Nurses' level of sleepiness during night shift.

AIMS: This study aimed to determine the peak hours of sleepiness and the factors affecting the sleepiness levels of nurses. BACKGROUND: Sleepiness is commonly seen in individuals working night shifts. However, in case of nurses, this sleepiness can be a major threat to patient and staff safety. METHOD: This was a prospective cross-sectional study. Data were collected between July and September 2023, and a stratified sampling method was used according to the departments in which the nurses worked. Data were collected using the Personal Information Form and Visual Analog Scale. Nurses reported their sleepiness levels at the beginning of each hour between midnight and 8:00 am. EQUATOR CHECKLIST: The study adhered to the STROBE checklist for reporting. RESULTS: The mean sleepiness levels of emergency department nurses, intensive care nurses, internal or surgical clinic nurses, and all nurses were 59.75 ± 15.50, 43.53 ± 20.49, 44.67 ± 18.88, and 49.15 ± 19.67, respectively. The highest sleepiness level of the nurses was at 05:00 am. A significant correlation was found between the variables of age, gender, marital status, sleep quality, number of patients cared, working style and satisfaction with working in the department, and sleepiness level (P < 0.05). CONCLUSION: Nurses working night shifts experience sleepiness (highest at 5:00 am). In addition, the sleepiness levels of nurses are affected by some personal and clinical factors. IMPLICATIONS FOR NURSING AND NURSING POLICY: Based on the results, there is a need for necessary policies regarding nurses' working hours and working conditions. To protect patient and employee safety, necessary strategies should be devised regarding the hours when nurses experience the highest sleepiness and the factors affecting sleepiness levels.

Surgical management of tethered spinal cord syndrome through biportal endoscopic approach: a novel technical note.

This video article explores a case of tethered cord release through a minimally invasive biportal endoscopic approach. A 24-year-old female with chronic back pain and thigh numbness underwent surgery. The chosen approach involved biportal endoscopic technique, demonstrating precision with minimal bone excision. Preoperative imaging revealed a midline fusion defect at L5 and abnormal conus medullaris termination. The surgical procedure involved one-sided hemilaminectomy, durotomy, and careful filum terminale separation. Postoperatively, radiological exams confirmed success with minimal bone defect. Emphasizing minimal invasiveness, reduced bone excision, and muscle sparing, this technique showcased successful outcomes, enabling the patient's rapid postoperative recovery without complications. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23228.

Examining nurses' humanistic behaviour ability and empathy levels in clinical practice: A descriptive and exploratory study.

BACKGROUND: It is critical for nurses to provide healthcare services to healthy/sick individuals with a humanistic approach and with empathy. AIMS: This research aimed to determine nurses' humanistic behaviour ability, empathy levels and related factors in clinical practice. DESIGN: A descriptive cross-sectional and exploratory study. METHODS: Probability sampling method was used, and 337 nurses working in two public hospitals were included in the study. Data was collected using the Humanistic Practice Ability of Nursing Scale and the Empathy Level Determination Scale. Structural equation model analysis and descriptive statistics were used to evaluate the hypothesised model. This study adhered to the STROBE checklist for reporting. RESULTS: Nurses' humanistic ability and empathy level in nursing practices were found to be above average. Both the ability to act humanely in nursing practices and their empathy levels were found to be significantly higher in nurses who were married and had children. A significant relationship was found between empathy levels and humanistic behaviours. Accordingly, nurses' empathy levels positively affected their humanistic care behaviours, and the model established between the two concepts was found to be statistically appropriate. CONCLUSIONS: Nurses' empathy levels positively affect their ability to act humanistically. The result of the model established between the two concepts also supports this. Care strategies should be developed that consider factors that will improve empathetic and humanistic behaviours in nurses and maximise individualised care practices. IMPLICATIONS FOR THE PROFESSION: Increasing the awareness of nurses about the factors affecting humanistic behaviours and empathic attitudes while caring for individuals in clinical practice, will contribute to improving the quality of nursing care.

An Evaluation on the Attitude Toward Using Patient Rights and Satisfaction Levels in Emergency Department Patients.

INTRODUCTION: In emergency health care services, patient satisfaction is one of the fundamental indicators of quality emergency care, making it essential to identify factors that can impact this component of care. This study aimed to determine emergency service patients' attitudes toward using patient rights, their satisfaction levels with emergency service, and related factors. METHODS: The cross-sectional study was conducted with 382 patients who presented to the emergency department between November 2022 and March 2023. Data were collected using the Patient Description Form, the Emergency Department Patient Satisfaction Scale, and the Scale of Patient Rights Using Attitude. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for reporting. RESULTS: The mean score of the Emergency Department Patient Satisfaction Scale was 53.88 ± 6.88 (minimum score, 30; maximum score, 68), and the mean score of the Scale of Patient Rights Using Attitude was 108.89 ± 11.90 (minimum score, 73; maximum score, 135). As a result of the regression analysis, it was found that the Scale of Patient Rights Using Attitude scores and frequency of ED visits significantly contributed to the Emergency Department Patient Satisfaction Scale scores. Younger patients who had higher educational status presented to the emergency department more frequently and had chronic diseases were associated with positive attitudes about using patient rights and had higher levels of ED patient satisfaction (P < .001). DISCUSSION: The study has provided valuable information for assessing the attitudes of ED patients toward exercising their patient rights and their satisfaction levels. Respect for patient rights and their effective utilization by patients can enhance the quality of ED services and increase patient satisfaction.

Comparison of procedure-related pain and patient satisfaction according to catheter size and insertion site in peripheral intravenous catheterization.

BACKGROUND: Peripheral intravenous catheterization is a painful and uncomfortable procedure and is the most commonly used invasive procedure in healthcare institutions. Compare procedure-related pain and patient satisfaction according to catheter size and insertion site in peripheral intravenous catheterization. METHODS: The study was comparative prospective randomized study. Individual Information Form, Visual Analog Scale, and Patient Satisfaction Scale about Catheterization were used for data collection. RESULTS: The highest pain score and the lowest patient satisfaction were determined in 20 gage insertion in the dorsum of the hand. It was less painful to perform the procedure in the forearm than in the dorsum of the hand. Moreover, there was a significant negative correlation between the level of pain experienced due to peripheral intravenous catheterization and patient satisfaction with catheterization. CONCLUSIONS: A smaller peripheral intravenous catheter inserted in the forearm resulted in less pain sensation and higher patient satisfaction.

Is prophylactic anti-convulsive treatment necessary in subdural hematomas?

BACKGROUND: Subdural hematoma (SDH) is usually an emergent clinical condition in neurosurgery. The relationship between the SDH and epilepsy is not well established. Therefore, the use of anti-convulsive treatment in patients with SDH is controversial. The aim of this study is to analyze the presence of seizures in patients who underwent surgery for SDH. METHODS: Patients who were operated on for SDH in our department between 2016 and 2021 were reviewed retrospectively. Demographic features, Glasgow Coma Scale (GCS) score at admission, type of SDH, location, etiology, type of surgical intervention, presence of seizures, and re-operation were evaluated. RESULTS: There were 175 patients with SDH. There is a statistically significant difference between the frequency of seizures and the type of SDH. More seizures were observed in acute SDH than in the others. There is also a statistically significant difference between the GCS score and the frequency of seizures. Patients with a GCS score <12 at admission had more frequent seizures than patients with a score of 12 or higher. No statistically significant difference was found between factors such as etiology, re-operation, hematoma location, and the development of seizures. CONCLUSION: Anti-convulsive treatment may be recommended in patients with acute SDH and a low GCS score at admission. Further studies with larger series should be performed to determine the most appropriate anti-convulsive agent for patients with SDH.

Comparison of Turkish and English YouTube videos on phlebotomy in terms of content, reliability and quality.

AIM: This study was conducted to evaluate the content, reliability and quality of YouTube videos about phlebotomy. METHOD: A retrospective, register-based study was conducted exclusively with videos publicly available on YouTube in June 2022. Ninety videos have been evaluated in terms of content, reliability and quality. This evaluation was performed by two independent researchers. The skill checklist created with reference to the WHO blood collection guide was used for the content evaluation of the videos. The short form of the DISCERN questionnaire was used to evaluate the reliability of the video. The quality of the videos was evaluated with a 5-point Global Quality Scale. RESULTS: The mean validity score of the English videos was 2.58 ± 0.88, the quality score was 2.98 ± 1.02 and the content score was 8.78 ± 1.47. In the Turkish videos, the mean validity score was 1.90 ± 1.27, the quality score was 2.35 ± 0.97 and the content score was 8.02 ± 1.07. The content, validity and quality scores of the English videos were found to be significantly higher than the Turkish videos. CONCLUSION: Some videos do not include evidence-based practice and some videos contain technical differences as in the literature. In addition, in some videos, non-recommended techniques such as touching the cleaning area, opening and closing the fist were used. For these reasons, the results show that YouTube videos on phlebotomy are a limited resource for students.

Incontinence-Associated Dermatitis: Prevalence in Intensive Care Units and Knowledge, Attitudes, and Practices of Nurses.

BACKGROUND: Incontinence-associated dermatitis (IAD) is a major concern among hospitals, especially in intensive care units (ICUs). PURPOSE: To describe ICU nurses' knowledge, attitudes, and practices of IAD and to examine the relationships with IAD prevalence in the ICU setting. METHODS: A descriptive correlational design was used including the Knowledge, Attitudes and Practices of Incontinence-Associated Dermatitis Questionnaire and 1-month IAD prevalence data. RESULTS: The prevalence of IAD in ICUs was 6.89%. A positive correlation was found between IAD prevalence and nurses' IAD knowledge and attitudes. Nurses working in the ICU for more than 7 years, caring for patients at high risk for or having IAD, and thinking IAD-related nursing practices were sufficient had significantly higher IAD knowledge, attitudes, and practices. CONCLUSIONS: Findings indicate that ICU nurses learned about IAD through clinical experience and have inadequate training on IAD. A standardized evidence-based care protocol for IAD should be developed.

The Effect of the Flipped Classroom Model on Teaching Clinical Practice Skills.

INTRODUCTION: No evidence was found in the literature for the use of the flipped classroom model in teaching clinical practice skills in paramedics. The study aimed to determine the effect of the flipped classroom model in teaching clinical practice skills to paramedic program students. METHODS: The study was a single-center, randomized controlled, single-blind parallel-group study. The research was carried out with a university's first-year paramedic program students in the 2021 to 2022 academic year. The students were divided into groups by stratified sampling (intervention group = 21, control group = 21). Five clinical skills practices at various times were explained to the intervention group with the flipped classroom model and to the control group with the traditional lecture method. The research data were collected with the Introductory Characteristics Information Form, Checklists, Time Tracking Form, and Students' Questionnaire for Evaluating the flipped classroom model. RESULTS: Although the students in the intervention group received a higher total score from all 5 clinical practice skills than the students in the control group, this difference was not statistically significant (P > .05). However, although the time allocated for applications in the intervention group was 40 to 75 minutes longer than in the control group, most students stated that this model successfully taught skills and theory, increased their motivation during the application, and reduced application and exam anxiety. DISCUSSION: The flipped classroom model can be used as an alternative method to the traditional system in teaching clinical practice skills. This innovative educational approach can be recommended as a student-centered method in clinical skills teaching.

Polarization Control in Integrated Graphene-Silicon Quantum Photonics Waveguides.

We numerically investigated the use of graphene nanoribbons placed on top of silicon-on-insulator (SOI) strip waveguides for light polarization control in silicon photonic-integrated waveguides. We found that two factors mainly affected the polarization control: the graphene chemical potential and the geometrical parameters of the waveguide, such as the waveguide and nanoribbon widths and distance. We show that the graphene chemical potential influences both TE and TM polarizations almost in the same way, while the waveguide width tapering enables both TE-pass and TM-pass polarizing functionalities. Overall, by increasing the oxide spacer thickness between the silicon waveguide and the top graphene layer, the device insertion losses can be reduced, while preserving a high polarization extinction ratio.

Polarization Control in Integrated Silicon Waveguides Using Semiconductor Nanowires.

In this work, we show the design of a silicon photonic-based polarization converting device based on the integration of semiconduction InP nanowires on the silicon photonic platform. We present a comprehensive numerical analysis showing that full polarization conversion (from quasi-TE modes to quasi-TM modes, and vice versa) can be achieved in devices exhibiting small footprints (total device lengths below 20 µm) with minimal power loss (<2 dB). The approach described in this work can pave the way to the realization of complex and re-configurable photonic processors based on the manipulation of the state of polarization of guided light beams.

The determination of adherence to fluid control and symptoms of patients undergoing hemodialysis.

Background and aims: The aim of this study was to determine the adherence of hemodialysis (HD) patients with fluid control and the symptoms they experienced. Method: The data of the study were collected between October 2015 and January 2016 and totally 596 patients undergoing hemodialysis were included in the study. The data of the study were collected by using Patient Information Form, Fluid Control Scale on Hemodialysis Patients (FCSHP), and Dialysis Symptom Index (DSI). Results: Total mean score patients received from FCSHP was 48.68±4.43, score of the subscale information was 18.85±2.24, score of the subscale behavior was 21.28±3.23, and score of the subscale attitude was 8.54±1.56. Mean score obtained by them from DSI was calculated as 65.07±2.17.Symptoms that patients experience most frequently were found as feeling tired or decreased energy, pins and needles in feet, and having difficulty in falling into sleep. The patients with high adherence to fluid control were found to have less symptoms. Conclusion: It was recommended to assess periodically adherence to fluid control in individuals receiving hemodialysis treatment and symptoms they experience and to provide training and consultancy by addressing those having difficulty in adherence to fluid control.

The Effect of Aromatherapy on Elderly Persons With Dry Skin: A Randomized Controlled Trial.

Dry skin, which is one of the most frequent dermatological problems seen in the elderly population, is an important problem that increases with aging. This study was conducted as a randomized controlled experimental trial to determine the effect of aromatherapy, applied to elderly persons residing in a nursing home in a city center, on dry skin. Elderly persons were grouped into a control group (20 elderly persons), an olive oil group (20 elderly persons), and an aromatherapy group (20 elderly persons). When examining between-measurements differences of the groups in the study, skin moisture levels of the elderly individuals in the aromatherapy group increased in all zones, arm, leg, back, and chest, at measurements of the second and fourth weeks compared with the first measurements. This improvement was determined to be higher after the second week. Skin moisture levels of elderly persons in the olive oil group were determined to significantly increase at the arm zone in the fourth week and at the back zone in the second and fourth weeks compared with the first measurements. Skin moisture levels of elderly persons in the control group, on the contrary, did not change in the second and fourth weeks compared with the first measurements and their dry skin continued at the same level. The intervention performed in this manner in the present study can be used in the clinical practice as an effective nursing intervention to reducing dry skin among elderly persons.

Tunable narrow band optical reflector based on indirectly coupled micro ring resonators.

This paper presents a novel narrow band wavelength selective optical reflector implemented by indirectly coupling two micro ring resonators in silicon-on-insulator technology. The device is studied using an analytical model based on the transfer matrix method. With the proposed configuration, by electrically driving the integrated micro heaters, a single reflection wavelength with narrow bandwidth can be tuned. The experimental results show a good agreement with the model outcomes. The average measured reflectivity over a wavelength span of 37 nm is 0.55, with a peak of about 50 pm full-width-half-maximum, which corresponds to a quality factor of ∼30, 000. The proposed device can offer an alternative approach to realize compact reflective structures for single wavelength reflection operations in photonic integrated circuits.

Array of plasmonic Vivaldi antennas coupled to silicon waveguides for wireless networks through on-chip optical technology - WiNOT.

Optical technology applied to on-chip wireless communication is particularly promising to overcome the performance limitations of the state-of-the-art networks on-chip. A key enabling component for such applications is the plasmonic antenna coupled to conventional silicon waveguides, which can guarantee full compatibility with standard optical circuitry. In this paper, we propose an antenna array configuration based on tilted plasmonic Vivaldi antennas coupled to a silicon waveguide. The details of the single antenna and of the array design are reported. The radiation characteristics of the array are suitable for on-chip point-to-point communication, i.e. in-plane maximum gain of 14.70 dB for an array with five antennas. The array exploits a travelling wave feeding scheme and, therefore, is compact in size (about 3.5 µm × 8.7 µm ).

Integrated Vivaldi plasmonic antenna for wireless on-chip optical communications.

In this paper we propose a novel hybrid optical plasmonic Vivaldi antenna for operation in the standard C telecommunication band for wavelengths in the 1550 nm range. The antenna is fed by a silicon waveguide and is designed to have high gain and large bandwidth. The shape of the radiation pattern, with a main lobe along the antenna axis, makes this antenna suitable for point-to-point connections for inter- or intra-chip optical communications. Direct port-to-port short links for different connection distances and in a homogeneous environment have also been simulated to verify, by comparing the results of a full-wave simulation with the Friis transmission equation, the correctness of the antenna parameters obtained via near-to-far field transformation.

Use of N-terminal pro-brain natriuretic peptide to assess left ventricular function after adjuvant doxorubicin therapy in early breast cancer patients: a prospective series.

BACKGROUND AND OBJECTIVE: Anthracyclines are well established and highly efficacious antineoplastic agents for various haematopoietic and solid tumours, such as breast cancer. The main adverse effect of anthracycline therapy is cardiotoxicity. The aim of this prospective study was to determine the role of plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing left ventricular function in early breast cancer patients receiving adjuvant anthracycline treatment. METHODS: Thirty-three newly diagnosed breast cancer patients who received a total doxorubicin dosage of 240 mg/m2 over four treatment cycles as part of adjuvant chemotherapy after curative breast surgery were included in this study. Venous NT-proBNP levels were measured before and at the end of doxorubicin therapy. Left ventricular function was measured by echocardiography conducted 3 weeks after surgery and at the end of doxorubicin therapy. RESULTS: NT-proBNP levels were significantly higher in patients (n=10) with decreased left ventricular ejection fraction (LVEF) [p=0.02]. There was no difference in LVEF (p=0.164) or NT-proBNP levels (p=0.844) between the patients who had high NT-proBNP levels and those who had normal NT-proBNP levels before doxorubicin chemotherapy. None of the factors studied (breast cancer grade, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, age) was found to be significantly related to NT-proBNP. CONCLUSION: The association between higher NT-proBNP levels and reduced LVEF in asymptomatic breast cancer patients after doxorubicin administration could be an early indication of subclinical acute anthracycline cardiotoxicity. Furthermore, breast cancer patients experiencing a progressive increase in NT-proBNP levels might be in a higher risk group for acute anthracycline cardiotoxicity.