AimTo assess the relationship between sleep quality and demographic variables, morning-evening type, and burnout in nurses who work shifts.MethodsWe carried out a cross-sectional self-administered study with forced choice and open-ended structured questionnaires – Pittsburg Sleep Quality Index, Morningness-eveningness Questionnaire, and Maslach Burnout Inventory. The study was carried out at Gazi University Medicine Faculty Hospital of Ankara on 524 invited nurses from July to September 2008, with a response rate of 89.94% (n = 483). Descriptive and inferential statistics were applied to determine the risk factors of poor sleep quality.ResultsMost socio-demographic variables did not affect sleep quality. Participants with poor sleep quality had quite high burnout levels. Most nurses who belonged to a type that is neither morning nor evening had poor sleep quality. Nurses who experienced an incident worsening their sleep patterns (P < 0.001) and needlestick or sharp object injuries (P = 0.010) in the last month had poor sleep quality. The subjective sleep quality and sleep latency points of evening types within created models for the effect of burnout dimensions were high.ConclusionsNurses working consistently either in the morning or at night had better sleep quality than those working rotating shifts. Further studies are still needed to develop interventions that improve sleep quality and decrease burnout in nurses working shifts.

Aims To assess the effectiveness of physical‐procedural interventions in reducing pain during intramuscular injections. Design Systematic review and meta‐analysis. Method English keywords were used to search databases [MEDLINE (OVID, Ebsco), SCOPUS, Science Direct, COCHRANE and the reference lists from retrieved articles] from their inception to November 2017 and randomized and quasi‐experimental trials were selected based on inclusion and exclusion criteria. The standardized mean difference and random effects model were used. Results From 2,318 articles, 15 articles (1996–2017) met the criteria for the meta‐analysis. Physical‐procedural interventions described in the articles were included in this systematic review. The overall standardized mean difference was 0.595 (95% confidence interval (CI) = 0.417–0.773), indicating a moderate effect on pain levels. Generally, these interventions (two‐needle technique, acupressure, manual pressure, ShotBlocker, Z‐technique, air‐lock technique, injection site postinjection massage, and speed of injection) have been found to moderately reduce pain. Conclusion It seems difficult to conclude that a single intervention reduces pain in adults. However, we can state that the most effective interventions for reducing pain during intramuscular injections in adults involve the ventrogluteal site, the Z‐technique, and manual pressure. Impact The systematic review will provide guidance to clinicians, staff, and educator nurses and future studies. The systematic review will help nurses and educators apply techniques based on evidence in any setting. The systematic review will guide well‐designed and well‐reported studies to contribute to the accumulation of evidence in nursing research.

Background In the globalizing world, nurses often meet humans from different cultures and values. This fact has led them to make ethical decisions, which do not comply with their own moral jurisdictions at care setting. Objectives The objective of the study was to investigate the relationships between moral development levels of the nurses and their scores of nursing principled thinking and practical consideration during decision making for ethical dilemmas. Methods This was a descriptive correlational study. Nursing Dilemma Test, Moral Development Scale for Professionals and socio-demographic form were used. Study was conducted with 227 nurses. Ethical considerations: An institutional authorization, an ethics approval from non-interventional ethics committee of the respective university, permission from the authors of the scales used and informed consents from the nurses were obtained in order to conduct the study. Results In this study, nurses were found to be at post-conventional level according to Kohlberg’s moral development theory. Sociodemographic and working characteristics of the nurses have not affected their scores of moral development level and their scores of nursing principled thinking, practical consideration and familiarity (p > 0.05). Nurses take attention for moral principles during decision making although not at a desirable level, and they are relatively affected by environmental factors Conclusion Although nurses are familiar with ethical problems at scenarios including ethical dilemmas, they cannot make decisions in accordance with their moral development levels during decision making for ethical dilemmas. Nurses should be instructed and supported for ethical decision making by recognizing factors that may be effective on their decision making.

Background Peripheral intravenous catheterisation (PIVC) is a complex procedure. Aim This study reviewed studies evaluating the effects of different simulators in comparison with traditional methods used in PIVC training for nursing students and hospital nurses. Design A systematic review and meta‐analysis of randomised (RCT) and non‐randomised controlled (N‐RCT) studies. Methods MEDLINE, Cochrane, Scopus, ERIC, Web of Science, and ScienceDirect were searched using PIVC, simulation and nursing education. The quality of evidence was assessed using the GRADE system; the risk of bias was assessed using the RoB 2 (for RCTs) and A Cochrane Risk of Bias Assessment Tool for N‐RCTs. The study was conducted as per the PRISMA guidelines. Results In total, 2,812 records were identified, and 12 studies published between 2002 and 2018 were finally included. Most studies included Virtual IV simulator and the plastic IV arm model in PIVC training for hospital nurses and nursing students, reported on outcomes such as PIVC‐related knowledge, skills, confidence, state/trait anxiety and satisfaction. Seven studies were included in the meta‐analysis, the effect sizes for all the outcomes ranged from small to moderate. However, the effect sizes were non‐significant for all outcomes. The quality of evidence was assessed as being low for skills, knowledge, satisfaction, and trait/state anxiety, and moderate for confidence. Conclusions The effect of Virtual IV training on PIVC‐related skills, knowledge, satisfaction and anxiety among nursing students and hospital nurses, in comparison with the plastic arm training method, remains unclear. However, Virtual IV training was found to increase PIVC confidence. Relevance to clinical practice There is a small effect in favour of VR in PIVC education although non‐significant. More evidence is needed to determine the superiority of simulation methods. In PIVC training of nurses and nursing students, hospitals and schools can choose a method in accordance with their resources. Trial registration PROSPERO 2019 CRD42019124599.

Medical institutions should eliminate factors threatening patient safety to give the health service in quality. In this study main purpose is to determine the perception and attitude of health professionals on patient's safety. Material and Methods: A descriptive study was conducted at the university hospital through November 2010-February 2011. The population and sample of research were comprised of health professionals from all departments and response rate was 54% (n=261). Data collected with Hospital Survey on Patient Safety Culture. 70.1% of the health professionals in the study were nurse and 29.9% were assistant doctors, 37.5% of the participants were working at surgery department, 36.4% were in internal medicine departments and 26.1% were in intensive care unit-emergency room-operating room. According to answers given in the survey, high rates were resulted in 'team work within units' and 'overall perception of patient safety'. Low rates were measured for 'staffing' and 'nonpunitive response to error'. Inadequate staffs, accusing-punitive approach, intensive workload, absence of error reporting system are factors weakening the patient safety environment. Awareness of errors, education programs, supporting environment and legal regulations must be done to develop the culture. Also staff's working and shift hours must be regulated. ÖzetSağlık hizmeti veren kurumlar kaliteli hizmet sunabilmek için hasta güvenliğini tehdit eden faktörleri ortadan kaldırmalıdırlar. Bu çalışmanın amacı sağlık profesyonellerinin hasta güvenliğine ilişkin görüşlerini ve algılamalarını belirlemektir. Çalışma Kasım 2010-Şubat 2011 tarihleri arasında bir üniversite hastanesinde yürütülmüş tanımlayıcı bir çalışmadır. Çalışmanın evrenini ve örneklemini hastanenin tüm birimlerindeki sağlık profesyonelleri oluşturmuştur ve katılım oranı %54'tür (n=261). Veriler Hasta Güvenliği Kültürü Hastane Anketi ile toplanmıştır. Çalışmaya katılan sağlık profesyonellerinin %70.1'i hemşire ve %29.9'u asistan doktor; %37.5'i cerrahi birimlerde, %36.4'ü dahili birimlerde ve %26.1'i yoğun bakım-acil servisameliyathanede çalışmaktadır. Anketin tüm maddeleri incelendiğinde en yüksek olumlu cevap yüzde ortalamalarının 'Üniteler içinde ekip çalışması', 'Güvenliğin kapsamlı algılanması' alt boyutlarına ait olduğu belirlenmiştir. En düşük ortalamaların ise, 'Personel sağlama', 'Hataya karşı cezalandırıcı olmayan yanıt alt boyutlarına ait olduğu belirlenmiştir. Yetersiz personel, suçlayıcı-cezalandırıcı yaklaşım, yoğun iş yükü, hata raporlama sisteminin eksikliği hasta güvenliğini zayıflatan faktörlerdir. Hasta güvenliği kültürünün gelişmesi için hataların farkına varma, eğitim programları, destekleyici ortam ve yasal düzenlemeler sağlanmalıdır. Ayrıca çalışanların çalışma ve vardiya süreleri düzenlenmelidir. Anahtar kelimeler: Hasta güvenliği kültürü, sağlık profesyoneli, hemşireler, kalite