Browsing by Author "Erol, S"

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    Is Nurse Workforce Sufficient in Intensive Care Units in Turkey. Results of the Multicenter Karia Study
    Uyan, A; Durmus, G; Sezak, N; Pepe, F; Kaygusuz, T; Öztoprak, N; Özdemir, K; Aksoy, F; Erol, S; Koç, MM; Öncül, A; Çagan Aktas, S; Çaskurlu, H; Çelebi, G; Kandemir, O; Özger, S; Harman, R; Demiray, K; Ari, A; Alkan Çeviker, S; Esen Yildiz, I; Menekse, S; Senol, G; Sari, S; Dogan, M; Ugurlu, K; Arslan, M; Akdemir, I; Firat, P; Kürekçi, Y; Çaglayan, D; Uçar, M; Gözüküçük, R; Elmaslar Mert, HT; Alay, H; Erdogan, H; Demirel, A; Dogan, N; Koçak, F; Güven, E; Ünsal, G; Sipahi, H; Isikgöz Tasbakan, M; Arda, B; Ulusoy, S; Sipahi, OR
    Introduction: In this multicenter study, we analysed the magnitude of healthcare worker (HCW) [infection control practitioner (ICP), nurses and others] workforce in hospitals participated in the study. Materials and Methods: This study was performed in 41 hospitals (with intensive care units-ICU) located in 22 cities from seven regions of Turkey. We analysed the ICP workforce, nursing and auxiliary HCW (AHCW) workforce in ICUs, number of ICU beds and occupied beds in four different days [two of which were in summer during the vacation time (August 27 and 31, 2016) and two others in autumn (October 12 and 15, 2016)]. The Turkish Ministry of Health (TMOH) requires two patients per nurse in level 3 ICUs, three patients per nurse in level 2 ICUs and five patients per nurse in level 1 ICUs. There is no standardization for the number of AHCW in ICUs. Finally, one ICP per 150 hospital beds is required by TMOH. Results: The total number of ICUs, ICU beds and ICPs were 214, 2377 and 111, respectively in he 41 participated centers. The number ICPs was adequate only in 12 hospitals. The percentage of nurses whose working experience was <1 year, was; 19% in level 1 ICUs, 25% in level 2 ICUs and 24% in level 3 ICUs. The number of patients per nurse was mostly <5 in level 1 ICUs whereas the number of patients per nurse in level 3 ICUs was generally >2. The number of patients per other HCW was minimum 3.75 and maximum 4.89 on weekdays and on day shift while it was minimum 5.02 and maximum 7.7 on weekends or on night shift. When we compared the number of level 1, 2 and 3 ICUs with adequate nursing workforce vs inadequate nursing workforce, the p value was <0.0001 at all time points except summer weekend night shift (p=0.002). Conclusion: Our data suggest that ICP workforce is inadequate in Turkey. Besides, HCW workforce is inadequate and almost 1/4 of nurses are relatively inexperienced especially in level 3 ICUs. Turkish healthcare system should promptly make necessary arrangements for adequate HCW staffing.
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    The Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis?
    Ciftci, S; Soyluk, O; Selek, A; Erol, S; Hekimsoy, Z; Esen, A; Dursun, H; Sahin, S; Oruk, G; Mert, M; Soylu, H; Yurekli, BS; Ertorer, ME; Omma, T; Evran, M; Adas, M; Tanrikulu, S; Aydin, K; Pekkolay, Z; Can, B; Karakilic, E; Karaca, Z; Bilen, H; Canturk, Z; Cetinarslan, B; Kadioglu, P; Yarman, S
    The purpose of this study was to determine possible cut-off levels of basal DHEA-S percentile rank in the differential diagnosis of patients with Cushing's syndrome (CS) with ACTH levels in the gray zone and normal DHEA-S levels. In this retrospective study including 623 pathologically confirmed CS, the DHEA-S percentile rank was calculated in 389 patients with DHEA-S levels within reference interval. The patients were classified as group 1 (n=265 Cushing's disease; CD), group 2 (n=104 adrenal CS) and group 3 (n=20 ectopic ACTH syndrome).ROC-curve analyses were used to calculate the optimal cut-off level of DHEA-S percentile rank in the reference interval in the differential diagnosis of CS, and the effectiveness of this cut-off level in the identification of the accurate etiology of CS was assessed in patients who were in gray zone according to their ACTH levels. The DHEA-S percentile rank in the reference interval were significantly lower in group 2 compared to the other two groups (p<0.001), while group 1 and group 3 had similar levels. The optimal cut-off level of DHEA-S percentile rank in the reference interval providing differential diagnosis between group 1 and group 2 was calculated as 19.5th percentile (80.8% sensitivity, 81.5% specificity) and the level demonstrated the accurate etiology in 100% of CD and 76% of adrenal CS patients who were in the gray zone. This study showed that the cut-off value of DHEA-S level less than 20% of the reference interval could be used for differential diagnosis of CD and adrenal CS with high sensitivity and specificity, and it should be taken into the initial evaluation.
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    Impact of antimicrobial drug restrictions on doctors' behaviors
    Karabay, O; Hosoglu, S; Güçlü, E; Akalin, S; Altay, FA; Aydin, E; Ceylan, B; Çelik, A; Çelik, I; Demirdal, T; Demirli, K; Erben, N; Erkorkmaz, Ü; Erol, S; Evirgen, Ö; Gönen, I; Güner, AE; Güven, T; Kadanali, A; Koçoglu, ME; Kökoglu, OF; Küçükbayrak, A; Sargin, F; Sünnetçioglu, M; Senol, S; Isikgöz Tasbakan, M; Tekin, R; Turhan, V; Yilmaz, G; Dede, B
    Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics. Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician. Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had <= 5 years of occupational experience (junior specialists = JSs) and 942 (49.4%) of them were physicians. Specialists having >5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05). Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did.