İsmet Eşer

Effectiveness of a honey dressing for healing pressure ulcers.

Objective To compare the effect of a honey dressing vs an ethoxy-diaminoacridine plus nitrofurazone dressing in patients with pressure ulcers. Design This 5-week randomized clinical trial evaluated the effect of a honey dressing on pressure ulcer healing. Setting and subjects Thirty-six patients with a total of 68 stage II or III pressure ulcers referred from a university hospital in İzmir were enrolled in the study. Twenty-six subjects completed the trial. Instruments Ulcers were measured with acetate tracings and Pressure Ulcer Scale for Healing (PUSH) evaluations. Methods Fifteen patients with 25 pressure ulcers were treated with honey dressings, and 11 patients with 25 pressure ulcers were treated with ethoxy-diaminoacridine plus nitrofurazone dressings. Wound healing was assessed weekly using the PUSH tool, version 3.0. The primary outcome measure was the change in PUSH tool scores in each group at 5 weeks. Results The two groups were statistically similar with regard to baseline and wound characteristics. After 5 weeks of treatment, patients who were treated by honey dressing had significantly better PUSH tool scores than subjects treated with the ethoxy-diaminoacridine plus nitrofurazone dressing (6.55 ± 2.14 vs 12.62 ± 2.15, P < .001). Conclusion By week 5, PUSH tool scores showed that healing among subjects using a honey dressing was approximately 4 times the rate of healing in the comparison group. The use of a honey dressing is effective and practical.

Examination of Nursing Diagnoses Used by Nursing Students and Their Opinions About Nursing Diagnoses

PURPOSE This study was planned as a descriptive study for the purpose of determining what nursing diagnoses are used by nursing students and their opinions about nursing diagnoses. METHODS The response rate was 70% (n= 346). Research data about the nursing diagnoses students used and their opinions about them were collected on a semi-structured questionnaire developed by the researchers after reviewing related information in the literature. FINDINGS Of the students, 76.9% knew what nursing diagnosis was, but 31.5% had difficulty stating patient care needs as nursing diagnoses. CONCLUSIONS The majority of students in this study agreed that nursing diagnoses are a priority subject in the nursing profession, that nursing diagnoses needed to be used on the wards, and that nursing diagnoses needed to be documented in medical records on the wards. IMPLICATIONS FOR NURSING PRACTICE It is recommended that nursing diagnoses be given more concentration in the nursing curriculum and that courses about nursing diagnoses be prepared for the purpose of giving students more detailed information.

Effectiveness of polyethylene covers versus carbomer drops (Viscotears) to prevent dry eye syndrome in the critically ill.

AIM The purpose of this study was to compare the effectiveness of the polyethylene covers versus carbomer eye drops to prevent dry eye syndrome in intensive care unit patients. BACKGROUND Concerns about eye care for critically ill patients remain an issue. Few studies have focused on the effect of polyethylene covers and eye drops. In addition, there are no studies comparing polyethylene covers and carbomer eye drops for critically ill patients. DESIGN A prospective, randomised and contralateral eye study was conducted. METHODS The study took place in an intensive care unit in 2007. Thirty-six eyes of 18 patients, who were under mechanical ventilation or unconscious for more than 24 hours in the intensive care unit, were studied. After examining the eyes of the patients with the Schirmer 1 test and fluorescein dye test, suitable patients were included in the study. One eye of the patient was randomly covered with a polyethylene cover every 12 hours, and carbomer drops were instilled on the other eye every six hours. All eyes were checked for an ocular surface abnormality by the same ophthalmologist everyday. The study interventions were continued until a defect was detected or for five days. Patients with a defect detected completed the study and were recorded as positive for the primary endpoint. Results.  Carbomer drop was effective in prophylaxis of dry eye syndrome in only three of 18 patients, whereas polyethylene cover showed greater effect in 18 of 18 eyes at the end of the study (SD 0·3835, Z = -3·873, p < 0·001). A negative effect of greater rima palpebra in the resting position was observed in the efficacy of carbomer drop (r = -0·476, p < 0·05). CONCLUSION This study suggests that a polyethylene cover is significantly effective in prevention of dry eye syndrome in intensive care patients. As an eye care intervention, the effectiveness of polyethylene cover should be supported by further studies. RELEVANCE TO CLINICAL PRACTICE This study, which is an initial step in preventing dry eye syndrome in critically ill patients, also offers a new and effective eye care method in these patients.

The Effect of Abdominal Massage on Gastric Residual Volume: A Randomized Controlled Trial

This study is a randomized controlled trial aimed at determining the effects of abdominal massage on high gastric residual volume seen in patients intermittently fed with enteral nutrition through a nasogastric tube. The study also investigated consequent abdominal distension and vomiting complications. The study was carried out in a university hospital between January and December 2009. The sample included 40 intervention (abdominal massage) and 40 control subjects. Findings demonstrated that 2.5% of the subjects in the massage group and 30.0% of the subjects in the control group developed high gastric residual volume from enteral nutrition through a nasogastric tube. Abdominal circumference measurements of subjects on the first and last days demonstrated that 20% of the subjects in the control group and only 2.5% of the subjects in the massage group developed abdominal distension (p = .044). Vomiting was observed in 10% of the control subjects; no vomiting was observed in the intervention group. Findings suggest that nurses should apply abdominal massage to subjects receiving enteral feedings intermittently to prevent high gastric residual volume and abdominal distension.

Impact of heparin locking frequency on preventing temporary dialysis catheter dysfunction in haemodialysis patients.

A prospective analysis was conducted comparing dysfunction attributable to catheter thrombosis in subjects who received a heparin catheter lock three times a week (n = 15) to those who received a heparin lock six times a week (n = 15) immediately after the insertion of a temporary haemodialysis catheter. Thrombus related catheter removal occurred in two patients in control but no patients in the experiment group. Heparin locking six times a week was found to be effective in prolonging the mean of the first day where difficulty was experienced in aspiration. It also prevented any possible difficulty in catheter flushing. Increased locking frequency prevents any thrombus accumulation within the temporary catheter, while it has limited but significant preventive effect on thrombus accumulated around the catheter.

Effects of Reiki on Post-cesarean Delivery Pain, Anxiety, and Hemodynamic Parameters: A Randomized, Controlled Clinical Trial

The aim of this study was to investigate the effect of Reiki on pain, anxiety, and hemodynamic parameters on postoperative days 1 and 2 in patients who had undergone cesarean delivery. The design of this study was a randomized, controlled clinical trial. The study took place between February and July 2011 in the Obstetrical Unit at Odemis Public Hospital in Izmir, Turkey. Ninety patients equalized by age and number of births were randomly assigned to either a Reiki group or a control group (a rest without treatment). Treatment applied to both groups in the first 24 and 48 hours after delivery for a total of 30 minutes to 10 identified regions of the body for 3 minutes each. Reiki was applied for 2 days once a day (in the first 24 and 48 hours) within 4-8 hours of the administration of standard analgesic, which was administered intravenously by a nurse. A visual analog scale and the State Anxiety Inventory were used to measure pain and anxiety. Hemodynamic parameters, including blood pressure (systolic and diastolic), pulse and breathing rates, and analgesic requirements also were recorded. Statistically significant differences in pain intensity (p = .000), anxiety value (p = .000), and breathing rate (p = .000) measured over time were found between the two groups. There was a statistically significant difference between the two groups in the time (p = .000) and number (p = .000) of analgesics needed after Reiki application and a rest without treatment. Results showed that Reiki application reduced the intensity of pain, the value of anxiety, and the breathing rate, as well as the need for and number of analgesics. However, it did not affect blood pressure or pulse rate. Reiki application as a nursing intervention is recommended as a pain and anxiety-relieving method in women after cesarean delivery.

Nursing diagnoses in patients having mechanical ventilation support in a respiratory intensive care unit in Turkey

This research was carried out to find out the nursing diagnoses in patients who have mechanical ventilation support in a respiratory intensive care unit. The study was conducted with 51 evaluations of critically ill adult patients who underwent invasive and non-invasive mechanical ventilation therapy in 2008. Data collection was based on Gordons 11 Functional Health Patterns, and nursing diagnoses were determined according to North American Nursing Diagnosis Association-International (NANDA-I) Taxonomy II. The nursing diagnoses were determined by two researchers separately. The consistency between the nursing diagnoses defined by the two researchers was evaluated by using Cohens kappa (κ). Forty men (78.4%) and 11 women (21.6%) whose mean ages were 70.19 (SD = 8.96) years were included in the study. Nineteen subgroups of nursing diagnoses about safety/protection domain, and 15 subgroups about activity/rest domain were seen at different rates in the patients. There was a statistically significant difference between mechanical ventilation via tracheostomy or endotracheal tube and decreased cardiac output (d.f. = 1, χ(2) = 4.760, P = 0.029). The relationship between the length of time under mechanical ventilation and impaired physical mobility was considerably significant (d.f. = 3, χ(2) = 24.459, P = 0.000). It was found out that there was a high degree of agreement (96.8%) between the nursing diagnoses defined by the two researchers separately (κ = 0.936, SE = 0.08).

An examination of the effect of castor oil packs on constipation in the elderly.

This research, conducted at two rest homes in Manisa, Turkey, was undertaken to examine the effect of castor oil pack (COP) administrations on constipation in the elderly. Study participants were monitored for 7 days before, 3 days during, and 4 days after COP administration utilizing the Recall Bias and Visual Scale Analog (RB-VSAQ) as well as the Standard Diary developed by Pamuk et al. Wilcoxon Signed Ranks, Repeated Measures, Bonferroni, and Mann-Whitney U tests were used for data analysis. Eighty percent of study subjects had been constipated for 10 years or longer. COP administration did not have an effect on the number of bowel movements or amount of feces, but decreased the feces consistency score, straining during defecation and feeling of complete evacuation after a bowel movement, thus decreasing symptoms of constipation. We conclude that COP may be used for controlling symptoms of constipation.

Intensive Care Nurses’ Views and Practices for Eye Care: An International Comparison:

Eye care is an important area of critical care. However, lack of eye care studies is a common issue across the globe. The aim of this study is to determine the views and practices of intensive care unit (ICU) nurses on eye care in Turkey and Palestine. This descriptive study was conducted using a self-administrated questionnaire. The data were collected from 111 nurses in nine kinds of ICUs in two education hospital. Normal saline (75.9%) was the most commonly reported solution for eye hygiene among the Palestinian nurses, and gauze soaked in normal saline or sterile water (64.3%) were the most frequently used supplies by the Turkish nurses. Although both Palestinian and Turkish ICU nurses took some precautions to prevent eye complications in critical patients, there were some gaps and insufficiencies in the eye care of ICU patients. There is a need for continuing training in this area.

Ethical Decision Making Levels of Nursing Students

Objective: The present study was conducted to determine nursing students’ levels of ethical decision-making. Methods: The sample of the descriptive study consisted of 240 nursing students. The data were collected using the Student Information Form and “Nursing Dilemma Test”. Results: It was found that Principled Thinking (PT) mean score (48.38±7.97) of nursing students was above average while their Practical Consideration (PC) mean score (17.87±4.13) was close to average. It was also determined that the nursing students participated in the study were not familiar (17.75±2.77) with the dilemmas included in the Nursing Ethical Dilemma Test. Conclusion: The students paid attention to consider ethical principles when making decisions about ethical dilemmas; however, they are also affected by environmental factors as well. Sex and class level were found to be influential in the process of ethical decision making.