Comparison of predictive models in postoperative nausea and vomiting in patients undergoing breast cancer surgery.

BACKGROUND: Post-operative nausea and vomiting remain an unresolved concern in Türkiye and some parts of the world, impacting the quality of the patient's recovery process and diminishing overall satisfaction. OBJECTIVE: This study was conducted as a descriptive investigation to compare the incidence of nausea and vomiting following breast cancer surgery with the nausea and vomiting risk scores proposed by Apfel and Koivuranta. METHODS: This study was conducted with 100 patients admitted to the General Surgery service of a university hospital between 31 August 2019 and 31 May 2021 for breast cancer surgery. The patient information form developed by the researchers, Apfel Nausea and Vomiting Risk Score, and Koivuranta Nausea and Vomiting Risk Score were used as data collection tools. RESULTS: It was identified that 61% of the patients experienced nausea and vomiting within the initial 24 h following surgery. A significant correlation was found between age, post-operative opioid use, motion sickness or history of PONV, and nausea and vomiting (p < 0,05). The sensitivity of the Apfel score obtained was 80%, the specificity was 46%, and the AUC value was 0.686. The sensitivity of the Koivuranta score was 80%, the specificity was 35%, and the AUC value was 0.675 (p < 0.05). CONCLUSION: It has been observed that patients experience high rates of nausea and vomiting after breast cancer surgery and that the Apfel and Koivuranta Risk Scores are equally applicable in predicting post-operative nausea and vomiting.

Psychometric Properties of the Turkish Version of the Surgical Anxiety Questionnaire (SAQ).

PURPOSE: This study aimed to determine the psychometric properties of the Turkish surgical anxiety questionnaire (SAQ) version. DESIGN: This study design was methodological. METHODS: The study was evaluated with construct validity, exploratory (EFA) and confirmatory factor analysis (CFA), and convergent and discriminant validity. For scale reliability, internal consistency, Cronbach Alpha Coefficient, Pearson Correlation Analysis, and Inter-item Correlation Analysis, test-retest, and parallel forms methods were used. FINDINGS: The Turkish version of the surgical anxiety questionnaire consisted of a 3-factor structure, and the Cronbach's alpha value was 0.93. The CFA factor loads varied between 0.48-0.98. A positive, high correlation was found between SAQ and the Amsterdam Preoperative Anxiety and Knowledge Scale (APASIS). A positive, moderate correlation between SAQ and State-Trait Anxiety Inventory-1(STAI-1) was found. CONCLUSION: SAQ has strong validity and reliability in the Turkish society. Nurses could use the SAQ to determine the anxiety level in surgical patients.

Environmental sustainability, medical waste management, energy and medicine consumption of the surgical intensive care nurses: A qualitative study.

BACKGROUND: In intensive care units, it is noticeable that there is intensive use of resources in the treatment and care process, leading to a significant amount of waste generation. In addition, the demand for intensive care, increasing life expectancy and surgical interventions, complex comorbidities and ecological crisis make it necessary to make critical care more sustainable. AIM: To explore the perspectives of nurses working in surgical intensive care units regarding responsible medical waste management, energy and medication consumption. STUDY DESIGN: This qualitative descriptive study was conducted in surgical intensive care units of a university hospital in Turkey in November 2023. Twenty-three nurses filled in an introductory form and participated in a semi-structured interview. Data were analysed using inductive content analysis. RESULTS: Three main themes were determined: environmentally sustainable intensive care, prevention of waste in intensive care; responsible consumption and recycling; suggestions for institutional and individual behavioural change regarding environmental sustainability. CONCLUSIONS: The majority of nurses lack knowledge about sustainable development goals. However, in the intensive care unit, they provided effective and creative solutions for medical waste management, energy and medication consumption and individual and institutional behavioural change regarding environmental sustainability. RELEVANCE TO CLINICAL PRACTICE: Sustainability strategies should be created in institutions to ensure responsible medical waste management, energy and medicine consumption and reduce carbon footprint. In accordance with this purpose, 'Green teams' including unit-based doctors, nurses and paramedics should be established. Training should be provided and awareness should be raised to reduce energy use resulting from heating, lighting, ventilation and air conditioning.

The effect of Bdellovibrio bacteriovorus containing dressing on superficial incisional surgical site infections experimentally induced by Klebsiella pneumoniae in mice.

Bdellovibrio bacteriovorus is a bacterial agent that stands out for its ability to act as a predator against gram-negative bacteria and has found application against antibiotic-resistant pathogens. The aim of this study is to determine the efficacy of Bdellovibrio bacteriovorus against antibiotic-resistant pathogens, particularly those causing infections in surgical incision sites. A total of 6 experimental groups were created in mice, and surgical area infections were initiated with Klebsiella pneumoniae in incision sites. The effects of antibiotics and Bdellovibrio bacteriovorus alone or in combination were compared to the control group. In the Bdellovibrio bacteriovorus treatment group, edema and redness were observed in all mice at 24th hours, in 20% of mice at 48th hours, and in none at the 72 nd h. A significant difference was observed in the Bdellovibrio bacteriovorus treatment groups in reducing Klebsiella pneumoniae burden in the incision area compared to antibiotics alone or Bdellovibrio bacteriovorus + antibiotics, (p < 0.001). Likewise, cytokine level determinations indicated that B. bacteriovorus applications generated a therapeutic response without inducing an inflammatory response.

Recycling, responsible consumption and nursing: A qualitative study of surgical nurses' recycling and medical waste management.

AIM: This study was conducted to examine the opinions of nurses working in surgical wards on recycling and medical waste management. BACKGROUND: Surgical services and operating rooms are the most waste-generating parts of health institutions. The primary purpose of waste management is to ensure waste minimization and increase recycling. METHOD: In this qualitative study, in-depth interviews were conducted with 15 nurses. The data were analysed by the content analysis method. The COREQ checklist was used in the study. RESULTS: As a result of the study, four main themes were determined: Barriers in medical waste and recycling management, solution suggestions in medical waste and recycling management, waste of medical and consumable materials and the effect of the pandemic process on medical waste and recycling management. CONCLUSION: Medical waste and recycling management was interrupted due to lack of education, emergencies, hiring of untrained personnel and workload. During the pandemic, medical waste increased, and it could not be recycled. The solution suggestions are training at frequent intervals, monitoring by the responsible nurses and imposing sanctions on those who do not comply. IMPLICATIONS FOR NURSING MANAGEMENT: Knowing nurses' obstacles in managing medical waste and recycling and putting forward solutions in this regard affects sustainability. Knowing the obstacles to the management of medical waste and recycling by nurses could help in solutions.

Intensive care nurses' knowledge and use of a nursing checklist: A cross-sectional survey.

AIM: This descriptive study was conducted to determine the awareness of nurses working in intensive care units about the daily patient checklist. BACKGROUND: Checklists are used in the daily follow-up and evaluation of patients admitted to the intensive care unit. METHOD: The research was carried out with 180 nurses through the social media account of the Turkish Intensive Care Specialists Association Nurse Commission between July 2021 and March 2022. Data were collected with a descriptive information form and intensive care unit daily patient checklist. Necessary permissions were obtained before the study. RESULTS: Among nurses, 45.0% of them got 15 full points from the Checklist. Moreover, 81.1% of the nurses stated that they knew that a checklist should be used to help eliminate the deficiencies of daily care and treatment in the intensive care unit, while 66.7% stated that they used a checklist. It was determined that nurses knew the most about parameters 'Check the daily infection parameters', 'Glycaemic control', 'Therapy', and the least about parameters 'Thromboprophylaxis', 'Ulcer prevention', 'Hypo-hyper delirium' and 'Use a daily checklist'. CONCLUSION: It was determined that the level of awareness of intensive care unit nurses about some parameters that should be followed daily for patient care was low. IMPLICATIONS FOR NURSING MANAGEMENT: Checklists can be used as a guide for health care professionals in the routine daily evaluation of intensive care unit patients. It is thought that these reminder abbreviations will provide efficiency in preventing the disruption of applications, reducing medical errors, reducing mortality and morbidity, and cost.

Prevalence of Nausea-Vomiting and Coping Strategies in Patients Undergoing Outpatient Surgery.

PURPOSE: The present study aimed to determine the prevalence and coping strategies for postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) in patients undergoing outpatient surgery. DESIGN: A descriptive research design was used. METHODS: This descriptive study was carried out with 350 patients who were admitted within the scope of outpatient surgery of the ear, nose, and throat; orthopaedics, urology, and general surgery departments of a university hospital between July 3, 2017 and March 6, 2018. A patient diagnosis form consisting of 34 items developed by the researcher and nausea-vomiting diary were used to collect data. FINDINGS: The results showed that 30.6% of the patients had PONV and 26.3% had PDNV. Of the 92 patients with postdischarge nausea, 26.1% experienced mild, 44.6% moderate, 20.7% high, and 8.7% severe nausea. Among the strategies for coping with PDNV, the patients preferred resting (49%), going outdoors (23.4%), eating something (17%), and drinking something (10.6%). A statistically significant difference was found between postdischarge nausea and risk factors for nausea-vomiting, such as female gender, history of nausea-vomiting, nausea in the postanesthesia care unit, and opioid use in the postanesthesia care unit (P < .05). CONCLUSIONS: This study shows that approximately a quarter of patients who undergo outpatient surgery will experience nausea and vomiting immediately after surgery as well as at home after discharge. Assessment of risk factors for PONV/PDNV was discovered to be an important factor in the care of perioperative patients. Therefore, the risk scoring system is expected to contribute to reducing PONV/PDNV incidence and improving patient coping strategies and satisfaction.