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    Effects of Different Head-of-Bed Elevations and Body Positions on Intracranial Pressure and Cerebral Perfusion Pressure in Neurosurgical Patients
    (Lippincott Williams & Wilkins, 2018) Ugras, Gulay Altun; Yuksel, Serpil; Temiz, Zeynep; Eroglu, Selin; Sirin, Keziban; Turan, Yuksel
    Purpose: The aim of this study was to evaluate the effects of different head of bed (HOB) elevations and body positions on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) and to identify safe positions for neurosurgical patients with different Glasgow Coma Scale (GCS) scores. Methods: This study with a quasi-experimental, prospective repeated measures is designed with control over the intervention consisted of 30 patients hospitalized in the neurocritical care units (NCU). Patients' HOB was elevated (degree of 15,30,45) and the patients were at supine, left lateral and right lateral positions. ICP and CPP were recorded for each patient. Results: It was found that ICP increased and CPP decreased at supine, left and right lateral positions with different HOB elevations, which, however, did not reach statistical significance. When patients with a GCS score of 3-8 were at degree of 15 right and left lateral positions and 45 right lateral position; and when patients with a GCS score of 13-15 were positioned at degree of 15 left lateral, ICP and CPP changed significantly. Conclusion: The results of this study showed that different positions the patients' HOB (degree of 15,30,45) led to slight insignificant changes in ICP and CPP; and these values were maintained within the ranges established by recent guidelines.
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    Health Problems and Reasons for Stress of Intensive Care Nurses During COVID-19
    (Aves, 2022) Ugras, Gulay Altun; Yuksel, Serpil; Dolek, Elife Kettas; Erden, Sevilay; Sirin, Keziban
    AIM: This study aimed to examine health problems and related reasons for stress including physiological, psychological, and patient-care-related stressors among intensive care unit (ICU) nurses during COVID-19 in Turkey. METHOD: This study was designed as a cross-sectional study. Data were collected between June and July 2020 and from 1140 ICU nurses who were actively working in the pandemic process from 65 provinces in Turkey. An online questionnaire was used consisting of questions regarding nurses' health problems, reasons for psychological, physiological, and patient care-related stress during the pandemic. Descriptive data were presented in mean, median, or number and percentage. RESULTS: Only 15.6% of ICU nurses experienced health problems. Nurses had psychological symptoms such as anxiety, insomnia, and physiological symptoms such as respiratory, musculoskeletal symptoms. The majority of nurses experienced the following psychological stressors: fear of being a COVID-19 carrier and infecting loved ones, and getting sick with COVID-19. Reasons for physiological stress were mostly due to working with personal protective equipment (PPE), skipping toilet breaks, and inadequate hydration. Reasons for patient care-related stress included excessive sweating in PPE, fogging of goggles, and inability to select a venipuncture site with double gloves. CONCLUSION: The findings of this study indicate that almost one-fifth of ICU nurses experience various health problems although most of them experience intense psychological, physiological, and patient care-related stress.