Dilek Çilingir

Therapeutic Effects of Nurse Telephone Follow-up for Lung Cancer Patients in Turkey.

Background: Patients with lung cancer can encounter many difficulties as they adjust to the side effects of chemotherapy treatments. Objective: The aim of this study is to determine the therapeutic effects of nurse telephone follow-up for lung cancer patients. Methods: In this quasi-experimental study, the sample consisted of 60 patients with lung cancer assigned to an intervention group (n = 30) and a control group (n = 30). The control group participants were sequentially enrolled first and then the intervention group participants were enrolled. The data were collected using the Patient Information Form, Eastern Cooperative Oncology Group Performance Status, the Edmonton Symptom Assessment Scale, and the Functional Living Index–Cancer. The Nursing Care Guide was created by the nurse researchers’ team and given to both the intervention and control groups. Telephone follow-up calls were conducted with intervention patients within the first week after their chemotherapy session. The Kolmogorov-Smirnov, Pearson &khgr;2, Fisher exact, Mann-Whitney U, and Friedman test and descriptive statistics were used to evaluate the data. Results: Patients in the intervention group demonstrated significantly better adjustment to the symptoms secondary to chemotherapy and higher social functioning quality of life scores compared with reported scores in the control group. Conclusion: Nurse telephone follow-up can reduce chemotherapy-related symptoms for lung cancer patients and improve participants’ social functioning. Implications for Practice: Nurse telephone follow-up is an acceptable and feasible form of patient contact and is a convenient and efficient way to offer patients the support and continuity of care they need.

Evaluating ethical sensitivity in surgical intensive care nurses

Background and aim: Surgical intensive care nurses should have ethical sensitivity allowing them to identify ethical issues in order that they can recognize them and make the right decisions. This descriptive study was conducted with the aim of evaluating the ethical sensitivity of surgical intensive care nurses. Materials and methods: The research was carried out with the participation of 160 nurses in six Turkish hospitals, four state, one university, and one private. The data were collected using the “Nurse Description Form” developed by the researcher and the “Ethical Sensitivity Questionnaire.” The percent, mean, standard deviation, median, minimum and maximum values, significance test for the difference between two means, variance analysis, Mann–Whitney U test, and Kruskal–Wallis Variance Analysis test were used to evaluate the data. Ethical considerations: Ethical commission permission and the corporate permission of the hospitals were received before conducting the research. Results: It was determined that the ethical sensitivities of surgical intensive care nurses were moderate based on the Ethical Sensitivity Questionnaire total score and subdimension score averages. A statistical difference was determined between the Ethical Sensitivity Questionnaire total score of surgical intensive care nurses and the institution where they worked, the period of working in the occupation, and the period of working in the intensive care unit (p < 0.05). Conclusion: Based on the results of the research, the organization of training and studies devoted to the elimination of ethical sensitivity differences between institutions and workers is suggested.

Surgical Count Implementations in the Operating Rooms: An Examplefrom Turkey

Aim: Although retained foreign bodies are a rare and preventable problem, it is one of the medical errors in surgery can have heavy medico-legal consequences. Retained sponges can cause significant morbidity, prolonged hospital stay, postoperative complications, pain and disabilities. Also the costs associated with treatment of retained surgical items can be considerable. The study was undertaken to determine the current implementations related to instruments and sponges counts in the operating rooms in Turkey. Method: This descriptive study was carried out with 261 operating room nurses. The data collection tool was a questionnaire which was designed on the Google Drive application using the internet. Thereafter its internet link was distributed throughout Turkey using nursing, surgical nursing and operating room nursing social media websites; the answers were gathered in the same way. Results: Ninety-five percent of participants stated that instruments and sponges were usually counted by the scrub nurses (88.5%). Sponges (97.7%), pads (95.4%), tampons (89.2%), surgical instruments (88.1%) and needles (70.4%) were the items which were usually counted. According to 81.6% of the nurses, a written count protocol exists for their hospitals, however, they noted there was a significant difference in implementation among the various institutions (p=0.026). While 49.8% of participants stated that the count before surgery was done by nurses, 23.7% reported that the count was performed by operating room employees. Furthermore, 81.2% of the nurses noted that if the scrub nurses were replaced during surgery, the surgical count would be repeated. Nurses stated that last count was usually done just before applying skin sutures (72.7%), and if there were a problem with the count, radiological imaging would be done (73.5%) and the count irregularity would be signed by staff (31.0%). Conclusion: Our results demonstrated that because surgical counts were generally done by the scrub nurses, changing of scrub nurse have high risk for surgical count error. In addition, although most of the hospitals have a count protocol, a serious issue concerns the use of unprofessional hospital employees who carry out this task, thus jeopardizing patient safety to be operating room employess join the count are other problems related to surgical count. There is not any comprehensive research related to surgical instrument and material count in Turkey. The current study enables us to obtain information concerning surgical count protocol in the operating rooms in Turkey.

Reoperation and Nursing Care

Yeniden ameliyat olma (reoperasyon), ameliyata neden olan durumun tekrarlanması ya da komplikasyon nedeniyle hastanın yeniden ameliyata alınmasıdır. Ameliyat olan hastalar, ameliyat sonrası dönemde birçok sorunla karşılaşabilmektedir. Bu dönemde yaşanan sorunlar, hastayı olumsuz etkilemekte ve bazı durumlarda hastanın yeniden ameliyat edilmesi gerekmektedir. Bununla birlikte, ikinci kez ameliyat olan hastaların mortalite ve gelişebilecek komplikasyon oranları da artmaktadır. Hastanın ikinci kez ameliyat olmasına karar verilmesi sağlık çalışanı yönünden oldukça güç bir durumdur. Bireysel etmenler göz önünde bulundurularak kar-zarar ilişkisinin gözden geçirilmesi karar vermede etkili olmaktadır. Yeniden ameliyat olma riski taşıyan hastaların bulunduğu kliniklerde çalışan cerrahi hemşiresinin, uygulanacak girişimleri erken tespit edilebilmesi için klinik deneyim kazanmış olması gerekmektedir. Bu nedenle, cerrahi hemşiresi hastanın ameliyat öncesi dönemde öyküsünü doğru sorgulamalı, bireysel etmenleri değerlendirmeli, etkili hemşirelik bakımı uygulayarak yaşanan sorunların azaltılmasında ve komplikasyon yönetiminde etkin olmalıdır. Ayrıca ikinci kez ameliyat olan bireyin ameliyat sonrası taburculuğunun planlanmasında, cerrahi hemşiresinin riskleri bilmesi ve önlem alınacak durumları bireye iletmesi kaliteli iyileşmenin gerçekleşmesine katkı sağlayacaktır.