Compassion fatigue and the meaning in life as predictors of secondary traumatic stress in nurses during the COVID-19 pandemic.

AIM: This study aimed to investigate the relationship among secondary traumatic stress, compassion fatigue, and meaning in life in nurses during the COVID-19 pandemic. BACKGROUND: Changes in working conditions during the pandemic also changed the needs of nurses. In addition to physical health, the COVID-19 pandemic led to many psychosocial health problems such as sleep disturbances, depression, and traumatic stress. This makes nurses vulnerable to psychological side effects of the pandemic. DESIGN: A cross-sectional study was conducted. METHODS: This study was conducted with 166 nurses. Data were collected online at May-June 2021. A Personal Information Form, the Secondary Traumatic Stress Scale, Compassion Fatigue Scale, and Meaning in Life Scale were used. The STROBE reporting checklist was followed. RESULTS: As secondary traumatic stress levels increase, compassion fatigue increases, meaning in life decreases, and the search for meaning in life increases. CONCLUSION: Predictors of secondary traumatic stress were shown to be compassion fatigue, change in sleep habits, meaning in life, marital status, and having a chronic illness. This suggested that working during the pandemic posed significant risks in terms of manifesting negative consequences on mental health in the long term.

Effectiveness of simulation-based peripheral intravenous catheterization training for nursing students and hospital nurses: A systematic review and meta-analysis.

BACKGROUND: Peripheral intravenous catheterisation (PIVC) is a complex procedure. AIM: This study reviewed studies evaluating the effects of different simulators in comparison with traditional methods used in PIVC training for nursing students and hospital nurses. DESIGN: A systematic review and meta-analysis of randomised (RCT) and non-randomised controlled (N-RCT) studies. METHODS: MEDLINE, Cochrane, Scopus, ERIC, Web of Science, and ScienceDirect were searched using PIVC, simulation and nursing education. The quality of evidence was assessed using the GRADE system; the risk of bias was assessed using the RoB 2 (for RCTs) and A Cochrane Risk of Bias Assessment Tool for N-RCTs. The study was conducted as per the PRISMA guidelines. RESULTS: In total, 2,812 records were identified, and 12 studies published between 2002 and 2018 were finally included. Most studies included Virtual IV simulator and the plastic IV arm model in PIVC training for hospital nurses and nursing students, reported on outcomes such as PIVC-related knowledge, skills, confidence, state/trait anxiety and satisfaction. Seven studies were included in the meta-analysis, the effect sizes for all the outcomes ranged from small to moderate. However, the effect sizes were non-significant for all outcomes. The quality of evidence was assessed as being low for skills, knowledge, satisfaction, and trait/state anxiety, and moderate for confidence. CONCLUSIONS: The effect of Virtual IV training on PIVC-related skills, knowledge, satisfaction and anxiety among nursing students and hospital nurses, in comparison with the plastic arm training method, remains unclear. However, Virtual IV training was found to increase PIVC confidence. RELEVANCE TO CLINICAL PRACTICE: There is a small effect in favour of VR in PIVC education although non-significant. More evidence is needed to determine the superiority of simulation methods. In PIVC training of nurses and nursing students, hospitals and schools can choose a method in accordance with their resources. TRIAL REGISTRATION: PROSPERO 2019 CRD42019124599.

Systematic review and meta-analysis: Physical-procedural interventions used to reduce pain during intramuscular injections in adults.

AIMS: To assess the effectiveness of physical-procedural interventions in reducing pain during intramuscular injections. DESIGN: Systematic review and meta-analysis. METHOD: English keywords were used to search databases [MEDLINE (OVID, Ebsco), SCOPUS, Science Direct, COCHRANE and the reference lists from retrieved articles] from their inception to November 2017 and randomized and quasi-experimental trials were selected based on inclusion and exclusion criteria. The standardized mean difference and random effects model were used. RESULTS: From 2,318 articles, 15 articles (1996-2017) met the criteria for the meta-analysis. Physical-procedural interventions described in the articles were included in this systematic review. The overall standardized mean difference was 0.595 (95% confidence interval (CI) = 0.417-0.773), indicating a moderate effect on pain levels. Generally, these interventions (two-needle technique, acupressure, manual pressure, ShotBlocker, Z-technique, air-lock technique, injection site postinjection massage, and speed of injection) have been found to moderately reduce pain. CONCLUSION: It seems difficult to conclude that a single intervention reduces pain in adults. However, we can state that the most effective interventions for reducing pain during intramuscular injections in adults involve the ventrogluteal site, the Z-technique, and manual pressure. IMPACT: The systematic review will provide guidance to clinicians, staff, and educator nurses and future studies. The systematic review will help nurses and educators apply techniques based on evidence in any setting. The systematic review will guide well-designed and well-reported studies to contribute to the accumulation of evidence in nursing research.

Subcutaneous injections: A cross-sectional study of knowledge and practice preferences of nurses.

BACKGROUND: Widespread use of subcutaneous injection for parenteral medications is likely to be related to high medication bioavailability and rapid onset of action. Correct subcutaneous injection technique and site selection are essential for nursing care quality and patient safety. AIM: The study aimed to determine nurses' knowledge and practice preferences regarding subcutaneous injection technique and administration site selection. DESIGN: This cross-sectional study took place between March and June 2021. METHODS: This study included 289 nurses, willing to participate who worked in units performing subcutaneous injections in a university hospital in Turkey. RESULTS: Most nurses reported their preferred administration site for subcutaneous injections was the lateral aspects of the upper arm. More than half of the nurses did not use a rotation chart, they swabbed the skin before a subcutaneous injection, and they always pinched the skin at the injection site; 50% of nurses reported always administering subcutaneous injections at an angle of either 90 or 45 degrees. Most nurses performed an injection in less than 30 s and waited for 10 s before withdrawing the needle. They did not apply massage onto the site following the injection. Nurses' knowledge of subcutaneous injection was at a moderate level. CONCLUSIONS: Nurse knowledge of best practice subcutaneous injection administration and site selection could be improved in line with current evidence to improve personcentred and quality and safe care delivery. Future research should involve developing and evaluating educational strategies and practice standards to enhance nurse understanding of best practice evidence to meet patient safety goals.

Does fibromyalgia affect physical activity due to pain?

OBJECTIVES: The aim of this case-control study was to evaluate the physical activity levels of patients with fibromyalgia syndrome (FMS) and to assess a possible relation between physical activity and FMS characteristics. METHODS: Seventy patients with FMS and 50 age-gender-matched controls were included. Pain was evaluated using the visual analog scale. The Fibromyalgia Impact Questionnaire (FIQ) scoring system was used for the evaluation of the impact of FMS. Furthermore, for assessing the physical activity in our participants, we used the International Physical Activity Questionnaire (IPAQ). The Mann-Whitney U and Pearson's correlation tests were used for group comparisons and correlation analyses. RESULTS: The patients presented significantly less transportation-related, recreational, and total physical activity levels, besides reporting significantly less time spent walking and less time spent in vigorous activities than controls (p<0.05). Furthermore, there was a negative correlation between pain and the scores of self-reported moderate or vigorous physical activity (r=-0.41, p<0.01) in patients. However, we could not find any correlation between FIQ and IPAQ scores. CONCLUSION: Patients with FMS are physically less active than healthy individuals. This reduced activity seems to be associated with pain, but not with the impact of the disease. In the management of the patient with FMS, considering the patient's physical activity behavior negatively affected by pain may contribute to holistic approach to the patients.

Intravenous medication errors in the emergency department, knowledge, tendency to make errors and affecting factors: An observational study.

BACKGROUND: Intravenous medication errors are common in hospital settings particularly emergency department. This study aimed to determine intravenous medication preparation and administration errors, contributing factors, tendency towards making errors and knowledge level of emergency department healthcare workers. METHODS: A cross-sectional study using a structured, direct observation method was conducted. It was conducted with 23 emergency healthcare workers working in the emergency department of a university hospital in Turkey. Data were collected by questionnaires: Knowledge Test on Intravenous Medication Administration, Intravenous Drug Administration Standard Observation Form, Drug and Transfusion Administration Sub-Dimension scale, Perceived Stress Scale and Pittsburgh Sleep Quality Index. RESULTS: It was determined that the knowledge level of the emergency healthcare workers about intravenous medication administration was moderate, and the tendency mistakes regarding drug and transfusion applications was very low. There was no relationship between education level, years of work, years of work in the emergency department, perceived stress level and sleep quality, and the tendency of making mistakes in drug and transfusion applications. CONCLUSION: It is important for patient safety to prevent medication errors by determining the factors affecting intravenous medication administration, tendency to make mistakes and knowledge levels, which are frequently used in emergency department.

Morning-evening type and burnout level as factors influencing sleep quality of shift nurses: a questionnaire study.

AIM: To assess the relationship between sleep quality and demographic variables, morning-evening type, and burnout in nurses who work shift. METHODS: We carried out a cross-sectional self-administered study with forced choice and open-ended structured questionnaires - Pittsburgh Sleep Quality Index, Morningness-eveningness Questionnaire, and Maslach Burnout Inventory. The study was carried out at Gazi University Medicine Faculty Hospital of Ankara on 524 invited nurses from July to September 2008, with a response rate of 89.94% (n=483). Descriptive and inferential statistics were applied to determine the risk factors of poor sleep quality. RESULTS: Most socio-demographic variables did not affect sleep quality. Participants with poor sleep quality had quite high burnout levels. Most nurses who belonged to a type that is neither morning nor evening had poor sleep quality. Nurses who experienced an incident worsening their sleep patterns (P<0.001) and needlestick or sharp object injuries (P=0.010) in the last month had poor sleep quality. The subjective sleep quality and sleep latency points of evening types within created models for the effect of burnout dimensions were high. CONCLUSIONS: Nurses working consistently either in the morning or at night had better sleep quality than those working rotating shifts. Further studies are still needed to develop interventions that improve sleep quality and decrease burnout in nurses working shifts.

Development and Validation of the Oral Mucositis Risk Assessment Scale in Hematology Patients.

OBJECTIVES: This study was conducted as a methodological study to develop a valid and reliable scale to evaluate the risk of developing oral mucositis in hematology patients. DATA SOURCES: The universe and sample were comprised of one hundred eighty-seven in-patients who were taken to receive chemotherapy in the hematology clinics over a six-month period. The data were collected through the Patient Diagnosis Form, the World Health Organization's Mucositis Evaluation Form and Oral Mucositis Risk Assessment Scale in Hematology Patients developed. Risk of "taking high-dose chemotherapy regimen", "neutropenia", "dry mouth", "pain", "leukopenia", "parenteral feeding", "previous history of oral mucositis" and "chemotherapy or radiotherapy in the past" were found as an oral mucositis risk factor. We have added "using high-risk chemotherapeutic agents", "bone marrow transplant", " head-neck or mouth cancer" which we consider clinically important. The scale consists of 11 items. The sensitivity value is 0.941 and the selectivity value is 0.724. CONCLUSION: We recommend that use the Oral Mucositis Risk Assessment Scale in Hematology Patients. Similar studies should be performed in oncology clinics and especially in patients receiving head and neck, oral radiotherapy. IMPLICATIONS FOR NURSING PRACTICE: Oral mucositis is an important problem for hematology patients. nurses' risk assessment and early intervention to oral mucositis prevent the formation and complications of oral mucositis.

Acupuncture reduces the postoperative pain in teeth with symptomatic apical periodontitis: a preliminary randomized placebo-controlled prospective clinical trial.

OBJECTIVE: Endodontic treatment generally results in a wide range of postoperative pain intensity. The aim of this study was to investigate the effect of preoperative acupuncture on postoperative pain in molar teeth with symptomatic apical periodontitis. METHOD AND MATERIALS: Thirty patients having symptomatic apical periodontitis with a preoperative and percussion pain of visual analog scale (VAS) more than 60 were included in this study. The patients were randomly distributed into two groups; G1, real acupuncture; and G2, placebo (mock acupuncture). After 15 minutes of application, root canal treatment was performed. A logistic regression analysis was used to determine the variable(s) (group, age, gender, tooth number, preoperative pain, preoperative percussion pain, and radiographic status) that controls the postoperative pain significantly. Chi-square, Mann Whitney U, and independent t tests were performed to analyze the data, and the level of significance was set at .05 (P = .05). RESULTS: A regression analysis demonstrated that the group variable had the most significant effect on postoperative pain at day 1 (P = .003). Results showed that acupuncture reduced the preoperative and percussion pain levels significantly more than placebo group at all day intervals (P < .05). For postoperative pain at the 7-day follow-up, the pain ranged from "mild" to "no pain" in G1, compared with "moderate" to "minimal" in G2. Only one patient required postoperative analgesics in the acupuncture group compared to eight patients for placebo. CONCLUSIONS: Preoperative acupuncture can be beneficial in reducing postoperative pain in teeth with symptomatic apical periodontitis.

The determination of record-keeping behavior of nurses regarding intravenous fluid treatment: the case of Turkey.

Record-keeping is one of the legal and professional responsibilities of nurses. This study aims to determine the record-keeping behavior of nurses regarding intravenous fluid treatment (IVFT). The study was conducted with 150 nurses working in adult clinics of a 936-bed university hospital. The most frequently fulfilled record-keeping behaviors were solution type, total solution amount, and date of treatment. The least frequent fulfilled behaviors were the diagnosis of patients and the time of passage of medication added to the solution. The nurses never recorded type of i.v. fluid treatment, complications, and discontinuation of therapy. According to findings of the study, the record-keeping behavior of nurses regarding IVFT is not at the desired level.