences, problems and quality of life. OBJECTIVE: The aim of this study was to determine adult extracorporeal membrane oxygenation patients' experiences, problems and quality of life following discharge. METHODS: A mixed methods research was used. Study sample consisted of 11 adult extracorporeal membrane oxygenation patients discharged at least one month prior to study entry. In-depth interviews were conducted. Participants' quality of life was assessed using the EuroQol 5 Dimension 5 Level questionnaire. RESULTS: Two categories (pre- and post-discharge), 7 themes and 16 sub-themes were developed based on in-depth interviews. According to the EuroQol 5 Dimension 5 Level, participants had high perceptions of health. CONCLUSION: Extracorporeal membrane oxygenation patients should be provided with comprehensive post-discharge education, exercise programs, social support and regular home visits for post-discharge assessment and follow-up care.

Home Percutaneous Endoscopic Gastrostomy Feeding: Difficulties and Needs of Caregivers, Qualitative Study.

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) may cause complications when adequate and appropriate care is not provided. To avoid these complications, caregivers' experiences and practices must be considered. METHODS: This study used the phenomenological qualitative research method. Twenty-one caregivers underwent in-depth interviews and were observed for PEG practices. Interview and observational data were analyzed using content analysis. RESULTS: This study revealed 8 themes and 24 subthemes under 3 categories of PEG management, social-emotional change of the caregivers, and expectations, and it was observed that caregivers made errors in stoma care, tube feeding, and medication administration through the PEG tube. CONCLUSION: Results indicated that comprehensive and practical discharge training, and home care and counseling services should be provided to effectively address the challenges faced by caregivers of patients with PEG.

Nursing Care of the Patient With Neurogenic Bladder After Kidney Transplantation: A Case Report.

OBJECTIVE: Urologic complications are among the most common complications after kidney transplantation. These complications are urinary retention, hematuria, hemorrhage, urinary leakage, vesicoureteral reflux, pyelonephritis, and nephrolithiasis. Although neurogenic bladder is one of the indications for kidney transplantation, it is not considered in the literature to be an expected complication after transplantation. In this case, we discuss the nursing care of a patient who underwent kidney transplantation from a living donor and developed neurogenic bladder. CASE REPORT: A 60-year-old woman underwent kidney transplantation from a living donor, and neurogenic bladder developed in the patient 1 year after kidney transplantation. Clear intermittent catheterization treatment was administered for the kidney transplant recipient with neurogenic bladder. Clear intermittent catheterization treatment was stopped in the patient who had frequent urinary tract infections and, alternatively, sacral neuromodulation treatment was administered to the patient. CONCLUSIONS: The nursing care of a patient with neurogenic bladder after kidney transplantation aims to prevent excessive bladder distension, infection, stone formation, vesicoureteral reflux, renal failure, urinary tract damage, and incontinence, and to ensure regular and complete discharge of the bladder. The most common treatment modalities for these objectives are permanent or intermittent catheterization, sacral neuromodulation, and medical therapy. In the care of the patient with neurogenic bladder after kidney transplantation, nurses should provide appropriate care related to treatment options and bladder training, plan urination schedules of the patient, and monitor for possible complications.

Caring for Patients With Ventricular Assist Devices: A Mini-Review of the Literature.

Heart transplantation, one of the treatment options for end-stage heart failure, is still regarded as the gold standard treatment to improve quality and length of life. However, the rapid increase in the number of patients waiting for heart transplantation and the inadequate number of donors makes heart transplantation a less feasible option and increases the need for ventricular assist devices as an alternative. The success of ventricular assist device implantation requires the collaboration of a multidisciplinary team consisting of cardiac surgeons, nurses, ventricular assist device coordinators, cardiologist, cardiac anesthesia specialists, perfusionists, and physiotherapists. Nurses working in different fields such as intensive care units, operating rooms, outpatient clinics, and ventricular assist device coordination units have important responsibilities in multidisciplinary teams. In this study, national and international studies on the responsibilities of nurses for the management and care of ventricular assist devices were reviewed. Nurses undertake many tasks, especially in the postoperative care of patients and in preparing them for discharge. Important responsibilities of nurses in the care of patients with ventricular assist devices include monitoring complications, managing equipment and emergency situations, establishing dressing change protocols, organizing daily life activities, determining rehabilitation needs, ensuring use of medicines, and providing comprehensive discharge education. Organizational and communication skills of nurses working with multidisciplinary teams are very important for the success of the ventricular assist device implantation process.

Nursing Diagnoses and Interventions in Kidney Transplant Recipients: A Retrospective Study.

PURPOSE: The aim of the study is to determine the nursing diagnoses and interventions applied to kidney transplant recipients. MATERIALS AND METHODS: A descriptive, retrospective study of nursing care plans of patients who underwent kidney transplantation from January 2008 through December 2016 was performed. Data were collected using a descriptive characteristics information form for patients and nursing care plans registered to the hospital's information-processing system. Data for nursing care plans of 100 kidney transplant recipients were analyzed. FINDINGS: It was determined that 59% of the kidney transplant recipients were male and the mean age ± SD was 42.56 ± 12.40 years; 81% of the patients had undergone kidney transplantation from living donors. The most commonly used nursing diagnoses in the care of kidney transplant recipients were (1) risk of infection (100%); (2) deficient knowledge (100%); (3) risk for bleeding (31%); (4) acute pain (26%); and (5) risk for falls (16%). The most common interventions were (1) examining the infection-related laboratory findings (69.0%); (2) limiting the number of visitors (64.0); and (3) setting aside time for patient questions and concerns (59.0%). CONCLUSIONS: Nursing diagnoses and interventions applied in the care of kidney transplant recipients seem to be limited. To provide holistic care to the kidney transplant recipients, the nursing care plans should include more extensive nursing diagnosis and interventions to maintain physical, psychological, and social well-being.

Quality of life among patients with left ventricular assist device: Comparison of two populations.

BACKGROUND: This study aims to evaluate quality of life among patients with an implanted left ventricular assist device in two different populations. METHODS: This cross-sectional study included a total of 20 patients (15 males, 5 females; mean age 41.8±13.4 years; range, 20 to 65 years) from Turkey and 40 patients (33 males, 7 females; mean age 55.1±11.6 years; range, 21 to 76 years) from Germany who underwent left ventricular assist device implantation and reached their third month of treatment between January 2016 and August 2016. The Euro Quality of Life-5 Dimension Questionnaire and Kansas City Cardiomyopathy Questionnaire-12 were used to assess quality of life of both groups. RESULTS: Sixty-five percent of the German patients returned to work, while none of the Turkish patients returned after implantation (p=0.000). The Turkish (70%) and German (40%) patients reported that they had difficulty in living with a left ventricular assist device (p=0.028). The mean Euro Quality of Life-5 Dimension Questionnaire visual analog scale scores of the Turkish and German patients were 70.50% and 62.38%, respectively. The mean Kansas City Cardiomyopathy Questionnaire-12 scores of the Turkish patients were significantly higher than those of the German patients (p=0.01). CONCLUSION: Left ventricular assist device implantation improved the quality of life of both Turkish and German patients. Turkish patients with left ventricular assist device should be encouraged to adopt a more independent life, not to limit their lives to home and to return to work according to their functional capacity.