The global nursing shortage has many faces. Health and education
systems are both undergoing revolutionary changes which have
disrupted traditional health and educational practices. Business values
have replaced both health and educational norms and professional
values. The commodification of education and health has increased
the need for common educational standards which in the case of
nursing has facilitated nurse migration and the export of nurse
education. Unfortunately it threatens to standardize down as well as
up. In other words, without considering the needs of a 21st century
education which, in the health professions more generally has not
kept pace with societal needs, there is a risk that the nursing profession
seen as a commodity, will face educational deskilling in the interest
of maximizing profits in the expanding privatized health and education
systems. This paper argues that the nursing profession must be open
to new ideas that will transform both education and practice.

Many pregnancies in the world, including those in developed countries,
are unplanned. The health of a woman and her partner before pregnancy
may determine the fate of the baby. The concept of preconception care
emerged about thirty years ago in developed countries in order to prevent
poor obstetric outcomes. This approach focuses on improving the health
of expectant mothers and fathers before conception and includes a
number of pre-pregnancy initiatives to achieve a healthy pregnancy
term and healthy baby. This modern primary-care service must be
available to all women in their reproductive ages, not only for couples
who are planning to have children. The healthcare providers working
in related fields are on the team that will make this change in Turkey.
They need education and counseling to increase their awareness of this
issue and to ensure they are competent in order to offer a comprehensive
service. The scope and benefits of preconception care, evaluation criteria,
health service models, and the responsibility of healthcare providers
will be addressed in this article.

OBJECTIVE: The aim of this study was to determine the views of first-year
nursing students in their first clinical practice and fourth-year students
regarding the use of peer education methods in clinical practice.
METHODS: The participants were first and fourth-year students at one
state university nursing faculty. A qualitative, semi-structured focus
group technique was used. Four focus group interviews were conducted
with 45 students, of which 22 were first-year and 23 were fourth-year
students.
RESULTS: First-year students reported they experienced anxiety from
encountering their first patient, having a lack of information, and
making a mistake; however, they stated that the support of fourthyear
students was effective in reducing their anxiety. During the
practice, students reported that they felt excited, brave, safe, worthy,
and important. At the same time they reported that they got an idea
about how to use their nursing knowledge in practice effectively.
Peer-education also contributed both positive and negative outcomes
to the fourth-year students. They were worried about being unable to
set boundaries and making mistakes/being good role models. At the
same time, guiding and advising the first-year students increased their
self-confidence. As a result, fourth-year students felt ready to graduate
and work as nurses.
CONCLUSION: The implementation of a peer education model in clinical
nursing education is helpful for all students. Therefore, in order to
fully evaluate the effectiveness of this program, longer and more
structured peer-education activities should be carried out.

OBJECTIVE: To determine the effects of hospital clowns used for
therapeutic humor on the anxiety levels of preoperative children and
parents.
METHODS: The study was conducted in a private hospital on 64 pediatric
patients aged 7 - 14 who were not hospitalized in the emergency ward
and their parents. The “Socio-demographic data form” and “State of
anxiety inventory” were used for data collection. Trained clown nurses
paid a 5-minute visit to preoperative children and their parents. The
anxiety levels of parents and children were evaluated before and after
the visit. The data was evaluated by percentage, mean and standard
deviation, ANOVA, t test, Mann-Whitney U test and Kruskal-Wallis
H test.
RESULTS: A statistically significant difference was found in the score
means in the anxiety level scores of children and parents before and
after the clown visit. The anxiety levels of parents were observed to
be significantly low before the operation; however, a significant
difference could not be seen in the children. A statistically significant
difference was not found in the anxiety level scores of parents and
children before and after the visit in terms of other socio-demographic
features.
CONCLUSION: Using hospital clowns to reduce the anxiety levels of
children and parents before the operation was proven to be an effective
method.

Despite all of the preventative measures in the health sector, the expected
levels in errors are not being prevented. Therefore, as a result of previous
studies, some methods have been developed to eliminate possible
negative outcomes. One of these methods used for reaching the root
cause of errors was “Failure Modes and Effects Analysis” which is carried
out in nine stages, while the field of health often benefits from a “Process
Failure Mode and Effects Analysis”. In this study, “a patient fall during
the transfer to the operating room” is given as an example and is discussed
and analyzed. This example was chosen because the occurrence rate of
patient falls during transfer is 35%. As a result, applying the “Failure
Mode and Effects Analysis” in health care can reveal the formation of
errors that may occur and the necessary measures that must be taken
to avoid them. The aim of this article is to define what failure mode and
effects analysis is, to explain its designation and importance in healthcare,
and to share an example in practice.

OBJECTIVE: The purpose of the study was to test the validity and reliability
and to examine the factor structure of the Turkish version of Revised
Prenatal Distress Questionnaire (NUPDQ-17 Item Version).
METHODS: It is a methodological study. The study was conducted on
pregnant women at one private hospital. Data was collected using
Pregnancy Description Form and Revised Prenatal Distress Questionnaire
(NUPDQ-17 Item Version). Following the language adaptation and
validation review of the scale, the latest version of Turkish form was
tested on 10 healthy pregnant women. Later, test-retest reliability was
performed on a total of 233 pregnant women. Construct validity and
reliability analyses were conducted on 522 pregnant women.
RESULTS: Fallowing language adaptation and content validity analysis,
Content Validity Index value was found to be 96%. Exploratory factor
analyses were performed and factor loads of items were found between
0.37 and 0.80. Cronbach’s alpha reliability (n = 522) coefficient was
0.85 and item-total correlation coefficients were between (r) 0.20 and
0.78 (p<0.001).
CONCLUSION: The results show that the Turkish version of the Revised
Prenatal Distress Questionnaire is an easy-to-understand, single-factor,
valid and reliable tool for the assessment of prenatal distress in pregnant
Turkish women.

OBJECTIVE: For an organization to be effective, employees should regard
themselves as citizens of the organization and exhibit organizational
citizenship behavior. This descriptive study was implemented to
determine the organizational citizenship behaviors of academician
nurses and affecting factors.
METHODS: The study sample was composed of 71 nursing schools in
Turkey. A 14-item questionnaire and 20-item "Organizational
Citizenship Behavior Scale" were used in data collection. Data was
obtained from academician nurses by post or by hand, and findings
were evaluated based on 641 fully-completed data forms.
RESULTS: Research assistant nurses in medical science faculties or
nursing vocational schools who were thinking about quitting their
jobs exhibited more organizational citizenship behaviors.
CONCLUSION: The organizational citizenship behaviors of participants
were not high: the most common behavior was ‘informing’ while the
least common was ‘helping’.

Improving the quality of health care is a major goal worldwide. There
is an expectation for information systems to collect, use and manage
any information which serves that goal, to create new information
from it, and to use it in all areas of health care services in order to
make a positive impact on the quality of health care. Clinical Decision
Support Systems provides health care professionals access to information
records, new knowledge, and information management assistance. The
use of Clinical Decision Support Systems in Nursing services is not
old, but is developing very quickly