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    Effects of oral care solutions on mucous membrane integrity and bacterial colonization
    (WILEY-BLACKWELL, 2014) Ozden, Dilek; Turk, Gulengun; Duger, Cevdet; Guler, Elem K.; Tok, Fatma; Gulsoy, Zuhal
    AimThis research was conducted with the aim of determining the influence of three different oral care solutions on oral mucous membrane integrity in critically ill patients. BackgroundOral care is a basic part of nursing care in intensive care units. DesignA randomized controlled trial was conducted. MethodA total of 60 patients (20 patients in each group) comprised the study sample of the research. Patients were randomly allocated to three groups. Patients in groups 1, 2 and 3 were administered mouth care three times a day using 5% sodium bicarbonate, 02% chlorhexidine and saline solution, respectively. Data were collected by means of a Descriptive characteristics form' and an oral assessment tool'. ResultsMean scores of oral assessment tool increased according to days in all groups, however, this increase was found to be statistically insignificant (p>005). Mean scores of the patients in saline solution group were seen to be lower than those of the other groups. When inter-group comparison of days was done, the difference between oral assessment scores was found to be statistically significant (p=0000). ConclusionIt was found that there was no difference between patient groups receiving saline solution, sodium bicarbonate and 02% chlorhexidine for mouth care in terms of oral mucous membrane integrity; oral mucosa of all patients was found to be mildly dysfunctioning. Relevance to clinical practiceIt is thought that standardized protocols for oral hygiene developed in the light of the findings of randomized controlled trials may improve the oral health in critically ill patients.
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    Evaluation of Reasons for Not Giving Donor Consent by Families of Patients With Brain Death: A Retrospective, Mixed-Method Study
    (Baskent Univ, 2024) Gulsoy, Zuhal; Kol, Iclal Ozdemir; Yildirim, Gulay
    Objectives: The number of patients with organ failure is increasing day by day; today, the numbers of organs and tissues for transplant remain inadequate. This study, which was carried out in a hospital of Sivas Cumhuriyet University in Turkey, aimed to determine reasons for not giving consent for organ donation after brain death and to clarify the familial causes listed among these reasons. Materials and Methods: This study was a retrospective, mixed -method study. Records of patients diagnosed with brain death and patient relatives who stated that they did not donate organs and who agreed to participate were included in the study. Results: Of 48 patients diagnosed with brain death, 39 (81.3%) did not donate organs. Reasons for not donating could be grouped under 5 themes: distrust (communication defects, frustration, anger, not meeting expectations), thoughts that the procedure would not provide benefits, fear (not accepting death, not understanding brain death, and experiencing loss), unwillingness to impair body integrity, and phobia of social reactions. Conclusions: We found that some patient relatives who were not against and even supported organ donation decided not to donate organs at the last minute. Reasons for not giving donation consent included distrust, anger, and frustration resulting from communication problems with health professionals, making the candidate donor feel valueless, previous bad experiences and prejudgments about the institution, and not providing the appropriate physical conditions related to the comfort of the patient relative during the process. It is important to keep in mind that the organ donation process begins with the patient's admission to the hospital; if managed correctly, the process can affect the decision of relatives in a positive way. Identifying and preventing potential obstacles that could affect decisions may increase donation rates. Health professionals with special training on this subject are needed for these situations.
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    First clinical practice experiences of nursing students in intensive care unit: A qualitative study
    (Wiley, 2025) Yildiz, Ezgi; Gulsoy, Zuhal; Karagozoglu, Serife
    Background Nursing students' practice experiences in the intensive care unit will greatly influence their acquisition of professional skills and the development of their future nursing roles. Aim This study aimed to determine nursing students' first clinical practice experiences in the intensive care unit. Study Design The type of research is qualitative research. The study data were collected from 14 students who were doing clinical practice in the anaesthesia intensive care unit of a university hospital. Face-to-face individual interviews were conducted with each student. A semi-structured interview guide was used in the interviews. Data were analysed with MAXQDA Analytics Pro 2020. This study adhered to the COREQ checklist for reporting. Results Four main themes were reached: 'First Emotions in the Intensive Care Unit', 'Experiences Related to the Perception of Profession', 'Experiences Related to Patient Care' and 'Experiences Related to Personal Development'. It was determined that the most prominent feelings in these clinical practice experiences of the students were fear in patient care, satisfaction and professional image in professional acquisition, and making life more meaningful in their perspective on life. Conclusions Students evaluated the intensive care clinical practice as beneficial in terms of professional and personal development. It is recommended that an orientation program be organized for students before intensive care clinical practice. Relevance to Clinical PracticeQualified critical care nurses of the future are a product of a qualified nursing clinical education today.
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    Knot Formed in Nasogastric Tube: A Case Report
    (Galenos Yayincilik, 2019) Gulsoy, Zuhal; Karagozoglu, Serife; Kol, Iclal Ozdemir
    Nasogastric tubes are used for various indications such as gastrointestinal decompression, enteral nutrition, drug administration, naso-biliary drainage and upper gastrointestinal bleeding. In addition to nutrition, nasogastric tubes are frequently used by nurses in order to provide some medicines in intensive care units. Besides the advantages of easy and early access to the gastric tract, and placement by the nurse, there are disadvantages such as position verification difficulty, nasopharyngeal trauma, tube displacement and aspiration risk. In our case, we present a case of mechanical obstruction caused by the knot formed at the end of the tube as a result of the use of nasogastric tube that was not suitable for the purpose. Many complications can be prevented by correct placement of nasogastric tubes, verification of the location before each use, evaluation of obstruction and regular control of the level. Prevention of complications is of great importance in order not to interrupt the treatment and nutrition. In this context, intensive care nurses providing uninterrupted 24-hour care services have vital responsibilities.
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    The Effect of Endotracheal Suctioning on Pain in Conscious Adult Patients in Intensive Care Unit
    (Lippincott Williams & Wilkins, 2024) Gulsoy, Zuhal; Kol, Iclal Ozdemir
    Background and Purpose Pain assessment and management are an important issue to ensure the comfort of patients in the intensive care unit, and reducing pain is an important nursing intervention. Therefore, it is important to evaluate pain correctly. For correct pain management, it is necessary to correctly determine the presence and severity of pain. The study was conducted to determine whether endotracheal suctioning was painless and whether the Behavioral Pain Scale (BPS) was an accurate assessment tool to assess pain during endotracheal suctioning. Methods This study is a prospective clinical study. Thirty-two patients were endotracheal suctioned using the same technique by the same person, and their before-procedure BPS and visual analog scale (VAS) scores were recorded. The study was conducted in the anesthesia and reanimation intensive care unit of a university hospital between December 12, 2020, and April 14, 2021. Results The before-procedure BPS and VAS scores indicated no pain. There was an increase in the procedure BPS score, whereas the VAS score did not change. Conclusions Endotracheal suctioning did not cause pain in conscious patients when the procedure was performed with the correct catheter in accordance with the guideline. In addition, it can be said that BPS is not sufficient to evaluate pain, but the reason for its high level is because endotracheal suctioning is an uncomfortable procedure. Of course, more studies and further studies are needed for a clear result. It is important for health care professionals to relieve or reduce the pain of patients during the endotracheal aspiration procedure. In addition, the presence and severity of pain associated with the endotracheal aspiration procedure should be accurately measured. This study is registered in ClinicalTrials.gov with the IDNCT04634474. The data that support the findings of this study are available from the corresponding author upon reasonable request.
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    The Effect of Endotracheal Suctioning on Pain in Conscious Adult Patients in Intensive Care Unit [2]
    (Lippincott Williams & Wilkins, 2024) Gulsoy, Zuhal; Kol, Iclal Ozdemir
    Background and purpose: Pain assessment and management are an important issue to ensure the comfort of patients in the intensive care unit, and reducing pain is an important nursing intervention. Therefore, it is important to evaluate pain correctly. For correct pain management, it is necessary to correctly determine the presence and severity of pain. The study was conducted to determine whether endotracheal suctioning was painless and whether the Behavioral Pain Scale (BPS) was an accurate assessment tool to assess pain during endotracheal suctioning. Methods: This study is a prospective clinical study. Thirty-two patients were endotracheal suctioned using the same technique by the same person, and their before-procedure BPS and visual analog scale (VAS) scores were recorded. The study was conducted in the anesthesia and reanimation intensive care unit of a university hospital between December 12, 2020, and April 14, 2021. Results: The before-procedure BPS and VAS scores indicated no pain. There was an increase in the procedure BPS score, whereas the VAS score did not change. Conclusions: Endotracheal suctioning did not cause pain in conscious patients when the procedure was performed with the correct catheter in accordance with the guideline. In addition, it can be said that BPS is not sufficient to evaluate pain, but the reason for its high level is because endotracheal suctioning is an uncomfortable procedure. Of course, more studies and further studies are needed for a clear result.It is important for health care professionals to relieve or reduce the pain of patients during the endotracheal aspiration procedure. In addition, the presence and severity of pain associated with the endotracheal aspiration procedure should be accurately measured. This study is registered in ClinicalTrials.gov with the IDNCT04634474.The data that support the findings of this study are available from the corresponding author upon reasonable request.
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    The Efficacy of Continuous Venovenous Hemodiafiltration with Cytokine Filter on Sepsis
    (Erciyes Univ Sch Medicine, 2020) Yildirim, Mehtap; Kol, Iclal Ozdemir; Avci, Onur; Gulsoy, Zuhal; Kaygusuz, Kenan; Gursoy, Sinan
    Objective: Continuous renal replacement therapy is made with high biocompatibility membranes that have high current power by using diffusion and convection together or separately. The aim of the present study was to compare the EMIC-2 and AV600S filters used for continuous venovenous hemodiafiltration (CVVHDF) with respect to the effects on sepsis, the elimination of toxins that are elevated due to acute renal injury, and the effects on inflammatory mediators in severe sepsis. Materials and Methods: The study included 38 patients who were diagnosed with severe sepsis and were treated with hemodiafiltration in the intensive care unit. Acute Physiology and Chronic Health Evaluation-2 (APACHE-2) and Sequential Organ Failure Assessment (SOFA) scores of the patients were calculated before CVVHDF starts. Hematocrit (Hct), white blood cell, blood pressure, heart rate, and body temperature values were measured and recorded. Procalcitonin (PCT), tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-6, and IL-1 values on blood were also recorded before the process and at 8, 16, and 24 h of the process. Results: When the AV600S filtered and EMIC-2 filtered groups are compared, TNF-alpha values are low in the EMIC-2 filtered group (p<0.05). There is no significant difference between the groups with respect to the measurements about APACHE-2, SOFA, IL-1 beta, IL-6, PCT, Hct, body temperature, mean blood pressures, and heart rate. Conclusion: We think that the filters do not cause a significant change on the elimination of inflammatory cytokines, except TNF-alpha, on limited numbers of patients who have sepsis with acute renal injury undergoing CVVHDF with EMIC-2 and AV600S.