The effect of nocturnal patient care interventions on patient sleep and satisfaction with nursing care in neurosurgery intensive care unit.

BACKGROUND: Sleep disturbance in an intensive care unit is a common problem. One of the main factors causing sleep disturbances in an intensive care unit is nocturnal patient care interventions. AIMS AND OBJECTIVES: This study aims to determine the impact of patient care interventions performed at night in a neurosurgical intensive care unit on patients' sleep and their nursing care satisfaction. METHODS: The descriptive study was conducted on 82 patients in a neurosurgical intensive care unit between January 2009 and March 2010. The data were collected by data collection instruments and Newcastle Satisfaction with Nursing Scales. The data were statistically analyzed by frequency, mean, standard deviation, chi-square, and Mann-Whitney U test. RESULTS: The study showed that 53.7% of the patients experienced sleep disturbances in the neurosurgical intensive care unit. Because of nursing interventions at night, 39.1% of these patients had their sleep affected, but this problem did not cause any negative impact on the patients' satisfaction (Newcastle Satisfaction with Nursing Scales score = 88.21 ± 9.83). The patients received, on average, 42.21 ± 7.45 times patient care interventions at night; however, the frequency of patient care interventions at night showed no effect on sleep disturbances in this study (p > .05). The most frequently given patient care interventions were, respectively, vital signs monitoring, neurological assessment, and repositioning in bed. These interventions were performed commonly at 6 a.m., 12 a.m., and 7 p.m. CONCLUSION: In this study, despite the patients reporting sleep disturbances in the neurosurgical intensive care unit because of nocturnal patient care interventions that prevented them from sleeping, the patients' satisfaction on the given nursing care was not negatively impacted. To reduce sleep disturbances because of nursing care initiatives and promote uninterrupted sleep in the intensive care unit, it can be useful to develop new protocols regulating night care activities.

The effects of open and closed endotracheal suctioning on intracranial pressure and cerebral perfusion pressure: a crossover, single-blind clinical trial.

Although endotracheal suctioning is a routine nursing intervention, this procedure can lead to an increase in intracranial pressure (ICP). This study was planned to determine the appropriate suctioning technique (open system suctioning [OS] and closed system suctioning [CS]) to minimize variability of ICP and cerebral perfusion pressure (CPP) in neurologically impaired patients. The study, which was designed as a crossover, single-blind clinical trial, consisted of 32 neurosurgical patients who underwent ICP monitoring, intra-arterial blood pressure monitoring, and endotracheal intubation in the intensive care unit. According to the need for suctioning, each patient in the experimental and control groups underwent suctioning with both closed and open systems. Recordings were composed of the patients' ICP, mean arterial blood pressure, CPP, heart rate (HR), and arterial blood gases during suctioning. It was observed that both suctioning techniques significantly increased ICP, mean arterial blood pressure, CPP, and HR; ICP was found to be significantly higher in OS compared with CS, whereas there were no significant differences in CPP and HR between the two techniques. The patients suctioned using OS had significantly lower mean PaO(2) than those suctioned using CS; however, the comparison of the two techniques revealed no significant differences in PaCO(2). The data obtained indicate that CS, compared with OS, can be used safely on this patient group.

The nurse's role in providing information to surgical patients and family members in Turkey: a descriptive study.

In 2008, we conducted a nonexperimental, cross-sectional, descriptive study in the surgical services department of a hospital in Istanbul, Turkey, with the aim of determining how much information was required by perioperative patients and their family members, the extent to which this information was provided, and the role that nurses play in this process. We included a total of 394 outpatients and inpatients and their family members (ie, 197 patients, 197 family members) and 30 nurses in the study. We collected the research data by using one questionnaire for patients, a second for family members of patients, and a third for nurses. We discovered that the patients and their family members wanted to be given more information about the surgical process than they had received. Patients wanted more information about the intraoperative period, whereas their family members wanted more information about the postoperative period. We also found that nurses were aware that they did not play an effective role in providing information to patients and their family members because of a lack of knowledge about what information they were responsible for providing and insufficient staffing. We concluded that nurses should know what education they are responsible for providing, put more effort into understanding patient and family member information needs, and plan a better means of providing information to meet those needs.

The effect of analgesic education on pain in patients undergoing breast surgery: within 24 hours after the operation.

AIM: The goal of this study was to assess the effect of patient information about the analgesics used after breast surgery, on patient's level of pain and mobilisation ability. BACKGROUND: Pain needs to be managed efficiently; in particular, for surgical cases, postoperative pain must be effectively controlled. Information about analgesic helped reduce the severity of pain. DESIGN: This study was a clinical trial comparing a test group that received information about the analgesic to be used and a control group that received information as usual. METHODS: Eighty-four patients who had a modified radical mastectomy or breast-conserving surgery were included in the study. Data were collected in a breast surgery clinic with a questionnaire, with the use of Short-form McGill-Melzack Pain Questionnaire and the Visual Analogue Scale. The test group received information about the surgical pain and the analgesics that would be used during the postoperative period. RESULTS: The results showed that the level of pain reported by patients was similar in the test and control groups. However, the average level of postoperative pain in the test group was lower than that in the control group. The total pain reduction score for the test group, after surgery, was greater than for the control group. Following surgery, 73·8% of the test group and 50·0% of the control group achieved mobilisation within the first six hours. CONCLUSION: Informing patients about the analgesics to be used for their care reduced pain and provided earlier mobilisation. RELEVANCE TO CLINICAL PRACTICE: The findings of this study can provide guidance to nurses and improve analgesic control of pain management.

Identification of risk factors for breast cancer for women in istanbul.

BACKGROUND: Breast cancer is the most common cancer type seen in women, accounts for 18% of all cancer types in women and the risk of a woman to get breast cancer during her life is 11%. These notified rates enable breast cancer to be defined as a preventable and if pre-diagnosed, a treatable cancer type, despite it was regarded as a terrifying type of cancer in the past. OBJECTIVE: The aim of the study was to determine the lifestyle pattern of women without breast cancer in Istanbul. METHOD: The study was carried out as a descriptive and cross-sectional study with 1000 women. RESULTS: The majority of the women (29.7%) were in the 35-44 year old age group. Out of these 93.1% gave birth before the age of 30, 29.5% breastfed for 7-12 months, 65.8% started menarche between 13-15 years of age (mean of 13.3 years), 15.5% were in menopause and had entered menopause at a mean age of 46.5 years. Their mean body mass index was 24.3kg/m(2) and 24.5% of them preferred foods containing high fat content. The majority of the women (85.4%) did not participate in sports regularly. One third (30.3%) of the women had underwent Breast Self Examination. There was a positive family history of breast cancer for 12.1% of the women. CONCLUSION: Sedentary lifestyles, lower Breast Self Examination and routine mammography rates and family histories of breast cancer were the risk factors that needed to be given priority for further action.

Nursing role on preventing secondary brain injury.

Secondary brain injury is a complicated, multifactorial process that results from hypoxemia, hypercapnia or hypocapnia, and increased ICP. Implementation of a traumatic brain injury protocol for patients with head injury including hemodynamic management, pulmonary care, maintenance of body temperature, control of the environment, positioning of patients, and seizure prophylaxis provides critical care nurses a proactive means to prevent or minimize the development of secondary brain injury in the emergency department.