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This is a double - blind clinical trial to evaluate the safety and efficacy of topical nitroglycerin ointment on venous catheterization in patients referred to emergency ward of Baghiyatollah hospital in 1997.The units under investigation consisting of 70 patients, 40 women and 30 men ranging in age from 20 to 69.The samples were randomly assigned into two equal groups, 35 patients in case group and 35 patients in experimental group. The experimental group received 2% nitroglycerin ointment and the case group received the placebo ointment that was applied prior to venus catheterization on the skin of the dorsum of the hand, wrist or front part of forearm.To collect data, an observational checklist was used in which demographic characteristics, and efficacy and immunity of the ointment were recorded.The findings revealed that the vein diameter in case group was not increased after applying the ointment, while it was considerably increased in experimental group from 4 mm to 6.6 mm. Although the method of catheterization in two groups was the same, catheterization in case group was more difficult than experimental group. Using T.test, the findings revealed that there was statistically significant relationship between vein diameter before and after applying the ointment in experimental group and after applying it in case and experimental groups (PO.001). Moreover, tachycardia and hypotension was not observed in both groups during 15, 30, 45 minutes and one and two hours immediately after applying the ointment, however in both groups, a sort of mild headache was observed. The findings also showed that there was significant relationship in observing the vein after catheterization in two groups (P<0.2). However, before applying the ointment, there was significant relationship in observing the vein in the experimental group. Furthermore, after applying the ointment, arhythmia appeared, but it was not significant.The results showed that applying nitroglycerin ointment was a useful method in expanding the peripheral veins, therefore, it resulted in easy venous catheterization.

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This study is a quasi-experimental research with aim of evaluation the effect of respiratory exercise in acute respiratory complication and the length of time patient hospitalization undergoing coronary artery bypass surgery in Kermanshah Emam Ali hospital in year 2000 The study subject consisted of 60 patients (42 male and 18 Femal), with age rang between 30-70 years old, who were eligible for this study. The subjects were selected with convenience sampeling and randomly allocated to two groups (Experimental and control). Experimental group received education in two sessions of videoteaching and control group recived routin cares. Tools of data collection consist of demographic questionnaire, clinical records, check list and respiratory exercise. Results revealed: The incidence rate of atelectasis in experimental group was (26.7%), less than contral group (%56.7), test showed significant difference between incidence rate of atelectasis (P = 0.01). Therefore the length of hospitalization in experimental group was less than control group (P=0.02). Accomplishment of post operative respiratory exercises in all samples were lower than doing exercise pre-operatively, and the highest score for effective exercise and coughing were in two and three days after surgery (P=0.000). The result of this research reveales, videoteaching is effective in promoting nursing care and self care in clients.

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Introduction: Nowadays continuing education is considered an essential part of nursing education. This study was planned to evaluate the effect of continuing education of neonatal intensive care nursing on knowledge and the practice of nurses who were working in the children’s hospitals.

Materials and Methods: A semi-experimental study was carried out including 42 nurses of the children’s hospitals affiliated to Tehran University of Medical Sciences during 18 months in 1999- 2000. The data were collected by a questionnaire and a checklist. The questionnaire included demographic information and 60 multichoices questions based on the knowledge of the neonatal intensive care nursing. The observation checklist contained 5 parts, how to establish: resuscitation operation, endotracheal suction, management of the patient under mechanical ventilation, nasogastric tube insertion and feeding by gavage. At the end of the training courses the questionnaire and the checklist were completed again individually. The result of the pre and post tests and checklist were compared in the areas of knowledge and practice. The data was analyzed by 2 and paired t Student test.

Results: Statistical analysis showed a meaningful difference in the knowledge and practice after the continuing nursing education (p<00001).               

Conclusion: This research revealed the positive effect of the continuing nursing education on the knowledge and the practice of the nurses who were working in the pediatric wards. It is important to consider the continuing nursing education program to promote the health care system.

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Introduction: Bed sore is an important complication of operation. Long immobility, hypotension and hypothermia in perioperative period predispose patients to bed sore. The prevention of bed sore is a priority in caring for immobilized patients and different methods have been used for this purpose. Hydrocolloid dressing is one of these methods.

Materials and Methods: This study is a quasi-experimental research. Subjects consisted of 60 patients aged 40-70 years who had eligibility criteria for this study. Subjects were selected with convenience sampling and randomly allocated to two 30-patient groups (experimental and control). In experimental group, hydrocolloid dressing was used before surgery. No procedure was performed for control group. After surgery sacral area was examined on three occasions to detect bed sore: immediately, 24 and 48 hours after surgery. The data were collected by demographic questionnaire and staging bed sore checklist and analyzed by SPSS statistic program and use of descriptive methods such as Chi square, Fisher exact test, t test, ANOVA and least significant difference (LSD).

Results: Incidence of bed sore was 13.3% in experimental group and %36.7 in control group. Chi square test showed significant difference between incidence of bed sore in two groups (p=0.03). Incidence of bed sore in two groups had no relationship with respect to gender and number of grafts. There was a significant relationship between bed sore and age, body mass index and duration of hypothermia, immobility and cardiopulmonary bypass (p<0.05).

Conclusion: Considering findings of this research, it seems that use of hydrocolloid dressing is effective in preventing perioperative bed sore after coronary artery bypass surgery.

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  Background & Aim: The quality of clinical services is a major concern for healthcare systems throughout the world. Clinical Governance, a relatively new approach to improve quality of healthcare systems, plays a fundamental role in the establishment of primary healthcare strategies to provide high quality services. Moreover, regarding the importance of organizational culture as a powerful lever to improve organizational behavior, success of organizations in implementing strategies largely depends on the support receiving from organization. Accordingly the aim of this study was to examine the correlation between organizational culture with establishment of clinical governance in public hospitals in Rasht .

  Methods & Materials: A cross-sectional correlation study with structural equation modeling was used. All 152 nurses working in managerial positions participated in the study. Data were collected using Denison Organizational Culture questionnaire, and research-made questionnaire on clinical governance. Validity and reliability of questionnaire were confirmed. Data were analyzed using the Pearson correlation coefficient test and confirmatory factor analysis in the SPSS and LISREL . 

  Results: There was a significant positive relationship between clinical governance and all components of organizational culture (P< 120.01' type="#_x0000_t75"> ). Factor analysis showed the impactof organizational culture on successful establishment of clinical governance .

  Conclusion: Improvement of organizational culture leads to sustainable establishment of clinical governance through which quality of healthcare services improves. Managers of hospitals should pay attention to instituting appropriate organizational culture in order to establish clinical governance .

  

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Background & Aim: The most common complication of peripheral intravenous catheter use is phlebitis. This study aimed to determine the effect of Arnebia Euchroma on the prevention of peripheral intravenous catheter-related phlebitis.
Methods & Materials: A double-blind randomized clinical trial done on 120 patients hospitalized in CCU and heart wards of Shariaty hospital in Tehran in 2017. The convenience samples were allocated into the two groups of control and intervention. After the insertion of an IV catheter (by sterile technique, in the site of upper limb without any signs of phlebitis), Arnebia Euchroma poultice for the intervention group and placebo poultice for the control group, was applied to the skin in the distal portion of IV catheter at 3×3 cm from the catheter insertion site. Then, this site was covered by sterile dressing. The patient was monitored every 12 hours by removing the dressing, and the poultice was applied again. Data were analyzed by descriptive and inferential statistics using the SPSS software.
Results: The two groups were homogeneous in terms of age and sex, but were different in the number of hospitalization days. While no phlebitis was observed in the baseline, there was a significant difference between the two groups (42.37% for intervention group vs 0% for control group) at the hour of 12. By adjusting the effect of hospitalization days, the difference was still significant (P<0.001).
Conclusion: Arnebia Euchroma poultice was effective in the prevention of phlebitis. Thus, this poultice can be used when inserting a peripheral intravenous catheter.
Clinical trial registry: IRCT2017012432147N1
 

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Background & Aim: Epilepsy is the most common chronic neurological disease after headache. About half of the patients with epilepsy do not properly adhere to medication regimens, which leads to a lack of control over seizures, increased treatment costs, and even increased mortality rate in these patients. The aim of this study was to determine the effect of telephone education on medication adherence in patients with epilepsy.
Methods & Materials: In this quasi-experimental study, 60 patients referred to neurology clinic of Valiasr Hospital in Zanjan in 2019 were selected by the convenience sampling method, and were randomly divided into either control or experimental groups. The Morisky drug adherence Questionnaire was used for data collection. At the beginning of the study and after completing the questionnaires, a face-to-face training session was held for the study participants. Then, telephone education was performed for the experimental group for two months and no intervention for the control group. Two months after the intervention, all the patients completed the questionnaire again. Finally, the collected data were analyzed through the SPSS software version 25 using descriptive (mean and standard deviation) and inferential statistics (Chi-square, Fisher's exact test, independent t-test and paired t-test).
Results: Before the intervention, there was no statistically significant difference between the two groups in terms of individual characteristics and medication adherence scores (P<0.05); But two months after the intervention, a statistically significant difference was observed in the mean score of medication adherence between the two control and experimental groups so that the patients in the experimental group had higher scores of medication adherence (P<0.001).
Conclusion: The results of this study showed the usefulness of using the telephone education method in improving the medication adherence of patients with epilepsy. Therefore, it is recommended that this method be used in the training program for these patients. In addition, further studies are needed on the comparison of the effectiveness of telephone education with other methods of telemedicine such as cyberspace and online education.