Cerrahi Hemşirelerinin Cerrahi Alan İnfeksiyonlarını Önlemeye Yönelik Bilgi Düzeyleri

Giriş: Hemşirelerin cerrahi alan infeksiyonunu (CAİ) önlemek için doğru ve hızlı karar vermeleri ve kanıta dayalı uygulamalarla ilgili önerileri bilmeleri kaliteli hemşirelik bakımı verebilmek için çok önemlidir. Amaç: Bu araştırmanın amacı cerrahi hemşirelerinin CAİ önlenmesi konusundaki bilgi düzeylerini belirlemektir. Gereç ve Yöntem: Tanımlayıcı tipte planlanan araştırma, Ege Bölgesinde bir Eğitim Araştırma Hastanesi cerrahi kliniklerinde çalışan 58 hemşire ile 20 Ocak 2020-15 Şubat 2020 tarihleri arasında yapıldı. Veriler “Bireysel Özellikler Formu” ve Hastalık Kontrol ve Önleme Merkezleri 2017 güncel rehberine göre hazırlanmış “Cerrahi Alan İnfeksiyonunu Önlemeye Yönelik Bilgi Formu” ile toplandı. Çalışmada verilerin değerlendirilmesinde Tanımlayıcı istatistiksel metotlar ile birlikte Mann-Whitney U Testi, Kruskal-Wallis Testi, Lojistik Regresyon analizinden yararlanıldı. Bulgular: Çalışmaya katılan hemşirelerin; yaş ortalaması 40.2±6.1, %93.1’i (n=54) kadın, %82.8’i (n=48) evli, %93.1’i (n=54) lisans mezunu, %67.2’si (n=39) 16 yıl ve daha fazla süredir hemşirelik yapmaktadır. Araştırmaya katılan hemşirelerin %37.9’unun (n=22) infeksiyon kontrolü konusunda eğitim aldığı saptandı. Çalışmadan elde edilen verilere göre hemşirelerin “Cerrahi Alan İnfeksiyonu Önleme Bilgi Düzeyi” puan ortalaması 13.1±2.2 (min:7, max: 18), bilgi formunda yer alan ifadeleri doğru yanıtlama oranı ise ortalama %62.2±10.4 olarak hesaplandı. Sonuç: Hemşirelerin cerrahi alan infeksiyonlarını önlemeye ilişkin bilgi puan ortalaması orta seviyenin üstünde saptandı. Hemşirelerin cerrahi alan infeksiyonunun önlenmesi konusundaki yetkinliğini artırmak ve bilgi eksikliğini gidermek için güncel rehberler eşliğinde hizmet içi eğitim programları düzenlenmelidir

Corneal Thickness and Topography Indices after Collagen Cross-linking for Keratoconus: 18 Months Follow-up and Literature Review

Objective: To evaluate the changes in corneal topography indices and corneal thickness after cross-linking treatment for keratoconus. Study Design: Retrospective Observational Study Patients and Methods: The data of patients who underwent corneal collagen cross-linking treatment for keratoconus were retrieved. Central corneal thickness (CCT), maximum and mean keratometry (Kmax, Kmean) values and topography indices: index of surface variance (ISV), index of vertical asymmetry (IVA), keratoconus index (KI), central keratoconus index (CKI), minimum radius of curvature (Rmin), index of height asymmetry (IHA), and index of height decentration (IHD) were obtained from Pentacam and Wavelight-Allegretto Wave Topolyzer outputs. Follow-up was 18 months. Results: The study comprised of 15 eyes of 10 patients with keratoconus. Central corneal thickness had decreased significantly 1 month after the procedure (p=0.003) but there were no statistically significant changes between the baseline values and last visits (p>0.05). Kmax and Kmean values were not statistically different from the preoperative values and at the last visits (p>0.05). Almost all of the corneal topography indices improved significantly after postoperative 6th month (p<0.05). Conclusion: There were improvements in topography indices during 18-month follow-up period, suggesting that the cornea becomes more optically regular and symmetrical after cross-linking

Hemşirelerin farklı kültürden olan hastaya yaklaşımları

1. ÖZET Hemşirelerin Farklı Kültürden Olan Hastaya Yaklaşımları Öğrencinin Adı: Cemile ÇELEBİ Danışmanı: Prof. Dr. Şule ECEVİT ALPAR Anabilim Dalı: Hemşirelik Amaç; Çalışmada hemşirelerin farklı kültürden olan hastaya bakım ve tedavi sırasında yaklaşımlarının belirlenmesi amaçlanmıştır. Gereç ve Yöntem; Tanımlayıcı olarak yapılan araştırmada, Ocak-Nisan 2019 tarihleri arasında İstanbul ili Anadolu ve Avrupa yakasında yer alan iki eğitim araştırma hastanesinde görev yapan 205 hemşire örneklemi oluşturmuştur. Veriler anket formu ve Hemşirelerin Farklı Kültürden Hastaya Yaklaşım Formu ile toplanmış olup, ankette; hemşirelerin sosyo demografik özelliklerini içeren yedi soru, kültürel birikimine yönelik yedi soru ve formda ise; hemşirelerin farklı kültürden hastaya yaklaşımlarına yönelik kırk beş soru yer almıştır. Çalışmada elde edilen veriler tanımlayıcı istatistik yöntemler ve bağımlı, bağımsız değişkenler arasındaki farklar X² ile analiz edilmiştir. Bulgular; Hemşirelerin Farklı Kültürden Olan Hastaya Yaklaşımları veri toplama formunun Alpha katsayısı 0,903 olarak bulunmuştur. Hemşirelerin Farklı Kültürden Olan Hastaya Yaklaşımları veri toplama formundan aldıkları puanlar ile tanımlayıcı özellikleri karşılaştırıldığında yabancı dil bilme ile farklı kültürden hastaya yaklaşım arasında istatistiksel açıdan anlamlı farklılık olduğu belirlenirken sosyo demografik özelliklerle arasındaki farklılıkların anlamlı olmadığı saptanmıştır. Sonuç; Araştırma sonucunda yabancı dil bilen hemşirelerin farklı kültürden hastaya bakım verirken daha az zorluk yaşadıkları saptanmıştır. Hemşirelik eğitimi verilen kurumlarda ve hastanelerde hemşirelere yabancı dil öğretmeye yönelik eğitim verilmesi önerilmektedir. -------------------- 2. ABSTRACT The Approaches of the Nurses to the Patients from Different Cultures Student Name: Cemile ÇELEBİ Advisor: Prof. Dr. Şule ECEVİT ALPAR Department: Department of Nursing Aims and Objectives; The purpose of this study is to determine the approaches of the nurses to the patients from different cultures during nursing and treatment. Methodology; In this descriptive study, 205 nurses working in two education and research hospitals located on the Anatolian and European sides of Istanbul between January and April 2019 formed the sample. Data were collected by questionnaire form and Nurses' Approach to Patients from Different Culture Form. seven questions including socio-demographic characteristics of nurses, seven questions and forms for cultural accumulation; Forty-five questions about nurses' approaches to patients from different cultures were included. The data obtained in this study were analyzed by using descriptive statistical methods and the differences between dependent and independent variables by X². Findings; The Alpha coefficient of the nurses' approach to the patient from different cultures data collection form was found to be 0.903. When the scores obtained from nurses' data collection form and their descriptive characteristics were compared, it was determined that there was a statistically significant difference between knowing a foreign language and approaching the patient from different cultures, while the differences between socio-demographic characteristics were not significant. Conclusion; As a result of the study, it was found that nurses who speak foreign languages had less difficulty in caring for patients from different cultures. In nursing institutions and hospitals, it is recommended that nurses should be trained to teach foreign languages

Unusual Presentation of Duplex Kidneys: Ureteropelvic Junction Obstruction

Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management. Method. We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO. Result. Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years). The lower pole and upper moiety were affected in 12 and two kidneys, respectively, and both were affected in two patients. The anomaly was right-sided in 12 moieties and left-sided in six. The duplication was incomplete in seven patients and complete in nine. The mean renal pelvis diameter at the time of surgery was 25.6 (range 11–48 mm) mm by USG. The mean renal function of the involved moiety was 28.3% before surgery. Management included pyelopyelostomy or ureteropyelostomy in six moieties, dismembered pyeloplasty in eight moieties, heminephrectomy in four cases, and simultaneous upper heminephrectomy and lower pole ureteropyelostomy in one patient. Conclusion. There is no standard approach for these patients and treatment should be individualized according to physical presentation, detailed anatomy, and severity of obstruction

Treatment of mixed astigmatism: early clinical outcomes with WaveLight and Technolas excimer lasers

Background/aim: We aimed to compare the results of WaveLight Allegretto Wave Eye-Q 400 Hz and Technolas 217z100 excimer lasers in the treatment of mixed astigmatism. Materials and methods: Forty-nine patients who underwent laser in situ keratomileusis for mixed astigmatism were included in this retrospective study. Twenty-eight eyes of 21 patients were treated with WaveLight and 46 eyes of 28 patients were treated with the Technolas excimer laser. The patients' visual acuities and refractive values were evaluated on postoperative day 1 and at 1 and 3 months. Results: In the WaveLight and Technolas groups, cylindrical refractive errors at month 3 were -0.92 +/- 0.28 D and -0.88 +/- 0.46 D, respectively. Spherical equivalent values for the groups at month 3 were -0.38 perpendicular to 0.73 D and -0.33 perpendicular to 0.20 D, respectively. There was no significant difference in postoperative uncorrected distance visual acuity at month 3 between the two groups (P = 0.671). At postoperative month 3, 70% of patients treated with WaveLight and 100% of patients treated with Technolas had an uncorrected distance visual acuity of 20/25 or better (P = 0.211). Conclusion: There were no significant differences in refraction and visual acuity between the WaveLight and Technolas groups during a 3-month follow-up period after laser in situ keratomileusis for mixed astigmatism