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AMAÇ: Araştırmanın amacı, hekim, hemşire ve diğer sağlık personellerinden oluşan sağlık çalışanlarının Sağlık Bakanlığına bağlı devlet hastaneleri, toplum sağlığı ve aile sağlığı merkezlerinde (TSM/ASM) çalışan hemşirelerin sorunlarına ilişkin görüşlerinin belirlenmesidir. YÖNTEM: Araştırma, Trabzon'daki devlet hastaneleri, toplum ve aile sağlığı merkezlerinde çalışan toplam 940 hemşire, 389 hekim ve 395 diğer sağlık personeli ile gerçekleştirilmiştir. Veriler, demografik özelliklerle ilgili sekiz soru, hemşirelerin sorunları ve çözüm önerilerine yönelik açık uçlu iki sorudan oluşan anket formu ile toplanmıştır. BULGULAR: Hastanede çalışan hemşirelerin %19'u öncelikle döner sermayeden izinli ya da raporlu günlerde yararlanılmamasını, hekimlerin %14'ü maaş ve zamların düşük olmasını, diğer sağlık personelinin %14'ü döner sermayenin sağlık personeli arasında adil dağıtılmamasını, toplum sağlığı merkezi ve aile sağlığı merkezindeki hemşirelerin %31'i, hekimlerin %32'si ve diğer sağlık personelinin %12'si maaş ve zamların düşük olmasını hemşirelerin sorunları arasında belirtmişlerdir. SONUÇ: Tüm sağlık personeli, hemşirelerin ücretlendirilme, yönetim ve yasal düzenlemelere ilişkin sorunları olduğunu belirtmiştir.

Journal of Surgery IntroductionOperating rooms, due to their complex structure and crowdedness and cases that can change suddenly, are the surgical units where unwanted incidents can occur frequently [1]. Forgetting a sponges and instruments in the surgical field is one of these unwanted incidents that may occur in an operating room [2,3]. Forgetting a sponges and instruments inside patient's body, is not a medical error but a preventable incident [4,5]. Studies demonstrate that the rate of forgetting a surgical sponges and instruments inside a patient's body, ranges from 1/1,500 to 1/19,000 [5,6]. American Surgical Association stated that retained surgical instruments case is occured at least once a year in each hospital and significant procedures are applied for 8,000 and 18,000 of these [7,8]. Retained surgical instruments cases mostly happens in the surgical field of abdomen (46-55%), but also pelvis, chest, and vagina can be included in this category [5,9]. The frequency of retained foreign objects cases ranges from 1/1,000 to 1/1,500 in abdominal and pelvic surgery. Although it is not frequent, retained foreign objects cases is found in orthopedics, urology and neurologic operations [5].During the course of surgery, everthing which can cause a reaction in patient, can be identified as foreign object. Within this scope, the most frequent retained surgical instruments are, sponge that ranks first and followed by surgical instruments, ecarteur, needle and compress [3,9,10]. Furthermore, broken surgical instruments, rubber tubes, and AbstractAim: Although retained foreign bodies are a rare and preventable problem, it is one of the medical errors in surgery can have heavy medico-legal consequences. Retained sponges can cause significant morbidity, prolonged hospital stay, postoperative complications, pain and disabilities. Also the costs associated with treatment of retained surgical items can be considerable. The study was undertaken to determine the current implementations related to instruments and sponges counts in the operating rooms in Turkey.Method: This descriptive study was carried out with 261 operating room nurses. The data collection tool was a questionnaire which was designed on the Google Drive application using the internet. Thereafter its internet link was distributed throughout Turkey using nursing, surgical nursing and operating room nursing social media websites; the answers were gathered in the same way.Results: Ninety-five percent of participants stated that instruments and sponges were usually counted by the scrub nurses (88.5%). Sponges (97.7%), pads (95.4%), tampons (89.2%), surgical instruments (88.1%) and needles (70.4%) were the items which were usually counted. According to 81.6% of the nurses, a written count protocol exists for their hospitals, however, they noted there was a significant difference in implementation among the various institutions (p=0.026). While 49.8% of participants stated that the count before surgery was done by nurses, 23.7% reported that the count was perfor...

Nutritional screening tools are mainly used to identify patients at risk of malnutrition. We aimed to compare commonly used nutritional tools in assessing the nutritional status of patients undergoing surgery for gastric cancer Methods: Consecutive patients undergoing surgery for gastric cancer between January 2017 and May 2019 were retrospectively evaluated from the comprehensive database. Nutritional Risk Screening-2002 (NRS), Malnutrition Universal Screening Tool, Subjective Global Assessment, Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Screening Tool, and Short Nutritional Assessment Questionnaire scores were calculated for all patients. The assessment capabilities of these tools were compared using the European Society for Clinical Nutrition and Metabolism (ESPEN) diagnostic criteria for malnutrition as the reference standard. The distinctive abilities of the tool risk groups were also evaluated using parameters reflecting nutritional status, including albumin, lymphocyte count, and fat-free mass index. Results: One hundred forty patients with the mean age of 64.2±11.8 years were analyzed, and 29 (20.71%) of whom were diagnosed as malnourished based on the ESPEN criteria. The strongest association (phi=0.62, large effect) and the highest agreement (kappa=0.59, moderate agreement) between tools and malnutrition were found for MNA-SF. This exhibited the highest specificity (0.84, 95% CI: 0.76 to 0.90), positive predictive value (0.58, 95% CI: 0.42 to 0.73), accuracy (0.84, 95% CI: 0.77 to 0.90), area under curve (0.850, 95% CI: 0.777 to 0.923), and diagnostic odds ratio (32.29, 95% CI: 10.02 to 104.04). Statistically significant decreases in all three parameters were observed only for the NRS risk groups. Additionally, MNA-SF exhibited a statistically significant decrease in the fat-free Amaç: Beslenme tarama araçları çoğunlukla malnutrisyon riski olan hastaları belirlemek için kullanılır. Bu çalışmada mide kanseri nedeniyle ameliyat planlanan hastaların beslenme durumlarını değerlendirmede sıklıkla kullanılan beslenme araçlarını karşılaştırmayı amaçladık. Yöntemler: Ocak 2017-Mayıs 2019 tarihleri arasında mide kanseri nedeniyle ameliyat olan hastalar, kapsamlı veri tabanından elde edilen bilgiler ile retrospektif olarak değerlendirildi. Tüm hastalar için Nutritional Risk Screening-2002 (NRS), Malnutrition Universal Screening Tool, Subjective Global Assessment, Mini Nutritional Assessment-Kısa Form (MNA-SF), Malnutrition Screening Tool, ve Short Nutritional Assessment Questionnaire araçlarının skorları hesaplandı. Bu araçların beslenme değerlendirme becerilerinin karşılaştırılmasında, referans standart olarak Avrupa Klinik Beslenme ve Metabolizma Derneği'nin (ESPEN) malnutrisyon tanı kriteri kullanıldı. Araçların risk gruplarını ayırt edici özellikleri ise albümin, lenfosit sayısı ve yağsız kitle indeksi gibi beslenme durumunu yansıtan parametreler kullanılarak değerlendirildi. Bulgular: Bu çalışmada yaş ortalaması 64.2±11.8 olan toplam 140 hasta analiz edildi ve bu hastaların 29'u (%20.71) E...