The effectiveness of auscultatory, colorimetric capnometry and pH measurement methods to confirm placement of nasogastric tubes: A methodological study.

AIM: To determine the effectiveness of auscultatory, colorimetric capnometry and pH measurement methods for confirmation of correct nasogastric tube placement in critically ill patients. BACKGROUND: Incorrect nasogastric tube placement causes serious complications. DESIGN: This was a methodological and comparative study. METHODS: The study sample consisted of 88 new insertions of nasogastric feeding tubes between April 2018-2019. Results from the 'auscultatory', 'pH' and 'colorimetric capnometry' methods were compared with the location of the nasogastric tube as determined through radiography. Descriptive statistics, Eta analysis and the Cohen kappa compliance test as well as sensitivity and specificity were conducted. RESULTS: There was a weak agreement (26.3%) between the auscultation and radiological evaluation for confirming nasogastric tube placement. The pH measurement and colorimetric capnometry methods were not correlated with radiological evaluation. Stomach pH increased as patient age increased and use of the colorimetric capnometry method failed to confirm the oesophageal and duodenal location. The specificity of the auscultation was low, and both the specificity and sensitivity pH methods were low. CONCLUSION: It was determined that auscultation, measuring pH and colorimetric capnometry were unreliable methods for confirming placement of nasogastric tubes. It is recommended to confirm initial placement of the nasogastric tube with radiography and to develop effective and reliable non-radiological measurement methods that can be performed at the bedside.

Student Nurses' Assessment of Medical Errors.

PURPOSE: The aim of this study was to evaluate the quality of nursing students' assessment of cases of medical error. METHOD: This descriptive cross-sectional study was conducted with 145 nursing students in Izmir, Turkey. The epidemiology of the medical errors that the students witnessed during clinical practice was examined. Then, the success of the students in using the Text-Based Medical Error cases tool developed by the researchers was examined. RESULTS: Of the students, 24.1% had witnessed medical errors during clinical practice. The percentage of students successfully analyzing cases of medical errors related to patient identification, falling, medication administration, blood transfusions, health-care-associated infections, and pressure ulcers were 51.72%, 7.59%, 17.24%, 8.28%, 45.52%, and 56.55%, respectively. CONCLUSION: The students' ability to evaluate cases of medical error needs improvement.

The Effect of Cryotherapy on the Prevention of Oral Mucositis and on the Oral pH Value in Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of cryotherapy on the prevention of oral mucositis (OM) and on the oral pH value in patients with multiple myeloma undergoing autologous stem cell transplantation. DATA SOURCES: This nonrandomized controlled clinical trial was carried out in Bone Marrow Transplant Centers of three hospitals with total 32 patients. In addition to standard oral care, a total of 80 minutes of cryotherapy was applied to the experimental group. OM was assessed according to the World Health Organization's Oral Toxicity Scale before chemotherapy and for 21 days after chemotherapy (every day in the first 14 days, then every other day until the 21st day [if not discharged]). CONCLUSION: According to the findings, cryotherapy did not change the incidence of oral OM, and neither affected the severity of nor decreased the duration of it. Oral pH value was found to be significantly different between the patient groups only before and 1 day after chemotherapy. IMPLICATIONS FOR NURSING PRACTICE: Cryotherapy is an inexpensive, easy-to-use method with no side effects; it would be beneficial to continue cryotherapy to prevent the development of OM in patients with cancer receiving drugs with a short half-life such as melphalan. It is also recommended to conduct further studies with different chemotherapy drugs with short half-lives to determine its effect on the prevention of OM development.

Examining the effect of simulation-based learning on intravenous therapy administration' knowledge, performance, and clinical assessment skills of first-year nursing students.

BACKGROUND: Most nurses at some point of, or throughout, their career will be involved in infusion care. Therefore, it is important to provide a realistic learning environment to nursing students regarding how to safely practice intravenous (IV) therapy administration. OBJECTIVES: The aim of this study was examining the effect of simulation-based learning on IV therapy administration knowledge, performance and clinical assessment skills of first-year nursing students. METHODS: This study was a randomized controlled quasi-experimental study. A total of 62 students was included in the study. The students were randomly assigned to either hybrid simulation (HS) (n = 31) or low fidelity simulation (LFS) (n = 31) groups. In the HS group, each student performed in the standardized patients using moulage, and the LFS group each student was performed with mannequin using visuals. Each of the students' level of IV therapy administration knowledge, performance and clinical assessment and satisfaction and self-confidence score was evaluated. RESULTS: After the lecture, demonstration and simulation training, there was a statistically significant difference between groups in terms of knowledge (p < 0.05), IV catheter insertion performance in simulation and clinical (p = 0.00; p = 0.00) and clinical assessment to classify IV therapy complications on real patients (p = 0.00). Also, satisfaction and self-confidence scale scores of the students in the HS were significantly higher than in the LFS group (p = 0.00). However, there was no significant difference in simulation design scale scores between the two groups (p = 0.164). CONCLUSION: The students in the HS group better transferred they had learned in the teaching environment to clinical practice. Also, the results show that creating an effective environment in simulation had a positive effect on the development of the students' clinical skills.

Can Albumin Bilirubin Ratio and Inflammatory Prognostic Index Be A New Marker Determining Survival in Metastatic Pancreatic Cancer?

OBJECTIVE: The main purpose of our study is to analyze the predictive and prognostic value of inflammatory prognostic index (IPI (using albumin, CRP, neutrophils and lymphocytes) and albumin / bilirubin ratio in metastatic pancreatic cancer patients in addition to other markers currently used. MATERIALS AND METHODS: Medical records of patients with pancreatic cancer treated in Celal Bayar University Medical Faculty Hospital Medical Oncology Clinic between February 2012 and April 2020 were retrospectively reviewed. Clinicopathologic variables such as age, gender, performance status (PS), treatments, histopathology type, localization of metastasis, comorbidity were recorded by an electronic medical record system. Patients performance status were recorded according to the Eastern Cooperative Oncology Group (ECOG). A total of 110 pancreatic cancer patients were reviewed. The IPI was calculated as C-reactive protein × NLR (neutrophil/lymphocyte ratio)/serum albumin. Univariate and multivariate analyses were performed to assess the prognostic value of relevant factors. RESULTS: Median OS of all patients was 6 months. The NLR cut off value we calculated was 3,47. The median OS of 47 (49,4%) patients was 8 months (95 % cl. 8,673- 15,383) with NLR < 3,47 and median OS of 48 (50,6%) patients was 4 months (95 % cl. 4,221-7,523) with NLR ≥ 3,47 (P: 0,001). The cut off value calculated for the IPI was 0,79. The median OS of 24 (25,8 %) patients was 8 months (95 % cl. 7,475-18,814) with IPI < 0,79 andmedian OS of 69 (74,2 %) patients was 5 months (95 % cl. 5,774-9,580) with IPI ≥ 0,79 (P: 0,047). The ABR cut off value we calculated was 5,23. The median OS of 45 (47,3 %) patients was 4 months (95 % cl. 8,879- 15,174) with ABR ≥ 5,23 and median OS of 50 (42,7 %) patients was 9 months (95 % cl. 4,015-7,585) with ABR < 5,23 (p< 0.001) (Figure 1). According to this analyses, presenting with jaundice, peritoneum metastasis, CA19.9 and LDH values higher than cut off, high NLR, high IPI and high ABR were also significantly associated with OS. In multivariate analyses, ABR was an independent prognostic factor in PC. Patients with high ABR (> 5,23) had increases in the risk of death compared with those with low ABR (< 5,23) (HR, 0,305; 95 % CI, 0,176-0,531; p: 0.000). Alongside ABR, CA-19.9 (HR, 2,300; 95 % CI, 1,111-4,764; p: 0,025) and LDH (HR, 3,348; 95 % CI, 1,792-6,253; p: 0.000) were an independent prognostic factor in PC. CONCLUSION: In this study, we demonstrated that both IPI and ABR, which were not evaluated in PC before, are non-invasive, cheap, accessible, and easily formulated parameters in determining the prognosis. Especially the fact that ABR is an independent prognostic indicator in multivariate analysis makes it stronger. Although we are aware that our study is retrospective, we hope that the reliability of these scores will increase if it is done with more patient series and if it is done multicenter.

Effect of an aged simulation suit on nursing students' attitudes and empathy.

PURPOSE: Today, with an increasingly older population, it is essential to have well-educated and well-prepared nurses who can meet the health-related needs of geriatric patients but in some cases students have difficulty in understanding and empathizing with older persons. The impact of use of an aged simulation suit on the empathy and attitudes of nursing students towards older persons was investigated in this study. METHODS: A descriptive mixed-methods study was conducted, using the Basic Empathy Scale, The Kogan's Attitude towards Old People Scale, and semi-structured interviews. RESULTS: The Kogan's Attitude towards Old People Scale mean scores and the Basic Empathy Scale mean scores showed that there was a statistically significant increase in the empathy and attitude scores of students from the high-score group after they had carried out tasks using an aged simulation suit. A total of four themes were determined through data analysis. CONCLUSION: The use of an aged simulation suit proved to be an effective educational technique which made a positive contribution towards nursing students' development of empathy and also made a positive change in their attitude towards older persons.

Ethical decision-making levels of oncology nurses.

AIM: This study was carried out in order to determine ethical decision-making levels of oncology nurses. ETHICAL CONSIDERATION: Research Ethics Committee's approval was obtained prior to the data collection. Permission to use the Turkish version of the Nursing Dilemma Test was received from Birgül Cerit. Written approval was taken from school administrators to conduct the study confirming that there were no invasive procedures planned for human beings during the study period. The study was conducted in accordance with the Helsinki Declaration. Verbal consent was obtained from each of the nurses who agreed to participate after they were informed about the study content. METHOD: The population of this study conducted in a descriptive way consisted of a total of 96 nurses working at the oncology units and outpatient chemotherapy units of four different hospitals between September 2017 and March 2018. The study sample included 60 nurses who responded to the question form. The data of the study were collected using "Nurses Information Questionnaire" and "Nursing Dilemma Test" developed by Crisham in 1981. RESULTS: Oncology nurses' mean scores in Principled Thinking (49.00 ± 6.46) and those in Practical Considerations (18.35 ± 4.47) were found to be above the moderate level. It was determined that the oncology nurses participated in the study were familiar with situations similar to the dilemmas included in the Nursing Dilemma Test (15.00 ± 4.20). CONCLUSION: It was concluded that oncology nurses try to take ethical principles into consideration but are also affected by environmental factors while making decisions concerning ethical dilemmas. The most frequently encountered ethical dilemmas by oncology nurses include the following: deciding not to perform cardiopulmonary resuscitation, telling the truth to the patient, studies being carried out without the patient's content, and patient's refusal of treatment. In order to improve oncology nurses' critical thinking and ethical decision-making skills, it is important to determine ethical dilemmas encountered by oncology nurses, and nurses should be encouraged to be involved in ethical decision-making process through cooperation with the other healthcare personnel.

Ethical Decision Making Levels of Nursing Students.

OBJECTIVE: The present study was conducted to determine nursing students' levels of ethical decision-making. METHODS: The sample of the descriptive study consisted of 240 nursing students. The data were collected using the Student Information Form and "Nursing Dilemma Test". RESULTS: It was found that Principled Thinking (PT) mean score (48.38±7.97) of nursing students was above average while their Practical Consideration (PC) mean score (17.87±4.13) was close to average. It was also determined that the nursing students participated in the study were not familiar (17.75±2.77) with the dilemmas included in the Nursing Ethical Dilemma Test. CONCLUSION: The students paid attention to consider ethical principles when making decisions about ethical dilemmas; however, they are also affected by environmental factors as well. Sex and class level were found to be influential in the process of ethical decision making.

Intensive care unit nurses' knowledge of medication administration via enteral tubes.

BACKGROUND: Medication administration via enteral tubes is a complex and key application for which nurses in intensive care units are responsible. AIM: The aim of this study was to evaluate drug administrations via enteral tubes by nurses in intensive care units. METHODS: This research was conducted using a descriptive and cross-sectional research design. The study was conducted with 289 nurses at intensive care units in hospitals in Izmir, Turkey. The data of the study were collected with the 'Sociodemographic Information Form' and the 'Enteral Medication Administrations Questionnaire', which was designed in accordance with the literature and consists of questions on interventions before, during and following medication administrations via enteral tubes. RESULTS: It was found that more than half the nurses (62.3%) use nasogastric tubes for medication administrations and that all of them use the enteral way for the administration of medications in the form of tablets, while 58.8% use this method to administer the medications in the form of enteric-coated tablets. It was determined that approximately half the nurses (52.6%) apply more than one medication separately, and a majority (84.1%) use tap water to wash the enteral tube. CONCLUSIONS: Enteral medication administration practices are inconsistent. Some nurses use unsafe practices and may therefore compromise patient care. RELEVANCE TO CLINICAL PRACTICE: Conduction of education programmes on medication administration via enteral tubes for intensive care unit nurses is important in improving nurses' knowledge.

Investigation of Turkish nurses frequency and knowledge of administration of intramuscular injections to the ventrogluteal site: Results from questionnaires.

BACKGROUND: Intramuscular injection is important in the administration of parenteral medication and is a frequently-performed nursing responsibility. OBJECTIVE: The objective of this study was to identify the frequency of use of the ventrogluteal site and the level of nurses' knowledge of administering an intramuscular injection to this site. DESIGN: A descriptive cross-sectional study was conducted of nurses working in four hospitals (n=362). Data collection tools included a 12 item sociodemographic questionnaire and a 24 item questionnaire on knowledge of the ventrogluteal site for intramuscular injection. FINDINGS: 17.1% of participants reported using the VG site frequently in intramuscular injections. On the other hand, 35.9% reported that they do not use the VG site in intramuscular injections just because they are not used to giving injections on this site. Level of knowledge of ventrogluteal site was also limited with the mean score of correct answers from 24 questions being 14.37. CONCLUSION: It was found in the study that nurses' knowledge of the ventrogluteal site was limited, and they are not preferentially using the ventrogluteal site for intramuscular injections to adults even though it is recommended in recent nursing literature.

Breast cancer risk and early diagnosis applications in Turkish women aged 50 and over.

BACKGROUND: The aim of the study was to determine breast cancer risk and early diagnosis applications in women aged ≥50. MATERIALS AND METHODS: This cross-sectional, descriptive field study focused on a population of 4,815 in Mansurog?lu with a 55.1% participation rate in screening. In the study, body mass index (BMI) was also evaluated in the calculation of breast cancer risk by the Breast Cancer Risk Assessment Tool (BCRA) (also called the "Gail Risk Assessment Tool") . The interviewers had a three-hour training provided by the researchers, during which interactive training methods were used and applications were supported with role-plays. RESULTS: The mean age of the women participating in the study was 60.1±8.80. Of these women, 57.3% were in the 50-59 age group, 71.7% were married, 57.3% were primary school graduates and 61.7% were housewives. Breast-cancer development rate was 7.4% in the women participating in the study. When they were evaluated according to their relationship with those with breast cancer, it was determined that 73.0% of them had first- degree relatives with breast cancer. According to the assessment based on the Gail method, the women's breast cancer development risk within the next 5 years was 17.6%, whereas their calculated lifetime risk was found to be as low as 0.2%. Statistically significant differences (P=0.000) were determined between performing BSE - CBE and socio-demographic factors. CONCLUSIONS: It was determined that 17.6% of the participants had breast cancer risk. There was no statistically significant difference between the women with and without breast cancer risk in terms of early diagnosis practices, which can be regarded as a remarkable finding. It was planned to provide training about the early diagnosis and treatment of breast cancer for people with high-risk scores, and to conduct population-based breast cancer screening programs.

Determination of knowledge of Turkish midwifery students about human papilloma virus infection and its vaccines.

Human papilloma virus (HPV) is one of the most common sexually transmitted agents and its infection is the most established cause of cervical cancer. Midwives play a key position in the implementation of cervical cancer. This descriptive study aimed to determine the level of knowledge concerning HPV and HPV vaccination among 268 midwifery students. Data were collected between November 15 and 30, 2011, through a self-reported questionnaire. The mean age of participants was 20.75 ± 1.60. Among all students, 44.4% had heard of HPV, while 40.4% had heard of HPV vaccinatiob. The relationship between the midwifery student knowledge on HPV and HPV vaccine and their current educational year was significant (p=0.001). In conclusion midwifery students have moderate level of knowledge about HPV and its vaccine and relevant information should be included in their teaching curriculum.

Research activities and perceptions of barriers to research utilization among Turkish nurses.

BACKGROUND: This study assessed the barriers to the use of research in nursing practice among Turkish registered nurses. METHODS: A descriptive cross-sectional study of 718 nurses in three hospitals was conducted. The data collection instrument used for the study consisted of the Barriers to Research Utilization Scale and a self-administered questionnaire that included demographic data, educational background, and nurses' involvement in research activities. RESULTS: Almost half of the participants (48.5%) responded that they had attended academic conferences in the past 2 years. Most of the participants had not published a research article (90.5%), and 23.4% reported that they had never read research articles. Seven items within the top 10 barriers were found on the setting subscale. CONCLUSION: The results describe the research activities and perceptions of the barriers to the use of research among nurses in Turkey. Creating an organizational climate that values research use and supports nurses in participating in research activities is crucial.

Cigarette dependence among males and females aged 50+ living in Izmir, Turkey.

BACKGROUND: Smoking, the most important preventable cause of death overall, is also the leading cause of cancer-related mortality. Tobacco consumption has a direct or indirect relationship with most types of cancer. In Turkey, the second leading cause of death is cancer, with lung cancer the most prevalent. OBJECTIVE: The aim of this study was to determine the level of cigarette dependence among men and women aged 50+, living in Izmir. METHODS: This research is a descriptive and cross-sectional field study, carried out with the participation of a total of 2,497 subjects. RESULTS: It was found that 48.8% of the participants used to be smokers, and 95.5% of the smoking participants had been smoking for at least 11 years at the time of study. 36.1% of the participants were being exposed to secondhand smoke at home, and almost one third of the smokers (29%) had a moderate level of dependence. CONCLUSIONS: Continuing education may help high-risk groups develop good habits for a healthier lifestyle such as smoking less and quitting smoking, thereby reducing the level of morbidity and mortality of most common types of cancer.

Physical restraint use in Turkish intensive care units.

OBJECTIVE: This study aimed to determine intensive care nurses' reasons for the application and removal of physical restraint and physical restraint patterns used in Turkey intensive care units. DESIGN: This research was conducted using descriptive and cross-sectional research design. SETTING: Data were collected in intensive care units of the 2 university hospitals and the 5 state hospitals in Izmir, West Turkey. Nurses were given the self-administered questionnaire with open-ended questions. PARTICIPANTS: The study participants were 190 nurses working in intensive care units of 7 hospitals. FINDINGS: Most of the nurses (86.8%) reported that maintenance of the placement of medical devices was the main reason for physical restraint applications. The nurses (68.9%) reported improved mental status as the most important reason for removal of restraint from the patient. A total of 84.7% of nurses reported that wrist and ankle ties were the most common forms of physical restraint device; 84.7% used physical restraint without any verbal or written physician order. CONCLUSIONS: Identifying the reasons for application and removal of physical restraints can help clinical nurse specialist tailor education, impact policy, and serve as role models to reduce the use of restraints in hospitals.

Dietary agents in prevention of prostate cancer.

Prostate cancer is the second leading cause of internal malignancy among men worldwide, with an annual incidence of 679,000 cases, and an annual mortality load of 220,000 deaths, making it the sixth leading cause of cancer mortality among men. It is generally on the increase. Environmental and lifestyle factors may have an aetiological role in prostate cancer and hence may provide potential targets for future intervention. In fact, because of the disease high prevalence, slowly progressive nature, and long latency prostate cancer is a very good candidate for chemoprevention. Dietary agents have gained considerable attention as chemopreventive agents against prostate cancer. The methodology for this review included computerized literature searches of the PubMed database using the keywords 'chemoprevention of prostate cancer' from 1992 to 2007. This mini-review examines the influence of plant-derived dietary agents for which articles reported statistically significant effects in the management of prostate cancer.

Evaluation of the Geographical and Family Background of Student Nurses and Midwives and their Knowledge of Cancer and Nutrition.

Plant foods are the custodians of numerous dietary constituents, including vitamins, minerals, fibre, and other potentially anticarcinogenic agents. Eating habits are influenced by many biological, social, psychological, and cultural factors. Despite the relative paucity of definite evidence relevant to prevention in cancer and the tools available for early detection of cancer, people should be informed about the protective factors (dietary influence, life-style and exercise) continuously to develop new habits which will protect against cancer. A descriptive study was here designed to examine the effects of geographical and family background on nutrition of nursing students and their knowledge of recommended dietary guidelines for health promotion and cancer prevention. Most of students and their families lived in Aegean and Marmara regions, and in general they regularly consumed vegetables, fruits and cereals. Fresh vegetable and fruit consumption is rather high in Thrace, Aegean, Marmara and Mediterranean regions of Turkey. Students were found to be well informed during courses on dietary guidelines for health promotion and cancer prevention. The greatest promise for cancer prevention rests on our ability to change multiple and often interrelated behaviours that have been shown to increase the risk of cancer.