No abstract

Pain is a stressor for intensive care unit (ICU) patients, and inadequate pain assessment has been linked to increased morbidity and mortality. One hundred and twenty patients were evaluated during three periods: (T1) 1 min before, (T2) during, and (T3) 20 min after the nociceptive procedure. For each patient, data were obtained through at least two nociceptive procedures. Conscious patients' self-reports of pain were assessed using the Numerical Rating Scale and Visual Analog Scale. For unconscious patients, the Behavioral Pain Scale was used instead. Descriptive statistical methods, Friedman's test, and Spearman's rank correlation coefficient were used for the data analysis. Significant changes were observed in heart rate (HR), respiratory rate (RR), and peripheral oxygen saturation (SpO ) during nociceptive procedures. The HR, RR, and pain scores increased, while the SpO decreased. Positive correlation coefficients were observed between the pain intensity and HR and RR levels. According to our study findings, vital signs are not strong indicators for pain assessment in neurosurgery ICU patients. However, HR and RR can be used as cues when behavioral indicators are not valid in these unconscious patients.

Many factors may affect sleep in the neurosurgery intensive care unit (NSICU), including therapeutic and diagnostic procedures, medications, the underlying disease process, and noise generated in NSICU. This study was aimed to determine the factors and nursing interventions, which affect the patients' sleep in NSICU, and to ascertain future descriptive research studies in nursing. The sample consisted of 84 voluntary patients hospitalized at a university hospital. They were consecutively asked to fill out a questionnaire in face-to-face interviews, and on the same day they were transferred out of the NSICU to a neurosurgical ward. Sixty-six patients (78.6%) experienced sleep disturbances. In those patients, being kept immobile (63.6%) and being in a noisy environment (57.6%) were the factors, which most frequently disturbed sleep. Likewise, the nursing interventions were found to have profound influences on patients' sleep; namely, being asked to move an arm/leg or to keep them in the same position for neurological diagnostic reasons (43.9%), and being asked questions to determine the level of consciousness (40.9%) were identified as the common sleep disturbance factors. In conclusion, immobility, environmental noise factors, and the disturbances from implementing the nursing interventions should not be ignored. Sleep disturbance in NSICU should be addressed on the multidisciplinary care plan and in health team conference, and care should be planned to assure good quality of patients' sleep. Nurses, physicians, nursing and medical students should establish and evaluate the combined interventions required for neurological assessment to decrease the negative effects of various factors on patients' sleep.sleep; neurosurgery; intensive care unit

In this study, despite the patients reporting sleep disturbances in the neurosurgical intensive care unit because of nocturnal patient care interventions that prevented them from sleeping, the patients' satisfaction on the given nursing care was not negatively impacted. To reduce sleep disturbances because of nursing care initiatives and promote uninterrupted sleep in the intensive care unit, it can be useful to develop new protocols regulating night care activities.

Although endotracheal suctioning is a routine nursing intervention, this procedure can lead to an increase in intracranial pressure (ICP). This study was planned to determine the appropriate suctioning technique (open system suctioning [OS] and closed system suctioning [CS]) to minimize variability of ICP and cerebral perfusion pressure (CPP) in neurologically impaired patients. The study, which was designed as a crossover, single-blind clinical trial, consisted of 32 neurosurgical patients who underwent ICP monitoring, intra-arterial blood pressure monitoring, and endotracheal intubation in the intensive care unit. According to the need for suctioning, each patient in the experimental and control groups underwent suctioning with both closed and open systems. Recordings were composed of the patients' ICP, mean arterial blood pressure, CPP, heart rate (HR), and arterial blood gases during suctioning. It was observed that both suctioning techniques significantly increased ICP, mean arterial blood pressure, CPP, and HR; ICP was found to be significantly higher in OS compared with CS, whereas there were no significant differences in CPP and HR between the two techniques. The patients suctioned using OS had significantly lower mean PaO(2) than those suctioned using CS; however, the comparison of the two techniques revealed no significant differences in PaCO(2). The data obtained indicate that CS, compared with OS, can be used safely on this patient group.

The results of this study showed that different positions the patients' HOB (degree of 15,30,45) led to slight insignificant changes in ICP and CPP; and these values were maintained within the ranges established by recent guidelines.

The purpose of this study was to determine discharge learning needs of patients undergoing thyroidectomy. The population of this descriptive study consisted of patients undergoing thyroidectomy in the Endocrine Surgery Unit of a university hospital between February and December 2013. The study included 251 patients who were discharged after thyroidectomy. Data obtained using the data collection form and the Patient Leaning Needs Scale (PLNS) were analyzed by frequency, mean, standard deviation, Kruskal Wallis and student-t tests. The mean age of the patients was 47.91±13.05 and 76.1% were females. The PLNS total mean score was 208.38±34.91, with the maximum score of 39.23±6.80 on the subscale of treatment and complications and the minimum score of 19.45±4.70 on the subscale of feelings related to condition. It was found that the PLNS total score of the patients was not influenced by age, gender, marital status (p>0.05). This study demonstrated that patients had high learning needs after thyroidectomy.

Nursing students in both cities seem more likely to participate in disaster preparedness and response courses/lectures. The present study also addresses the need to incorporate mass casualty care and disaster management skills into undergraduate curricula. Core contents for nursing curricula in both cities need to be continued. Outcome competencies must be identified and validated through further research.