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Intravenous injection is one of the most frequently performed invasive nursing procedures in hospitals. However, patients may experience pain and anxiety during this procedure, which can affect patient satisfaction.
The aim of this study was to determine the levels of pain, anxiety and satisfaction in patients undergoing intravenous injection and to examine the sociodemographic, clinical and procedural factors affecting these levels.
A descriptive, cross-sectional study was conducted between August and November 2025 in the emergency departments of Atatürk University Research Hospital, a large tertiary care university hospital. This single-centre study was carried out in a high-volume emergency department that provides 24-hour services to a diverse patient population. A total of 405 patients who received intravenous injections and agreed to participate in the study were included. Data were collected using an Information Form, Visual Analogue Scale (VAS) for pain, VAS for anxiety and Post-Injection Satisfaction Scale. Descriptive statistics, t-tests, analysis of variance, correlation analyses and multiple regression analyses were used to analyse the data.
The mean pain VAS score for patients was 4.39±2.33, the mean anxiety VAS score was 4.42±2.14 and the mean Post-Injection Satisfaction Scale score was 3.51±0.77, indicating moderate levels of pain and anxiety on a 0–10 VAS. Women were found to have significantly higher levels of pain and anxiety than men (p
It was found that patients experienced moderate pain and anxiety during intravenous injection and that this situation negatively affected patient satisfaction. The results indicate that individualised nursing approaches in intravenous injection practices and the implementation of pharmacological and non-pharmacological interventions aimed at reducing pain and anxiety may increase patient satisfaction.
Early and balanced replacement of blood products appears to be the key factor in improving outcomes of major bleeding patients including acute trauma, cardiac, obstetric and transplant surgery patients. Definitive clinical guidance regarding the optimal ratio of blood products, including those containing fibrinogen, is still lacking. Therefore, we tested the hypothesis that increasing the fibrinogen content to erythrocyte suspension ratio improves the mortality and functional outcomes of patients undergoing surgeries with expected major bleeding.
The Approximate Dose-Equivalent of Fibrinogen-to-Erythrocyte Suspension (ADEFES) ratio is a multicentre, prospective, observational, cohort study of patients undergoing major surgical procedures with expected major perioperative bleeding (ie, requiring packed red blood cells (PRBC)>4U/24 hours). For 5U of cryoprecipitate and 1.5 U of fresh frozen plasma (FFP), the approximate dose-equivalent for fibrinogen is considered as 1 gram of fibrinogen. Association of the ADEFES ratio at 24 hours will be assessed on the primary objective, which will consist of the composite of 30-day all-cause mortality, 30-day bleeding-specific mortality and the ‘highly-dependent scores’ of Katz index of independence in activities of daily living.
The study protocol was approved by the Ethics Committee of Ankara Bilkent City Hospital (approval no. E2-23-4265, dated 07 June 2023; Chair: Prof. Dr. F.E. Canpolat) and by the institutional review boards of all participating centres. The study will be conducted in accordance with the principles of the Declaration of Helsinki and the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, as well as in compliance with national regulations on data protection and Good Clinical Practice standards. Written informed consent will be obtained from all participants prior to inclusion in the study.
The results of this study will be disseminated through peer-reviewed scientific journals, presentations at national and international conferences, and communication with relevant stakeholders including clinical practitioners and healthcare institutions. If applicable, study outcomes will also be shared via institutional newsletters and digital platforms to reach a broader audience in the medical community.
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