TRAUMA NURSING CONFERENCE

Previously Published Papers on "Trauma Nursing Conference"

• A Study to Evaluate the Effectiveness of Simulation on Anaesthetic Non-Technical Skills in the Management of Major Trauma Patients

  Authors: Velitchka Schembri Agius, Fiona Sammut, Tanya Esposito, Stephen Sciberras, John Mckenna, Keywords: simulation, major trauma, non technical skills, crisis management, teamwork DOI:10.5281/zenodo. Abstract: Background: Dynamic, challenging instances during the management of major trauma patients requires optimal team intervention to ensure patient safety and effective crisis management. These factors highlight the importance of increased awareness in both technical and non-technical skills (NTS) training. Simulation based training (SBT) is an effective tool that replicates and teaches the required clinical skills, resulting in teamwork improvement, better patient safety, and care. Aims: This study investigates change in NTS, during the management of major trauma patients, using SBT. We also investigated the relationship between NTS performance and participation in previous NTS workshop (NTSW), years of experience, previous simulation (PS), previous exposure to major trauma patient management (MTPM) and group size. Methods: NTS behaviours were assessed by a single rater using previously validated framework for observing and rating Anaesthetists’ Non-Technical Skills (ANTS) for anaesthetists and Anaesthetic Non-Technical Skills for Anaesthetic Practitioners (ANTS-AP) for anaesthetic nurses during SBT. Two anaesthetists (one senior, one junior) together with one to four registered anaesthetic nurses formed 17 teams. The SBT consisted of 3 major trauma scenarios: 1) Major haemorrhage following multiple stab wounds to the torso, 2) Traumatic brain injury complicated by unanticipated difficult intubation, and 3) Penetrating neck injury with major haemorrhage, complicated by a failed intubation. The scores of each NTS category for each scenario are evaluated for significance in change and used to correlate whether NTS during the simulation were affected by previous NTSW, PS, previous exposure to MTPM and group size. Results: The resulting anaesthetists and anesthetic nurses’ p-values were < 0.05 indicating a significant improvement in all NTS resulting from score differences between scenarios 1 & 2 and 1 & 3. Anaesthetists’ NTS categories were not influenced by PS, previous NTSW, and exposure to MTPM. However, anaesthetic nurses NTS categories were influenced by PS, exposure to MTPM but not by NTSW. Conclusions: SBT has shown to be effective in improving the NTS for both anaesthetists and anaesthetic nurses. This enhances safety and team performance for MTPM. The impact of SBT in the clinical environment for patient management and safety warrants further research.

• Investigation of the Medical Malpractice Tendency of Student Nurses

  Authors: Serap Torun, Osman Bilgin, Ceylan Bıçkıcı, Keywords: nursing student, medical malpractice, nursing, tendency, patient safety DOI:10.5281/zenodo.3454951 Abstract: Introduction: Medical malpractice can be defined as health workers neglecting the expected standard or intentionally not implementing it, doing it wrong and/or incomplete, not being able to implement the accurate practice due to personal or systemic reasons despite desiring to do it correctly and the condition that causes permanent or temporary damage to the patient as a result. If the training periods in which health workers improve their knowledge and skills are passed efficiently, they are expected to have a low rate of error in their professional lives. Aim: Aim of the study is to determine the medical malpractice tendencies of students studying in nursing department. Material and Methods: This descriptive research has been performed with 454 students who study in 3rd and 4th years in the Nursing Department of the Faculty of Health Sciences in a state university in normal and evening education and go out for clinical practice during the 2017-2018 academic year. The sample consisted of 454 students who agreed to participate in the study. Ethics committee approval, the permission of the institution and the verbal consent of the participants were obtained. In collection of data, ‘Personal Information Form’ developed by the researchers and the Malpractice Tendency Scale (SMT) were used. The data were analyzed using SPSS 20 package program. 0.05 was used as the level of significance. Results: The Cronbach’s alpha internal consistency coefficient of the scale was 0.94 and the total mean value of the scale was 211.69 ± 22.14. The mean age of the participants was 22,08 ± 1,852 years; 165 (36,4%) were male and 288 (63,6%) were female. Their mean General Point Average (GPA) was 2.65 ± 0.454 (min 1.03 - max 3.90). Students' average duration of self study per week was 2.89 ± 3.81 (min 0 - max 30) hours. The mean score (80.73) of the 4th year students in the sub-dimension of Drug and Transfusion Applications was significantly higher than the mean score (79.20) of 3rd year students (p < 0.05). The mean score (81.01) of the Drug and Transfusion Applications sub-dimension of those who willingly chose the profession was higher than the mean score (78.88) of those who chose the profession unwillingly. The mean average score (21.48) of Fallings sub-dimension of students who cared for 3 to 4 patients per day was lower than the mean score (22.41) of those who cared for 5 patients and over daily on average (p < 0.05). Conclusion: As a result of this study, it was concluded that malpractice tendency of nursing students was low, and an inverse relationship was found between the duration of education and malpractice tendency.

• Evidence Based Practice for Oral Care in Children

  Authors: T. Turan, Ç. Erdoğan, Keywords: Children, evidence based practice, nursing, oral care. DOI:10.5281/zenodo.2021897 Abstract: As far as is known, general nursing care practices do not include specific evidence-based practices related to oral care in children. This study aimed to evaluate the evidence based nursing practice for oral care in children. This article is planned as a review article by searching the literature in this field. According to all age groups and the oral care in various specific situations located evidence in the literature were examined. It has been determined that the methods and frequency used in oral care practices performed by nurses in clinics differ from one hospital to another. In addition, it is seen that different solutions are used in basic oral care, oral care practices to prevent ventilator-associated pneumonia and evidence-based practice in mucositis management in children. As a result, a standard should be established in oral care practices for children and education for children is recommended.

• An Alternative and Complementary Medicine Method in Vulnerable Pediatric Cancer Patients: Yoga

  Authors: Ç. Erdoğan, T. Turan, Keywords: Cancer treatment, children, nursing, yoga. DOI:10.5281/zenodo.1340595 Abstract: Pediatric cancer patients experience multiple distressing, challenges, physical symptom such as fatigue, pain, sleep disturbance, and balance impairment that continue years after treatment completion. In recent years, yoga is often used in children with cancer to cope with these symptoms. Yoga practice is defined as a unique physical activity that combines physical practice, breath work and mindfulness/meditation. Yoga is an increasingly popular mind-body practice also characterized as a mindfulness mode of exercise. This study aimed to evaluate the impact of yoga intervention of children with cancer. This article planned searching the literature in this field. It has been determined that individualized yoga is feasible and provides benefits for inpatient children, improves health-related quality of life, physical activity levels, physical fitness. After yoga program, children anxiety score decreases significantly. Additionally, individualized yoga is feasible for inpatient children receiving intensive chemotherapy. As a result, yoga is an alternative and complementary medicine that can be safely used in children with cancer.

• A Review on the Importance of Nursing Approaches in Nutrition of Children with Cancer

  Authors: Ş. Çiftcioğlu, E. Efe, Keywords: Cancer treatment, children, complication, nutrition, nursing approaches. DOI:10.5281/zenodo.1132381 Abstract: In recent years, cancer has been at the top of diseases that cause death in children. Adequate and balanced nutrition plays an important role in the treatment of cancer. Cancer and cancer treatment is affecting food intake, absorption and metabolism, causing nutritional disorders. Appropriate nutrition is very important for the cancerous child to feel well before, during and after the treatment. There are various difficulties in feeding children with cancer. These are the cancer-related factors. Other factors are environmental and behavioral. As health professionals who spend more time with children in the hospital, nurses should be able to support the children on nutrition and help them to have balanced nutrition. This study aimed to evaluate the importance of nursing approaches in the nutrition of children with cancer. This article is planned as a review article by searching the literature on this field. Anorexia may develop due to psychogenic causes or chemotherapeutic agents or accompanying infections and nutrient uptake may be reduced.  In addition, stomatitis, mucositis, taste and odor changes in the mouth, the feeling of nausea, vomiting and diarrhea can also reduce oral intake and result in significant losses in the energy deficit. In assessing the nutritional status of children with cancer, determining weight loss and good nutrition is essential anamnesis of a child.  Some anthropometric measurements and biochemical tests should be used to evaluate the nutrition of the child. The nutritional status of pediatric cancer patients has been studied for a long time and malnutrition, in particular under nutrition, in this population has long been recognized. Yet, its management remains variable with many malnourished children going unrecognized and consequently untreated. Nutritional support is important to pediatric cancer patients and should be integrated into the overall treatment of these children.

• Evaluation of the Effect of Nursing Services Provided in a Correctional Institution on the Physical Health Levels and Health Behaviors of Female Inmates

  Authors: Şenay Pehli̇van, Gülümser Kublay, Keywords: Correctional institution, correctional nursing, prison nursing, female inmates, physical health problems, health behaviors. DOI:10.5281/zenodo.1132008 Abstract: Female inmates placed in a Correctional Institution (CI) have more physical health problems than other women and their male counterparts. Thus, they require more health care services in the CI and nursing services in particular. CI nurses also have the opportunity to teach behaviors which will protect and improve their health to these women who are difficult to reach in the community. The aim of this study was to evaluate effect of nursing services provided in a CI on the physical health levels and health behaviors of female inmates. The study has a quasi-experimental design. The study was done in Female Closed CI in Ankara, Turkey. The study was conducted on 30 female inmates. Before the implementation of nursing interventions in the initial phase of the study, female inmates were evaluated in terms of physical health problems and health behavior using forms, a physical examination, medical history, health files (file containing medical information related to prisons) and the Omaha System (OS). Findings obtained from evaluations were grouped and symptoms-findings were expressed with OS diagnosis codes. Knowledge, behavior and status scores of prisoners in relation to health problems were determined. After the implementation of the nursing interventions, female inmates were evaluated in terms of physical health problems and health behavior using OS. The research data were collected using the Female Evaluation Form developed by the researcher and the OS. It was found that knowledge, behavior and status scores of prisoners significantly increased after the implementation of nursing interventions (p < 0.05).

• Nurses’ Views on ‘Effective Nurse Leader’ Characteristics in Iraq

  Authors: S. Abed, S. O’Neill, Keywords: Health care, nurse education, nurse leadership, nursing in Iraq, transformational leadership. DOI:10.5281/zenodo.1131469 Abstract: This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

• Dynamic Behavior of Brain Tissue under Transient Loading

  Authors: Y. J. Zhou, G. Lu, Keywords: Analytical method, mechanical responses, spherical wave propagation, traumatic brain injury. DOI:10.5281/zenodo.1093952 Abstract: In this paper, an analytical study is made for the dynamic behavior of human brain tissue under transient loading. In this analytical model the Mooney-Rivlin constitutive law is coupled with visco-elastic constitutive equations to take into account both the nonlinear and time-dependent mechanical behavior of brain tissue. Five ordinary differential equations representing the relationships of five main parameters (radial stress, circumferential stress, radial strain, circumferential strain, and particle velocity) are obtained by using the characteristic method to transform five partial differential equations (two continuity equations, one motion equation, and two constitutive equations). Analytical expressions of the attenuation properties for spherical wave in brain tissue are analytically derived. Numerical results are obtained based on the five ordinary differential equations. The mechanical responses (particle velocity and stress) of brain are compared at different radii including 5, 6, 10, 15 and 25 mm under four different input conditions. The results illustrate that loading curves types of the particle velocity significantly influences the stress in brain tissue. The understanding of the influence by the input loading cures can be used to reduce the potentially injury to brain under head impact by designing protective structures to control the loading curves types.

• Possible Role of Polyamine on Tumor Spread after Surgical Trauma

  Authors: Kuniyasu Soda, Keywords: Immune function, LAK, Polyamine, Surgical trauma. DOI:10.5281/zenodo.1089473 Abstract: Surgical trauma seems to facilitate metastatic spread, although the underlying mechanisms are not known. Increased concentrations of polyamines (spermine and spermidine) in the blood seem to have associated with the enhanced malignant potential of cancer cells and decrease in anti-tumor immunity of cancer patients. In addition to de novo synthesis in rapidly growing cells such as normal regenerating cells and cancer cells, cells can take up polyamines from extra-cellular sources. We have shown that increased polyamine concentration results in decreases in cytokine production and expression of adhesion molecules involved in anti-tumor immunity, such as CD11a. And, immune cells in an environment with increased polyamine levels lose anti-tumor immune functions, such as lymphokine activated killer cell (LAK) activities. Because blood polyamine levels are increased in post-surgical patients, polyamine seems to have roles on post-traumatic tumor spread.

• Morphology and Risk Factors for Blunt Aortic Trauma in Car Accidents - An Autopsy Study

  Authors: Ticijana Prijon, Branko Ermenc, Keywords: Aorta, blunt trauma, car accidents, morphology, risk factors. DOI:10.5281/zenodo.1094353 Abstract: Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall. An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.