Gülay Altun Uğraş

The Effects of Open and Closed Endotracheal Suctioning on Intracranial Pressure and Cerebral Perfusion Pressure: A Crossover, Single-Blind Clinical Trial

ABSTRACT Although endotracheal suctioning is a routine nursing intervention, this procedure can lead to an increase in intracranial pressure (ICP). This study was planned to determine the appropriate suctioning technique (open system suctioning [OS] and closed system suctioning [CS]) to minimize variability of ICP and cerebral perfusion pressure (CPP) in neurologically impaired patients. The study, which was designed as a crossover, single-blind clinical trial, consisted of 32 neurosurgical patients who underwent ICP monitoring, intra-arterial blood pressure monitoring, and endotracheal intubation in the intensive care unit. According to the need for suctioning, each patient in the experimental and control groups underwent suctioning with both closed and open systems. Recordings were composed of the patients’ ICP, mean arterial blood pressure, CPP, heart rate (HR), and arterial blood gases during suctioning. It was observed that both suctioning techniques significantly increased ICP, mean arterial blood pressure, CPP, and HR; ICP was found to be significantly higher in OS compared with CS, whereas there were no significant differences in CPP and HR between the two techniques. The patients suctioned using OS had significantly lower mean PaO2 than those suctioned using CS; however, the comparison of the two techniques revealed no significant differences in PaCO2. The data obtained indicate that CS, compared with OS, can be used safely on this patient group.

Determination of Patient Learning Needs after Thyroidectomy

The purpose of this study was to determine discharge learning needs of patients undergoing thyroidectomy. The population of this descriptive study consisted of patients undergoing thyroidectomy in the Endocrine Surgery Unit of a university hospital between February and December 2013. The study included 251 patients who were discharged after thyroidectomy. Data obtained using the data collection form and the Patient Leaning Needs Scale (PLNS) were analyzed by frequency, mean, standard deviation, Kruskal Wallis and student-t tests. The mean age of the patients was 47.91±13.05 and 76.1% were females. The PLNS total mean score was 208.38±34.91, with the maximum score of 39.23±6.80 on the subscale of treatment and complications and the minimum score of 19.45±4.70 on the subscale of feelings related to condition. It was found that the PLNS total score of the patients was not influenced by age, gender, marital status (p>0.05). This study demonstrated that patients had high learning needs after thyroidectomy.

The effect of nocturnal patient care interventions on patient sleep and satisfaction with nursing care in neurosurgery intensive care unit.

ABSTRACT Background: Sleep disturbance in an intensive care unit is a common problem. One of the main factors causing sleep disturbances in an intensive care unit is nocturnal patient care interventions. Aims and objectives: This study aims to determine the impact of patient care interventions performed at night in a neurosurgical intensive care unit on patients’ sleep and their nursing care satisfaction. Methods: The descriptive study was conducted on 82 patients in a neurosurgical intensive care unit between January 2009 and March 2010. The data were collected by data collection instruments and Newcastle Satisfaction with Nursing Scales. The data were statistically analyzed by frequency, mean, standard deviation, chi-square, and Mann–Whitney U test. Results: The study showed that 53.7% of the patients experienced sleep disturbances in the neurosurgical intensive care unit. Because of nursing interventions at night, 39.1% of these patients had their sleep affected, but this problem did not cause any negative impact on the patients’ satisfaction (Newcastle Satisfaction with Nursing Scales score = 88.21 ± 9.83). The patients received, on average, 42.21 ± 7.45 times patient care interventions at night; however, the frequency of patient care interventions at night showed no effect on sleep disturbances in this study (p > .05). The most frequently given patient care interventions were, respectively, vital signs monitoring, neurological assessment, and repositioning in bed. These interventions were performed commonly at 6 a.m., 12 a.m., and 7 p.m. Conclusion: In this study, despite the patients reporting sleep disturbances in the neurosurgical intensive care unit because of nocturnal patient care interventions that prevented them from sleeping, the patients’ satisfaction on the given nursing care was not negatively impacted. To reduce sleep disturbances because of nursing care initiatives and promote uninterrupted sleep in the intensive care unit, it can be useful to develop new protocols regulating night care activities.

KULAK AMELİYATI GEÇİREN HASTALARIN EVDE BAKIM KONUSUNDA BİLGİLENDİRİLME DURUMU

Kulak ameliyati sonrasi hastalarin evde bakim konusunda bilgilendirilme durumunu belirlemek amaciyla tanimlayici olarak planlanan calisma, Istanbul’daki iki devlet hastanesinin Kulak Burun Bogaz Servislerinde, Temmuz-Ekim 2007 tarihleri arasinda mastoidektomi, timpanoplasti, stapedektomi ameliyati olan 117 hasta ile gerceklestirildi. Veriler, yuzdelik degerler ile belirtildi. Hastalarin yarisindan fazlasinin evde bakim konusunda bilgilendirildigi calismada, cogunlugunun bu bilgiyi hekimden aldigi, bilgi almak istenilen saglik profesyonelinin buyuk bir oranda hekim oldugu saptandi. Sozlu bilgilendirmenin yazili materyale oranla on plana ciktigi izlenen calismada, siklikla ilac kullanimi konusunda ve ameliyat sonrasi bir hafta/daha fazla bir sure boyunca basin islatilmamasi ve sac yikanmamasi, banyo yapilmamasi gerektigi hakkinda ve pansuman uygulamalarina iliskin bilgi verildigi saptandi. Bilgilendirildigini belirten hasta sayisi yaridan fazla olmakla birlikte, hastalara verilen bilginin literaturde onerilene oranla oldukca sinirli oldugu ve hastalara yazili materyal verilmedigi, hemsirelerden cok hekimlerin evde bakima donuk bilgilendirme surecinde daha aktif rol aldiklari izlendi.