The effect of kangaroo care on cortisol levels and immune factors in breast milk.

This paper investigated the effect of kangaroo mother care (KMC) in the early postpartum period on cortisol levels and immune factors in breast milk. This quasi-experimental study was conducted at the obstetrics clinic of a university hospital in western Türkiye. The sample consisted of 63 mothers and their infants. All mothers had a cesarean delivery. Participants were divided into control (n = 32) and experimental groups (n = 31). The control group received routine care at the clinic. The experimental group received KMC for the first 3 days after birth in addition to the routine care at the clinic. Milk samples were collected on the third day after delivery to examine cortisol, IgA, IgM, and IgG levels. All parameters were measured using the enzyme-linked immunosorbent assay method. The experimental group had lower cortisol levels (17.740 ± 1.438) than the control group (18.503 ± 1.449) (p < .05). This result showed that the difference between the two groups was clinically significant (effect size = .53). There was no significant difference in IgA, IgM, and IgG levels between the groups (p > .05). The experimental and control groups had similar immunological factors, but the former had lower cortisol levels than the latter. Therefore, healthcare professionals should encourage mothers to provide KMC to their infants as soon as possible.

Correlation between mindfulness, empathy and compassion levels of nursing students: A cross-sectional study.

BACKGROUND: The concept of mindfulness does not attract enough attention in the field of health. Despite this, it is thought to be effective on the concept of empathy and compassion, which have an importance in nursing practices. AIM: The aim of the study was to investigate the correlation between the mindfulness, empathy and compassion levels of nursing students. METHODS: This is a descriptive-correlational and cross-sectional study which comprised 347 students in the nursing department of a university. As data collection tools, the Mindful Attention Awareness Scale, the Basic Empathy Scale and the Compassion Scale. FINDINGS: The results of the study show that no significant correlation was found between the mindfulness, total empathy levels and cognitive empathy levels of the students, and that there was a significant negative correlation between their emotional empathy levels. There was found to be a significant positive correlation between their mindfulness and total compassion levels. DISCUSSION: The findings of this study contribute to the literature that the mindfulness of nursing students is not related to total empathy levels, but is closely related to compassion levels. Some studies in the literature support these findings. CONCLUSION: It is thought that knowing, teaching and developing the concepts of empathy and compassion in nursing education is important for raising nurses who can provide compassionate care with a high level of empathy. The practice of mindfulness should always have a prominent role in nursing education. Its correlation with empathy and compassion should be consistently highlighted.

Nurses' knowledge and experience related to short peripheral venous catheter extravasation.

BACKGROUND: The majority of hospitalized patients receive a Peripheral Venous Catheter (PVC) in the course of their treatment. Extravasation injury is a serious complication of intravenous treatment. OBJECTIVE: This cross-sectional survey designed study aims to investigate nurses' knowledge and experience related to short peripheral venous catheter extravasation. METHOD: The study sample included 145 nurses working in a university hospital in the west of Turkey. A questionnaire developed in accordance with the literature was used for data collection. The data were assessed by frequency and proportions. RESULTS: Of the nurses included in this study, 26.2% reported they had experienced extravasation injury in a patient; 74.5% said they had received no instruction in the management of extravasation during their in-service training program; and 85.5% stated they did not keep a record of extravasation. 89.7% of the nurses reported infused medications as a cause of extravasation, and 81.4% reported catheter sites as a cause. Among the medications reported by the nurses as causing extravasation: 89.7% reported contrast agents; 84.8% TPN solutions; 71.0% cytotoxic agents; and 65.1% mannitol. The symptoms of extravasation reported by nurses included: swelling (97.9%), redness (97.2%), pain (92.4%), rise in temperature (65.5%), and ulceration (60.0%). In responding to the occurrence of extravasation, interventions reported by the nurses included: stopping the flow of fluid (98.6%), elevation (89.7%), cold application (76.6%), and aspiration of drug (40.7%). CONCLUSION: Based on these results, it is recommended that guidelines are developed for the management of extravasation, that periodic in-service training programs are provided and that observational studies are carried out into the administration of vesicant drugs.

Effectiveness of transparent film dressing for peripheral intravenous catheter.

BACKGROUND: The intravenous applications are the most common type of such interventions. It is underlined that in cases where the peripheral intravenous catheter is not properly secured in place, even a minor movement inside the vein would result in injury of vein. OBJECTIVE: The insertion of peripheral intravenous catheter is a common practice. This is a randomized controlled prospective study aiming at investigating the effectiveness of use of transparent film dressing for peripheral intravenous catheter. METHODS: The universe of this study included inpatients in the Internal Diseases clinic of a University Hospital, and the sample included a total of 110 peripheral intravenous catheters that were calculated by power analysis. The patient identification form, the peripheral venous catheter and treatment information form, and the visual infusion phlebitis identification scale were used to collect data. The forms were completed by the investigators on the basis of daily observations. The data were assessed by the percentage, chi-square test, and logistic regression analysis via the software SPSS 20.00. RESULTS: The individuals in the study group and the control group included in the sample are comparable in terms of gender, having/not having a chronic disease, the site of peripheral intravenous catheter, use of antibiotics, intravenous fluid therapy, and mean age. There were no statistically significant differences between the groups. There was a significant relationship between the dwell time for the catheter and development of any complications and the groups. CONCLUSION: The use of transparent film dressing for insertion of peripheral intravenous catheter can be recommended as it increases the dwell time for the catheter and reduces incidence of complications.

Problems Encountered by Nurses Due to the Use of Personal Protective Equipment During the Coronavirus Pandemic: Results of a Survey.

The importance of personal protective equipment (PPE) for nurses in the global fight against the coronavirus disease-19 (COVID-19) pandemic cannot be overstated. PPE must be available, safe, and effective. There is increasing evidence that the use of PPE can cause physical health problems. PURPOSE: The purpose of this study was to further examine PPE-related physical problems experienced by nurses as well as the role of wear time on these problems. METHODS: Using a descriptive cross-sectional design, a survey was conducted among nurses working for state or university hospitals across Turkey who actively cared for patients with COVID-19. Survey questions included demographic variables, type of PPE used, physical problems experienced, and length of time PPE was worn (4 hours or less, or more than 4 hours). Descriptive statistics and logistic regression analysis were used to analyze the data. RESULTS: Three hundred and seven (307) nurses completed the survey. The most commonly reported problems were sweating when wearing a surgical (50.9%) or N95 (64.2%) mask, dry hands from wearing gloves (73.9%), perspiration when wearing overalls/gowns (84.1%), and vision problems when wearing goggles/face shields (47.9%). Logistic regression analysis indicated a signifcant relationship between > 4 hours length of use and the occurrence of the following: redness of the cheeks, dry mouth, redness of the nose bridge, and redness of the ears for N95 masks; dryness of the mouth when wearing surgical masks; skin dryness, sweating, and redness from wearing gloves; headaches from wearing goggles/face shields; and sweating when wearing overalls or a gown (P < .05 for all variables). CONCLUSION: The results of this study show that physical problems related to the use of PPE are common and increase when PPE is worn for more than 4 hours. The availability, safety, and effectiveness of PPE are crucial to help protect nurses. Studies to examine PPE quality, characteristics, efficacy, and optimal use are necessary to maintain the healthy workforce needed to care for patients during this pandemic.

Examining Knowledge, Skill, Stress, Satisfaction, and Self-Confidence Levels of Nursing Students in Three Different Simulation Modalities.

PURPOSE: The aim of this study was to compare the effect of different simulation modalities on knowledge, skill, stress, satisfaction, and self-confidence levels of students receiving undergraduate education in three nursing schools. METHOD: This was an experimental study. Students applied the scenario of "Respiratory Sounds Assessment" which was prepared according to three different simulation modalities. In the study, the standardized patient, high-fidelity simulation, and partial task trainer were used as simulation modalities. RESULTS: An increase was observed in postpractice knowledge levels of the three groups which had similar knowledge levels before the practice. Virtual Analog Scale stress levels of the students in the standardized patient group were higher than those of others. The students' mean scores of satisfaction in learning were higher in the standardized patient group. The students in the partial task trainer group had lower scores of self-confidence in learning. Skill scores of the students were lower in the standardized patient practice than those in others. CONCLUSION: Simulation-based experiences give students the opportunity of experiencing situations they may experience in the actual practice beforehand. Therefore, this may increase their performance in real practices, as reality increases in the standardized patient group.

The Effects of Two Methods on Venipuncture Pain in Children: Procedural Restraint and Cognitive-Behavioral Intervention Package.

BACKGROUND: Invasive interventions can produce fear, anxiety, and pain in children. This may negatively affect the children's treatment and care. AIM: This study was conducted to determine the effects of procedural restraint (PR) and cognitive-behavioral intervention package (CBIP) on venipuncture pain in children between 6-12 years of age. DESIGN: Quasi-experimental study. SETTINGS: The study was conducted in the pediatric blood collection service of the hospital in Turkey between October 1, 2015, and April 1, 2016. PARTICIPANTS/SUBJECTS: The population of the study consisted of children admitted to the blood collection service during the study period who met the inclusion criteria. METHODS: The children included in the study were divided into two groups. Group 1 (n = 31) received PR in accordance with routine clinical practice. Group 2 (n = 30) received the CBIP. The data were collected by the researchers using a questionnaire, the visual analog scale (VAS), and the Wong-Baker FACES (WB-FACES) Pain Rating Scale. RESULTS: The children in the PR group had a mean VAS score of 5.90 ± 3.22 and a mean WB-FACES score of 8.70 ± 2.22. The children in the CBIP group had a mean VAS score of 2.43 ± 2.02 and a mean WB-FACES score of 2.80 ± 2.49. A statistically significant difference was found between the mean VAS and WB-FACES pain scores of the groups (p < .05). CONCLUSIONS: The results of this study showed that the children in the CBIP group had a lower pain level during venipuncture compared to those restrained for the procedure.

Incidence of infiltration/extravasation in newborns using peripheral venous catheter and affecting factors.

OBJECTIVE: The objective of this study was to identify the incidence of infiltration and extravasation in newborns using peripheral venous catheter, and affecting factors. METHOD: This observational study examined catheters inserted into newborns who received inpatient care in the neonatal intensive care unit of a state hospital located in the west of Turkey. A total of 452 peripheral venous catheters inserted into 152 newborns were observed. The forms were completed by the researchers based on their observations at each shift. RESULTS: The infiltration/extravasation occurred in 45.6% of peripheral venous catheters inserted into newborns; 19.7% were stage I and 11.7% were stage IV. A statistically significant relationship was found between the gestation week as well as the birth weight of newborns and the occurrence of infiltration/extravasation complication. In addition, there were statistically significant relationships between the administration of single or multiple antibiotics, total parenteral nutrition and the incidence of infiltration/extravasation complication. CONCLUSION: It is recommended to use an appropriate scale for the assessment of infiltration/extravasation as well as to implement measures for preventing the occurrence of infiltration/extravasation.

Validity and reliability of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T), Turkish version1.

OBJECTIVE: A methodological type of study was conducted for the purpose of investigating the validity and reliability of the Turkish version of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale of the clinical learning environment of students, clinical nurses, and educators. METHODS: Sample was comprised of 602 Turkish nursing students with clinical practice experience at the hospital. The CLES+T, developed by Saarikoski, was used for data collection. Language equivalency, internal consistency, item-total correlation, and structure validity were conducted within the scope of the validity and reliability study on the CLES +T scale. RESULTS: It was determined that item-total correlations of four items were lower than 0.30, and those items were removed from the scale as a result of item analysis. The Cronbach's alpha value of the scale was 0.93-0.99; item total point correlations of the scale varied between 0.45 and 0.66; six factors were identified in the CLES+T factor analysis study, with a total variance explained by these six factors of 64%. CONCLUSION: According to the findings of the research, the CLES+T Turkish version was found to be a valid and reliable scale, which can be used to evaluate satisfaction of nursing students with their clinical education in Turkey.

Incidence of infiltration/extravasation in newborns using peripheral venous catheter and affecting factors / Incidência de infiltração/extravasamento em recém-nascidos usando catéter venoso periférico e fatores correlacionados / Incidencia de infiltración/fuga en recién nacidos utilizando catéter venoso periférico y factores correlacionados

ABSTRACT Objective The objective of this study was to identify the incidence of infiltration and extravasation in newborns using peripheral venous catheter, and affecting factors. Method This observational study examined catheters inserted into newborns who received inpatient care in the neonatal intensive care unit of a state hospital located in the west of Turkey. A total of 452 peripheral venous catheters inserted into 152 newborns were observed. The forms were completed by the researchers based on their observations at each shift. Results The infiltration/extravasation occurred in 45.6% of peripheral venous catheters inserted into newborns; 19.7% were stage I and 11.7% were stage IV. A statistically significant relationship was found between the gestation week as well as the birth weight of newborns and the occurrence of infiltration/extravasation complication. In addition, there were statistically significant relationships between the administration of single or multiple antibiotics, total parenteral nutrition and the incidence of infiltration/extravasation complication. Conclusion It is recommended to use an appropriate scale for the assessment of infiltration/extravasation as well as to implement measures for preventing the occurrence of infiltration/extravasation.

RESUMO Objetivo O objetivo deste estudo foi identificar a incidência de infiltração e extravasamento em recém-nascidos usando catéter venoso periférico e fatores correlacionados. Método Este estudo observacional examinou catéteres inseridos em recém-nascidos que estavam internados na unidade de terapia intensiva neonatal de um hospital estadual localizado no oeste da Turquia. Um total de 452 catéteres venosos periféricos inseridos em 152 recém-nascidos foram observados. Os formulários foram completados pelos pesquisadores com base nas suas observações em cada turno. Resultados A infiltração/extravasamento ocorreu em 45,6% dos catéteres venosos periféricos inseridos em recém-nascidos; 19,7% eram estágio I e 11,7% eram estágio IV. Uma relação estatisticamente significativa foi encontrada entre a semana gestacional, bem como o peso ao nascer dos recém-nascidos, e a ocorrência de complicação de infiltração/extravasamento. Além disso, houve relações estatisticamente significativas entre a administração de um ou vários antibióticos, nutrição parenteral total e a incidência de complicação de infiltração/extravasamento. Conclusão É recomendado o uso de uma escala apropriada para a avaliação da infiltração/extravasamento, bem como implantar medidas para a prevenção da ocorrência de infiltração/extravasamento.

RESUMEN Objetivo El objetivo de este estudio fue identificar la incidencia de infiltración y fuga en recién nacidos utilizando catéter venoso periférico y los factores correlacionados. Método Este estudio observacional examinó los catéteres introducidos en recién nacidos que estaban en estancia hospitalaria en unidad de cuidados intensivos neonatales de un hospital ubicado en el oeste de Turquía. Un total de 452 catéteres venosos periféricos introducidos en 152 recién nacidos fueron observados. Los formularios fueron rellenados por los investigadores con base en sus observaciones en cada turno. Resultados La infiltración/fuga ocurrió en el 45,6% de los catéteres venosos periféricos introducidos en recién nacidos; el 19,7% eran estadío I y el 11,7% eran estadío IV. Una relación estadísticamente significativa fue encontrada entre la semana gestacional, así como el peso al nacer de los recién nacidos, y la ocurrencia de complicación de infiltración/fuga. Además, hubo relaciones estadísticamente significativas entre la administración de uno o varios antibióticos, nutrición parenteral total y la incidencia de complicación de infiltración/fuga. Conclusión Se recomienda el empleo de una escala apropiada para la evaluación de la infiltración/fuga, así como implantar medidas para la prevención de la ocurrencia de infiltración/fuga.

Validity and reliability of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T), Turkish version / Validade e confiabilidade da versão turca da escala de avaliação do Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem (CLES+T) / Validez y confiabilidad del Entorno de Aprendizaje Clínico, Supervisión y Enfermera Docente (CLES+T), versión turca

ABSTRACT Aim: A methodological type of study was conducted for the purpose of investigating the validity and reliability of the Turkish version of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale of the clinical learning environment of students, clinical nurses, and educators. Methods: Sample was comprised of 602 Turkish nursing students with clinical practice experience at the hospital. The CLES+T, developed by Saarikoski, was used for data collection. Language equivalency, internal consistency, item-total correlation, and structure validity were conducted within the scope of the validity and reliability study on the CLES +T scale. Results: It was determined that item-total correlations of four items were lower than 0.30, and those items were removed from the scale as a result of item analysis. The Cronbach's alpha value of the scale was 0.93-0.99; item total point correlations of the scale varied between 0.45 and 0.66; six factors were identified in the CLES+T factor analysis study, with a total variance explained by these six factors of 64%. Conclusion: According to the findings of the research, the CLES+T Turkish version was found to be a valid and reliable scale, which can be used to evaluate satisfaction of nursing students with their clinical education in Turkey.

RESUMO Objetivo: Um estudo do tipo metodológico foi desenvolvido com o propósito de investigar a validade e a confiabilidade da versão turca da escala de avaliação do Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem (CLES + T) no ambiente de aprendizagem clínica de estudantes, enfermeiros clínicos e educadores. Métodos: A amostra foi composta por 602 estudantes de enfermagem turcos com experiência na prática clínica hospitalar. O CLES + T, desenvolvido por Saarikoski, foi utilizado para coleta de dados. Equivalência de linguagem, consistência interna, correlação item-total e validade de estrutura foram avaliados no escopo do estudo de validade e confiabilidade na escala CLES + T. Resultados: As correlações item-total de quatro itens foram inferiores a 0,30, e tais itens foram removidos da escala como resultado da análise de itens. O valor alfa de Cronbach da escala foi de 0,93-0,99; as correlações item-total da escala variaram entre 0,45 e 0,66; seis fatores foram identificados na análise fatorial da escala, com uma variância total explicada por esses seis fatores de 64%. Conclusão: De acordo com os resultados da pesquisa, a versão turca do escala CLES+T foi considerada válida e confiável, a qual pode ser usada para avaliar a satisfação de estudantes de enfermagem com sua educação clínica na Turquia.

RESUMEN Objetivo: Se realizó un estudio de tipo metodológico con el fin de investigar la validez y la fiabilidad de la versión turca de la escala de evaluación del entorno de aprendizaje clínico, la supervisión y la enfermera docente (CLES + T) del entorno clínico de aprendizaje de estudiantes, enfermeras clínicas, y docentes. Métodos: La muestra estuvo compuesta por 602 estudiantes de enfermería turcos con experiencia en práctica clínica en el hospital. Se utilizó el CLES + T, desarrollado por Saarikoski, para la recopilación de datos. Se realizaron la equivalencia idiomática, la consistencia interna, la correlación ítem-total y la validez de la estructura dentro del alcance del estudio de validez y confiabilidad en la escala CLES + T. Resultados: se determinó que las correlaciones ítem-total de cuatro ítems eran inferiores a 0.30, y se eliminaron de la escala como resultado del análisis. El valor alfa de Cronbach de la escala fue 0.93-0.99; las correlaciones de puntos totales de los ítems de la escala variaron entre 0.45 y 0.66; se identificaron seis factores en el estudio de análisis del factor CLES + T, con una varianza total explicada por estos seis factores del 64%. Conclusión: según los resultados de la investigación, se encontró que la versión turca de CLES + T era una escala válida y confiable, que se puede utilizar para evaluar la satisfacción de los estudiantes de enfermería con su educación clínica en Turquía.

Investigation of suitability of ventrogluteal site for intramuscular injections in children aged 36 months and under.

PURPOSE: This study was performed to determine suitability of ventrogluteal (VG) site for intramuscular (IM) injections in children aged 36 months and under. DESIGN AND METHODS: The present study was designed as a prospective descriptive study and performed between 2016 January and June. The study included a total of 120 children aged 36 months and under that met the study criteria. The subcutaneous tissue thickness and muscle thickness of anterolateral, deltoid, and VG sites were measured and assessed by ultrasound. RESULT: A strong and powerful correlation was identified between the measurements of subcutaneous tissue and muscle thicknesses in the injection site by the age groups. The thickness of subcutaneous tissue was deltoid < anterolateral < VG by age groups. The muscle thickness of anterolateral and VG sites was significantly higher than that of deltoid site. PRACTICE IMPLICATIONS: This study established that skin thickness of VG site was suitable for IM injection in children aged 36 months and under.

Opinions of Nurses About the Evaluation of Risk of Falling Among Inpatients.

BACKGROUND: Patient falls and fall-related injuries are an important problem for patients, relatives, caregivers, and the health system at large. AIMS: This study aims to identify opinions of nurses about the risk of falling among patients staying in hospitals. METHOD: This study uses a qualitative descriptive design and employs a semistructured interview method to identify the opinions and experiences of nurses about patient falls. This study evaluated the opinions of a total of 12 staff nurses. FINDINGS: It was found that nurses consider patients in the postoperative period to be most prone to falls. They think that most falls take place during transfers and that the medical diagnosis of the patient plays a crucial role in fall incidents. The most important problem associated with patient falls was symptoms of traumatic brain injury. According to the participating nurses, the risk of fall for every patient should be evaluated upon admission. Measures that the nurses take against patient falls include raising the bed's side rails and securing the bed brakes. CONCLUSIONS: The findings of this research suggest that in-service training programs about the evaluation of the risk of falling should be organized for nurses. Guidelines should be developed for patients with different levels of risk of falling. It is suggested that nurses should be in charge of training patients who are conscious, their relatives, and caregiver personnel. CLINICAL RELEVANCE: The training of nurses and caregivers helps to prevent the falls of inpatients.

Care plans using concept maps and their effects on the critical thinking dispositions of nursing students.

It is expected that nursing education improves abilities of students in solving problems, decision making and critical thinking in different circumstances. This study was performed to analyse the effects of care plans prepared using concept maps on the critical thinking dispositions of students. An experimental group and a control group were made up of a total of 80 freshman and sophomore students from the nursing department of a health school. The study used a pre-test post-test control group design. The critical thinking dispositions of the groups were measured using the California Critical Thinking Disposition Inventory. In addition, the care plans prepared by the experimental group students were evaluated using the criteria for evaluating care plans with concept maps. T-test was used in analysing the data. The results showed that there were no statistically significant differences in the total and sub-scale pre-test scores between the experimental group and control group students. There were also significant differences in the total and sub-scale post-test scores between the experimental group and control group students. There were significant differences between concept map care plan evaluation criteria mean scores of the experimental students. In the light of these findings, it could be argued that the concept mapping strategy improves critical thinking skills of students.