Effect of peri-intubation non-pharmacological interventions on postoperative laryngeal symptoms: A systematic review with meta-analysis and meta-regression.

OBJECTIVES: To evaluate the effectiveness of peri-intubation non-pharmacological interventions in reducing postoperative sore throat (POST), cough (PEC), and hoarseness in surgical patients. DESIGN: A systematic review with meta-analysis and meta-regression. SETTING: Elective surgery under general anesthesia in operating rooms. MAIN OUTCOME MEASURES: Evaluate the impact of non-pharmacological interventions, including pre-intubation (gargling with Sodium Azulene Sulfonate, licorice, or using Strepsils tablets of honey and lemon lozenge), during-intubation (inflating the TT cuff with normal saline and softening the ETT cuff with warm normal saline), and post-intubation (cold vapor therapy, gargling with honey lemon water, and using green tea gargle), on the occurrence of POST, PEC, and hoarseness. RESULTS: Nineteen trials with 2,136 participants were included. Pre-intubation intervention significantly reduced POST immediately after extubation (n = 861; OR: 0.28, 95 % CI: 0.20-0.38, P < 0.001), and 24 h post-extubation (n = 1006; OR: 0.21, 95 % CI: 0.16-0.28, P < 0.001). During-intubation intervention did not show significant effects on POST. Pre-intubation intervention also reduced POST-associated pain score at 24 h post-extubation (n = 440; MD: -0.50, 95 % CI: -0.81 to -0.18, P < 0.001). Post-intubation interventions were effective in reducing POST-associated pain scores at different time points post-extubation (P < 0.05). Pre-intubation intervention significantly reduced PEC (OR: 0.13, 95 % CI: 0.02-0.70, P = 0.02) and hoarseness (OR: 0.36, 95 %CI: 0.15-0.86, P = 0.02) at 24 h post-extubation. However, during-intubation interventions did not reduce hoarseness at 24 h post-extubation. CONCLUSION: Pre-intubation non-pharmacological interventions were found to be the most effective in reducing the incidence and severity of POST, PEC, and hoarseness. IMPLICATIONS FOR CLINICAL PRACTICE: Implementing pre-intubation non-pharmacological interventions can be beneficial for bedside nurses and healthcare professionals in reducing postoperative complications and nurses can contribute to improving patient comfort and recovery outcomes following surgery. SYSTEMATIC REVIEW PROTOCOL: The protocol was registered in the PROSPERO international prospective register of systematic reviews on 2 January 2024 (CRD42023492813).

Nursing interventions for the self-efficacy of ostomy patients: A systematic review.

BACKGROUND: Self-efficacy interventions, which include the acquisition of skills that enable patients to manage their health on a daily basis, play a key role in ostomy patients, which leads to significant changes in the quality of life of patients. In this context, nursing interventions to increase self-efficacy of ostomy patients are very important. In this context, nursing interventions are crucial to increase the self-efficacy of ostomy patients. OBJECTIVES: The aim of this systematic review is to describe nursing interventions for ostomy patients' self-efficacy (primary outcome) and the impact of these interventions on patient outcomes (complications, quality of life, satisfaction, psychological resilience, stoma adaptation) (secondary outcomes). METHOD: As a systematic review, this study included articles published in PUBMED, Web of Science, Science-Direct, TUBITAK-ULAKBIM, and TRDizin databases between January 2013 and January 2023 that included nursing interventions for self-efficacy ostomy patients. This systematic review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The risk of bias was assessed using the RoB2 tool developed by Cochrane. RESULTS: A total of 1211 articles were retrieved from the databases using Turkish and English keywords. Fifteen studies met the study criteria. These studies found that various interventions, such as training, telephone follow-up, psychosocial support groups, or mobile applications provided to intervention groups, increased self-efficacy, decreased stoma-related complications, improved stoma adaptation, and improved quality of life by increasing patients' knowledge and awareness of stoma. CONCLUSION: Nursing interventions to improve the self-efficacy and adaptation of ostomy patients are critical. This improvement leads to a reduction in adverse patient outcomes and ostomy complications, shorter hospital stays, and increased patient and nurse satisfaction.

Roles, experience and views of nurses working in robotic surgery settings: A mixed-methods study.

Robotic-assisted surgery has benefits for patients, but there are challenges to working in this field. In Turkey, training is not provided for nurses working in robotic-assisted surgery, and national legislation on nurses' roles in these settings has not been implemented. This study aimed to demonstrate the roles and experiences of nurses in robotic-assisted surgery in Turkey. This study was conducted as a mixed-methods research. The qualitative data were analysed by content analysis. More than half of the nurses had received basic training in robotic-assisted surgery. Qualitative data consisted of five themes, including the effects of robotic surgery, feelings and thoughts on robotic surgery, working as a nurse in robotic surgery settings, responsibilities of nurses and competence of nurses working in robotic surgery settings. Determining the working conditions and roles of nurses working in robotic-assisted surgery settings by policymakers in regulations is crucial for improving the quality of nursing care and the outcomes of patients.

The Effect of Clinical Decision Support Systems on Patients, Nurses, and Work Environment in ICUs: A Systematic Review.

This study aimed to examine the impact of clinical decision support systems on patient outcomes, working environment outcomes, and decision-making processes in nursing. The authors conducted a systematic literature review to obtain evidence on studies about clinical decision support systems and the practices of ICU nurses. For this purpose, the authors searched 10 electronic databases, including PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE, Science Direct, Tr-Dizin, Harman, and DergiPark. Search terms included "clinical decision support systems," "decision making," "intensive care," "nurse/nursing," "patient outcome," and "working environment" to identify relevant studies published during the period from the year 2007 to October 2022. Our search yielded 619 articles, of which 39 met the inclusion criteria. A higher percentage of studies compared with others were descriptive (20%), conducted through a qualitative (18%), and carried out in the United States (41%). According to the results of the narrative analysis, the authors identified three main themes: "patient care outcomes," "work environment outcomes," and the "decision-making process in nursing." Clinical decision support systems, which target practices of ICU nurses and patient care outcomes, have positive effects on outcomes and show promise in improving the quality of care; however, available studies are limited.

Structural and psychological empowerment and burnout among nurses: A systematic review and meta-analysis.

AIM: This study aims to review available evidence about the relationship between structural and psychological empowerment and burnout among nurses. BACKGROUND: Nurses are key healthcare providers, who experience higher levels of burnout due to uncertainty and role conflicts about nursing roles and responsibilities and poor management. Nurse empowerment is an effective approach to reduce nurse burnout and enhance patient care quality. INTRODUCTION: Positive working conditions along with positive attitudes and perceptions for nurses are crucial in the workplace. Nurse empowerment in the workplace results in quality improvements in work life and the provision of healthcare. METHOD: We conducted a systematic review in accordance with the recommendations of the Joanna Briggs Institute and the PRISMA guideline. Relevant studies published between 2007 and 2022 were identified via PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE (R), Science Direct and Turkish scientific literature databases. Studies that reported correlation coefficients were pooled to conduct a meta-analysis. RESULTS: Random-effects meta-analyses showed a negative association between structural and psychological empowerment and emotional exhaustion. The overall findings showed a moderate and negative association between the six dimensions of structural empowerment and depersonalization. There was a positive association between structural empowerment and personal accomplishment. DISCUSSION: There is a relationship between decreased burnout levels and nurse empowerment. The causal relationship between empowerment and burnout levels needs to be investigated in various healthcare settings in several countries. CONCLUSION: The relationship between structural and psychological empowerment and burnout levels emphasizes that empowerment can reduce nurse burnout. Nurse empowerment is a critical management strategy for improving the quality of life for nurses, increasing the quality and effectiveness of patient care and achieving positive outcomes. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The encouragement and empowerment of nurses for prompt decision-making and effective resource utilization, reduces nurse burnout, enhancing nurses' job commitment, productivity, satisfaction and competence along with increased quality of care. The encouragement of nurses as empowered managers at the macro, meso and institutional levels not only improves the overall quality of health services but also helps to find solutions for the issues concerning healthcare service users and the health system environment.

Experiences of perioperative nurses with robotic-assisted surgery: a systematic review of qualitative studies.

To determine the experiences of perioperative nurses with robotic-assisted surgery is needed to improve the robotic-assisted surgery practices. This study systematically reviewed and analysed the qualitative studies concerning perioperative nurses' experiences of robotic-assisted surgery. This systematic literature review included studies up to December 2020. The study data were analysed using inductive content analysis. This systematic review included six articles. There were a total of 71 nurses who participated in the included articles (min = 6, max = 17). Their mean age was 35.7, and their experience in robotic-assisted surgery ranged from 8 months to 10 years. Content analysis generated six categories: adaptation to robotic-assisted surgery technology, the importance of teamwork in robotic-assisted surgery, changing tasks and responsibilities in robotic-assisted surgery, training requirements for robotic-assisted surgery, the effects of robotic-assisted surgery on patients and patient safety, and difficulties with robotic-assisted surgery. A variety of themes and sub-themes emerged in these categories. The review highlights the importance of developing new ways of thinking about the assessment and management of disruptions, developing different teamwork patterns and communication skills, and overcoming the challenges involved in technologically advanced surgeries. Nurses' roles in robotic technology should be redefined in healthcare. Nurses should learn how to adapt to advancing technology and how to supplement and enhance their skills.

Experience and views of nurses on nursing services and personal protective equipment in Covid-19 pandemic the case of Turkey: A cross-sectional study.

BACKGROUND: During the COVID-19 pandemic, there were difficulties in planning the nursing workforce and personal protective equipment. AIM: The purpose of this study was to identify the experiences and views of nurses on personal protective equipment use and nursing workforce planning in Turkey. METHODS: This descriptive and cross-sectional study was conducted between 23 December 2020 and 3 May 2021, among 362 nurses who agreed to participate in this study voluntarily. RESULTS: The findings showed that the satisfaction scores were significantly higher for those nurses who worked in 8-h shifts, were not assigned to different clinics, were notified by an official letter and 1 week or month in advance before assignment compared with nurses in other categories. CONCLUSIONS: The problems that have arisen in the COVID-19 pandemic process have made it clear that there is a need for a nursing services management model in the event of an epidemic. IMPLICATIONS FOR NURSING MANAGEMENT: This study reveals the need for the 'Nursing Services Management Model in the Event of an Epidemic' by discussing the problems of nurse workforce planning and protective personal equipment management from the perspective of nurses who experienced these problems at first hand.

Knowledge and practices of operating room nurses in the prevention of pressure injuries.

BACKGROUND: Operating room (OR) nurses play an important role in preventing the pressure injuries (PIs) that may develop during the perioperative process. This study was conducted to determine OR nurses' level of knowledge about PIs, and how they manage them. METHODS: This is a cross-sectional, quantitative and descriptive study. The sample of the study consisted of 234 OR nurses working in eight different public hospitals in Ankara. The questionnaire applied in this study was prepared in accordance with the guidelines. This questionnaire consisted of three sections: demographic profiling, common preventive practices, and the knowledge of OR nurses about intraoperative PI prevention. FINDINGS: 66.7% of the participants had received education about PIs during their basic nursing training, and 41.5% had received education after graduation. 97.4% of OR nurses did not follow international guidelines about PIs. The mean total score of the OR nurses for the questions about PIs was 52.0 ± 13.7 out of a possible score of 100. The lowest mean score was obtained for the topic of 'staging pressure injuries', and the highest score was obtained from 'interventions to prevent pressure injuries'. In addition, 81.5% of the OR nurses stated that they were not given information about patients with a high PI risk by clinical nurses. 97.9% of the OR nurses did not use a scale to assess intraoperative PI risks. Fewer than half of the nurses said that they assessed the risk of PIs during surgery. 90.8% the nurses did not record risk assessment and interventions to prevent PIs. CONCLUSION: There is a need to incorporate basic operating room PI (ORPI) training into both the basic nursing and in-service training to improve the knowledge of OR nurses about how to prevent and manage ORPIs. In addition, measures to assess PI risk and prevent ORPI should be included in institutional policies and procedures.

Impact of tailored training about pressure injuries on nurses' knowledge levels and pressure injury point prevalence: The case of Turkey.

AIM: This study was conducted to determine the impact of tailored training provided to nurses for preventing pressure injuries (PIs) on nurses' knowledge levels and the PI point prevalence (PP). MATERIALS AND METHODS: This interventional study was carried out in a university hospital with a bed capacity of 1114 in an urban center in Turkey. Ethics committee approval (28.06.2018/31) and institutional permission were obtained for the study, in addition to the nurses' written, informed consent. The study was completed in three stages. In the first stage an initial PP study was conducted in the clinics with the participation of the nurses and the members of the research team (n = 422 patients). In the second stage the knowledge levels of 194 nurses were measured before training was given on following-up and preventing PIs. The nurses then participated in the tailored training and their knowledge levels were re-measured afterwards. All the nurses were given individual advice related to the prevention of PIs for 30 days after they had completed the training. In the third stage a second PP study was conducted four months after the first PP study (n = 454 patients). The data were collected using the Pressure Injury Prevalence Form, the Braden Pressure Ulcer Risk Assessment Tool and the Knowledge Level Measurement Form. Descriptive values, the paired samples t-test, Pearson's chi-squared test and Fisher's Exact test were used to evaluate the data. RESULTS: The nurses' pretest mean knowledge score was 55.36% ± 14.40 and their posttest mean score was 69.92% ± 9.73. The difference between these scores was statistically significant (p < 0.05). The study found no significant difference between the first PP ratio and the second PP ratio (p > 0.05), and the nurses were better able to evaluate skin and PIs after the training. CONCLUSION: The study determined that the tailored training given to the nurses increased their knowledge; however, it had no impact on the PP after four months. It is recommended that any training programs using this model be continued and that PP studies of institutions be conducted annually.

Effect of Preoperative Skin Preparation Methods on Sternotomy Surgical Site Infection Rates: A Quasi-Experimental Study.

BACKGROUND: A surgical site infection (SSI) reduces patient quality of life, increases morbidity and mortality rates, and increases health care costs. Results of studies comparing the effects of preoperative skin preparations are contradictory. PURPOSE: This study aimed to determine the effect of different preoperative skin preparation methods on the rate of SSIs in patients undergoing sternotomy. METHODS: A quasi-experimental study was conducted among 96 male patients undergoing sternotomy. The control group (CG) (n = 34) received routine care consisting of shaving body hair with a razor blade followed by instructions to take a bath or shower. In the intervention groups, patients received education about SSI prevention and body hair was removed with an electric clipper, followed by bathing with daphne soap containing olive oil (IG-1) (n = 31) or 2% chlorhexidine solution (IG-2) (n = 31). Patient demographic, medical history, surgical, and wound assessment variables were obtained. Potential SSI signs and symptoms were assessed for up to 90 days following surgery. RESULTS: Patient demographic, medical history, and surgical variables did not differ among the 3 groups. Sternal SSI occurred in 10.4% of all study patients; 8.8% of the CG patients, 12.9% of the IG-1 patients, and 9.7% of the IG-2 patients developed an SSI (P > .05). CONCLUSION: There were no significant differences in the rate of sternotomy SSI among the 3 groups. Randomized controlled trials with large samples are needed to compare these methods to determine optimal and affordable preoperative skin preparation methods.

Effect of Gum Chewing on Recovery After Surgery for Colorectal Surgery Patients: A Randomized Controlled Trial.

The aim of this study was to determine the role of chewing gum in bowel functions after left colon and/or rectal surgery. In this randomized controlled study, the sample consisted of adult patients who had undergone elective open left colon and/or rectal surgical interventions under general anesthesia. The sample comprised 17 patients in the experimental group and control group. The patients in the experimental group chewed a sugar-free gum after removal of their nasogastric tubes, 3 times a day for 45 minutes, from the first postoperative morning until they had first flatus. Routine care was maintained for the patients in the control group until their first flatus. The effects of chewing gum on the length of time until first flatus, the first defecation in the postoperative period, and the discharge of patients were investigated. The patients in the experimental group had flatus and defecation earlier, and the duration of their hospital stay was shorter than those of patients in the control group. It was found that gum chewing as a physiological method promotes the early initiation of bowel functions and, consequently, shortens the hospital stay after elective left colon and/or rectal surgery.

La pandemia en el Año Internacional de la Enfermería y durante la campaña Nursing Now: el ejemplo de Turquía / The pandemic in the international year of the nurse and during the Nursing Now campaign: the example of Turkey

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Experiences of adult extracorporeal membrane oxygenation patients following discharge: A mixed methods study.

BACKGROUND: Survival and discharge rates after extracorporeal membrane oxygenation are gradually increasing. More research is warranted to investigate extracorporeal membrane oxygenation patients' post-discharge experiences, problems and quality of life. OBJECTIVE: The aim of this study was to determine adult extracorporeal membrane oxygenation patients' experiences, problems and quality of life following discharge. METHODS: A mixed methods research was used. Study sample consisted of 11 adult extracorporeal membrane oxygenation patients discharged at least one month prior to study entry. In-depth interviews were conducted. Participants' quality of life was assessed using the EuroQol 5 Dimension 5 Level questionnaire. RESULTS: Two categories (pre- and post-discharge), 7 themes and 16 sub-themes were developed based on in-depth interviews. According to the EuroQol 5 Dimension 5 Level, participants had high perceptions of health. CONCLUSION: Extracorporeal membrane oxygenation patients should be provided with comprehensive post-discharge education, exercise programs, social support and regular home visits for post-discharge assessment and follow-up care.

Home Percutaneous Endoscopic Gastrostomy Feeding: Difficulties and Needs of Caregivers, Qualitative Study.

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) may cause complications when adequate and appropriate care is not provided. To avoid these complications, caregivers' experiences and practices must be considered. METHODS: This study used the phenomenological qualitative research method. Twenty-one caregivers underwent in-depth interviews and were observed for PEG practices. Interview and observational data were analyzed using content analysis. RESULTS: This study revealed 8 themes and 24 subthemes under 3 categories of PEG management, social-emotional change of the caregivers, and expectations, and it was observed that caregivers made errors in stoma care, tube feeding, and medication administration through the PEG tube. CONCLUSION: Results indicated that comprehensive and practical discharge training, and home care and counseling services should be provided to effectively address the challenges faced by caregivers of patients with PEG.

Nursing Diagnoses and Interventions in Kidney Transplant Recipients: A Retrospective Study.

PURPOSE: The aim of the study is to determine the nursing diagnoses and interventions applied to kidney transplant recipients. MATERIALS AND METHODS: A descriptive, retrospective study of nursing care plans of patients who underwent kidney transplantation from January 2008 through December 2016 was performed. Data were collected using a descriptive characteristics information form for patients and nursing care plans registered to the hospital's information-processing system. Data for nursing care plans of 100 kidney transplant recipients were analyzed. FINDINGS: It was determined that 59% of the kidney transplant recipients were male and the mean age ± SD was 42.56 ± 12.40 years; 81% of the patients had undergone kidney transplantation from living donors. The most commonly used nursing diagnoses in the care of kidney transplant recipients were (1) risk of infection (100%); (2) deficient knowledge (100%); (3) risk for bleeding (31%); (4) acute pain (26%); and (5) risk for falls (16%). The most common interventions were (1) examining the infection-related laboratory findings (69.0%); (2) limiting the number of visitors (64.0); and (3) setting aside time for patient questions and concerns (59.0%). CONCLUSIONS: Nursing diagnoses and interventions applied in the care of kidney transplant recipients seem to be limited. To provide holistic care to the kidney transplant recipients, the nursing care plans should include more extensive nursing diagnosis and interventions to maintain physical, psychological, and social well-being.

Wound care of the driveline exit site in patients with a ventricular assist device: A systematic review.

BACKGROUND: This study aims to systematically define and analyze the studies on driveline exit site care methods for patients with a ventricular assist device. METHODS: The studies related to driveline exit site care of the patients with a ventricular assist device published in English and Turkish between 2008 and 2017 were reviewed from the international Science Direct, PubMed, Web of Science, Scopus, and the national databases. Of a total of 83 articles, a total of seven research articles which met the inclusion criteria were included in the study. RESULTS: Findings related to the agents used in the cleaning of the driveline exit site, dressing closures, dressing change frequency, and use of driveline anchoring devices were obtained from studies included in the research. It was found that chlorhexidine solution for skin cleaning and sterile gauze sheets and transparent covering for dressing closure were the most preferred methods for the driveline exit site care. Dressing change frequency varied considerably from center to center and anchoring devices were used in all studies. CONCLUSION: There is no gold standard method for the driveline exit site care of patients with a ventricular assist device and researches on the driveline exit site care seem to be limited. It is recommended that large-scale, randomized-controlled studies should be conducted which would provide a stronger proof of the driveline exit site care.

Nursing diagnoses and interventions in the care of elderly patients undergoing surgery.

AIM: The aim of this study was to determine nursing diagnoses and interventions in the care plans of elderly patients undergoing surgery. METHODS: This descriptive and retrospective study was conducted with the files of 129 elderly patients undergoing surgery in a university hospital in Turkey. Data were collected using a questionnaire and nursing care plans. Frequency and percentage calculations were used to evaluate the data. RESULTS: The mean age of hospitalized patients was 72.8 ± 5.8 years; 28.7% of patients were hospitalized at a general surgery clinic and 51.9% were male. Nurses had been using 14 nursing diagnoses and 171 different nursing interventions while planning their care of elderly patients undergoing surgery. The most frequently used nursing diagnoses were falling risk, infection and hypertension. CONCLUSION: Nurses use limited diagnoses and standard interventions to plan the care of elderly surgical patients.

The effect of transcutaneous electrical nerve stimulation on post-thoracotomy pain.

BACKGROUND: Pain guidelines suggest transcutaneous electrical nerve stimulation (TENS) as a reliable analgesic method in postoperative pain. OBJECTIVES: This study was conducted as a randomized controlled study to determine the effect of TENS on postoperative pain and analgesic consumption in patients who have undergone posterolateral thoracotomy (PLT). DESIGN: The study was conducted in the Thoracic Surgery Clinic of a university hospital with 40 patients (test group: 20, control group: 20) and its power was 99%. While, test group patients were administered TENS, the control group patients were not. The pain assessment and analgesic consumption in both groups were recorded. RESULTS: The pain levels and analgesic consumption of the test group were lower than that of the control group (p < .05). CONCLUSIONS: TENS reduced PLT pain and analgesic consumption. Thus, TENS can be recommended as an easy and reliable analgesic method in PLT.