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    Gluteal muscle and subcutaneous tissue thicknesses in adults: a systematic review and meta-analysis
    (Sage Publications Ltd, 2023) Gulnar, Emel; Ordu, Yadigar; Bayram, Sule Biyik; Caliskan, Nurcan
    Background: Nurses often administer intramuscular injections at the gluteal site. This study aimed to determine gluteal muscle and subcutaneous tissue thicknesses in adults. Methods: Systematic review and meta-analysis. The databases Turkish Medline, Ulakbim, National Thesis Center, Cochrane, Web of Science, Science Direct, PubMed, CINAHL Plus with Full text (EBSCO host), OVID and SCOPUS were screened using the keywords 'intramuscular injection', 'subcutaneous tissue thickness', 'muscle tissue thickness' and 'needle length' between April and May 2021. The studies were evaluated with ultrasound. This study was reported according to the PRISMA recommendations. Results: Six studies met the eligibility criteria. The total sample size was 734 (women: 432, men: 302). The V method revealed that the ventrogluteal site had a muscle and subcutaneous tissue thickness of 38.071 +/- 2.119 and 19.927 +/- 2.493 mm, respectively. The geometric method revealed that the ventrogluteal site had a muscle and subcutaneous tissue thickness of 35.989 +/- 4.190 and 19.661 +/- 3.992 mm, respectively. The geometric method also revealed that the dorsogluteal site had a thickness of 42.560 +/- 8.840 mm. According to the V method, females had thicker subcutaneous tissue at the ventrogluteal site than males (Q = 5.37, df = 1, p = 0.0204). Body mass index did not affect the subcutaneous tissue thicknesses at the ventrogluteal site. Conclusion: The results show that gluteal muscle, subcutaneous and total tissue thicknesses vary across injection sites.
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    Obstacles to Providing Urinary Incontinence Care Among Nurses in Turkey: A Descriptive Study
    (Hmp, 2019) Caliskan, Nurcan; Gulnar, Emel; Aydogan, Sinan; Bayram, Sule Biyik; Yagci, Nilay
    Nurses play an important role in identifying, evaluating, monitoring, and managing patients with urinary incontinence (UI). PURPOSE: This study was conducted to determine nurses' knowledge, attitudes, practices, and obstacles to managing patients' UI. METHODS: A descriptive study was conducted between September 2017 and February 2018 at 2 university hospitals, 2 private hospitals, and 4 state hospitals in a metropolitan city in Turkey. All registered nurses present at the times of data collection were eligible to participate. After providing informed consent, they were asked to complete a 25-item demographic characteristic questionnaire, a 7-item UI assessment and care implementation form, a 12-item form assessing obstacles faced during UI care provision, a 24-item UI knowledge questionnaire (higher scores indicated more knowledge; a score of 70% correct was considered adequate), and the Urinary Incontinence Attitude Scale. The latter comprised 15 Likert-type questions that measures attitudes toward UI symptoms, treatment, and prevention (maximum score of 60; higher scores infer positive attitude). Data were collected and entered into a software program for statistical analysis including Mann Whitney U, chi-square, and correlation tests. Incomplete forms were excluded. RESULTS: Of the 475 potential participants, 254 nurses completed all forms; 228 (89.8%) were women, 177 (69.7%) had a bachelor's degree, 146 (57.5%) worked in a state hospital, and 105 (41.3%) worked for 2 to 3 years. The mean score for UI knowledge was 15.22 +/- 3.43 (range 0-24), and the mean attitude score was 46.40 +/- 5.50 (range 15-60). The major nurse- or hospital-related obstacles to providing UI care were a lack of systems for patient follow-up (67.7%) and lack of patient education materials (60.2%). A weak positive correlation was noted between UI knowledge level and attitude (r = 0.263; P =.000). CONCLUSION: Although nurses had a positive attitude toward UI, UI knowledge scores were low. Lack of patient follow-up systems and patient education materials were important obstacles to nurses providing UI care. In addition to addressing these obstacles, postgraduation evidence-based UI education for nurses is needed to optimize care.
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    The effect of digital storytelling on nursing students' compliance with isolation precautions and their knowledge levels: A randomized controlled trial
    (Wiley, 2024) Bayram, Sule Biyik; Gulnar, Emel; Caliskan, Nurcan; Kilic, Cigdem Torun
    Background: Digital storytelling is a teaching tool that can help nursing students master the curriculum and improve their skills. This study investigated the effect of digital storytelling on nursing students' knowledge levels and compliance with isolation precautions. Methodology: A pretest-posttest open-label randomized controlled trial. This study was conducted in the nursing department of the faculty of health sciences of a university in T & uuml;rkiye. The sample consisted of 109 fourth-year nursing students divided into experimental (n = 66) and control (n = 43) groups. Data were collected using a Demographic Characteristics Questionnaire (DCQ), the Isolation Knowledge Test (IKT), the Questionnaire of Students' Opinions on Digital Storytelling (QSODS) and the Scale of Compliance with Isolation Precautions (SCIP). The experimental group participated a digital storytelling activity, whilst the control group received an education based on the curriculum. The data were analysed using the Mann-Whitney U test, the Wilcoxon test, analysis of variance (ANOVA), and the Spearman correlation test. Results and Conclusions: The experimental group had significantly higher posttest IKT and SCIP scores than the control group (p < 0.05). Both groups had lower IKT and SCIP scores 2 months after the experiment. However, the change was much smaller in the experimental group. Digital storytelling helped the experimental group participants learn about isolation precautions and how to comply with them. Digital storytelling also promotes learning retention. In conclusion, digital tools are effective in distance learning.
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    The effect of flipped learning on blood pressure knowledge and self-directed learning skills of first-year nursing students: A randomized controlled trial
    (Elsevier Sci Ltd, 2023) Bayram, Sule Biyik; Gulnar, Emel; Ozveren, Huesna; Caliskan, Nurcan
    Aim: This study investigated the effect of flipped learning on first-year nursing students' blood pressure knowledge levels and self-directed learning skills. Background: Flipped learning is an innovative approach that helps nursing students learn about blood pressure and how to measure how to measure blood pressure accurately. Flipped learning also promotes active and student-centered learning settings and encourages nursing students to develop self-directed skills. Design: This study adopted a pretest-posttest open-label randomized controlled trial. Method: The sample consisted of 94 first-year nursing students randomized into experimental (n = 48) and control groups (n = 46). The experimental group participants were trained using the flipped learning model. Data were collected using a personal information form, the Blood Pressure Knowledge Test (BPKT) and the Self -Directed Learning Skills Scale (SDLSS). Results: There was no significant difference in pretest BPKT scores between the experimental and control groups. However, there was a significant difference in posttest BPKT scores between the experimental and control groups (p = 0.011). Moreover, there was a significant difference between the experimental group's mean pretest, posttest and follow-up SDLSS scores (p = 0.009). Conclusion: The experimental group had a significantly higher mean posttest BPKT score than the pretest score. They had significantly higher mean posttest SDLSS total and self-monitoring, motivation, and self-confi-dence subscale scores than the pretest score.
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    The effect of mobile assisted teaching on nursing students' learning ventrogluteal injection application: The case of Turkey
    (Wiley, 2024) Bayram, Sule Biyik; Ozener, Gamze; Cakici, Nilay; Eren, Handan; Aydogan, Sinan; Ozturk, Deniz; Gulnar, Emel
    Background: There are deficiencies in ensuring the permanence of some theoretical information taught in nursing education and transferring it to practice environment. Mobile-assisted teaching can be useful to eliminate deficiencies. The aim of this study was to determine the effect of mobile-assisted teaching on nursing students' learning ventrogluteal injection.Methodology: The study was conducted in Turkey between February and June 2022. This study is a single group pre-posttest intervention. The study sample consisted of 354 students studying in the 2nd, 3rd and 4th grades in Turkey. After the students completed the Introductory Characteristics Form and Ventrogluteal Region Information Suggestion Form in the pre-test, the researchers sent a ventrogluteal injection animation video to their mobile phones. The students who watched the video completed the Ventrogluteal Region Information Suggestion Form and Mobile Education Activity Form in the final test.Results and Conclusion: There was a statistically significant difference between the pre-posttest score medians of the students (p < 0.001). While the preference of the students for the ventrogluteal region in intramuscular injection was 28.5% before mobile learning, it increased to 51.1% after the training. In this study, after the training given through mobile learning, the knowledge level of the students about ventrogluteal injection and their preferences for ventrogluteal injection increased. In line with these results, mobile-assisted education should be used in nursing education.
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    The effect of Mobile-Assisted training and counseling on nurses' ventrogluteal injections application of nursing: A mixed method study
    (Wiley, 2024) Guelnar, Emel; Ozener, Gamze; Yilmaz, Asli; Aydogan, Sinan; Gencer, Ozge; Bayram, Sule Biyik; Ozturk, Deniz
    Background: Nurses often administer intramuscular (IM) injections. However, they do not use the ventrogluteal (VG) site, although it is highly recommended. Aim: This study investigated whether a mobile-assisted training and counseling program (intervention) encouraged nurses to use the VG site to administer IM injections. Methods: This study adopted a pretest-posttest interventional design with no control group and employed a mixed research design. The sample consisted of 105 nurses from a public hospital in a metropolitan city in Turkey. Quantitative data were collected using a descriptive characteristics form and a Ventrogluteal Site Information Form (VSIF). Qualitative data were collected using a semi-structured interview form. First, participants took a pretest and then watched an animation about VG injections on their mobile devices. Afterward, they were provided with counseling and then administered a posttest. Sixteen participants were interviewed after the posttest. Results: Participants had a significantly higher mean posttest VSIF score (17.50 + 3.23) than the pretest score (12.73 + 5.40) (p < 0.05). They stated that the intervention helped them reinforce what they already knew and encouraged them to use the VG site to administer IM injections. They also noted that it boosted their confidence and helped them experience less anxiety. Conclusion: The results showed that the intervention helped participants learn more about IM injections into the VG site. Therefore, hospitals should provide nurses with mobile-assisted training and counseling programs to encourage them to use the VG site to administer IM injections.
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    The Effect of Two Types of Subcutaneous Heparin Injections on Pain, Ecchymosis, Hematoma and Drug Absorption: A Quasi-Experimental Study
    (Wiley, 2025) Bayram, Sule Biyik; Gulnar, Emel; Caliskan, Nurcan; Kosucu, Polat; Bektas, Onur; Bayram, Aysun; Aksoy, Fatma
    Background: Subcutaneous heparin injections sometimes cause pain, ecchymosis, and hematoma. The prevalence of complications depends on the injection site, technique, and drug absorption. This study investigated the effect of two types of subcutaneous heparin injections on pain, ecchymosis, and hematoma as well as drug absorption rates. Methods: The study is a quasi-experimental. The research was conducted between September 2021 and May 2022. The sample consisted of 122 patients treated in the general surgery clinic of a university hospital in the Black Sea region of T & uuml;rkiye. We used ultrasonography (USG) to measure the subcutaneous tissue thicknesses of the sites before heparin injections. We used the tissue-releasing technique (TRT) to administer heparin injections to 68 participants (Group TRT). We used the tissue-pinching technique (TPT) to administer heparin injections to 54 participants (Group TPT). We administered all injections into the arm or abdomen. We used a Subcutaneous Injection Form to collect data. We monitored all participants for the injection site, drug absorption after 1 day, pain, ecchymosis, and hematoma for 3 days. Results: There was no significant difference in the prevalence of pain, ecchymosis, and hematoma between the groups (p > 0.05). Most injections into the arm and abdomen resulted in drug absorption. However, one in ten injections into the arm resulted in the needle reaching the muscle rather than the subcutaneous tissue (11.7%). Abdominal injections caused no complications. The drug was administered in the right place in abdominal injections. Conclusion: The tissue-releasing and TPTs are not superior to each other as far as drug absorption, pain, ecchymosis, and hematoma are concerned. In this study recommend pinching the tissue or using the abdominal region in cases where the subcutaneous tissue thickness is less than 15.96 mm. The nurse should consider Body Mass Index before choosing the right subcutaneous heparin injection site and the correct injection technique.