Medical Device-Related Pressure Injury Care and Prevention Training Program (DevICeU): Effects on intensive care nurses' knowledge, prevention performance and point prevalence

OBJECTIVE

To determine the effect of the training given to intensive care unit (ICU) nurses to prevent medical device-related pressure injuries (MDRPIs) on nurses' knowledge levels, their prevention performance, and the point prevalence (PP) of MDRPIs.

RESEARCH METHODOLOGY/DESIGN

A pre-post test intervention study without a control group.

SETTING

The study was conducted between May and July 2023 with ICU nurses in three phases: pre-training phase (E0) (104 nurses, 116 patients), training implementation phase (E) and post-training phase (E1) (89 nurses, 120 patients).

MAIN OUTCOME MEASURES

The data were collected by using the Patient (E0, E1) and Nurse (E0) Characteristic Forms, MDRPI Follow-up and Prevalence Form (E0, E1), D.E.V.I.C.E Performance Observation Checklist (E0, E1), MDRPI Knowledge Assessment Questionnaire (E0, E1), Braden Pressure Ulcer Risk Assessment Scale (E0, E1), Pressure Injury Grading Form (E0, E1), and Feedback Form about the Training Process (E).

RESULTS

The mean MDRPI knowledge score of the nurses increased significantly from E0 to E1 (13.23 ± 1.43 vs. 20.02 ± 1.30, p = 0.001), with the highest improvement in the staging and prevention themes. Nurses' MDRPI prevention performance increased significantly from E0 to E1 (2.15 ± 1.01 vs. 11.17 ± 1.65, p = 0.001). There was a significant difference between the PP rate at E0 (61.2 %) and E1 (27.5 %) (p = 0.001).

CONCLUSION

The study indicated that the training on MDRPIs given to ICU nurses increased their knowledge and prevention performance and decreased the prevalence of MDRPIs. However, further studies with a larger sample size are needed to confirm these findings.

IMPLICATIONS FOR CLINICAL PRACTICE

Since MDRPIs have more complex staging and prevention practices than conventional PIs, they require the adoption of a training approach that includes visual materials and practical methods in addition to theoretical knowledge. Accurate definitions of medical device dimensions and fixation, skin assessment, and prevention practices will lead to the desired outcome of reducing MDRPIs in ICUs.

The effect of two different types of music played to cancer patients during chemotherapy on anxiety, nausea, and satisfaction levels

PURPOSE

To investigate the effect of two different types of music on anxiety, nausea, and satisfaction levels in cancer patients receiving chemotherapy (CT) for the first time.

METHODS

The study was conducted as a single-blind, pre-test, post-test, three-group randomized controlled trial in an outpatient CT unit between August 2022 and February 2023. A simple (computer-based) and stratified (age and gender) randomization method was used to assign 75 patients to the relaxing music group (RMG), Turkish classical music group (TCMG), and control group (CG) (n = 25 each). The primary outcome was the change in anxiety levels measured by Spielberger's State Anxiety Inventory before (T0) and after (T1) CT session. Secondary outcomes were the change in the severity of nausea from T0 to T1 and the level of satisfaction at T1.

RESULTS

The groups were similar in terms of baseline sociodemographic and health-related characteristics. Anxiety levels were lower than the baseline in RMG and TCMG in comparison to CG, and repeated measures analysis showed a significant group × time interaction (p = 0.001, F = 210.221, η2 = 0.745). Nausea severity increased from T0 to T1 for CG but decreased for RMG and TCMG with a significant group × time interaction (p = 0.001, F = 100.785, η2 = 0.583). The satisfaction level was significantly higher in TCMG than in CG and RMG (8.64 ± 0.95 vs. 7.88 ± 0.72, and 7.00 ± 0.70, respectively).

CONCLUSION

Music may be an effective non-pharmacologic option to relieve patients' anxiety and nausea during first-time CT. Larger, multicenter studies evaluating the long-term effect of music are needed to confirm these findings.

TRIAL REGISTRATION

clinicaltrials.gov (NCT05687838)/2022-13/18.

The effect of music on delirium, pain, sedation and anxiety in patients receiving mechanical ventilation in the intensive care unit

OBJECTIVES

To examine the effects of music for patients under mechanical ventilation support in the intensive care unit on their delirium, pain, sedation, and anxiety.

RESEARCH METHODOLOGY/DESIGN

A single-blind, randomized, controlled trial.

SETTING

The study was conducted with delirium positive patients between August 2020 and September 2021 in the medical/surgical intensive care unit of a university hospital in Turkey.

METHODS

The study sample was selected through a simple and stratified randomization method; patients who met the inclusion criteria were assigned to the music, noise reduction or control group. The data were collected by using a Confusion Assessment Method for the ICU (CAM-ICU), CAM-ICU-7, Critical Care Pain Observation Tool (CPOT), Richmond Agitation-Sedation Scale (RASS), Facial Anxiety Scale (FAS), PRE-DELIRIC model, and Glasgow Coma Scale (GCS). The interventions were repeated twice a day for five days.

RESULTS

A total of 36 patients were included, with 12 patients in each group. Significant decreases were found in the severity of delirium and pain and the level of sedation and anxiety in the music compared to the other groups (p < 0.05). The number of patients with delirium and the number of days with mechanical ventilation was found to be significantly lower in the music group compared to the other groups (p < 0.05).

CONCLUSION

Music intervention may be used as a nursing intervention to control delirium, pain, need for sedation and anxiety in intensive care unit patients. However, additional studies with larger sample is needed to validate findings.

Psychometric properties of the Turkish version of modified Freedman questionnaire for sleep quality

To investigate the psychometric characteristics of the modified Freedman Sleep Quality Questionnaire (mFSQQ) to assess sleep in Turkish intensive care unit (ICU) patients. This prospective cross-sectional study was conducted between December 2020 and August 2021 with patients older than 18 years, who stayed in the ICU for ≥ 24 h and were cooperative with a Glasgow Coma Scale score ≥ 10 in medical and surgical ICUs of a university hospital. During the adaptation of the items of the mFSQQ, language, content, and construct validity were examined, and the test-retest method and internal consistency were used to examine its reliability. The content validity index of the questionnaire was 0.82. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.71, which indicates adequate sampling; Bartlett's test of sphericity was χ2 = 2868.97, p < 0.001. The Turkish version had three subscales. The factor loadings of the items were above 0.30, and the factors explained 60.59% of the total variance. The test-retest reliability coefficient was 0.85, indicating high consistency. The Cronbach α reliability coefficient was 0.80, indicating high reliability. The item-total correlations were found to be sufficient (between 0.25 and 0.78). The Turkish version of the mFSQQ showed good psychometric characteristics and can be used as a routine evaluation instrument to determine sleep quality by the ICU team and to promote sleep.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41105-022-00389-2.