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Bu araştırma, cerrahi birimlerde çalışan hemşirelerin ameliyat öncesi ve sonrası sıvı tedavisi ile ilgili bilgi düzeylerini belirlemek amacıyla tanımlayıcı olarak yapılmıştır. Veriler 1 Ocak 2022-1 Temmuz 2022 tarihleri arasında üç devlet hastanesi ve bir üniversite hastanesinde çalışan hemşirelerden toplanmıştır. Araştırmaya katılmaya gönüllü olan 111 hemşireden veriler elde edilmiştir. Verilerin toplanmasında araştırmacılar tarafından geliştirilen bir form kullanılmıştır. Formda hemşirelerin demografik değişkenlerine ilişkin 8 soru ve hemşirelerin preoperatif ve postoperatif dönemde sıvı tedavisindeki güncel yaklaşımlar hakkındaki bilgilerini belirlemeye yönelik 30 ifade yer almaktadır. Hemşirelerden ilgili maddeleri Doğru / Yanlış / Fikrim Yok şeklinde cevaplamaları istenmiştir. İstatistiksel analiz, IBM SPSS 28.0 kullanılarak yapıldı. Tanımlayıcı istatistikler sayı, yüzde, ortalama ve standart sapma olarak verildi. Kategorik verilerin analizinde Pearson Ki-kare, değişkenler arasındaki ilişkilerin analizinde Fisher-Freeman-Halton ve Fisher's Exact Ki-kare testleri kullanıldı. Hemşirelerin geleneksel yaklaşımların benimsendiği konularda ve sık kullanılmayan uygulamalarda doğru cevap verme oranlarının düşük olduğu görüldü. Yeni mezun hemşirelerin hastalara ameliyat öncesi dönemde 2 saat öncesine kadar karbonhidrat verilebileceğine ilişkin bilgilerinin daha uzun süredir çalışmakta olan hemşirelerden daha iyi düzeyde olduğu görüldü. Yüksek lisans ve lisans mezunu hemşirelerin lise mezunu hemşirelerden, üniversite hastanesinde çalışan hemşirelerin, cerrahi yoğun bakım ünitelerinde (YBÜ) çalışan hemşirelerin cerrahi kliniklerde çalışan hemşirelere göre ameliyat öncesi ve sonrası sıvı tedavisine ilişkin bilgi düzeylerinin daha iyi olduğu görüldü ( p

Background: Psychotropic medications are the first line for the management of psychiatric illnesses; in addition, they are also being used in an off-labeled manner. Inappropriate prescribing of psychotropic medications either can cause serious harm or may be of no benefit to the patients. However, there is a dearth of information on the pattern of psychotropic drug use in the nonpsychiatry wards. Aim: The aim of this study is to assess the use of psychotropic drugs in general medicine and surgical wards of a teaching hospital. Materials and Methods: An observational study was conducted in the general medicine and surgical wards of a university teaching hospital over 6 months. Patients admitted to the medicine and surgical ward were observed for a prescription of psychotropic medications. Once they were prescribed with a psychotropic medication, the patients were included in the study and were followed until discharge. All the necessary information such as dose, route, class of psychotropic and prescriber's status were documented and analyzed. Results: A total of 322 patients were prescribed with 452 psychotropic medications. The average number of psychotropic per patient was 1.40 ± 0.76 (range: 1–4). The rate of psychotropic medications prescription in the nonpsychiatric ward is 10.73%. Alcohol dependence syndrome (n = 90 [26.71%]) and pain (n = 43 [43.87%]) were the observed psychiatric and nonpsychiatric indications. The frequently prescribed psychotropic classes were benzodiazepines (n = 165 [36.50%]) and antidepressants (n = 144 [31.86%]). Nonpsychiatrists (n = 250 [55.3%]) were the common prescribers and benzodiazepines (n = 124 [27.43%]) were the preferred class for nonpsychiatrist, whereas psychiatrist prescribed different class of psychotropic drugs. Conclusion: This study emphasizes that nonpsychiatrist irrespective of their specialty prescribed psychotropic medication for psychiatric and nonpsychiatric indications.

Introduction: The continuous increase of antimicrobial resistance (AMR) requires antimicrobial stewardship programs (ASPs) to optimize antimicrobial use, including selection, dose, duration, and way of administration. Methods and Results: An “Antimicrobial Stewardship Team” (AST) was established at “F. Miulli” Hospital of Bari. The AST is a multidisciplinary group formed by a pharmacist, an infectious disease specialist, a microbiologist, an anesthetist and a hygienist. The AST has started a clinical path of professional interactions and optimization of antimicrobial use. The AST was focused on surgical antibiotic prophylaxis, planning events/meetings with 13 wards of “F. Miulli” hospital and writing 13 operating guidelines. The AST was focused on antimicrobial therapies too. On this occasion, the AST did not organize events or meetings but was focused on professional interactions with clinicians to optimize the antimicrobial use in the treatment of multi-drug resistant (MDR) pathogens. A reduction of antimicrobial use (defined daily dose, DDD) and pharmaceutical expenditure was reached in surgical wards during 2017-2018, while, in the same period, an increase of antimicrobial use (DDD) and pharmaceutical expenditure was observed in non-surgical wards. Conclusions: The “Antimicrobial Stewardship Team” programs are essential to monitor the hospital economic resources and to support the purchase of the innovative antimicrobial therapies to treat multi-drug resistant pathogens.

Background: Staffing patterns refers to the number and types or categories of staff assigned to the particular wards in a hospital. Staffing patterns that accommodate imbalanced patient to nurse ratios can affect nursing staff negatively. The negative experiences increased emotional stress, physical exhaustion, high nurse turnover and consequences of poor patient outcomes. The high patient to nurse ratios and the profitability factor of private hospitals virtually dictates the type of staffing patterns that are used in these wards. As such, the current staffing patterns appear to require nursing staff to work longer shifts as well as overtime work without a choice, the consequences of which are the effects highlighted above.Purpose: The purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards.Methodology: A qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study.Results: The findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns.Conclusion: It is evident from the findings of the study that nurses are experiencing staffing patterns negatively.

Antimicrobial Resistance (AMR) and Healthcare Associated Infections (HAIs) are major global public health challenges in our time. This study provides a broader and updated overview of AMR trends in surgical wards of Mulago National Referral Hospital (MNRH) between 2014 and 2018. Laboratory data on the antimicrobial susceptibility profiles of bacterial isolates from 428 patient samples were available. The most common samples were as follows: tracheal aspirates (36.5%), pus swabs (28.0%), and blood (20.6%). Klebsiella (21.7%), Acinetobacter (17.5%), and Staphylococcus species (12.4%) were the most common isolates. The resistance patterns for different antimicrobials were: penicillins (40–100%), cephalosporins (30–100%), β-lactamase inhibitor combinations (70–100%), carbapenems (10–100%), polymyxin E (0–7%), aminoglycosides (50–100%), sulphonamides (80–100%), fluoroquinolones (40–70%), macrolides (40–100%), lincosamides (10–45%), phenicols (40–70%), nitrofurans (0–25%), and glycopeptide (0–20%). This study demonstrated a sustained increase in resistance among the most commonly used antibiotics in Uganda over the five-year study period. It implies ongoing hospital-based monitoring and surveillance of AMR patterns are needed to inform antibiotic prescribing, and to contribute to national and global AMR profiles. It also suggests continued emphasis on infection prevention and control practices (IPC), including antibiotic stewardship. Ultimately, laboratory capacity for timely bacteriological culture and sensitivity testing will provide a rational choice of antibiotics for HAI.

Background: The implementation of patient education within a hospital is a difficult task that plays a key role in improving and controlling diseases and providing quality healthcare services. Objective: The current study evaluated the effect of patient education on the quality of nursing care and inpatient satisfaction in surgical wards of selected hospitals in Isfahan, Iran. Methods: This quasi-experimental study was conducted in 2014. The sample group consisted of 64 patients admitted to the surgical wards of select hospitals in Isfahan and selected using the voluntary sampling method. Participants were randomly divided into experimental (n=32) and control (n=32) groups. A patient education program was implemented for each subject in the experimental group (during hospitalization and after discharge), but no intervention was conducted for the control group. Data was collected from both groups before and after the educational intervention using the standard questionnaire SERVQUAL to measure expectations (with a reliability of 87%), perceptions (with a reliability of 85%), and inpatient satisfaction (with a reliability of 83%). Data was analyzed using descriptive statistics, univariate and multivariate analysis of covariance, Kolmogorov-Smirnov, Chi-square, and t-tests in SPSS software (ver. 20). Results: The results of covariance analysis showed that the patient education program significantly increased the mean scores of the quality of nursing services and inpatient satisfaction in the experimental group compared with the control group (p Conclusion: A patient education program is an important pillar for improving public health. It is also a low-cost intervention to increase a patient's hope in living a good quality life.

Nursing process is a systematic, patient-oriented and purposive approach which provides a framework for nursing performance. On the other hand, nursing process causes the nursing care to develop from traditional method into a scientific and patient-oriented approach. The present paper aims to study the impact of training on nursing process implementation skill of surgical ward nurses in Shahid Beheshti Hospital of Yasuj in 2012. The present paper is a quasi-experimental study with one-sample t-test method conducted as a pre-test and post-test design. The studied unit included 48 nurses who had been active in surgical awards during research and were selected using purposive sampling method. The data collection instruments included checklist and nursing process questionnaire. The data was analyzed by paired-sample t-test in SPSS.16. The results indicate that, with regard to questionnaire, there is significant difference between using the nursing process before and after intervention (P=0.031). According to checklist, the paired-sample t-test showed no significant difference in implementation of nursing process (P=0.064). The results showed that nursing process has been more desirable from the point of view of nurses. The higher points given by nurses showed that using the checklist to evaluate the nursing process in this study may be more authentic compared to questionnaire.

Introduction : Trauma presents a significant global health burden. Death resulting from trauma remains high in low income countries despite a steady decrease in developed countries. Analysis of the pattern of death will enable intervention to reduce these deaths from trauma in developing countries. This study aims to present the pattern of trauma-related deaths in the surgical wards of University of Port Harcourt Teaching Hospital (UPTH). Methods : This was a retrospective study of all patients who died from trauma during admission into the surgical wards of UPTH from 2007 to 2012. Data on demography and traumatic events leading to death were collected from surgical wards, the emergency unit, and theatre records and analyzed using SPSS version 16.0. Results : Trauma accounted for 219 (42.4%) of the 527 mortalities recorded. Most of the deaths (62.6 %) occurred between 20 and 59 years. There were 148 males (67.6 %). The yearly mortality rates were as follows: 2007(12.3 %); 2008 (16.9%); 2009 (9.1%), 2010 (12.8 %), 2011 (23.3%) and 2012 (25.6%). Most of the patients (91.3%) died within 1 month of admission. The major events leading to deaths were burns 105(47.9%), traumatic brain injuries were 63(28.8%), and spinal cord injuries 21(9.6%). The secondary causes of death were mainly septic shock 112(51.1%); Respiratory failure 60(27.4%); and Multiple organ dysfunction 44(20.1%). Conclusion : Trauma is a leading cause of mortality in the surgical wards of our hospital. Trauma -related deaths continues to increase over the years. Safe keeping of petroleum products and adherence to traffic rules will reduce these avoidable deaths. Key words: Trauma, mortality, surgical wards, Port Harcourt, Nigeria

Background and aim: Dressing is a covering or bandage applied to a wound, Bleeding cases, Open fractures and superficial burns to protect it, prevent the complication and the patient's dressings need to be changed regularly. The study aimed to identify the level of knowledge about Dressing Process among nurses and to examine the relationship between demographic characteristics of the nurses and their Knowledge with regard to Dressing Process. Materials and Method: This descriptive study design as a quantitative approach was adopted through the period from 1st of August - 2011 to the 1st of September - 2012. The sample of the study included (140) nurses working in two hospitals in Mosul city in the center of Nineveh Governorate. In order to collect the data, a questionnaire was constructed depending on the previous studies and related literatures. Content validity of the questionnaire was determined by presenting the questionnaire to a panel of (15) experts and the reliability of the study was determined by applying the tool to (20) nurses in Ibn-Sina Teaching Hospital, while Person's Correlation Coefficient was ( r = 0.83; P.< 0.05 ). Results: The data analysis showed that there were significant statistical relationships among some categories of knowledge regarding Dressing Process with the attributes of the sample. Conclusion: The study concluded that knowledge of dressing process acceptable, while gender and enrollment in training sessions had an obvious association with nurses' knowledge. Keywords: Nurses, Knowledge, Dressing, Surgical Wards.

Objective To identify deaths in the surgical wards, elicit the cause of death and suggest changes that will ensure improved surgical care of patients and outcome. Study design Retrospective. Methods Records collected from the theatre operation registers, ward registers and case notes of all patients who were admitted into the surgical wards Federal Medical Centre, Owerri whether elective or emergency from January 1997 to December 2001 were reviewed. Data extracted included date of admission, age, sex, educational status, residence; surgical diagnosis and clinical cause of death Data obtained were analyzed and presented in tabular and descriptive forms. Results There were 4583 surgical admissions in all the surgical wards of which males were 2751 and females 1832. During this period there were 419 deaths with an overall death per admission crude mortality rate of 9.14%. The leading causes of death were acute abdomen (22.20%), RTA with head injury (18.14%) and malignances (14.56%). Of the 419 deaths males were 305 (72.79%) and females 114 (27.21%) in a ratio of 2.68:1. Conclusion Aggressive enlightenment and healthcare campaigns, health education, improvement of healthcare facilities and accessibility to healthcare facilities are highlighted. Structured study in the management of surgical cases is emphasized.

Aims: The overall aims of this thesis was describe the current nursing postoperative pain assessment and management practices in the surgical wards in Jordan and evaluate the effectiveness of implementing a ostoperative pain management (POPM) program in improving the Jordanian nurses’ POP assessment and management practices in the surgical wards. Lewin’s Force-Field Model for change provided the structure for planning for and implementing the POPM program. Method: Both qualitative and quantitative approaches were used. Qualitative content analysis inspired by the hermeneutic philosophy was used to describe the surgical nurses’ experiences in caring for patients having POP. Data were collected by interviewing 12 registered nurses working in surgical wards at four hospitals in Jordan. A retrospective quantitative design was used to collect data on the documentation system and strategies of the POP assessment and management in the surgical wards. A total of 322 patients’ records obtained from six hospitals in Jordan were audited in six-month period. The records review was performed using three audit instruments. Later, a POPM program for nurses was implemented in two surgical wards at a university hospital in Jordan. The program was evaluated by means of a quasi-experimental design with a nonequivalent control group where the control group (120 patients) and the intervention group (120 patients) were not drawn from the same population. All registered nurses (65 nurses) employed in the two surgical wards participated in the study to implement the program. First, assessment of patients’ communication about pain with nurses and their satisfaction about nurses’ intervention were assessed by means of a questionnaire. Second, the quality of nurses’ pain assessment was evaluated by comparing the attending nurses’ assessment of patients’ pain intensity rating scores with the researcher’s rating scores of the same patients. Third, a questionnaire was used to test the nurses’ knowledge of and their attitudes toward pain. Forth, the records were audited before and after the intervention. The POPM program was implemented for three months. Findings: The findings of the studies I and II formulated the foundation where the researchers can illuminate the main issues and obstacles in the process of change toward better POP management. Findings from these studies draw attention to the fact that there is an urgent need for improving POP assessment, management and documentation. The findings illustrated that the implementation of an educational program for nurses was successful. First of all, the quality communicated information about pain and pain management with patients was significantly improved. Secondly, the nurses developed the habit of assessing POP intensity using numeric rating scales, in addition to the assessment of other pain characteristics. Thirdly, the nurses improved their knowledge about POP, and their attitudes toward it were evidently changed. Finally, the nurses improved their practice in documenting patients’ pain. The patients’ records showed a significant difference in the amount and the quality of nursing documentation which reflected the fact that nurses became more aware about the importance of documentation and might also means that they change their practices toward better POP management. Discussion and Implications: The studies provide several contributions to the knowledge and understanding of the POP current management practices such as the recognition of the surgical patients suffering due to the unsatisfactory pain management routines, the impact of health institutions restraints on nurses that prohibit them from providing quality of care for patients with POP, and the need to change the current practices of nursing documentation of POP. The findings add to a growing body of literature on the benefits of implementing educational programs for nurses to improve their roles in caring for patients with POP. The findings of this thesis provide opportunities for nurses to evaluate themselves in the area of POP knowledge and management practices which may affect their caring abilities. Another implication related to nursing practice is that this study might increase the awareness of the health care professionals and the health institutions administration toward the establishment of team work to induce change with a common purpose in upgrading the quality of pain assessment and management. Managers and supervisors can facilitate the application of educational programs and incorporate with the team to move more quickly in the desired change. Implications of the study may be relevant to nursing education and in continuing education of health care institutions.

To assess the efficacy and safety of postoperative analgesia with continuous epidural sufentanil and bupivacaine, we performed a prospective study in 614 patients undergoing major surgery. Before surgical incision, all patients received an initial dose of 50 micrograms sufentanil in 6-10 mL bupivacaine 0.125% via a lumbar or thoracic catheter. After 1 h, a continuous infusion was started with 50 micrograms sufentanil in 50 mL bupivacaine 0.125% at a rate of 6-10 mL/h. The infusion was continued postoperatively for 1-5 days or longer, depending on the type of operation and the patient's analgesic need. In the majority of patients, adequate pain relief was obtained at rest and during movement. Late respiratory depression was observed in three patients; in most patients only minor side effects were seen. Technical complications during epidural puncture or insertion of the catheter were 4% and 3%, respectively. We conclude that continuous epidural sufentanil and bupivacaine is safe and effective.

Background: Toxigenic Clostridium difficile is the etiologic agent of C. difficile -associated diarrhea. It is believed that patient-to-patient transmission and environmental contamination are risk factors for the spread of this disease in hospitals. The development of precise typing schemes has provided some understanding of the epidemiology of this nosocomial infection. Objective: The purpose of this study was to identify strain types of C. difficile present in the environment of a maternity ward and surgical wards of a hospital in Warsaw, and to correlate these types with those isolated from neonates and surgical patients. Methods: Arbitrarily primed polymerase chain reaction (APPCR), with the arbitrary primer PG-05, was used to genotype 14 isolates of C. difficile obtained from different sources in a hospital in Warsaw. These included clinical isolates from neonates and surgical patients, as well as environmental isolates from the maternity and surgical wards. Results: A predominant toxigenic isolate was found in the maternity environment, and this strain type was also isolated from the stools of two of five newborns. Unique and different DNA banding patterns were observed in the remaining three isolates from neonates. In addition, isolates from an infant with diarrhea also showed a unique AP-PCR type. The isolates from three surgical patients analyzed had the same AP-PCR profile. This type was also found in the surgery ward environment. Conclusion: These data support environmental contamination as an important factor in the etiology of C. difficile -associated diarrhea in this hospital.

Nursing process is a systematic, patient-oriented and purposive approach which provides a framework for nursing performance. On the other hand, nursing process causes the nursing care to develop from traditional method into a scientific and patient-oriented approach. The present paper aims to study the impact of training on nursing process implementation skill of surgical ward nurses in Shahid Beheshti Hospital of Yasuj in 2012. The present paper is a quasi-experimental study with one-sample t-test method conducted as a pre-test and post-test design. The studied unit included 48 nurses who had been active in surgical awards during research and were selected using purposive sampling method. The data collection instruments included checklist and nursing process questionnaire. The data was analyzed by paired-sample t-test in SPSS.16. The results indicate that, with regard to questionnaire, there is significant difference between using the nursing process before and after intervention (P=0.031). According to checklist, the paired-sample t-test showed no significant difference in implementation of nursing process (P=0.064). The results showed that nursing process has been more desirable from the point of view of nurses. The higher points given by nurses showed that using the checklist to evaluate the nursing process in this study may be more authentic compared to questionnaire.

Background Surgeons and nurses sometimes perceive a high workload on the surgical wards, which may influence admission decisions and staffing policy. This study aimed to explore the relative contribution of various patient and care characteristics to the perceived patients’ care intensity and whether differences exist in the perception of surgeons and nurses. Methods We invited surgeons and surgical nurses in the Netherlands for a conjoint analysis study through internet and e-mail invitations. They rated 20 virtual clinical scenarios regarding patient care intensity on a 10-point Likert scale. The scenarios described patients with 5 different surgical conditions: cholelithiasis, a colon tumor, a pancreas tumor, critical leg ischemia, and an unstable vertebral fracture. Each scenario presented a mix of 13 different attributes, referring to the patients’ condition, physical symptoms, and admission and discharge circumstances. Results A total of 82 surgeons and 146 surgical nurses completed the questionnaire, resulting in 4560 rated scenarios, 912 per condition. For surgeons, 6 out of the 13 attributes contributed significantly to care intensity: age, polypharmacy, medical diagnosis, complication level, ICU-stay and ASA-classification, but not multidisciplinary care. For nurses, the same six attributes contributed significantly, but also BMI, nutrition status, admission type, patient dependency, anxiety or delirium during hospitalization, and discharge type. Both professionals ranked ‘complication level’ as having the highest impact. Discussion The differences between surgeons and nurses on attributes contributing to care intensity may be explained by differences in professional roles and daily work activities. Surgeons have a medical background, including technical aspects of their work and primary focus on patient curation. However, nurses are focused on direct patient care, i.e., checking vital functions, stimulating self-care and providing woundcare. Conclusions Surgeons and nurses differ in their perception of patients’ care intensity. Appreciation of each other’s differing interpretations might improve collaboration between doctors and nurses and may help managers to match hospital resources and personnel. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-1052-4) contains supplementary material, which is available to authorized users.

Background and Aim Laboratory blood tests for hospitalized patients are often overused. Excessive costs and no proof of benefit suggest re-evaluating the current approach to laboratory test ordering. The aim of the study is to improve the decision-making process of test ordering and to investigate what effect a rational, evidence-based use of laboratory test ordering in surgical wards would have on costs and healthcare resources. Methods Three-phase experimental prospective study carried out at the tertiary referral teaching hospital of Parma. Phase 1 (baseline status). The baseline status of laboratory test ordering was evaluated by recording the number of biochemical tests requested for patients undergoing elective surgery. Laboratory tests were grouped in "recommended" (RT) and "non recommended" (nRT) tests on the basis of pertinent literature. Phase 2 (improvement action): new guidelines were introduced into clinical practice. Phase 3 (feedback): Prospective data collection for first and second feedback was performed with no advance notice. Results A highly significant reduction in test ordering was found on occasion of the phases 2 and 3 of the study. The overall number of tests decreased, largely due to a decrease in the use of nRT. Conclusions Analysis was justified by the fact that most test requests proved not to be supported by clinical evidence. Inappropriate ordering of laboratory tests results in an unnecessarily high number of requests, which do not in turn improve patient management. Moreover, more appropriate, evidence-based laboratory test ordering for patients undergoing elective surgery may produce a significant reduction in costs, particularly in high-cost settings. (www.actabiomedica.it).