Nursing
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Article The Effect of a Light-Dark Cycle on Premature Infants in the Neonatal Intensive Care Unit: A Randomized Controlled Study(Journal of Pediatric Nursing, 2024-05-09) Olgun, Ayşe Betül; Yüksel, Didem; Yardımcı, FigenPurpose To investigate potential differences in discharge time, feeding methods and amounts, daily weight gain, vital signs, pain, and comfort levels among preterm infants born at 28–32 weeks' gestation who were hospitalized in the neonatal intensive care unit during long-term follow-up while implementing a light-dark cycle. Design and methods This is a randomized controlled study conducted with the support of a day-night cycle in premature infants born at 28–32 weeks' gestation and admitted to the neonatal intensive care unit of a teaching and research hospital affiliated with the Ministry of Health. The study compared the follow-up results from hospitalization to discharge over a period of 8 weeks. Results 50% of premature infants admitted to the unit are multiple pregnancies. There was no significant difference in discharge weight, comfort level, pain level, vital signs of the infants included in the study (p > 0.05). The optimal development of infant feeding patterns was examinedand it was observed that the study group had significantly improved before the control group in terms of the time to switch to full enteral feeding and oral feeding (p < 0,05). The daily weight gain of the babies was examined, it was seen that the weight gain was higher in the study group compared to the control group (p < 0,05). The mean duration of hospitalization was compared, it was seen that the babies in the study group were discharged significantly earlier (p < 0,05). Conclusion The study compared the long-term outcomes of premature babies hospitalized in neonatal intensive care and babies exposed to a light-dark cycle and regularly monitored in standard care. The results showed that the babies in the study group had higher daily weight gain and were discharged earlier than the control group. There were also no statistically significant differences in comfort and pain scores, vital signs or oxygen saturation between the study and control groups. Practice implications A light-dark cycle was found to be a feasible and promising intervention for infants at 28–32 weeks' gestation. It was a nurse-led management of care that could be integrated into the usual care of 28–32-week-old babies in neonatal units.Article The effect of knowledge levels of intensive care nurses about pressure injuries on their attitude toward preventing pressure injuries(Journal of Tissue Viability, 2023-08-31) Korkmaz, Serap; Sönmez, Münevver; Gürlek Kısacık, ÖznurAim: The aim of this study was to determine the current knowledge levels of intensive care nurses about pressure injuries and their attitudes toward preventing pressure injuries, and to reveal the relationship between these variables. Materials and Methods: This descriptive cross-sectional study was conducted with 152 nurses, working in the Adult Intensive Care Units of a Training and Research Hospital. Data were collected between 10.08.2021 and 31.11.2021 with the Patient Information Form, Modified Pieper Pressure Ulcer Knowledge Test and Attitude toward Pressure Injury Prevention Scale. Frequency analysis, descriptive statistics, multiple logistic regression analysis and the structural equation modeling technique were used in the analysis of the study data. Results: The mean age of the nurses was 25.82±3.42 years, 86.2% of them were female and 67.1% of them had a bachelor’s degree. Total mean score of the Modified Pieper Pressure Ulcer Knowledge Test of the intensive care nurses was found to be 32.58 ±6.58. The knowledge score of 113 out of 152 nurses was ≥60% or above. The total mean score of the Attitude toward Pressure Injury Prevention Scale was 42.00±5.70 and a total of 76.97% (117 participants) of them were found to score 75% or above on the scale. The results of the regression analysis showed that educational degree, and status of having training about pressure injuries did not affect the total mean score of the Knowledge Test and the Attitude Scale. However, it revealed that the frequency of encountering a patient with pressure injuries in the unit where they work has affected the total mean score of the scales significantly (p< 0.05). As per the results of the structural equation model, the Modified Pieper Pressure Ulcer Knowledge Test scores of the nurses were found to have a statistically significant effect on the scores of the Attitude toward Pressure Injury Prevention Scale (p<0.05). Conclusion: This study revealed that intensive care unit nurses had a positive attitude toward Pressure Injury Prevention and their knowledge was sufficient and that as the Modified Pieper Pressure Ulcer Knowledge Test scores increase, their positive attitude toward Pressure Injury Prevention also increases.Article Incidence of medical device-related pressure injuries in the intensive care unit and related risk factors(Journal of Tissue Viability, 2023-11) Aydım Kudu, Aslıhan; Taşdemir, Nurten; Sönmez, MünevverAim At present, physicians employ medical devices extensively in the treatment of numerous diseases and in the care and follow-up of patients. However, these medical devices are a potential cause of pressure injuries.The study aimed to investigate the incidence and affecting risk factors of medical device-related pressure injuries (MDRPIs) in an adult intensive care unit. Materials and methods This is a longitudinal descriptive/analytical and cross-sectional study. The researchers conducted this study with 213 intensive care patients between 15.06.2021 and 15.12.2021. The skin and mucosa under and around each medical device were observed once a day for MDRPIs during the stay of patients who had been hospitalized in the intensive care unit for at least 24 h. The data were collected using Patient Information Form developed by the researchers based on the literature, Medical Device-Related Pressure Injury Monitoring Form, the Jackson/Cubbin Pressure Area Risk Calculator (Jackson/Cubbin BARHATr)-Turkish Version, the National Pressure Injury Advisory Panel (NPIAP) Pressure Injury Staging System and the Glasgow Coma Scale. Results The incidence of MDRPIs was 28.6% (61/213). The study revealed that 48.4% (46/95) of these injuries were caused by medical devices for respiratory system, 26.3% (25/95) by devices for gastrointestinal and genitourinary system. The study also revealed that 70.5% of MDRPIs occurred on the skin and 29.5% on the mucosal membrane, and that 82.1% of the MDRPIs occurring on the skin were at Stage 1. In terms of anatomical location, 21.1% of these injuries developed on the fingers and 13.7% on the mouth/lip. In multivariate analysis, parenteral + enteral (p = 0.006, OR = 0.083, 95%CI = [0.014–0.497]) and oral nutrition (p = 0.037, OR = 0.210, 95%CI = [0.049–0.908]), a higher number of devices (nine or more) (p = 0.002, OR = 5.387, 95%CI = [1.840–15.772]) and the duration of device wear (p < 0.05) were identified as independent risk factors for the occurrence of MDRPIs. Conclusions The study showed that the incidence of MDRPIs was relatively high and was associated with various factors. It is critical for intensive care nurses, who encounter MDRPIs more frequently, to consider these factors while caring for their patients and to take appropriate preventive measures to reduce the incidence of these injuries.