Determining ethical sensitivity of nurses employed in surgical units

Amaç: Cerrahi birimlerde çalışan hemşirelerin etik ikilemlere karşı duyarlılık düzeylerinin belirlenmesidir. Yöntem: Tanımlayıcı türde yapılan bu araştırma, 22 Aralık 2013-15 Ocak 2014 tarihleri arasında çalışmaya katılmayı kabul eden 90 hemşire ile yürütüldü. Veriler, bireysel özellikler formu ile Ahlaki Duyarlılık Anketi kullanılarak toplandı. Verilerin analizinde tanımlayıcı istatistikler ile Mann Whitney U ve Kruskal-Wallis testi kullanıldı. Bulgular: Cerrahi hemşirelerinin Ahlaki Duyarlılık Anketi toplam puan ortalamasının 89.77±19.43 olduğu; otonomi alt boyut puan ortalamasının 18.35±5.51, çatışma alt boyut puan ortalamasının 13.96±2.97, yarar sağlama alt boyut puan ortalamasının 12.92±3.95, uygulama alt boyut puan ortalamasının 12.34±3.94, bütüncül yaklaşım alt boyut puan ortalamasının 12.00±4.88 ve oryantasyon alt boyut puan ortalamasının 8.13±3.88 olduğu saptandı. Hemşirelerin çalışma süreleri ile bütüncül yaklaşım ve oryantasyon alt boyut puan ortalamaları arasındaki farkın anlamlı olduğu saptandı (p<0.05). Mesleki derneklere üye olma durumu ile Ahlaki Duyarlılık Anketi toplam ve alt boyut puan ortalamaları karşılaştırıldığında; otonomi, bütüncül yaklaşım ve oryantasyon alt boyut puan ortalamaları arasındaki farkın anlamlı olduğu bulundu (p<0.05). Sonuç: Cerrahi birimlerinde çalışan hemşirelerin orta düzey etik duyarlılığa sahip olduğu saptandı. Hemşirelerin etik sorunları tanıma ve çözüm sağlamada mezuniyet öncesi eğitim programlarının güçlendirilmesi, mezuniyet sonrası sürekli eğitim programlarının ise hemşirelerin yaş grupları ve deneyim süresi göz önüne alınarak planlanması, önerilebilir.Aim: It is the determination of sensitivity levels of the nurses employed in surgical units to ethical dilemmas. Method: This descriptive study was conducted with 90 nurses who acknowledged to participate in the study between December 22 2013 and January 15 2014. Data was gathered using the Individual Characteristics form and the Moral Sensitivity Survey form. Descriptive statistics, Mann Whitney U and Kruskal-Wallis tests were used in the data analysis. Results: It was found that total mean score of Moral Sensitivity Survey of the surgical nurses was 89.77±19.43; the subscale mean score of autonomy was 18.35±5.51, subscale mean score of conflict was 13.96±2.97, subscale mean score of benefitting was 12.92±3.95, subscale mean score of implementation was 12.34±3.94, subscale mean score of holistic approach was 12.00±4.88 subscale mean score of orientation was 8.13±3.88. It was found that there was a statistically significant difference between the employment period of the nurses and the subscale mean scores of holistic approach and orientation (p<0.05). When compared the status of being member of professional associations with the total score of the Moral Sensitivity Survey and subscale mean scores, the difference between the subscale mean scores of autonomy, holistic approach and orientation was significant in statistical manner (p<0.05). Conclusion: It was found that the nurses employed in the surgical units have a moderate ethical sensitivity. It can be suggested to strengthen the pre-graduation education programs and to plan the postgraduation continuous education programs by taking into account the age groups and years of experience of nurses in recognizing the ethical problems and in providing solution

Approach to pediatric patients during surgical interventions

Çocuklarda cerrahi süreç, kendileri ve aileleri için genelde hoş olmayan ve zor deneyimleri içermektedir. Bu süreçteki çocuk, anksiyete ve stresi oldukça yoğun yaşar. Diğer taraftan çocuk hastalar, ameliyat sürecine doğrudan etki eden oldukça karmaşık konuma sahiptir. Çünkü çocuk hastanın bakımı sadece rutin cerrahi bakım prosedürünü ve ameliyathanedeki hasta bakımını içermez. Bunların yanı sıra, çocuk hava yolunu, anatomi ve fizyolojisini, çocuk gelişimini bilmeyi, çocuk ile ailenin bakımını üstlenebilmeyi gerektirir. Bu derleme, cerrahide çocuk hastalara ilişkin göz önünde bulundurulması gereken farklılıkları ve ameliyat süresince dikkate alınması gereken bakımları sunmak amacıyla hazırlanmıştır.A child’s surgical period usually contains unpleasant and difficult experiences, for the child and the parents. The child in this period experiences greater anxiety and distress. On the other hand, pediatric patients have complex states that directly effects their perioperative care during. Because their perioperative care includes not only the knowledge of general surgical procedure and care of a patient in the operating room. It also includes the specific understanding of a child’s airway, anatomy and physiology, the understanding of child development and care of the child and family. This review is prepared to present these differences of the pediatric surgical patients and the care during their perioperative period

Effect of preoperative sleep qualıty on post operative comfort levels of surgıcal patıents

Kesitsel ve tanımlayıcı tipte yürütülen bu çalışma, cerrahi girişim geçirmesi planlanan hastaların ameliyat öncesi uyku kalitesinin ameliyat sonrası konfor düzeyine etkisini değerlendirmek amacıyla yapıldı. 29.08.2019-12.11.2019 tarihleri arasında Lüleburgaz Devlet Hastanesi’nin Genel Cerrahi, Kulak Burun Boğaz, Ortopedi ve Beyin Cerrahisi kliniklerinde yatmakta olan ve cerrahi girişim geçirmesi planlanan 153 hastada yürütüldü. Verilerin toplanması amacıyla ameliyat öncesi sabahı hasta tanıtım formu dolduruldu ve ameliyattan önceki gece uyku durumunu değerlendiren uyku ölçeği uygulandı. Ameliyattan sonra ilk 24 saatte konforlarını değerlendiren konfor ölçeği uygulandı. Verilerin toplanmasında hasta tanıtım formu, Richards Campbell Uyku Ölçeği ve Perianestezi Konfor Ölçeği kullanıldı. Verilerin analizinde tanımlayıcı istatistikler, Kolmogrov Smirnov testi, Mann Whitney U testi, Kruskal Wallis analizi, Bonferroni yöntemi, korelasyon analizi ve regresyon analizi kullanıldı. Anlamlılık sınırı p<0,05 olarak değerlendirildi. Çalışmaya katılan hastaların Richards Campbell Uyku Ölçeği toplam puan ortalamaları ile Perianestezi Konfor Ölçeği toplam puan ortalamaları arasında istatistiksel olarak anlamlı ve pozitif yönde zayıf-orta düzeyde bir ilişkinin olduğu belirlendi (r=0,406; p=0,000). Çalışmaya katılan hastaların uyku kalitesinin konfor düzeyi üzerinde istatistiksel olarak anlamlı bir etkisinin olduğu ve değişimin %16,5’ini açıkladığı belirlendi (Düzeltilmiş R2=0,165; p=0,000). Cerrahi kliniklerinde yatan hastaların ameliyat öncesi uyku kalitesinin yüksek olması, hastaların ameliyat sonrası konfor düzeylerinin yüksek olmasına katkı sağladığı görüldü. 47 Hastaların cerrahi girişim sonrasında konfor düzeylerini arttırmak amacıyla cerrahi girişim öncesi uyku kalitesini arttırmaya yönelik girişimlerin yapılmasını önermekteyiz.This study, conducted in a cross-sectional and descriptive type, was conducted to evaluate the effect of preoperative sleep quality on postoperative comfort level of patients who are scheduled to undergo surgical intervention. Between 29.08.2019-12.11.2019, at Lüleburgaz State Hospital there were 153 patients who were planned to have surgical intervention in General Surgery, Otorhinolaryngology, Orthopedics and Neurosurgery. In order to collect the data, the patient introduction form was completed on the morning of the surgery and the sleep scale was applied, which evaluated the sleep condition the night before the surgery. After the surgery, comfort scale was applied in the first 24 hours evaluating their comfort. Patient Introduction Form, Richards Campbell Sleep Questionnaire were used to collect the data. Descriptive statistics, Kolmogrov Smirnov test, Mann Whitney U test, Kruskal Wallis analysis, Bonferroni method, correlation analysis and regression analysis were used in the analysis of the data. The limit of meaning fullness was p<0,05. It was determined that there was a statistically significant and positive weak-moderate relationship between the Richards Campbell Sleep Scale total score averages and Perianesthesia Comfort Scale total score averages (r=0,406; p=0,000). It was determined that the sleep quality of the patients participating in the study had a statistically significant effect on the comfort level and explained %16,5of the change (Fixed R2=0,165; p=0,000). It was seen that the high sleep quality of the patients in the surgical services contributed to the high comfort levels of the patients after surgery. In order to increase the comfort levels of patients after surgical intervention, we recommend that attempts are made to improve the quality of sleep before surgical interventio

Personal protective equipment related skin changes among nurses working in pandemic intensive care unit: A qualitative study

Aim: The respiratory tract is the main transmission way of the SARS-CoV-2 virus and nurses who care for COVID- 19 patients in intensive care units (ICUs) are required to constantly use personal protective equipment (PPE) during their daily work. This study aimed to examine the PPE-related skin changes experienced by the nurses working in pandemic ICU during the COVID-19 pandemic. Methods: Using a descriptive phenomenological approach, semi-structured interviews were conducted between November 1st and December 25th, 2020, in the pandemic ICU of a training and research hospital in Usak, Turkey. The nurses who worked in the pandemic ICU for at least one week and experienced skin changes due to PPE use were included. Individual interviews were carried out online through video conferencing. Colaizzi’s method was used in data analysis by using the ATLAS.ti 8.0. Results: The main themes were main causes of PPE-related skin changes, its location along with secondary adverse effects, symptomatology, prevention, and therapeutic interventions used for curing PPE-related skin changes. Nurses mostly reported PPE-related skin changes behind their ears, over their nose, cheeks and jaw due to wearing N95 masks and on the forehead due to wearing face shields. Wearing PPE at least 2 h, the type/quality of PPE, and being dehydrated were identified as the common causes. Conclusion: This study provides a deeper understanding into the PPE-related skin change experiences of pandemic ICU nurses and the importance of the quality of the PPE used. It is recommended to enable shortened working shifts and ergonomic PPE materials for ICU nurses

THE IMPACT OF PATIENT RELATIVES IN THE PREVENT PATIENT FALLS

Bu çalışma, hasta yakınlarının hastalarının düşmesini önlemek üzerindeki etkilerini belirlemek amacıyla şerçekleştirilmiştir. Tanımlayıcı nitelikte olan bu çalışma, Trakya Üniversitesi Saşlık Araştırma ve Uyşulama Merkezi şenel cerrahi bölümünde yatan hastaların yakınlarının katılımıyla Nisan-Mayıs 2015 tarihleri arasında şerçekleştirildi. Veriler, çalışmaya katılmaya şönüllü olan 59 hasta yakınından elde edildi. Anket formu, literatürden yararlanılarak araştırmacılar tarafından hazırlandı ve uyşulandı. Toplanan veriler SPSS 20,0 paket proşramı ile frekans ve yüzde kullanılarak analiz edildi. Hasta yakınlarının %47,5’i hasta düşmelerini önlemek adına alınabilecek önlemler hakkında bilşilendirilmiş olmasına raşmen bazı basit uyşulamalar (yardımcı araç kullanımını destekleme) konusunda şerekli özeni şöstermedişi belirlenmiştir. Hasta yakınlarının hasta düşmelerini enşellemek adına alınan önlemler hakkında yeterli bilşi sahibi olmadıkları ve çabalarının orta düzeyde olduşu saptandı. Hemşirelerin hasta eşitiminde şörev ve sorumlulukları hizmet içi eşitimlerle vurşulanması önerilmektedir.This study was carried out to determine the impact of the patients' relatives in preventing the patients falls. This descriptive study was conducted in the General Surgery ward of Trakya University Research and Practice Center with the participation of 59 volunteered relatives of patients between April-May 2015. The questionnaire was prepared by the researchers according to literature and applied. The data were analyzed using frequency and percent with SPSS 20.0 software package. It was determined that despite the 47.5% of patients’ relatives have been informed about the precautions taken to prevent patient falls, didn’t pay attention to some simple applications (support the use of aids-walker etc.). As a conclusion it was determined that participants didn’t have adequate information about taken to precautions in order to prevent patient falls and have moderate level of effort about this subject. We recommend health professionals to show more attention to the education of patient’s relatives about preventing patient falls. It is suggested to emphasize the duties and responsibilities of nurses in patient education with in-service trainin

From Correct Words to Correct Care: Usage of The Term Pressure Sore Among Turkish Nurses

Aim: Aim of this study is to determine the current situation of the term used for pressure sores among nurse

Pain-related fear among adult patients undergoing open-heart surgery: an interpretative phenomenological analysis

Background: One of the sources of anxiety and fear among patients undergoing open-heart surgery is the possibility of experiencing pain, such as sternotomy-related chest pain. Giving them the chance to express their feelings about the potential pain may be effective in reducing their anxiety and may support their coping strategies. Objectives: To examine pain-related fear among patients undergoing open-heart surgery and to understand the underlying reasons of their fears. Methods: A qualitative interview based on Heidegger’s interpretative phenomenological approach was conducted adhering to the COREQ guidelines. Sixteen patients who were undergoing open-heart surgery in the following day were interviewed at the cardiovascular surgery ward of a university hospital. The organization and mapping of the qualitative data was done by using ATLAS.ti 8.0. Results: The patients who were afraid of experiencing pain after surgery seemed to be more concerned about open-heart surgery itself (such as pain from sternotomy and chest tubes) and the possibility of prolongation of postoperative pain. To cope with these fears, the patients employed a variety of social and self-coping strategies. Trusting the healthcare team, having a high pain tolerance, and having personal thoughts that take precedence over painrelated fear were the key factors explaining not being afraid of experiencing pain. Conclusions: This study provides a deeper understanding of the underlying reasons and the needs of patients in controlling their pain-related fears before open-heart surgery. Trusting the healthcare professionals is one of the main factors for patients to control their painrelated fears. To develop a supportive sense of trust and to help patients in controlling their pain-related fears, surgical nurses must dedicate enough time for understanding patients’ concerns while planning their nursing care plans. Future studies may focus on exploring the role of nursing interventions and multidisciplinary team approaches on the management of preoperative pain-related fear

Challenges experienced by cardiac intensive care nurses during first out-of-bed patient mobilization after open-heart surgery: A descriptive phenomenological qualitative study

Aim: To investigate the potential challenges experienced by cardiac intensive care unit (ICU) nurses in the first out-of- bed patient mobilization after open-heart surgery and propose solutions. Design: A qualitative study design using the descriptive phenomenological approach. Methods: Individual face-to- face interviews were conducted via a widely used videoconferencing program between 28 July and 22 October 2022, in the tertiary cardiac ICU of a university hospital. Nurses who had at least 1 year of cardiac ICU experience and actively participating in patient care were included. The COREQ criteria and checklist were followed in this investigation and the data were analysed by using the ATLAS.ti 8.0. Findings: Nurses reported that they experience challenges when mobilizing patients, such as patients' fear, reluctance or resistance; nurses having insufficient experience, strength or lack of team members. Despite these challenges, they highlighted some positive outcomes of mobilization, such as feeling happy, reinforced team communication and nurse–patient relationship. The nurses also suggested some facilitators, such as patient motivation and an explanation of the process. Conclusion: Nurses experience various patient-related and nurse-related challenges during the first out-of- bed mobilization of the patient after open-heart surgery. It is recommended that healthcare institutions should implement effective strategies to address the staffing shortages and to support nurse motivation to ensure adequate nursing care. Impact: This study provides valuable insights into the existing literature by examining the potential challenges and strategies of the first out-of- bed patient mobilization in the cardiac ICU. It shows that patient education and organizational adaptations are effective ways to overcome the challenges. It also suggests that motivating and informing patients before the mobilization can make the process easier. Moreover, it reveals that successful patient mobilization makes nurses happy, improves team communication and strengthens nurse–patient relationship. Patient and Public Involvement and Engagement: No patient or public contribution

Determining the Postoperative Pain Management Interventions of Nursing Students

Amaç: Tanımlayıcı nitelikte olan bu çalışma, hemşirelik öğrencilerinin ameliyat sonrası ağrı yönetimine ilişkin girişimlerini belirlemek amacıyla yapıldı.Yöntem: Çalışmada Eylül 2014-Ocak 2015 tarihleri arasını kapsayan ikinci dönem klinik uygulama süreci içerisindeki 73 hemşirelik bakım planı incelendi. Öğrenciler bu tarihler arasında Edirne'deki üniversite hastanesinin genel cerrahi servisinde ayda altı gün olmak üzere klinik uygulamada bulundu. Veriler, uygulama süresince öğrenciler tarafından tamamlanan hemşirelik bakım planları aracılığıyla toplandı.Bulgular: Öğrencilerin %61.6'sının bakım planında ağrı tanısı koyduğu saptandı. Ağrı yönetiminde öğrencilerin %55.5'i farmakolojik ve farmakolojik olmayan yöntemleri birlikte kullanmaktaydı. Farmakolojik yöntemi kullanan 34 öğrencinin %29.4'ünün hastasında ilacın etkisini ve %8.8'i ilacın yan etkisini gözlemlediği belirlendi. Farmakolojik olmayan yöntemi seçen öğrencilerin hepsinin hastasının rahat bir pozisyonda yatmasını sağladığı ve %55.5'inin hastasına televizyon seyrettirerek ve kitap okutarak dikkatini dağıtmaya çalıştığı saptandı.Sonuç: Çalışma sonucunda, öğrenci hemşirelerin ameliyat sonrası ağrı yönetiminde farmakolojik ve farmakolojik olmayan yöntemleri birlikte kullandıkları, farmakolojik yöntem ile ağrı kontrolünü sağlayan öğrencilerin ise uyguladıkları ağrı kesicinin etki ve yan etkilerinin değerlendirmesini yetersiz yaptıkları belirlendi. Bu doğrultuda öğrencilere, ağrı ve ağrının farmakolojik kontrolü içerisinde, ağrı kesicilerin yan etkilerine yönelik olarak da cerrahi hastasının ameliyat sonrası dönemde takip edilmesinin öneminin vurgulanması önerilmektedirAim: This descriptive study was carried out to determine the postoperative pain management interventions of nursing students.Methods: Data were collected from 73 second-year students' nursing care plans after they had received surgical nursing training in the main surgical ward of university hospital in Edirne, Turkey between September 2014-January 2015. This training took six days per month. Results: It was found that 61.6% of students used the nursing diagnosis &quot;pain&quot; and 55.5% used both pharmacological and nonpharmacological methods together for pain management. 29.4% of the 34 students who used pharmacological methods evaluated the effects and 8.8% of them checked the side-effects of the painkillers. Among the students who chose non-pharmacologic methods, all students repositioned their patients and 55.5% of the students tried to distract patients by having them watch television or read something. Conclusion: The results show that students used pharmacologic and non-pharmacologic interventions for postoperative pain management, but they rarely checked the effects and side-effects of the painkillers. It is recommended to teach students about the effects and side-effects of the painkillers according to the control of pain and pharmacological pain control of surgical patients after surgery

Patient Safety from a Different Perspective: An Evaluation of the Type of Foods and Drinks Visitors Bring for Postoperative Patients

Introduction: To introduce different types of foods and beverages visitors bring for postoperative patients. Materials and Methods: This descriptive study was conducted on 96 visitors of postoperative patients at Trakya University Hospital in Edirne, Turkey. Data were collected in face-to-face interviews (15 min) during visiting hours (02:00-04:00 p.m.) between August and September, 2015. The  questionnaire included 15 questions on demographic characteristics, patient/visitor relation, visitor's knowledge of the type of patient's surgery, date of surgery, and the onset of patient's oral intake, the selected foods and/or drinks, and cause of such selection. Results: Based on the findings, 72.9% of the visitors had brought food for the patients, and soup was the most frequently selected food type (25.7%); also, 41.4% of the visitors had brought the food the patient had requested. In total, 74% of the visitors had brought drinks, with fruit juice accounting for 63.4% of the selected beverages; also, 53.5% of the visitors had brought the drink the patient had requested. By comparing the type of foods and drinks with the type and date of surgery, it was revealed that some visitors had brought pastries and biscuits for patients undergoing gastrectomy on the first postoperative day. Conclusion: It is recommended to control and manage the type of food products visitors bring for the patients during visiting hours. Moreover, visitors should be instructed on how to select foods or drinks for the patients