The relationship between the ethical attitudes and holistic competence levels of intensive care nurses: A cross-sectional study.

BACKGROUND: Intensive care units are directly associated with the competency level of nurses and are units where ethical problems are frequently experienced. This research aims to determine the relationship between intensive care nurses' ethical attitudes and holistic competence levels. METHODS: This study was conducted as a cross-sectional design using self-report questionnaires distributed to 131 intensive care nurses in Turkey. The data of the study were collected with the "Nurses Information Form," "Holistic Nursing Competence Scale" and "Ethical Attitude Scale for Nursing Care". RESULTS: The total mean score of the Holistic Nursing Competence of the nurses was 6.89±0.95. Holistic Nursing Competence level was significantly lower for those who had experienced less than one year in the profession, and it was higher for those who worked in the emergency intensive care unit and the nurses whose clinics had 21 and above nurses. The total mean score of the nurses' ethics attitude toward nursing care was 59.36±29.09. Ethical Attitude for Nursing Care was significantly lower for those who had a master's degree, and the nurses whose clinics had 21 and above nurses scored higher. There was a weak and negative correlation between the nurses' Holistic Nursing Competence Scale and the total mean score of the Ethical Attitude Scale for Nursing Care. The ethical attitude was predicted in 13.2% of the Holistic Nursing Competence of nurses. CONCLUSIONS: It was concluded that nurses' holistic competence levels were high, their ethical attitudes were negative, and there was a weak negative correlation between their holistic competence levels and their ethical attitudes toward care.

The effect of different concentrations of chlorhexidine on microbial colonization: A double-blinded randomized controlled study.

AIM: Study aims were to determine the most effective chlorhexidine concentration to be used in reducing microbial colonization in patients under mechanical ventilation and to examine the effect of oral care using different concentrations on the integrity of the oral mucous membranes. DESIGN: This research was a randomized controlled double-blinded experimental study. METHOD: The sample of study consisted of the 116 adult patients who remained intubated. Oral care was given to patients 4 times/day as per nurse protocol. Every morning during for 4 days, the intraoral mucosa of all groups of patients was assessed. Microbial colonization samples from oral mucosa were taken in the morning before oral care. A determination of the species of microorganisms in these samples was made. RESULTS: A statistically significant difference was found with regard to the reproduction of microorganisms between the oral mucosa samples taken from patients using 2% and 1% chlorhexidine solutions (P < 0.001). In the cultures taken from patients on the first and fourth days of intubation, a total of 36 different microorganisms were seen to be reproducing. CONCLUSION: It was concluded that the most effective oral solution for the prevention of microbial colonization in patients under mechanical ventilation was chlorhexidine 1%.

Autonomy Levels and Professional Attitudes of Nurse Educators.

AIM: This study aimed to determine the autonomy levels and the professional attitudes of nurse educators. METHODS: This study was a descriptive, cross-sectional design. Total of 486 people, including 172 faculty members, 103 lecturers, and 211 research assistants were included in this study. The individual information form, Sociotropy-Autonomy Scale autonomy subscale, and the inventory of professional attitude at occupation were used to collect the research data. RESULTS: The mean age of academics participating in the study was 35.14±8.39. In total, 94.2% of them were women. Of the academics, 35.5% were faculty members, 21.2% were lecturers, and 43.4% were research assistants. The mean autonomy score was 80.04±15.69 and the mean score of the professional attitude inventory was 146±10.59. The mean autonomy score was found to be the highest among professors, the mean score of professional attitudes inventory was highest among associate professors, while the mean value of both scale scores was the lowest in research assistants. CONCLUSION: According to the research findings, it was concluded that the autonomy levels of the nurse educators were above average, their professionalism was at a high level, and they developed more professional attitude as the professional experience increased.

Assessing the caring behaviours and occupational professional attitudes of nurses.

OBJECTIVE: To determine nurses' caring attributes and professionalism.. METHODS: The descriptive study was conducted between January and July 2015 in two university hospitals in two Turkish cities and located in two state hospitals belonging to the Ministry of Health of the Republic of Turkey. Data was gathered using nurse introduction form, caring behaviours inventory-24 and the inventory of professionalattitude at occupation. Data was analysed using SPSS 16.0. RESULTS: Of the 360 subjects, 316(87.8%) were female and 177(49.2%) worked in intensive care units. The overall mean age was 30.83}8.02 years. The mean CBI-24 score was 5.20}0.6, and the mean IPAO score 137.39}16.29. A statistically significant difference was found among caring behaviours point average and the institution, age, workexperience, clinic where they worked and their working position (p<0.05 each). Institutional work environmentaffected professional attitude of nurses (p<0.05). CONCLUSIONS: Nurses' caring attributes and professional levels were high..

Oral Chlorhexidine Against Ventilator-Associated Pneumonia and Microbial Colonization in Intensive Care Patients.

The aim of this systematic review was to determine the effect of chlorhexidine at different concentration and frequency on ventilator-associated pneumonia and microbial colonization in mechanically ventilated patients. Relevant studies in English language were identified by searching data bases between January 2010 and December 2017. Ten studies met the inclusion criteria. Chlorhexidine with 0.2% concentration was found to be more effective than the control group (placebo dental gel and normal saline) in preventing the development of ventilator-associated pneumonia in three of the eight studies. Twice-daily application was found to be effective reducing the rate of ventilator-associated pneumonia in three studies using 0.2% and 2% chlorhexidine. Microbial colonization was found to be less in 2% chlorhexidine group than herbal mouth wash 0.9% NaCl and 0.2% chlorhexidine in three studies. Chlorhexidine is an effective intervention in oral care for ventilator-associated pneumonia and microbial colonization.

Effects of oral care solutions on mucous membrane integrity and bacterial colonization.

AIM: This research was conducted with the aim of determining the influence of three different oral care solutions on oral mucous membrane integrity in critically ill patients. BACKGROUND: Oral care is a basic part of nursing care in intensive care units. DESIGN: A randomized controlled trial was conducted. METHOD: A total of 60 patients (20 patients in each group) comprised the study sample of the research. Patients were randomly allocated to three groups. Patients in groups 1, 2 and 3 were administered mouth care three times a day using 5% sodium bicarbonate, 0·2% chlorhexidine and saline solution, respectively. Data were collected by means of a 'Descriptive characteristics form' and an 'oral assessment tool'. RESULTS: Mean scores of oral assessment tool increased according to days in all groups, however, this increase was found to be statistically insignificant (p > 0·05). Mean scores of the patients in saline solution group were seen to be lower than those of the other groups. When inter-group comparison of days was done, the difference between oral assessment scores was found to be statistically significant (p = 0·000). CONCLUSION: It was found that there was no difference between patient groups receiving saline solution, sodium bicarbonate and 0·2% chlorhexidine for mouth care in terms of oral mucous membrane integrity; oral mucosa of all patients was found to be mildly dysfunctioning. RELEVANCE TO CLINICAL PRACTICE: It is thought that standardized protocols for oral hygiene developed in the light of the findings of randomized controlled trials may improve the oral health in critically ill patients.

Determination of nursing diagnoses used by students in the first clinical practice.

PURPOSE: This study was carried out descriptively with the purpose of determining nursing diagnoses that nursing freshmen students used in their first clinical practice. METHODS: The sample of the study consisted of 61 nursing students. Data of the study were collected with the examination of 208 care plans that the students had prepared. Nursing diagnoses in the examined care plans were classified according to nursing diagnoses grouped under the domains of Taxonomy II NANDA-I. RESULTS: Students determined 31 different diagnoses in nine domains of NANDA-I. Total nursing diagnoses used in care plans were 635. CONCLUSIONS: It was determined that the nursing diagnoses that the students mostly used, according to classification of NANDA-I, were in the domains of safety/protection, activity/rest, comfort, elimination and exchange, and nutrition.

Oral care practices of intensive care nurses: a descriptive study.

The aim of this study was to investigate intensive care unit (ICU) nurses' views and practices on oral care and to define the factors related to oral care measures. A study was carried out in eight ICUs of a teaching hospital in 2008. One hundred one nurses constituted the study sample. The data were collected using 'Oral Care Practices Survey' which included demographic characteristics (5 items) and current oral care practices (13 items). Oral care was given the highest priority by nearly 60% of the nurses. The most commonly used solution was sodium bicarbonate (79.2%), and the most frequently used equipment was foam swab (82.2%). Oral care was carried out less than every 4 h per day by 44.5% of the nurses. The oral care products and solutions were reported to be different in almost every unit. The relationship between the use of toothpaste and the place of employment was statistically significant (x(2) = 24.566, d.f. = 6, P = 0.000). There was a statistical significance between the clinics and frequency of oral care (x(2) = 81.486, d.f. = 42, P = 0.000). This study suggests that there is a wide variety of type and frequency of oral care measures among ICU nurses. Optimal oral care supported by evidence is an effective prevention method for eliminating oral complications.

Cognition of breast cancer among gestational age Turkish women: a cross-sectional study.

The aim of the study is to describe the cognition of breast cancer with respect to knowledge, beliefs, attitudes and behavior in a group of gestational age Turkish women. A questionnaire survey was therefore performed on 201 randomly selected women registered to the health database in Aydin. In age, marital status, and occupation were found to significantly impact on breast self-examination (BSE) performance, which should still be considered as an important tool for early diagnosis, although it does not substitute clinical examination and education. As delayed diagnosis is the leading problem in the management of disease, well-structured education should be supported to increase awareness of breast cancer. Given to the remarkable role of nurses in the community on women's health, a more focused approach on education of young female populations by nurses in Turkey should be considered.

How do nurses and teachers perform breast self-examination: are they reliable sources of information?

BACKGROUND: Breast cancer is the most common cause of cancer-related deaths among women worldwide. The aim of the present study was to determine and compare knowledge, behavior and attitudes among female nurses and teachers concerning breast self-examination (BSE). METHODS: Two-hundred and eighty nine women working in Aydin, Turkey (125 nurses and 164 teachers) were included in the study. The data were collected using a questionnaire designed to measure the knowledge, attitudes and behavior of the groups. Analysis involved percentiles, chi2 tests, t tests and factor analysis. RESULTS: The knowledge of nurses about BSE was higher than that of teachers (81.5% versus 45.1%; p < 0.001). BSE practice parameters (i.e. age groups, indications, frequency) were similar (p > 0.05), whereas skills in performing self-examination were higher in nurses (p < 0.001). Fear of having breast cancer is the most frequent reason for performing BSE. Among nurses, the reasons for failure to perform BSE were the absence of prominent breast problems (82%) and forgetting (56.4%). The teachers who did not perform BSE said that the reasons were lack of knowledge on how to perform self-examination (68.9%) and absence of problems (54%). Both groups had unacceptable technical errors in the performance of BSE. CONCLUSION: We conclude that nurses and teachers should be supported with information enabling them to accomplish their roles in the community. To improve BSE practice, it is crucial to coordinate continuous and planned education.