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Yayın Ameliyat Kaynaklı Basınç Yaralanmalarını Önlemede Etkili Kanıt Temelli Girişimler(2021) Yüksel, Serpil; Kandemir, DidemCerrahi girişim geçiren hastalar, basınç yaralanmaları açısındanyüksek risk altındadır. Özellikle uzun süren cerrahi girişimlersırasında basıncın etkisiyle dokuda oluşan değişim, ameliyat sonrası3-7. günlerde ciddi basınç yaralanmaları ile sonuçlanabilmektedir.Bu derlemede, ameliyat kaynaklı basınç yaralanmalarını önlemedeetkili kanıt temelli girişimleri literatür ışığında tartışmak amaçlandı.Derlemede, elektronik veri tabanları taranarak elde edilen, 2006-2020 yılları arasında yayınlanmış, tam metnine ulaşılabilen,ameliyat kaynaklı basınç yaralanmaları ile ilgili çalışma ve rehberlerincelendi. Ameliyat sırasında basınç yaralanması oluşma sıklığı%1.3-51 arasında değişmekte olup, tüm hastane kaynaklı basınçyaralanmalarının %45’ini oluşturmaktadır. Ameliyat kaynaklı basınçyaralanmalarını önlemede etkili kanıt temelli girişimler; riskdeğerlendirmesi, pozisyon verme, koruyucu örtü ve destek yüzeykullanımı başlıkları altında ele alınmıştır. Bu yaralanmaları önlemekamacıyla öncelikle uzun ameliyat süresi, hipotermi ve hipotansifataklar gibi basınç yaralanması riskini artıran faktörlerbelirlenmelidir. Ameliyat masasında, basıncı dağıtan destekyüzeyler kullanılmalıdır. Ameliyat sırasında hastaya basınçyaralanması riskini azaltacak şekilde pozisyon verilmeli ve topuklarelevasyona alınmalıdır. Gerekirse, topuk süspansiyon cihazlarıkullanılmalıdır. Ameliyat sonrası dönemde mutlaka ameliyatsırasında verilen pozisyondan farklı bir pozisyon verilmelidir. Sonuçolarak, ameliyat kaynaklı basınç yaralanmalarını önlemede, bireyselve cerrahi girişim ilişkili risk faktörlerinin dikkatle değerlendirilmesive önleme girişimlerinin bu faktörler ve kanıt temelli girişimlerdikkate alınarak planlanması önemlidir.Yayın Ameliyathane Hemşirelerinde Kas İskelet Sistemi Ağrılarının İncelenmesi(2019) Karaman, Ahmet; Uğraş, Gülay Altun; Öztekin, Seher Deniz; Kandemir, DidemAmaç: Bu araştırmanın amacı ameliyathane hemşirelerinin deneyimle- diği kas iskelet sistemi ağrılarını belirlemektir. Yöntem: Tanımlayıcı tipte yapılan araştırma, Haziran-Ekim 2015 ta- rihleri arasında 162 hemşire ile gerçekleştirildi. Veriler, bireysel özel- likler formu ile Genişletilmiş Nordic Kas İskelet Anketi kullanılarak toplandı. Verilerin analizinde tanımlayıcı istatistikler (frekans, ortala- ma ve standart sapma), Ki-kare ve Mann Whitney U testleri kullanıldı. Bulgular: Çalışmaya katılan ameliyathane hemşirelerinde görülen kas iskelet sistemi ağrılarının %56.8’inin sırt, %51.9’unun bel ve %49.4’ünün boyun bölgesinde olduğu; bunları sırasıyla omuz (%43.2), ayak/ ayak bileği (%38.3) ve diz (%31.5) bölgelerinin izlediği görüldü. Ameliyathane hemşirelerinin %88’inin son bir yılda, %79.3’ünün son bir ayda ve %57.6’sının son bir haftada en sık yaşadığı ağrının sırt ağ- rısı olduğu saptandı. Ameliyathanede yaş ortalaması düşük ve haftalık çalışma süresi yüksek olan hemşirelerde kas iskelet sistemi ağrılarının daha fazla görüldüğü belirlendi (p<0.01). Sonuç: Ameliyathane hemşirelerinde en fazla görülen kas iskelet sis- temi ağrılarının sıklıkla sırt, bel ve boyun bölgelerinde olduğu belir- lendi. Kurumlar tarafından çalışanların kas-iskelet sistemi sorunlarının belirlenmesi, ağrı nedenlerini önlemeye yönelik kurum politikalarının oluşturulması ve uygulamaya geçirilmesi önerilir.Yayın Analysis of mental health symptoms and insomnia levels of intensive care nurses during the COVID-19 pandemic with a structural equation model(Wiley, 2021) Kandemir, Didem; Temiz, Zeynep; Özhanlı, Yasemin; Erdoğan, Hatice; Kanbay, YalçınBackground: Faced with this critical situation and directly involved in the treatment and care of COVID-19 patients, front-line healthcare workers are at high risk in terms of mental health symptoms. Aims and Objectives: To determine the stress, anxiety, depression, and insomnia levels of intensive care nurses during the pandemic with a structural equation model. Design: A multi-site survey study. Methods: The study was performed with 194 nurses working in the intensive care units of five hospitals in Istanbul in July 2020. Data were collected using the Depression Anxiety Stress-21 Scale and Insomnia Severity Index electronically. The data were evaluated with descriptive statistics in SPSS package program. In order to test the structural model and hypotheses of the research, path analysis was performed with LISREL statistical software program. A validation study for the suitability of these scales to the study sample was done by the researchers using the confirmatory factor analysis method. The study conforms to the TREND checklist. Results: In this study, the majority of the intensive care nurses had moderate to extremely severe depression (65.5%), anxiety (58.3%) and stress (72.3%) scores; in addition, 39.7% of the nurses experienced moderate or severe insomnia. Within the framework of a structural model; the effects of stress, anxiety and insomnia on depression, which is the dependent variable, were found to be statistically significant (p < .001). Conclusions: It was found that the majority of the intensive care nurses fighting COVID-19 on the front-line experienced stress, anxiety, depression and insomnia at levels ranging from moderate to extremely severe; in addition, it was determined that there is a positive relationship between stress, anxiety, insomnia and depression. Relevance to clinical practice: This study, in which we have determined the mental health symptoms and insomnia levels of intensive care nurses, who are in the frontline during the COVID-19 pandemic, constitutes the scientific basis for the effective coping strategies that the authorities will take in this subject.Yayın The Effect of Reflexology on Low Back Pain in Operating Room Nurses(Lippincott Williams & Wilkins, 2022) Kandemir, Didem; Abdullayev, Ayşegül; Ak, Ezgi Seyhan; Ugras, Gülay Altun; Kanan, NevinOperating room nurses often face acute or chronic back and low back pains, shoulder and neck injuries. In recent years, the use of complementary and alternative treatment methods has been increasing due to the fact that pharmacological treatment cannot control the pain in general, and its various side effects and cost. The aim of this study was to investigate the effect of foot reflexology on low back pain of operating room nurses. This quasiexperimental study was conducted with 38 operating room nurses. The nurses in the experimental group were given a 30-minute reflexology protocol once a week for 4 weeks and their pain levels were assessed again at week 5. The control group nurses did not receive any intervention. Data were collected using a demographic information form and a visual analog scale (VAS). The low back pain of the nurses in the reflexology group decreased significantly at week 5 compared with week 1, whereas the severity of low back pain of the nurses in the control group did not change between weeks 1 and 5. There were no statistically significant differences between the groups in terms of the mean VAS pain score at week 1. However, the nurses in the reflexology group had significantly lower VAS pain mean scores at week 5 than the control group. In this study, reflexology significantly reduced the pain of nurses who had low back pain. Therefore, reflexology might be useful in controlling low back pain of operating room nurses.Yayın How effective is reflexology on physiological parameters and weaning time from mechanical ventilation in patients undergoing cardiovascular surgery?(ELSEVIER SCIENCE INC, 2019) Kandemir, Didem; Oztekin, Seher DenizIntroduction: Cardiovascular disease is one of the leading causes of morbidity and mortality in both developed and developing countries. The present research was designed to determine the effects of reflexology on physiological parameters and mechanical weaning (MV) weaning time. Methods: In this non-randomized controlled clinical trial, 85 patients who underwent open heart surgery were allocated into either an experimental group (n = 42) or aut control group (n = 43) using convenience sampling. The participants were informed about the study and a written and oral informed consent was obtained from each patient. Along with the study, a twenty-thirty-minute foot reflexology and routine care treatments were applied to the patients in the experimental group and control group, respectively in the post-operative period. In this context, physiological parameters and mechanical ventilation weaning time of the patients were examined at certain intervals. Results: According to the values obtained before reflexology for experimental and control group, the pulse rate (p = 0.013) and diastolic blood pressure (p = 0.021) of the patients in the experimental group at 5 min before reflexology were significantly higher. Moreover, oxygen saturation values of the patients in the experimental group at 5 min after extubation were lower (p = 0.012). However, reflexology did not exhibit any significant changes in other physiological parameters but the mechanical ventilation weaning time after reflexology was shorter in the experimental group (p = 0.023). Conclusion: Reflexology did not have a significant effect on physiological parameters in patients receiving mechanical ventilation support. Shortening the weaning time from mechanical ventilation suggests that it might be applied effectively in patients receiving mechanical ventilation support in intensive care unit.Yayın Nöroşirürji Yoğun Bakım Ünitesinde Travmatik Beyin Yaralanması Sonrası Vücut Sıcaklığının Korunması ve Yönetimi(2018) Ak, Ezgi Seyhan; Kandemir, Didem; Akyolcu, NerimanBeyin işlevlerinin, kafaya alınan bir darbe, penetran yaralanma veya bir sarsıntı ile bozulması olarak tanımlanan travmatik beyin yaralanması, günümüzde travmaya bağlı ölümlerin yarıdan fazlasını oluşturan, yüksek morbidite ve mortalite oranları ile yaşamı tehdit eden önemli bir sağlık sorunu olarak değerlendirilmektedir. Travmatik beyin yaralanması sonrası beyin ödemi gelişen hastalarda, hiperterminin oksijen gereksiniminin artması, Glasgow Koma Skalası skorunun azalması, nörolojik fonksiyonların zayıflaması ve yoğun bakım ünitesinde kalış süresinin uzamasını içeren birçok olumsuz sonuç ile ilişkili olduğu vurgulanmaktadır. Beyin hasarı sonrası, yüksek ateşin oluşturabileceği kafa içi basınç artışına bağlı gelişebilecek ikincil hasarları önleyebilmek amacıyla travmatik beyin yaralanması olan hastanın bakımında, hemşirenin temel rol ve sorumluluklarından biri olan ateş kontrolünün sağlanması ve normal vücut sıcaklığının sürdürülmesi önemli bir bakım girişimidir. Standart hipertermi yönetimi, antipiretik ilaç tedavisi ve yüzeysel/eksternal soğutma (soğutma battaniyeleri, buz paketleri vb.) ve endovasküler soğutma yöntemlerini kapsar. Titreme, metabolik gereksinimi ve dinlenme anında enerji harcamasını arttırdığı; yanı sıra beyin dokusunun oksijenizasyonunu azalttığı ve sedasyon gereksinimini arttırdığı için ateş kontrolünde sürekli değerlendirilmeli, koruyucu önlemler alınmalı, gerektiğinde ilaç tedavisi uygulanmalıdır. Bu derlemenin amacı kafa içi basıncı etkileyen ve artışına neden olan hipertermiyi literatür ışığında açıklayarak, nöroşirürji yoğun bakım ünitesinde çalışan hemşirelere güncel öneriler doğrultusunda rehberlik etmektir.Yayın Operating Room Nurses? Knowledge of and Attitudes About Pressure Injury Prevention: A Descriptive Cross-Sectional Study(Hmp, 2022) Kandemir, Didem; Özhanli, Yasemin; Erdoğan, Hatice; Temiz, ZeynepBACKGROUND: Understanding nurses' knowledge and attitudes might be important in influencing their behaviors of complying with pressure injury prevention measures in the operating room. PURPOSE: The aim of this descriptive and cross-sectional studywastodetermineoperating room nurses'knowledgeand attitudes about pressure injuryprevention. METHODS: This studywas performed with 174 nurses working in theoperating rooms of5 hospitals in Istanbul between July and October 2020. The data were collected with the Modified Pieper Pressure Ulcer Knowledge Test-MPPUKT and Attitude Towards Pressure Ulcer Prevention Instrument-APuP and analyzed with parametric and nonparametric tests using the SPSS 20.0 package program. The statistical significance level was accepted as P < .05. RESULTS: The total mean score of the MPPUKT of the operating room nurses was 32.72 +/- 6.65, and the knowledge level of only 57.5% of the nurses was considered sufficient (MPPUKT score >= 70%); the total mean score of the APuP was 44.67 +/- 3.10, and almost all (94.8%) had a satisfactory attitude (>= 75%). In addition, there was a significant positive correlation between the knowledge and attitudes of the operating room nurses about pressure injury prevention (P = .000). CONCLUSION: This study has shown that the knowledge level of the operating room nurses was weak and their attitudes were satisfactory. It is recommended to improve the knowledge and attitudes of operating room nurses to prevent pressure injuries through effective in-service training programs.Yayın The Opinions and Practices of Nursing Students About Preoperative Patient Safety(ISTANBUL UNIV, FAC NURSING, 2019) Ak, Ezgi Seyhan; Kandemir, Didem; Ayoglu, Tuluha; Ayhan, Medine KubraAim: This study was conducted to examine the opinions and practices of sophomore nursing students about preoperative patient safety. Method: This descriptive study was conducted from November 2016 to April 2017 by attendance of 219 sophomore nursing students who are practicing in the surgery departments of two university hospitals and meet the criteria of the study. For collection of data, the data collection form was used, which has been developed by the researchers in line with the literature and includes two parts. The necessary institutions and ethics committee permits were obtained before starting the research. Descriptive statistics and chi-square test were used for data analysis. Results: It was found out that the average age of the attending students was 20.29 +/- 1.65 (years) and 50.2% of them have chosen the profession because of high employment opportunity. It was found that, of the students, 33.8% have taken lesson for patient safety and 26.9% have participated in training events such as seminars, courses, etc. about patient safety. When the situation of carrying out the preoperative patient safety practices by them, it was found that the first three preoperative practices carried out by the students attended the study were measurement of vital signs, checking patient identification and verification of the operation site respectively. Conclusion: In this study, it was found out that the majority of students did not participate in any training program for preoperative patient safety; however, they performed some applications for patient safety. In line with these results, it can be suggested to increase the knowledge of preoperative patient safety practices by organizing training activities for patient safety and by ensuring the participation of students in these activities and comparing the information and application levels of the larger sample groups with all classes.
