Fundamentals of Nursing

Aim: The aim of the study was to investigate the effects of cold application on pain and bruising complications associated with subcutaneous heparin in intensive care patients. Design and method: The research was conducted as an experimental, post-test, double blind study in which each patient constituted their own control. It was performed with 60 patients receiving subcutaneous heparin treatment in the Anesthesia Intensive Care Unit. Cold application was performed on the patient"s right side abdominal region for two minutes each before and after the injection. Twenty-four hours later, an injection was performed on the left side of the abdominal region of the same patient without any cold application. The pain of the subcutaneous heparin injection was assessed at the time of the injection, and the size of bruises was measured 48 and 72 hours after the injection. Results: It was observed that the patients" total pain scores were significantly lower with the cold application intervention (z=-6.60, p=0.0001), and bruise size after 72 hours with cold application intervention was also significantly less than at 48 hours (z=-6.2, p=0.0001). The size of patients" bruises after 48 and 72 hours in the intervention without cold application was found to be greater ((z=-6.2, p=0.0001). Conclusions: It was found that two-minute cold application before and after subcutaneous heparin injections reduced pain score and the size of bruises 48 and 72 hours after heparin.

Introduction: Nurses face many legal and ethical issues while providing patient care and it is essential to understand the law and the way it affects the nursing practice. A study was conducted with the objectives to assess the knowledge on legal and ethical aspects in patient care among staff nurses, find out the association between level of knowledge and selected demographic variables and provide an awareness program on legal and ethical aspects inpatient care. Materials & Methods: A cross-sectional descriptive survey was carried out among 230 staff nurses working in critical care units. Data was collected by using demographic proforma and structured knowledge questionnaire on legal and ethical aspects in patient care. Result and conclusion: Only 10% of nurses had good knowledge and 77% had average knowledge. There was no significant association between level of knowledge and selected demographic variables. There is a need to improve the knowledge of staff nurses on legal and ethical aspects in patient care which will help to improve their critical thinking ability and decision making during legal and ethical issues.

Background: One of the soft skill competence in nursing is caring. Caring in nursing is a professional development component of nurse in hospital. By considering the fact that caring professional development had not been optimal yet for clinic nurses in the hospital, so a caring soft skills training was required as one of the method to improve carative caring nurses' skills. Methods: A quasi-experimental,pretest-posttest design without a control group was applied. The intervention consisted of the provision of material for 3 days, and training. Self-assessment nurse with CNPI (Caring Nurse-Patient Interactions Scale) was used. There are 53 nurses enrolled.This effect was analyzed by using General Linier Model test. Results: there are differences of carative factors before and after soft skills caring training with p<0,05. The highest increase in mean score of carative factors is environment (provision for a supportive, protective and/or corrective mental, physical, societal and spiritual environment). Carative factors that have not yet reached either category are factor 3 sensibility: Cultivation of sensitivity to one's self and to others, factor 6 Problem-solving: Systematic use of a creative problem-solving caring process and a factor of 10 Spirituality: Allowance for existential-phenomenological-spiritual forces Conclusions: soft skills caring training was proven effective in improving carative factors of nurses caring. This research recommended that soft skills caring training are commonly regarded to be an essential strategy for promoting caring nurses in nursing practices.

Objective: This study was conducted in order to determine the effects of music on vital signs and anxiety in hemodialysis patients. Method: This was randomized controlled (pre-test post-test) experimental study. In line with power analysis, a total of 46 patients who were receiving hemodialysis treatment were included in the study in two groups: 23 in the experimental group and 23 controls. The patients in the experimental group listened to music for 30 minutes during their treatment. The patients' vital signs and anxiety were evaluated before the application, and in the 30 th minute and 1 st , 2 nd , 3 rd and 4 th hours of hemodialysis. Results: No significant difference was found between the mean vital signs scores of the two groups for any of the times (p<0.05). In patients in the experimental group, it was seen that mean blood pressure in the 3 rd hour of hemodialysis (z=-2.265, p=0.024) and mean breathing rate in the 4 th hour of hemodialysis (z=-2.028, p=0.043) showed a statistically significant reduction. There was a statistically significant difference between the mean anxiety scores of the two groups of patients for all times (p<0.05). The mean anxiety score of the experimental group patients showed a statistically significant reduction in the 30 th minute of dialysis (z=-3.821, p= 0.000). Conclusion: The research findings show that music has a reducing effect on anxiety in hemodialysis patients.

Objective: Analyzing students' experiences about clinical practice will help instructors prepare learning settings where students can have more positive experiences. The purpose of this article is to identify nursing students' views regarding their clinical placement. Method: This descriptive study was conducted with fresher's in a nursing department of university during spring term of the 2014-2015 academic year in Ankara/Turkey. The data was collected with the question forms prepared by the researchers after the final exam of the "Fundamentals of Nursing Course". 253 students were provided questionnaires to answer, which were collected after completion. Results: Students mean age was 20.2; 85.4% of them were female and 40.3% of them choose this department for employment opportunities. Students evaluated professional competence and presence of nurses, as "Good" and "Very Good" (with 80% to 90%) and, communication between nurse and patient as "Moderate" and "Bad" (with 60%). Prejudices regarding clinical practice (with 38.7%), fear of making mistake (with 55.3%), prejudices toward clinical setting (with 58.5%), and grade anxiety (with 29.2%) were stated as factors that affect clinical learning negatively. Conclusion: Students' learning was affected by healthcare professions especially nurses, they worked with, instructors as well as some factors stem from themselves (fear of making a mistake, grade anxiety).

Patient falls are accepted as a significant problem of patient safety in health care institutions worldwide, and they appear to be among the most common reasons for secondary injury in hospitals. Falls may lead to such serious injuries as fractures, cuts or bleeding, which could in turn extend hospital stay, decreasing the functional capacity of the hospital and increasing health care costs. This research was conducted using descriptive and retrospective research design. The study was carried out in a 400-bed urban academic teaching hospital in the city of İzmir, Turkey. Information pertaining to patients aged over 65 (N=11702) (>24-hour stay) with a risk of fall according to the Fall Risk Scale was reviewed through electronic health records from January 1, 2015 through January 1, 2017. The patients who participated in the study aged between 65 and 99 and the mean age is 74.72 ± 6.79"dur. Fall records of the hospital over the last 2 years show that 23 (0.19%) patients experienced falls during their stay at the hospital. Two-thirds of the patients (69.8%) who fell sustained no injuries. Minor and major injuries were observed in 21.6% and 8.6% of the patients respectively. Majority of falls (74%) occurred in the patient"s room. In-patient falls in hospital soccur frequently, particularly in emergency rooms. Previo we studies have found similar characteristics of falls in relation to the location and consequences. However, the rate of falls we have found is much lower in comparison with previous studies. Also, falls can be devastating for hospitalized adults of older age, and it is important to identify high risk patients for better prevention.

İÇERİK
Giriş
Enfeksiyon Tipleri
Enfeksiyonun Klinik Bulguları
Enfeksiyon Hastalıklarında Süreç
Enfeksiyona Karşı Savunma Mekanizmaları
Doğal Savunma Mekanizmaları
Spesifik Savunma Mekanizmaları
Hücresel Bağışıklık
Humoral Bağışıklık
Enfeksiyon Kontrolü/Yönetimi
Sonuç
ÖĞRENME HEDEFLERİ
Enfeksiyon tiplerini tanımlama
Enfeksiyonun klinik bulgularına ilişkin örnek verme
Savunma mekanizmalarını açıklayabilme
Enfeksiyon kontrolüne ilişkin süreçleri tartışabilme
Anahtar Kelimeler
Enfeksiyon, epidemiyoloji, mikroorganizma, patojen, virülans, bağışıklık