Suzan Yıldız

Effect of two different feeding methods on preventing ventilator associated pneumonia in the paediatric intensive care unit (PICU): A randomised controlled study

BACKGROUND For infants and children who require intubation in the paediatric intensive care unit (PICU), ventilator-associated pneumonia (VAP) is a significant cause of secondary morbidity and mortality linked with extended use of intubation. Nurses are primarily responsible for the prevention of VAP and there are a number of procedures that contribute towards this end. Although enteral nutrition has been reported to be effective in the prevention of VAP, this remains controversial. OBJECTIVE To compare and evaluate the effects of intermittent feeding through a nasogastric catheter with those of continuous feeding through a nasoduodenal catheter in preventing VAP in the PICU. DESIGN The research design was a randomised, controlled experimental study. METHODS Forty paediatric patients were randomised and divided into two groups of 20: one group for nasoduodenal (ND) feeding and the other for nasogastric (NG) feeding. Patients were assessed for the development of VAP using the clinical pulmonary infection score and Centers for Disease Control and Prevention criteria while working in accordance with the VAP prevention bundles introduced within the unit. RESULTS The incidence of paediatric VAP was 15%. The rate of VAP in patients who were ND fed was 10%, whereas the rate of VAP in patients who had NG feeding was 20%. No statistically significant difference was observed between the ND- and NG-fed patients (p=0.661). CONCLUSION Although the results of our study were not statistically significant, nasoduodenal feeding helped to reduce the incidence of VAP.

Turkish Validation of the Infiltration Scale in Infants

Purpose To test the validity and reliability of an infiltration scale in infants that was adapted for the pediatric population. Design and methods The present study is an observational prospective study. The study was conducted in a NICU of a training and research hospital in Istanbul. Data were obtained from131 infants who were <4 kg. Language validity of the scale was tested by expert linguists. The comments of fourteen experts were taken for content validity. For reliability testing, three observers independently evaluated the scale. Results Infiltration developed in 28.72% of infants who were examined and grade 2 infiltration was detected at rate of 58%. The content validity index of the scale was 0.93. The Cronbachs alpha was calculated as 0.96 in the agreement of the three observer nurses’ evaluations. A highly significant association was detected between the coherence of Cohens kappa values and Intra‐Class Correlation coefficient (ICC) (p < 0.01). Conclusions The infiltration scale is a valid and reliable scale in infants. The validity and reliability of the scale has been verified and may be used in the identification of infiltration in infant gestational age between 24 and 39 weeks and weighing <4 kg. Practice Implications The infiltration scale for infants is a valid and reliable tool for monitoring catheter sites in the prevention of complications such as infiltration due to PIV therapy practices in neonatal intensive care units. HighlightsHourly evaluation of the catheter insertion site in infant using a valid and reliable infiltration scale has great importance.The Infiltration Scale’s use in infants weighing less than four kilograms will help to identify infiltration.Treatment and care could be planned in accordance with infiltration severity, thus improving the quality of care.

ACİLE BAŞVURAN ÇOCUK VE AİLEYE PSİKOSOSYAL YAKLAŞIM

Bu derleme acil hastaligi nedeniyle acil unitelerine basvuran cocugun ve ailesinin psikososyal ve emosyonel yonlerini incelemektedir. Cocuk acil unitelerinde yatan cocuklarin etkilendigi stresorleri, bu stresorlere karsi cocuk ve ailenin tepkilerini; olayla basedebilmelerini, korkularini, agriya karsi reaksiyonlarini, caresizliklerini, olumu algilamalarini ve gereksinimlerini icerir. Bu unitelerde calisan hemsirelerin bakim sirasindaki rolleri konusunda bilgi verir.