Journal of Nursing Theory and Practice

[Surgical isolation protocol and cost-effectiveness]


APRIL 30, 2012

Journal of Nursing Theory and Practice - 2012;25(02)

[A fundamental prerequisite for surgical procedure is full compliance with the rules on ensuring asepsis and antisepsis. The isolation and special clothing of the patient and surgical team has a long history. The doctors of our grandfathers’ generation donned white, and those of our fathers’ generation green clothing, while we now live in the age of the disposable isolation attire. The author aims was to demonstrate, through the work conducted at the central operating theatre of a county hospital, how a disposable isolation solution - used properly - is more cost-effective than a textile-based isolation system. The author introduces the professional guidelines for the use of a disposable isolation system, and the phases in its implementation and application. Through a cost analysis he proves that a properly used disposable isolation system represents a smaller financial burden for the given institution than the textile isolation systems used previously. Disposable isolation systems have lived up to expectations in day-to-day use, and there is demand for their use. ]



Further articles in this publication

Journal of Nursing Theory and Practice

[The importance of patient education and ILCO clubs in the rehabilitation of stoma patients]

VARGÁNÉ Terhes Anita

[Aim of the study: The author aims to reveal and propose a solution for the flaws in the education of stoma patients, especially with regard to patient education at the Department of Surgery in Szeged. She examined the opinions, attitudes and knowledge of stoma patients regarding patient information, rehabilitation, and the extent to which they participated in the self-help groups. Methodology and sample: In the course of the quantitative descriptive research a questionnaire-based survey was conducted among the stoma patients treated and cared for at the institute (N=96). The data was processed using mathematical statistical methods. Results: 83% of the patients received lifestyle information at the institute, which helped them to accept their illness, and 99% of them were taught about stoma care at the clinic. The patients that participated in the training course, with the assistance of the stomal therapy nurse, were better able to accept their disease. The proportion of those participating in the self-help group was 51%, despite the fact that 65% of those asked regarded the ILCO club as useful. Conclusions: The provision of lifestyle information and the development of patient education at the department have an important role, because the majority of the patients express no demand for club membership. The author also takes the opportunity to highlight the importance of a holistic and multidisciplinary approach to the nursing of stoma patients. ]

Journal of Nursing Theory and Practice

[The situation of healthcare vocational training and nurse training at the Ferenczi Sándor Healthcare Vocational School, Miskolc]

KONCZNÉ Kiss Krisztina

[Aim of the study: The author aims to examine the opinions of healthcare vocational school students participating in the survey, with regard to further education and working abroad. The study also examines how attractive nursing training is to the students, and whether the student scholarship program has any effect on their choice of major. She attempts to assess the extent to which the place of nursing in the employment hierarchy, and the dimension of prestige, influence the value that society places on nursing. Methodology and sample: The descriptive, prospective research was conducted by means of a questionnaire-based survey of 12-year students prior to taking their general secondary school examinations (n=106), and year 14-15 students in vocational training (n=137), at Ferenczi Sándor Healthcare Vocational School, Miskolc. The data was collated using the SPSS program, and the processing of the results thus obtained took place using statistical mathematical (frequency, correlative coefficient) techniques. Results: Some 58% of the students about to sit their general secondary school examinations would enrol for nurse training at the school if they received a monthly scholarship grant. A total of 83% of the students in vocational training would like to find work that matches their acquired qualification, 63% would like to remain in education, while 35% would like to start work immediately after sitting the examination. More than 80% of the students are attracted by the opportunity to work abroad. In their opinion the social perception of nursing is lower than that of the other occupations. Conclusions: Due to the low prestige of the nursing profession and the low pay, students are not inclined to choose nurse training; however, the system of scholarship grants, as a motivational force, serves as a positive incentive to continue studying. The lack of financial rewards, however, prompts many of them consider migration.]

Journal of Nursing Theory and Practice

[The specialities and competencies of nurse-level triage in paediatric emergency care ]

NAGY Gábor, PÁPAI Tibor

[A part of the emergency patient care system is paediatric emergency care, the organisation and management of which must take place in accordance with the same guiding principles and consensuses as adult emergency care. Owing to the special requirements stemming from the children’s age, anatomy and physiology, the assessment, categorisation, diagnostics, therapeutic interventions and implementation of the nursing process require special knowledge, skills and competencies in comparison to adult emergency care. The paper describes the process of patient admission and triage in intra-hospital paediatric emergency care in Hungary, with regard to the related nursing competencies. ]

All articles in the issue

Related contents

Clinical Oncology

[Circulating tumor cells - a promising new approach]


[It is an old observation, that tumor cells can escape from the primary, travel with the circulation, and fi nally be arrested in distant places. To know the potential „advantage” of this phenomenon (circulating tumor cells, CTC) is very important. One of the key questions is the proper sensitivity of isolation and characterisation techniques being able to represent the heterogeneity of tumorous clones. There is no doubt that the time arrived for the application of minimal invasive markers in oncology, with the hope that the survival of the patients can be improved using real-time monitoring and more effective therapy. The analysis of CTCs/cfDNA and other markers (e.g. miRNA, exosomes) obtained from the blood will be, hopefully, rutine tool in designing therapeutic strategy, and monitoring tumor response.]

Clinical Neuroscience

The etiology and age-related properties of patients with delirium in coronary intensive care unit and its effects on inhospital and follow up prognosis

ALTAY Servet, GÜRDOGAN Muhammet, KAYA Caglar, KARDAS Fatih, ZEYBEY Utku, CAKIR Burcu, EBIK Mustafa, DEMIR Melik

Delirium is a syndrome frequently encountered in intensive care and associated with a poor prognosis. Intensive care delirium is mostly based on general and palliative intensive care data in the literature. In this study, we aimed to investigate the incidence of delirium in coronary intensive care unit (CICU), related factors, its relationship with inhospital and follow up prognosis, incidence of age-related delirium and its effect on outcomes. This study was conducted with patients hospitalized in CICU of a tertiary university hospital between 01 August 2017 and 01 August 2018. Files of all patients were examined in details, and demographic, clinic and laboratory parameters were recorded. Patients confirmed with psychiatry consultation were included in the groups of patients who developed delirium. Patients were divided into groups with and without delirium developed, and baseline features, inhospital and follow up prognoses were investigated. In addition, patients were divided into four groups as <65 years old, 65-75 yo, 75-84 yo and> 85 yo, and the incidence of delirium, related factors and prognoses were compared among these groups. A total of 1108 patients (mean age: 64.4 ± 13.9 years; 66% men) who were followed in the intensive care unit with variable indications were included in the study. Of all patients 11.1% developed delirium in the CICU. Patients who developed delirium were older, comorbidities were more frequent, and these patients showed increased inflammation findings, and significant increase in inhospital mortality compared to those who did not develop delirium (p<0.05). At median 9-month follow up period, rehospitalization, reinfarction, cognitive dysfunction, initiation of psychiatric therapy and mortality were significantly higher in the delirium group (p<0.05). When patients who developed delirium were divided into four groups by age and analyzed, incidence of delirium and mortality rate in delirium group were significantly increased by age (p<0.05). Development of delirium in coronary intensive care unit is associated with increased inhospital and follow up morbidity and mortality. Delirium is more commonly seen in geriatric patients and those with comorbidity, and is associated with a poorer prognosis. High-risk patients should be more carefully monitored for the risk of delirium.

Clinical Neuroscience

[Zonisamide: one of the first-line antiepileptic drugs in focal epilepsy ]


[Chronic administration of antiepileptic drugs without history of unprovoked epileptic seizures are not recommended for epilepsy prophylaxis. Conversely, if the patient suffered the first unprovoked seizure, then the presence of epileptiform discharges on the EEG, focal neurological signs, and the presence of epileptogenic lesion on the MRI are risk factors for a second seizure (such as for the development of epilepsy). Without these risk factors, the chance of a second seizure is about 25-30%, while the presence of these risk factors (for example signs of previous stroke, neurotrauma, or encephalitis on the MRI) can predict >70% seizure recurrence. Thus the International League Against Epilepsy (ILAE) re-defined the term ’epilepsy’ which can be diagnosed even after the first seizure, if the risk of seizure recurrence is high. According to this definition, we can start antiepileptic drug therapy after a single unprovoked seizure. There are four antiepileptic drugs which has the highest evidence (level „A”) as first-line initial monotherapy for treating newly diagnosed epilepsy. These are: carbamazepine, phenytoin, levetiracetam, and zonisamide (ZNS). The present review focuses on the ZNS. Beacuse ZNS can be administrated once a day, it is an optimal drug for maintaining patient’s compliance and for those patients who have a high risk for developing a non-compliance (for example teenagers and young adults). Due to the low interaction potential, ZNS treatment is safe and effective in treating epilepsy of elderly people. ZNS is an ideal drug in epilepsy accompanied by obesity, because ZNS has a weight loss effect, especially in obese patients.]

Clinical Neuroscience

Autonomic nervous system may be affected after carpal tunnel syndrome surgery: A possible mechanism for persistence of symptoms after surgery

ONDER Burcu, KELES Yavuz Betul

After carpal tunnel surgery, some patients report complaints such as edema, pain, and numbness. Purpose – The aim of this study was to evaluate autonomic nervous system function in patients with a history of carpal tunnel surgery using sympathetic skin response (SSR). Thirty three patients (55 ±10 years old) with a history of unilateral operation for carpal tunnel syndrome were included in the study. The SSR test was performed for both hands. Both upper extremities median and ulnar nerve conduction results were recorded. A reduced amplitude (p=0.006) and delayed latency (p<0.0001) were detected in the SSR test on the operated side compared to contralateral side. There was no correlation between SSR and carpal tunnel syndrome severity. Although complex regional pain syndrome does not develop in patients after carpal tunnel surgery, some of the complaints may be caused by effects on the autonomic nervous system.