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Background: Although research on postoperative pain has increased, postoperative pain management is still a problem today. Most patients experience moderate to severe pain after cardiac surgery. As a result of pain, patients show inefficient adaptation behaviour in physiologic, role function, self-concept, and interdependence modes., Aim: This study was conducted to examine the pain perceptions of intensive care patients after cardiac surgery according to Roy's Adaptation Model (RAM)., Study Design: A qualitative design with a phenomenological approach was used in the study. The research data were collected by using a "descriptive information form", a "semi-structured interview form", and the "numerical rating scale" through the "in-depth interview method". The study sample consisted of 16 patients who were aged 18 years or older, had undergone cardiac surgery, experienced pain post-operatively in the intensive care unit at least once, and had intensive care experience. Patients with neuropathic or chronic pain or neurological or psychiatric disorders were not included in the study. Data were classified into physiologic, self-concept, and interdependence modes according to RAM., Results: The themes and sub-themes that emerged included physiologic modes (pain responses), self-concept modes (pain self-management), role-function modes (effects of pain), and interdependence modes (support systems in pain)., Conclusions: The results of our study can enable patients and nurses to communicate effectively about pain. In future studies, the effect of model-based pain management programs on cardiac surgery patients can be investigated., Relevance to Clinical Practice: Examining the pain perceptions of intensive care patients after cardiac surgery according to RAM will guide the improvement and development of pain management. It is thought that the model addresses intensive care patients experiencing pain holistically., (© 2023 The Authors. Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses.)

Background: To reduce the neurovascular complications caused by physical restraint in intensive care patients, there is a need to examine the occurrence of neurovascular complications and their rate., Objectives: The objective of this research was to investigate the effect of physical restraint on the occurrence of neurovascular complications and their rate., Methods: A prospective observational cohort study was carried out. A total of 90 patients from anaesthesia and internal intensive care units participated in this study. Patients were assessed at intervals of 24 h for 4 days using the following instruments: Individual Characteristics Form, Richmond Agitation-Sedation Scale (RASS), Behavioral Pain Scale, and Complication Diagnostic Diary., Results: Redness (p < 0.001), limb movement (p < 0.001), oedema (p < 0.001), and colour complication (p < 0.001) increased, whereas pulse strength (p < 0.001) decreased in physically restrained sites on the arm from day 1 to day 4. Redness was increased in patients physically restrained with all types of materials (p < 0.001; p < 0.001; p = 0.020). Although there was a statistically significant difference in terms of movement (p = 0.006; p = 0.003) and oedema (p < 0.001; p < 0.001), both with a roll of gauze and tough cuff, these complications were not significantly different in patients restrained with green foam tie (p > 0.05). According to logistic regression analysis, material type, position of the limb, space between the physical restraint and limb, age, RASS, and pain were independent risk factors for neurovascular complications. RASS and pain were independent protective factors against movement complications., Conclusions: The duration of physical restraint increases neurovascular complications. This study revealed that nurses did not regularly check the restrained wrist and did not focus on the peripheral circulation. It is necessary to develop training programs, standards, and appropriate follow-up strategies in intensive care units in Turkey., (Copyright © 2019 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: Physical restraint is still widely used despite studies supporting a reduction in its use. The development of guidelines to reduce the use of PR first requires the identification of factors related to the use of alternative methods. Aim: This study aimed to determine factors associated with the use of alternatives to physical restraint (PR) in intensive care units. Design: This was a cross‐sectional descriptive study. Methods: Data were collected from adult intensive care units of three hospitals in Turkey using the Physical Restraint Knowledge, Attitude and Practice Scale and a questionnaire including open‐ended questions. Results: Overall, 202 nurses (80% response rate) completed the questionnaire. Nurses' knowledge, attitude, and practice scores regarding PR were 6.89 ± 1.79, 29.85 ± 4.93, and 36.76 ± 3.36, respectively. PR was reported to be necessary for patients at risk of self‐harm, with dangerous behaviours, and who were trying to remove their catheters. Most nurses (64.9%) stated that they needed a written doctor's order. Analysis of free‐text responses showed that patient disorientation (because of delirium, sedation, or agitation), nurses' workload, and lack of training regarding restraint were the primary reasons why nurses could not use alternatives. The main alternatives suggested by nurses were categorized as sedation, communication, and environmental regulation. Logistic regression analysis identified training (P =.009), working unit (P =.001), and nurses' practice score to use PR (P =.004) as independent risk factors for not using alternative methods of PR. Conclusions: The results of this study revealed a moderate level of knowledge, attitude, and practice among nurses regarding the use of PR. Thus, education of nurses about the prevention of delirium and alternatives to PR according to the characteristics of their units is required. Relevance to clinical practice: Clinical guidelines and in‐service training need to be developed to increase the use of alternatives to PR and delirium management. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose This study was conducted to determine the attitudes and practices of nurses working in intensive care units of four different hospitals regarding oral care. Methods One hundred eighty-five nurses who worked in adult intensive care units comprised the sample of this cross-sectional descriptive study. Conclusion It can be said that intensive care nurses perform oral care without an oral care protocol and assessment guideline, and that the methods and frequency of oral care and solutions and tools used for oral care differ from one institution to another. Implications for Nursing Practice The results emphasized the need for continuing training in this area. [ABSTRACT FROM AUTHOR]

Aims. This study was carried out to determine the knowledge and practice of nurses before and after training and the development of standard practice guidelines for open and closed system suctioning methods in patients with endotracheal tubes. Background. Many life-threatening complications can occur when a suctioning procedure is not performed with the correct technique. It has been reported that standard practice guidelines for suctioning are insufficient in clinical practice. Design. Non-participant structured observational study. Methods. We assessed a total of 48 nurses who were employed in the cardiovascular surgery intensive care unit of a state hospital in Turkey. We used a questionnaire and nurse observation forms to assess the use of the open and closed system suctioning. Results. There was a significant difference between the mean scores of the answers ('true', 'wrong' and 'I do not know') for the use of open and closed system suctioning before and after training. In addition, all steps of both suctioning procedures were carried out correctly during the third observation. Conclusions. The compliance of the nurses to the standard practice guidelines for open and closed suctioning and their knowledge levels on the subject were increased after training, while the implementation of standards was satisfactory. Relevance to clinical practice. The development of open and closed system suctioning standard practice guidelines directly contributed to the enhancement of patient safety and the quality of nursing care. It is suggested that, as in other nursing care practices, suctioning should be carried out in accordance with standard practice guidelines, and health institutions should develop their standard practice guidelines and work in accordance with them. [ABSTRACT FROM AUTHOR]