Peripheral Intravenous Catheter-Related Phlebitis and Infiltration in an Emergency Department: A Descriptive Study.

This study aims to analyze the incidences of peripheral intravenous catheter-related phlebitis and infiltration and the associated risk factors in emergency departments. This descriptive cross-sectional, nonexperimental study was conducted with 300 participants in the emergency department of a university hospital in Türkiye between January 15 and February 15, 2018. The incidence of peripheral intravenous catheter-related phlebitis was 31%, which was grade 1 in 29.7% and grade 2 in 1.3% of the emergency department participants. Additionally, the incidence of peripheral intravenous catheter-related infiltration was 55.4%, including grades 1, 2, and 3 in 36.0%, 12.7%, and 6.7% of the participants, respectively. Incidences of phlebitis and infiltration were related to age, duration of peripheral intravenous catheterization longer than 24 hours, and repeated use of the catheter insertion site. The findings of this study may draw attention to the factors that trigger phlebitis and infiltration due to peripheral intravenous catheter insertions in the emergency department and may guide practices to prevent these complications before they develop. In this context, the Phlebitis Scale and Infiltration Scale developed by the Infusion Nurses Society are recommended to be used in the emergency department.

Comparison of the Effects of Body Mechanics Education Methods on Pain, Disability, and Quality of Life: A Randomized Controlled Study.

BACKGROUND: Educating patients undergoing surgery for LDH is important to maintain the proper performance of body mechanics. PURPOSE: The study compared the effects of standard, brochure-based, and video-based education on postoperative pain, disability, and the quality of life in patients undergoing surgery for lumbar disc herniation. DESIGN: This was a randomized controlled study. SETTINGS: The study was conducted in the Department of Neurosurgery of a training and research hospital in Turkey. PARTICIPANTS/SUBJECTS: Sixty patients (n = 20 control, n = 20 video, n = 20 brochure) undergoing surgery for LDH who volunteered to participate. METHODS: The study was carried out between 15 January and 30 July 2017. The data were collected preoperatively and postoperatively using the Patients' Characteristics Form, Oswestry Disability Index (ODI), Short-Form McGill Pain Questionnaire (SF-MPQ), Physical Functioning and Bodily Pain subscales of the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) and the Survey of Patient Satisfaction with Clinical Education and Materials. RESULTS: All three groups were similar in terms of socio-demographic and clinical characteristics. Preoperative scores obtained from the ODI, SF-MPQ, and the two subscales of the SF-36 were not significantly different. However, there was a statistically significant difference between the video group (81.5 ± 24.3) and the control group (67.7 ± 18.6) in terms of the Physical Functioning subscale of the SF-36 in the postoperative period (p< .05). CONCLUSIONS: Preoperative education on body mechanics increases the physical functioning of patients with LDH and facilitates the integration of information into their daily activities.

Comparison of normal saline and antiseptic solution effect on the early peristomal infection rates of patients with percutaneous endoscopic gastrostomy tubes: A randomized double-blind study.

BACKGROUND: This study's aim was to compare the efficacy of normal saline (NS) with that of antiseptic solution in early peristomal skin care after percutaneous endoscopic gastrostomy placement in terms of peristomal infection incidence. METHODS: This was a randomized controlled double-blind study conducted at a university hospital between December 2019 and April 2021. All patients who underwent percutaneous endoscopic gastrostomy and met the inclusion and exclusion criteria were included in the study. The study population consisted of 64 patients randomized to group 1: NS (n = 31) and group 2: 0.1% polyhexamethylene biguanide and 0.1% betaine (PHMB-B; n = 33). Daily peristomal skin care was performed for 7 days, starting 24 h after insertion. Peristomal skin was evaluated by two blinded investigators before each dressing, and findings were recorded. Data analysis was performed with descriptive statistics; chi-square analysis; and exact, Shapiro-Wilk, Mann-Whitney U, and Cochran Q tests. RESULTS: There was no statistically significant difference between the groups in terms of peristomal infection rates (group 1: 12.9%, group 2: 9.07%; P > 0.05). Redness increased from day 4 in group 1 and day 5 in group 2, and exudate increased from day 5 in both groups. There is a statistical difference in the number of patients between the days when redness and exudate appear and increase. CONCLUSION: Both NS and PHMB-B solutions can be preferred in peristomal care. However, NS may be the first choice for early peristomal care that does not show signs of infection, because it is not irritating and allergic and is cost-effective.

The effect of in-bed turning and mobilization training given to patients who undergo lumbar disk surgery on postoperative first mobility level: A single-blind, randomized controlled trial.

OBJECTIVE: This study was conducted to investigate the effects of mobilization and in-bed turning training given through the role-playing technique to patients to undergo lumbar disk surgery on the patient's pain, strain and dependence level during the first postoperative mobilization (turning, sitting, standing and walking). METHODS: Patients who would undergo a lumbar disk hernia surgery were recruited from a neurosurgery clinic in Turkey. Patients who met inclusion criteria and agreed to participate (n = 40) in the study were randomly assigned to an intervention group (in-bed turning and mobilization training simulated with the role-playing technique, n = 19) and a control group (usual clinical care, n = 21). The outcome of the study was patient mobility and observer mobility scale scores. RESULTS: Postoperative scores obtained from the patient mobility and observer mobility scale were lower in the intervention group than the scores of the control group, and the difference between the groups was found statistically significant (p < 0.05). The anxiety levels of the intervention group before (38.00 ± 6.59, p < 0.001) and after mobilization (31.63 ± 4.57, p = 0.032) were significantly lower. CONCLUSION: The findings indicate training improves patient care outcomes for first postoperative mobility. It is recommended that structured training for in-bed turning and mobilization should be integrated into routine clinical care in the preoperative period for patients to undergo lumbar disk hernia surgery. PRACTICE IMPLICATIONS: Preoperative training increases the patient's willingness to be mobilized and decreases the anxiety level and perceived pain and strain.

The effect of using illustrated materials for communication on the anxiety and comfort of cardiac surgery patients receiving mechanical ventilator support: A randomized controlled trial.

BACKGROUND: Using illustrated communication materials with patients receiving mechanical ventilation support increases patient satisfaction and reduces communication difficulties. However, there are no randomized controlled clinical studies showing the effect of the use of these materials on patient care outcomes. OBJECTIVE: To determine the effect of using illustrated communication materials on the anxiety and comfort levels of patients receiving mechanical ventilation support. METHODS: In this controlled clinical trial, patients were randomly assigned to either the intervention group that used illustrated communication materials or the control group that used routine communication methods. In the first minute of contact with patients in the intensive care unit, then at 30 min and 60 min, patients' numerical pain-rating scale scores, hemodynamic values, and face-anxiety scale scores were recorded. Satisfaction with communication and perianesthesia comfort scale scores were obtained the day after operation. RESULTS: After 30 min of communication, the percentage of face-anxiety points difference decreased in the intervention group (-14.16) compared to the control group (-6.11), and the difference was statistically significant (p < 0.05). In terms of perceived comfort during postoperative mechanical ventilation, the mean score of the patients in the intervention group (106.10) was higher than the control group (88.53), and the difference was statistically significant (p < 0.05). Furthermore, 90% of the patients in the intervention group and 30% of the patients in the control group were satisfied with the communication method used, and the difference between the groups was statistically significant. CONCLUSION: Using illustrated communication materials reduces anxiety and increases patient satisfaction and comfort levels. In communicating with intubated patients, the use of illustrated communication materials is recommended.

Comparison of operating room nurses' satisfaction and preferences in using personal protective equipment for eye protection in the COVID-19 pandemic.

Objectives. This study aimed to compare the problems, satisfaction and preferences of operating room nurses about the use of personal protective equipment (PPE) for eye protection during operations in the COVID-19 pandemic. Methods. This prospective quasi-experimental study was conducted in April 2021 in the operating room of a hospital in Turkey. The sample of this study consisted of 35 nurses who met the inclusion criteria. The evaluation of three types of eye protection equipment (goggles, goggle-type face shield and face shield) was repeated in the same group on consecutive days. Results. The comparison of the problems related to the use of PPE indicated that the highest rate of fogging (91.4%) was observed in goggles (p < 0.001), and skin injuries (28.6%) were experienced in goggles and face shields (p = 0.002). It was observed that operating room nurses were most satisfied (7.2 ± 1.4) with goggle-type face shields and ranked them in first place (80%) (p < 0.001). Conclusion. According to the results of this research, it was found that the PPE for eye protection that was the least problematic, provided the most satisfaction and was ranked in first place during the pandemic was the goggle-type face shield.

The effectiveness of video training in improving intensive care nurses' knowledge about brain death identification.

BACKGROUND: Because patients diagnosed with brain death in intensive care units constitute a potential cadaveric donor group for organ transplantation, intensive care units are potential donor sources. Nurses who closely monitor the patient collaborate with medical personnel in the recognition and early diagnosis of brain death. Nurses also have an important role in supporting the patient's family. Therefore, it is very important for nurses to know the diagnostic criteria for brain death. AIM: The aim of this study was to compare the effectiveness of theoretical education and video-assisted education in equipping intensive care nurses to recognize brain death. STUDY DESIGN: A randomized, experimental study was conducted between February and May 2020 with a total of 50 intensive care nurses, split into 25 in the video-assisted training group and 25 in the theoretical training group. In study, intensive care nurses were given a theoretical training and video-assisted training on brain death criteria. One group was trained theoretically and the other group used a video showing criteria for brainstem reflexes (pupil assessment, spontaneous breathing, corneal reflex, retching and coughing assessments) and deep tendon reflexes in a simulated patient, supported by animation. The data were collected before, immediately after and 3 months after the training using the Brain Death Criteria Knowledge Test, the Brain Death Case Test, and the Training Effectiveness Evaluation Form. The independent samples t-test, Mann-Whitney U test, Friedman test, Wilcoxon test, and Chi-square test were used for statistical analysis of data. RESULTS: It was found that the knowledge scores of both groups immediately after training and 3 months after training were higher than before the training (p < .001). However, the post-training knowledge scores of the video-assisted training group were significantly higher than those of the theoretical training group (p = .011). CONCLUSIONS: To enable intensive care nurses to identify brain death, video-assisted training with a simulated patient is recommended, as is repeating the training at regular intervals. RELEVANCE TO CLINICAL PRACTICE: The simulated patient video-assisted training method can be used for in-service training to provide intensive care nurses with the ability to identify brain death. The training may be repeated at regular intervals (e.g., every 3 months) to increase nurse recall.

Caring for Patients With Electrical Burns Using the Holistic Neuman Systems Model: A Case Study.

Patients with burns should be provided with holistic nursing care that considers all systems of the body. The Neuman Systems Model (NSM) is especially suited to holistic care as it proposes an open system approach and addresses five major interacting variables. This study aimed to investigate the applicability of the NSM when caring for a patient with electrical burns. In this case study, we planned and applied nursing care for a 20-year-old man with electrical burns based on the NSM. The study was conducted between November 25, 2018, and January 10, 2019. We used the six-item Neuman Diagnostic Tool (NDT) developed by Neuman in our interviews with the patient. We found that the electrical burns had caused multiple physiological, psychological, and sociocultural problems for our patient, most of which were physical problems, including the burn injury and subsequent limb amputation. The NDT guided our data collection and aided in our ability to determine stressors and formulate appropriate nursing diagnoses. The NSM strengthened the patient's flexible line of defense for coping individually and facilitated the identification of deficiencies in the normal and resistance lines of defense. The NSM provides a theoretical framework for nurses caring for patients with burns where entire systems are affected.

The effect of fear of COVID-19 on perceived clinical stress levels in senior nursing students: A cross-sectional study.

Aim: This study aimed to examine the effect of fear of COVID-19 on the perceived stress levels in senior nursing students performing their clinical practice. Methods: A cross-sectional study was conducted with senior nursing students in a nursing facility in March 2021. The data were collected using an APP Application sent to the smartphones of students (n = 148) receiving clinical education. Results: With a mean score of 17.2 ± 7.0 on the Fear of COVID-19 Scale, it was determined that the senior nursing students' COVID-19 fears were at a moderate level. Students' mean score from the Perceived Stress Scale was 71.0 ± 25.7, which indicated a moderate level. A positive, weak, and significant correlation was found between the total scores of fear of COVID-19 and perceived stress level (r = 0.291, p < 0.001). Conclusions: In this study, the perceived stress of students in their clinical practice was at a moderate level, as it was before the pandemic. It appears that a moderate level of fear of COVID-19 during the pandemic does not affect perceived stress levels in the clinical education setting. Accordingly, we recommend that clinical education should be maintained by taking necessary measures and implementing good management during the pandemic.

Redetermining the cutoff point of peristomal infection scoring: Methodological research.

BACKGROUND: Peristomal infections are a frequently encountered problem in enteral nutrition that warrants prompt diagnosis and early antimicrobial treatment. Current practice lacks a consensus on an accepted measurement tool with acknowledged validity and reliability. The Peristomal Infection Scoring System is one such tool that shows promise, yet the optimal cutoff value remains to be determined. METHODS: This methodological research was conducted with 54 adult participants to evaluate their peristomal areas in terms of infection by two nurse nutritionists and an expert physician in a simultaneous and independent manner, using peristomal infection scoring or the local signs and symptoms of infection. Performance was assessed by the receiver operating characteristic curve, interobserver reliability, and validity metrics. RESULTS: According to the expert physician's opinion, the peristomal infection rate was 9.2%. The agreement between the observers using the Peristomal Infection Scoring System was κ = 1,000, P < .001. The peristomal infection scoring area under the receiver operating characteristic curve was 0.98 (P < .001), and the best cutoff value was found to be 6 points, which correlated positively with a 0.88 coefficient (P < .001) and an accuracy of 98.1% (CI, 90.11%-99.95%). CONCLUSION: The Peristomal Infection Scoring System with a cutoff value of 6 points is a valid and reliable instrument to diagnose peristomal infections. It can be easily used by healthcare professionals in all settings as needed.

Investigation of the relationship between social appearance anxiety and perceived social support in patients with burns.

INTRODUCTION: Since burns affect body image, they cause appearance anxiety. Interventions designed to reduce appearance anxiety that can cause psychological problems such as depression are important. This study aimed to determine the social appearance anxiety of individuals following burns and the factors affecting it and to examine the relationship between social appearance anxiety and perceived social support. METHODS: This descriptive study was conducted between November 2018 and November 2019 with 106 adult patients with burns. Data were collected using a Personal Information Form, the Social Appearance Anxiety Scale, and the Multidimensional Scale of Perceived Social Support. Shapiro-Wilk test, Independent Two Samples T-Test, One Way Analysis of Variance, Duncan's test, Pearson's correlation analysis, multiple linear regression analysis, the Q-Q plot, and the Durbin-Watson statistics were used in data analysis. RESULTS: The social appearance anxiety scores were moderate (39.38 ± 17.71). Being single; having a high level of education; burns on the face, head, or neck; burn-related amputation; and passing the one-week after injury period were found to significantly increase social appearance anxiety (p < 0.05). Although the perceived social support scores of the individuals with burns were high (68.34 ± 18.08), they were found to have no correlation with social appearance anxiety (p > 0.05). CONCLUSIONS: The results of this study show that social support does not affect social appearance anxiety. In this respect, we recommend that interventions such as reconstruction and professional psychological support initiatives be prioritized for individuals with burn trauma who are evaluated to have high social appearance anxiety by the appearance anxiety scales.

Relationship between nursing students' smartphone addiction and interaction anxiety: A descriptive relation-seeker type study.

PURPOSE: This study aimed to investigate the relationship between nursing students' smartphone addiction and interaction anxiety. DESIGN AND METHODS: This descriptive relation-seeker type study was conducted with 333 students. The Smartphone Addiction Scale-Short Version and the Interaction Anxiousness Scale were used. FINDINGS: Of the students who participated in the study, 12% were at risk for smartphone addiction. A statistically significant correlation was determined between the scores for the two scales used. PRACTICE IMPLICATIONS: As students' smartphone addiction risks increased, their interaction anxiety also appeared to increase, pointing to a need for guidance to restrict smartphone use in this population.

The Clinical Learning Environment, Supervision and the Nurse Teacher Evaluation Scale: Turkish Version.

AIM: The aim of this study is to adapt the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale to the Turkish language and culture. METHODS: This psychometric test was conducted in a nursing school in Ankara, Turkey, from April to June 2014. Convenience sampling was used. The sample of this study was 190 third- and fourth-year nursing students. The items of the scale were evaluated by Pearson correlation coefficient for correlation-based item analysis. Cronbach's alpha, test and retest analysis were used to measure reliability. Exploratory factor analysis and correlation analysis were performed to determine validity. Principal component analysis was used to analyze factor. RESULTS: The subscales' Cronbach's alpha values were varied between .760 and .933. A positive relationship was found between tests and retests points of the subscales (P < .05). Five factors were identified in the exploratory factor analysis. There was a meaningful correlation between subscale points of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale and the Clinical Learning Environment Scale (P < .05). CONCLUSION: The Turkish version of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale was validated and a reliable measurement tool. It can be used to evaluate clinical nursing education in Turkey.

Reliability and validity of a Turkish version of the Sexual Quality of Life - Male questionnaire: a methodological study.

Background The aim of this methodological study was to assess the reliability and validity of the Sexual Quality of Life - Male (SQoL-M) questionnaire translated and adapted to measure the sexual quality of life of men in Turkey and Northern Cyprus. METHODS: To assess the reliability and validity of the Turkish version of the SQoL-M questionnaire, in January and February 2017 we formed a sample of 128 men from Ankara, Turkey, and Girne, Northern Cyprus, to complete the questionnaire. Two weeks later, 65 of these men completed the questionnaire during a retest. Factor analysis was conducted to evaluate the questionnaire's factor structure, internal consistency and test-retest reliability analyses were used to assess reliability and Pearson's correlation coefficient was used to measure criterion-related validity. RESULTS: Cronbach's α for the Turkish version of the SQoL-M questionnaire was 0.91, with corrected item-total score correlations ranging from 0.432 to 0.819. The test-retest correlation, calculated to compare scale scores of both groups of participants, was 0.83 (P<0.001). We also observed a statistically significant relationship between the Turkish version of the SQoL-M questionnaire and the Arizona Sexual Experience scale. CONCLUSIONS: The Turkish version of the SQoL-M questionnaire is a valid, reliable instrument for evaluating the sexual quality of life of men in Turkey and Northern Cyprus.

Analysis of the effects of high-fidelity simulation on nursing students' perceptions of their preparedness for disasters.

INTRODUCTION: As disasters may occur any time, health care staff and institutions should be prepared to manage these events. The aim of study is to analyze the effects of high-fidelity simulation on the perceptions of senior nursing students regarding their preparedness for disasters. METHODS: This study used a pretest-posttest design and was conducted as a quasi-experimental investigation. RESULTS: Slightly less than the half of the students (42.5%) expressed that they were prepared to face a disaster. There was a statistically significant difference in their scores on the Scale of Perception of Disaster Preparedness among Nurses between the pre-intervention and postdisaster stage (p < 0.05). CONCLUSION: Supporting simulation activities with drills positively affected nurses' perceptions of disasters.

Integrating simulation based learning into nursing education programs: Hybrid simulation.

BACKGROUND: Hybrid simulation can be developed with mannequins of any fidelity and tabletop simulators with a standardized patient to create a complex, high-level learning activity. OBJECTIVE: The aim of this study is to analyze the effects of a hybrid simulation technique used with nursing students in a scenario about the emergency setting. METHODS: This one-group pre-test post-test model quasi-experimental study was carried out with 39 students in Ankara, Turkey, from October 2014 to July 2015. RESULTS: Nearly all participants reported that the simulation improved their critical thinking, decision-making skills, and self-confidence before the clinical activity and that they felt as though they were real nurses during the activity (94.7%, 97.3%, 84.2%, and 92.1%, respectively). CONCLUSION: The results of this study support the integration of hybrid simulation experiences throughout the nursing curriculum, as evidenced by positive responses from students through the simulation evaluation questionnaire.

Life Experiences of Patients With Glaucoma: A Phenomenological Study.

BACKGROUND: Studies that describe the experiences of patients with glaucoma from different cultures may help health professionals gain a broader perspective on this issue. Currently, few qualitative studies describe how patients with glaucoma in Turkey cope with daily life. PURPOSE: The aim of this study was to explore the experiences of patients with glaucoma. METHOD: This descriptive phenomenological study used purposive sampling to enroll 20 patients with glaucoma. A qualitative, in-depth, face-to-face interview technique was used to collect data during January and February 2014. The data were analyzed using to the Van Kaam method. RESULTS: Seven themes were identified, including confirming the diagnosis by acute symptoms or unrelated symptoms, grateful to God for having a non-life-threatening disease, feeling happy after receiving more accurate information, coping with the disease by using eye drops and attending follow-up examinations regularly, managing daily life to avoid further damage to eyesight, emotional reactions related to going blind, and urging family members or friends to attend regular glaucoma checkups. CONCLUSIONS: Patients with glaucoma experience physiological and psychological problems throughout the course of their disease. Being informed and cultural practices such as "praising God" and "resignation" helped patients cope with the disease. Furthermore, because of the cultural characteristic of social collectivism, participants acted to protect the health of others by informing them about glaucoma. IMPLICATIONS FOR PRACTICE: Understanding the experiences of patients with glaucoma is important for nursing practice. Nurses should be encouraged to take a greater role in the care of patients with glaucoma by becoming the primary source of glaucoma disease, treatment, and care-related information.

Impact of preoperative defecation pattern on postoperative constipation for patients undergoing cardiac surgery.

AIMS AND OBJECTIVES: To analyse the impact of preoperative defecation pattern on postoperative defecation pattern for patients undergoing cardiac surgery. BACKGROUND: Constipation is a neglected problem that occurs frequently after cardiac surgery. DESIGN: Descriptive study. METHOD: The study sample comprised 102 patients who underwent cardiac surgery. A Descriptive Information Form, Rome III Diagnostic Criteria, Constipation Severity Instrument, Postoperative Defecation Pattern Evaluation Form and Bristol Stool Form Scale were used for data collection and analysis. RESULTS: The Constipation Severity Instrument scores of just over one-third (37·2%) of the patients who were constipated prior to surgery were higher compared to those who were not constipated. Following cardiac surgery, 39·2% of patients developed constipation and 80% of these patients were constipated prior to cardiac surgery. The findings indicate a significantly high relationship between preoperative and postoperative defecation pattern (r = 0·71, p < 0·001). CONCLUSION: Preoperative defecation pattern is a determining factor for the development of postoperative constipation for patients undergoing cardiac surgery. RELEVANCE TO CLINICAL PRACTICE: During the preoperative period, clinical nurses may evaluate the patients' defecation patterns using valid and reliable scales and follow the defecation of the patients, especially patients with defecation problems, during the postoperative period.