Evaluation of alarm fatigue of nurses working in the COVID-19 Intensive Care Service: A mixed methods study.

AIMS AND OBJECTIVES: To reveal the existence of alarms in COVID-19 intensive care units, where medical devices with alarm function are frequently used, the effects of alarms on nurses, especially their on-the-job performances and social lives, and their coping methods. METHODOLOGY/METHODS: This was a mixed design, including descriptive and qualitative research methods with two stages, and was carried out between March and April 2021. The study adhered to the STROBE checklist for cross-sectional studies and the COREQ guidelines for qualitative studies. SETTING: Nurses in the COVID-19 intensive care unit of a university hospital constituted the sample. 58 nurses participated in the quantitative data phase, and 18 nurses in the qualitative interviews. RESULTS: More than half of the nurses worked in the COVID-19 intensive care unit for more than 5 months and overtime, and 87.9 had day and night shifts. The monthly income level of 65.5% was between the hunger and poverty lines, and 12.1 % received psychiatric support in the last 6 months. A positive and significant relationship was found between the mean score obtained from the alarm fatigue questionnaire and the level of discomfort felt due to the alarms (1-10 points) (p = 0.001). Five themes and thirty sub-themes were emerged in the focus group interviews. CONCLUSION: The number of alarms of the medical devices in the COVID-19 intensive care units was more than the other intensive care units, resulting in fatigue in nurses. Since alarm fatigue is directly related to patient safety, the effective management of medical device alarms can reduce alarm fatigue and prevent potentially dangerous outcomes. RELEVANCE TO CLINICAL PRACTICE: Nurses care for patients with severe clinical conditions in COVID-19 intensive care units. This situation caused them to be exposed to more alarms. Nurses should make efforts to reduce their alarm intensity.

Is ischemia associated with the formation of White matter lesions in migraine?

OBJECTIVE: White matter lesions (WMLs) are more common in migraine patients than in the normal population. Ischemia/hypoxia and oxidative stress are considered to play a role in WMLs formation. This study aimed to investigate ischemia-modified albumin (IMA), ferroxidase and thiol/disulfide homeostasis in migraineurs with and without WMLs. PATIENTS AND METHODS: Sixty-two migraineurs with WML, 59 migraineurs without WML and 61 controls were included in the study. All participants underwent brain MRI. WMLs was evaluated according to the Fazekas scale. IMA, ferroxidase, total thiol, native thiol and disulfide measurements were carried out in all participants. RESULTS: The IMA levels were higher in the migraine groups compared to the control group (p < 0.001) and in the WML group compared to non-WML (p < 0.001). The total and native thiol levels were higher in the non-WML group compared to the control and WML groups (p < 0.001 for both). The disulfide levels were similar between the control and non-WML groups, but they were significantly lower in the WML group compared to the control and non-WML groups. There was no significant difference between the groups in terms of the ferroxidase levels (p = 0.092). The thiol/disulfide, IMA and ferroxidase levels were not significantly correlated with the frequency and duration of attacks, severity of pain and disability due to migraine. CONCLUSION: Increased serum IMA levels in migraineurs point to the role of ischemia/hypoxia, and increased total thiol and decreased disulfide levels indicate an oxidant/antioxidant imbalance in migraine. Ischemia/hypoxia may play a role in WMLs formation in migraine.

Effect of lutein on methotrexate-induced oxidative lung damage in rats: a biochemical and histopathological assessment.

BACKGROUND/AIMS: This study aimed to investigate the effect of lutein on methotrexate (MTX)-induced pulmonary toxicity in rats biochemically and histopathologically. METHODS: The rats in the MTX + lutein (MTXL, n = 6) group were given 1 mg/kg of lutein orally. A 0.9% NaCl solution was administered orally to the MTX (n = 6) group and the healthy group (HG, n = 6). One hour later, a single 20 mg/kg dose of MTX was injected intraperitoneally in the MTXL and MTX. Lutein or 0.9% NaCl solution was administered once a day for 5 days. At the end of this period, malondialdehyde (MDA), myeloperoxidase (MPO), total glutathione (tGSH), interleukin 1 beta (IL-1ß), and tumor necrosis factor alpha (TNF-α) were measured in the lung tissues from the animals euthanized with 50 mg/kg thiopental sodium anesthesia. Subsequently, histopathological examinations were performed. RESULTS: The levels of MDA, MPO, IL-1ß, and TNF-α in the lung tissue of the MTX were significantly higher than those of the MTXL and HG groups (p < 0.0001), and the amount of tGSH was lower. The histopathological findings in the MTX group, in which the oxidants and cytokines were higher, were more severe. CONCLUSION: Lutein prevented the MTX-induced oxidative lung damage biochemically and histopathologically. This result indicates that lutein may be useful in the treatment of MTX-induced lung damage.

The effect of the BATHE interview technique on the empowerment of diabetic patients in primary care: A cluster randomised controlled study.

AIM: To investigate the effect of the BATHE therapeutic interview technique on the empowerment of diabetes mellitus patients in primary care. METHOD: A cluster randomised controlled study using the BATHE interview technique was conducted on diabetes mellitus patients in primary care. Physicians in the intervention group were trained in the BATHE interview technique and used it with their diabetic patients in addition to the usual care. In the control group physicians delivered only the usual care. A total of 112 diabetes mellitus patients who met the study criteria (57 intervention, 55 control) were included. Three interviews were conducted with the patients in both groups at the beginning, the 3rd and 6th months. The Diabetes Empowerment Scale (DES) was filled up at baseline and in the 6th month. RESULTS: Due to some drop outs, the study finished with 44 patients in the control and 49 in the intervention group. According to an 'Intention to treat analysis' increase in the DES total score for the intervention group was higher than for the control group (Δ=10.56±8.97; Δ=5.64±7.36; p<0.001). Using multiple regression analysis, the BATHE intervention showed a significant predictor of the DES difference (B: 8.861; CI: 6.092-11.629; p<0.001). CONCLUSION: The use of the BATHE technique in primary care has a positive effect on the empowerment of diabetes mellitus patients.