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This study is a descriptive -analytical research which is designed to evaluate clinical skills of Nurses in coronary care units in affiliated hospitals of Tehran medical sciences University.The specific objectives of this research are as follows: Determining clinical skills of nurses in coronary care unit in the fields of patient assessment, intrepretation of Electrocardiogram, and ABG test administration, Iv therapy, educating the clients , caring the patients under cardiac catheterization and resuscitation ofcardio-pulmonary disorders. The population involved 50 nurses who were working in the coronary care units. The sample and population were the same. The researcher collected the data during a period of 3 months and observed the subjects minimum two full working shifts.The results indicated that nursing skills of the majority of the subjects towards the patientassessment was at weak level, one half of them had high level skill ofEKG interpretation(+90%), Meanwhile 2/3 of the subjects (68%) had a very weak skill (0-20%) in the field of ABGtest interpretation. One half of them had a medium skill for administration ofthe IV drugtherapy and all of them were at very weak levelforpatienteducation skills. More than one halfof these nurses had a good skill about nursing care of the patients under cardiaccatheterization. Finally, the last objective (Cardiac resuscitation skill) was not analysed due to afew cases.

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The main therapeutic objective of emergency after acute myocardial infarction (MI) is limiting the infarcted area through the opening of occluded artery, decreasing demand of myocardial oxygen and preventing MI complications.When arterial wall is injured, the collagen tissue is exposed to platelet aggregation that leads to releasing adenosine 5 diphosphate and subsequent to it, platelet adhesion and formation of fibrin is occured. After a while fibrin activates directly the fibrinolytic system, then plasminogen activator is infused and it changes plasminogen into plasmin so that it makes fibrin to be digested.TPA is one of the most effective thromboclastic drugs. It is an enzyme that is produced through recombinant DNA. TPA is a type of fibrin that is infused in circulatory system and binds to fibrin in a thrombus and it converts the plasminogen to plasmin. It is prescribed for adults presenting the early signs of acute myocardial infarction.The recommended dose of TPA for the adults weighing more then 65 Kg is 100 mg. If the patient weighs less than 65 Kg, dosage is determined by a formula as the following: 1.25 mg TPA per Kg body weight.The primary period of prescribing TPA in patients suffering from MI is at the time of transferring them to the hospital or emergency ward. More over, treatment is carried on with effective dose of TPA for 3 hours.The fundamental nursing procedures for the patients receiving TPA consist of complete assessing the patient and obtaining basic information and history of the patient's health and disease.During the infusion of TPA, the patient's bleeding should be continually checked. The recovery signs after TPA infusion is indicated as dysrhythmia, due to reperfusion and it should not be taken into consideration as a negative sign. Some other recovery signs are relieving chest pain and reversing ST segment

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This research is a descriptive study in order to assess barriers and facilitators of research utilization among nurses working in teaching hospitals in Tabriz, year 2001. The aim is to identify causes of low extent of utilization and also to assess barriers and facilitators of researches. This study was conducted upon 304 nurses working in 12 teaching hospitals of Tabriz, which were selected by random sampling. Instrument used for study was questionnaire. Data were analyzed using SPSS (10). The results of this study showed that three major barriers for research utilization included: 1) inadequate facilities for implementation, 2) Physicians will not cooperate with implementation and 3) the nurses do not have sufficient time to read researches. Facilitators which nurses suggested, emphasized on the role of education in enhancing their knowledge and skills of research evaluation.

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Consideration of the lifestyles of nursing students, because of the fact that they are at the age where their choice of lifestyle can influence their entire lives, is of vital importance. On the other hand nursing students are conveyors of health information and are responsible for guiding others towards the way of life therefore they themselves need to be appropriate models for those in need of help and the society as a whole. This study is a descriptive research, whose aim is comparing the lifestyle of first and final term female BS nursing students. This investigation was undertaken in Nursing and Midwifery schools of Tehran Medical Science Universities, by sampling 139 students in their first term and 159 students in their final term. The factors of life style under examination were nutrition, exercise, smoking, safety precautions and stress management. The method of data collection was questionnaires that consisted of demographic and life style particularities. Research findings showed that 37.4% of the first term students had moderate nutrition and 49.9% had good nutrition. As concerns physical exercise (37.4%) and (41.1%) of the first and final term students had moderate physical exercise respectively. Research findings also showed that none of the students of either two groups smoked cigarettes. As relates to safety precautions results showed that 37.2% first term students and 35% in final terms students had moderate behavior. In stress management (36.5%) first term students and (32.9) last term students had good behavior. In general (40%) of the samples in their first term had moderate lifestyles while (32.8%) in their last term had very good lifestyles. "t" Statistical test showed no significant difference between the two groups. Research findings showed that nursing education and training in no way influenced life style and that other factors were influential but they require further study.

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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: Death of a patient is an unavoidable stage of nursing and in many cases nurse is the only person who takes care of the patient at the time of death. An experienced and committed nurse obliges her/himself to care for the patient before and after death in the best way possible.           

Materials and Methods: This research is a descriptive study that carried out in order to determine knowledge and attitude of the nurses about pre and post-death cares. The samples were 227 nurses of Imam Khomeini Complex Hospital. The number of subjects chosen from each hospital was proportional to the number of nurses of that hospital. The samples were selected randomly. Data were collected by a questionnaire, validity of which was confirmed by content validity and reliability of it was confirmed by test-retest method. Data were analyzed with descriptive statistics.

Results: Results showed that in majority of the nurses level of knowledge about pre-death cares was moderate and was poor about post-death cares. The majority of the nurses had a positive attitude about pre-death cares and a relatively positive attitude about post-death cares. There was not any sample with negative attitude about pre or post-death cares.

Conclusion: Regarding the undesirable level of knowledge and positive attitude of the nurses under study concerning pre and post-death cares and considering that the necessity for improving the knowledge is training and education, the results of this research can help authorities to provide training and educational programs for enhancing nurses’ knowledge regarding pre- and post-death cares.

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Introduction: Documentation of nursing care and procedures is an evidence of performance and quality of these cares. Failure to document could be a sign of inadequate care performance.

Method and Materials: This study was carried out to determine causes of inadequate nursing documentation in wards of Shahid Beheshti Hospital, Zanjan, in 2003. This study was a descriptive survey a checklist was designed according to standard principles of nursing documentation which was validated by 10 academic members. Patients&apos files were assessed based on this checklist. Also, 20 nurses were interviewed (open question) to determine of causes of incorrect nursing documentation.

Results: The results showed that 17% of items of checklist had been documented correctly, documentation’s of 35.81% of these items were incomplete and 48% of items had not been documented. The interviews showed that the inadequate nursing documentation was related to inattention to these documentation’s and lack of control of nursing documentation, work overload of nurses, educational problems and unawareness of legal and occupational issues.

Conclusion: Documentation of nursing care was inadequate. The most important causes were inattention and lack of control. Considering importance of nursing documentation, ways to solve these problems must be sought.

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Introduction: Level of job satisfaction reflects positive or negative attitude of person toward his/her job and is influenced by many factors. Job satisfaction of nursing personnel directly affects their quality of care. Attention to this issue means attention to community health.

Materials and Methods: This study is a descriptive, cross sectional research, conducted to identify the level of job satisfaction of nursing personnel of health, therapeutic and medical education centers of the entire country in the year 2001. Sample size was 4000 and nurses were selected through random stratified sampling method. Data collection tool was questionnaire of Herzberg job satisfaction which was sent by mail. Job satisfaction was classified into three levels: low (0-33.33%), moderate (33.34-66.67%) and high (66.68-100%).

Results: We received back a total of 3029 questionnaires. Results showed that the majority of nurses had moderate level of job satisfaction in domains of working place situation (62.9%), relationship with colleagues (69.6%), professional situation (74.3%), supervision and administration (57.6%), managerial policies (50%) and personnel life in relation to the job (80.6%). Job satisfaction level was low in domains of job security (63.5%) and salary and benefits (77.3%). 2 test showed a significant relationship between age, job position, level of education, job experience, over time working, type of over time working, type of accommodation and participation in continuing education programs and job satisfaction.

Conclusion: As a whole, the level of job satisfaction of majority of nursing personnel was moderate and the majority of subjects were not satisfied with welfare possibilities of their job. According to the research results it is recommended that the authorities try to increase the salary and financial benefits of nursing personnel and also to develop welfare possibilities of this class of community.

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Introduction: Caring is the essence of nursing and medication process is an important part of nursing related interventions in the health care systems. Medical and/or nursing errors can lead to severe problems for both patients and nursing system. The purpose of this study was to investigate the ethical practice in medication process among nurses working in selected hospitals related to Tehran University of Medical Sciences.          

Materials and Method: This study is a descriptive–analytic research. Samples of the study were 305 nurses employed in adult units of selected hospitals. The research data gathering tools were a checklist and a questionnaire. Questionnaire included questions about demographic data and errors in medication process. Checklist included 17 questions related to expected behaviors regarded medication process. The researcher first completed the questionnaire and then the checklist was completed on two separate occasions at least 15 days apart. The data were analyzed using descriptive and analytic statistics such as Chi square, Fisher exact test and Pearson correlation coefficients.

Results: The majority of subjects were 26-35 years old, female and single. About half of nurses (49.6%) had undesirable performance in process of medication. Ethical practice had a significant correlation with type of ward (p=0.005), the mean number of occupied beds in a week (p=0.000), number of co-workers in the shift (p=0.001), educating (p=0.037), satisfaction with place of work (p=0.0043) and technical possibilities in the ward (p=0.029).

Conclusion: According to the results, the majority of nurses had an undesirable performance in medication process. It is suggested that managers, program planners and nursing teachers pay more attention to ethical practice in medication process in order to enhance performance of nurses in this field.

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Introduction: Self-burning is a cruel method of suicide and prevention is the most effective way to decrease its morbidity and mortality.

Material and Methods: This investigation is a descriptive prospective study performed at Shahid Motahari Burn Center, Tehran, Iran from December 2001 to December 2002. Inclusion criteria included being female, married, having no history of medical and mental disorders and admission of self-burning. Data were collected by a questionnaire and interviews and were analyzed with descriptive statistics methods and chi-square test.            

Results: A total of 35 cases entered our study. The mean age of patients was 24.573.94 years and 48.6% of cases were in the 21-25 year age group, 80% had primary school education, 97.1% were housekeeper and 68.8% had low economical status. There were statistically significant differences in all of these variables. In 42.9% self-burning had happened at 12-18 hour period and in 45.7% it had occurred at yard. Kerosene had been used by 91.4% of the women as the burning agent 94.3% of the women had experienced husband’s violence (verbal and physical), 60% of the women stated that their husbands were guilty in their action and 91.4% of the women didn’t know any supportive sources in the society. The mortality rate was 100%.

Conclusion: This research showed that family violence and marital problems are the most important causes of self-burning in the married women. Because of close relationship to families, community health nurses can prevent self-burning in married women by detecting and eliminating these risk factors.

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Introduction: Evaluation is a systematic process for collecting, analyzing and interpretation of the obtained information for the purpose of investigating how much the objectives in mind can be achieved. Education in an academic educational system means bringing about proper and increasing changes that affect the outcome of this system, that is affecting the students, and the aim of such evaluation was promotion of the quality of an education process.

Materials and Methods: In this study faculty of nursing and midwifery, Tehran University of Medical Sciences, benefiting from opinion poll of university lectures, student and graduates have evaluated their system of educational in the year 2004 and their aim was to remodel and adjust educational system with the society’s needs and promotion of the quality of such education’s. The employed method was cross sectional and descriptive and analytical on the basis of 10 procedural steps and with in 8 sections dealing with evaluated factors. Such as faculty board members, management and organizational capability, students, manpower and logistic affairs, educational environments research work centers, health and therapeutic sections, educational equipment, research equipment, laboratory and diagnosis centers, educational courses and programs, teaching and learning process as well as satisfaction expressed by students.

Results: the results of the research showed that general average of 8 investigating sections, based on SWOTs model were respectively 80.4% (nursing department), 81.5% (Midwifery department) and 82.1% (Ph.D nursing) that may well be interpreted as a desirable research work.                        

Conclusion: Educational evaluation is the best indicator showing how much we should go to achieve certain aims, analyzes quality of the activity if such a system and by which we achieve logical and routine results.

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Background & Aim: This paper investigate the application of some management’s new theories in nursing care in order to determine the similarities between management and nursing. The need of Health Services to be effectively managed was a prominent features of developed countries health policy in the 1980 s and early 1990. In the recent years, four management’s new theories has identified: organizational excellence, total quality management, organizational culture and empowerment. Each of these new theories has key role in nursing care. This paper identifies similarities and convergence’s between management profession with nursing care, using application of management’s new theories.

Conclusion: The comparison between nursing care and management’s new theories has been provided the collaboration and cooperation between nurses and management professions to deliver health care services to patients effectively.

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Background & Aim: Disorders of intelligence is associate with lack of growth in physical, social and educational dimensions. Also it can cause many problems for patient and their family in context of care and maintenance of patient. Psychiatric nurse recognize this problems and helping to resolve them. They can play the effective role to acceptance of mentally retarded adolescent by their family.

Methods & Materials: This research is a descriptive analytical cross-sectional study. Out of research population 406 subject were selected among sponsors of mentally retarded adolescent through convenient sampling (199 subjects had accepted their young adults in their families “daily class” and 207 subjects who had repelled their mentally retarded children “nightly class”) Data were collected through interview and filling questionnaire. And then were analyzed through SPSS software by using descriptive statistics and statistical tests like χ2 and t-test (in depended group).

Results: Findings of this research showed that among demographic characteristics of clients like age, level of education, causes and extent of mental-retardedness of Adolescents and acceptance by the family there is a significant correlation (p<0.05). There are also meaningful relation among individual factor such as ability to wear clothes, ability to feed, observing individual hygiene, precedence of lack of control on urine and stool, precedence of sleep disorder in form of insomnia, record of sensitivity and quick resentment, affliction to psychological disease, the problem of setting up communication with others, profile of hurting oneself and others, making noise and disturbance for others and background of escaping from home, and acceptance of mentally retarded young adult by family (df=1 p<0.001).

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Background & Aim: Number of patients with bloodborn disease is increased. Because of degenerative effects of the disease on body&aposs organs, and patient&aposs need to hospitalization, contamination risk for nurses and other patients is also increased. So investigation of the performance the principals of the safety injection by nurses are necessary.

Methods & Materials: This study is a descriptive research. Sample of the study were 85 nurses employed in emergency units of the selected hospitals. The research data gathering tools were a questionnaire included 7 question about demographic data and 3 checklists included 29, 20, 15 objects about performance of the safety injection in three steps (pre, during, and after injection). The statistical tests included t-test, Pearson correlation. Data analysis performed by SPSS software.

Results: This study showed that the majority of subjects were 23-30 years old (60%), female (70.6%), have BS (97.6%) in nursing and clinical experience under 5 years in hospital (55.3%) and emergency unit (80%) and didn’t participant in infection control course (75.3%) and work in rotation shift (82.4%). About half of the nurses (49.4%, 51.8%, 55.3%), had desirable performance in three steps of injection. Performance of safety injection had a significant correlation with sex (p=0.002), and preinjection step with during injection step and after injection (p=0.000), (p=0.001) respectively.

Conclusion: According to the results of this study, the half of nurses had desirable performance in injection process, but the half of them had undesirable performance. It is suggested that nurses and managers pay more attention and try to performance standard and world precautions and principals of safety injection to prevent convection of bloodborn diseases.

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Background & Objective: Administrators have to pay attention to nurses as an important group among hospitals employees in order to have better patient outcomes. Recently, nurses&apos quality of work life is a new concept that attention to it can improve organizational efficiency. This research is to investigate the quality of work life of nurses at Tehran University of Medical Sciences Hospitals in 2005-2006.

Methods & Materials: This is a cross-sectional study. The research was conducted among 349 nursing employees. Data were gathered using a questionnaire consisted of 30 elements of QWL. The respondents were asked to determine their overall quality of work life. Validity of the questionnaire was evaluated using content validity and reliability was determined using test-retest method. Statistical analysis was carried out using SPSS statistical software package.

Results: The results showed that the majority of nurses were dissatisfied with environmental health and safety at work, monetary compensation and job welfare. There was significant correlation between the executive position of nurses, years of experience and their salary (P<0.05).

Conclusion: The study findings showed that nurses had a poor quality of work life. This indicates that majority of employees are unsatisfied with the most aspects of their quality of work life.

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Background & Aim: Diabetes education does not assure adherence to diabetic regimen. The aim of this study was to investigate the effect of nurse-led telephone follow ups (Tele-Nursing) program on adherence to diabetic diet among type 2 diabetic patients.

Methods & Materials: This was a quasi experimental study. Sixty patients who were registered at Iranian Diabetes Society were selected using convenience sampling method. Data gathering instruments included a data sheet to record glycosylated hemoglobin and a questionnaire. Data were gathered at baseline and 12 weeks after the intervention. First, all participants attended in a three-day self-care education and dietary consultation program at Iranian Diabetes Society. Then, they were randomly assigned to the experiment and control groups. Telephone follow ups were applied in experiment group for 3 months, twice a week for the first month and then weekly for the second and third months. Data were analyzed using SPSS version 13.

Results: Results showed that there were significant statistical differences between control and experiment groups in adherence to diabetic diet (P=0.035). There were significant differences in glycosylated hemoglobin between control and experiment groups after the intervention (P<0.000).

Conclusion: According to the results of the study, it is concluded that the nurse-led telephone follow ups can improve HbA_1c and diet adherence in type 2 diabetic patients.

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Background & Aim: The Clinical Teaching Partner model (CTP) integrates theoretical knowledge with professional skills and brings the reality to workplaces. Closing educational and practical aspects in nursing discipline has been a challenging goal for nursing which requires cooperation between faculty instructors with nurse practitioners such collaboration will led to development and promotion of nursing discipline. Therefore selecting an effective and efficient approach in order to integrate theoretical knowledge with practical experiences would be crucial for nursing profession. This study was conducted in order to investigate the effect of CTP on nursing students&apos clinical skills outcome.

Methods & Materials: A quasi experimental, only post test design was applied. Study sample consisted of 1) three faculty instructors, 2) seven registered nurse practitioners who were staff nurses in three pediatric wards and voluntarily participated in the study and 3) fifty two nursing students which were in the 5th semester of nursing BSc. program and had eligible criteria to enter the study. Students were allocated randomly to the intervention (n=28) and control (n=24) groups. Participants in the control group, initially started their internship period in 3 pediatric wards and were evaluated by faculty instructors regarding their clinical skills at the end students in the intervention group, then started their clinical training course in the same ward as control group, but their clinical education was conducted by the nurse practitioners who voluntarily participated in the study and trained initially in the nursing faculties&apos skill lab. Students&apos clinical skills were evaluated by nursing mentors via some instruments at the end of the educational period in addition, clinical education outcomes and nursing students&apos satisfaction of achievement to apprenticeship goals were assessed at the end of the training period. Data were analyzed using the statistical tests including Chi square, Fisher exact test, Mann-Whiney U, and t-test in SPSS.

Results: Considering students demographic characteristics, both groups were homogenous. There was a significant difference in the students&apos clinical skills between two groups (P<0.001). A significant difference was shown in the nursing mentors and faculty instructors&apos satisfaction of application of cooperative education method between both groups (P=0.004). No significant differences were found between students&apos satisfaction of reaching to educational outcomes between both groups (P=0.058). There were also no statistical differences between nursing mentors and faculty instructors&apos satisfaction of achieving to clinical education outcomes (P=0.109).

Conclusion: According to this study, CTP is an effective approach in clinical education and development of clinical skills for nursing students therefore,

application of this method is recommended in clinical nursing education.

 

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Background & Aim: Blended E-Learning is an educational method which has been used recently in higher education worldwide. So, it seems that it is crucial for the Iranian academic members to accept it as a new educational method. This study was conducted to investigate attitudes of the faculty of Nursing and Midwifery School at Tehran University of Medical Sciences toward blended E-learning.

Methods & Materials: In this cross-sectional study, all faculty members of Tehran University of Medical Science (n=60) were recruited to the study. Data were gathered using validated and reliable self-designed questionnaires. The collected data were analyzed using SPSS software.

Results: The response rate was 93.33% (n=56). Most of the respondents (85.7%) were female. The mean age was 44.88 (SD=5.6). The years of teaching ranged from 5-30 years (mean=16.75). The majority of the respondents (66%) had positive attitude toward blended e-learning thirty four per cent had completely positive attitude and none of them had negative attitudes. About 41% reported that they were eager to provide their course syllabuses according to this approach and 87.5% said that they were willing to attend the blended e-learning education workshops. There were no significant relationships between demographic variables and the attitudes. There was a significant relationship between willing to attend the workshops and positive attitude toward blended e-learning (P=0.012).

Conclusion: According to the positive attitude of the respondents toward blended e-learning, it is recommended that further studies take place in order to design and implement the approach in formal education in the school of Nursing and Midwifery of Tehran University of Medical Science.

 

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Background & Aim: Health systems are challenging with increased health demands and limited economic status whilst, nurses shortages is a worldwide issue. Job dissatisfaction among nurses is a main cause for work leaves. The aim of this study was to assess job satisfaction among Iranian nurses and its related factors.

Methods & Materials: In this cross-sectional study, 1058 nurses were selected randomly during 1384-5. A two-sectioned self-report questionnaire was used which included demographic data and job satisfaction scale. Data were analyzed in SPSS version 12.0.

Results: Findings showed that only about one third of nurses were satisfied (satisfied & very satisfied) with their jobs (34.30%). In this study, main factors of job satisfaction were job safety (44.5%) as well as working environment and facilities (44.26%). On the other hand, nurses were dissatisfied with their job because of the described job duties (74.75%), managers&apos way of communication (70%), and their social position (70.3%).

Conclusion: Increasing the salary and payment, job equity, modifying working time and shift plans, providing opportunities for the nurses to further their carriers, and continuing education are important issues in increasing job satisfaction.

 

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Background & Aim: Adjustment of nursing scheduling for specific periods of time to meet the needs of hospitals, nurses and patients is a time-consuming and challenging task for nursing managers. The aim of this study was to design a nursing scheduler system based on genetic algorithm to render better services to patients and overcome traditional scheduling problems.

Methods & Materials: In this applied research, we designed software based on the data derived from interviews with the personnel of two pediatric wards. We transformed the expert entity planning procedure to mathematic function using Genetic Algorithm Programming and create the schedule. We compared the system-designed schedule with the schedule that was written by experts in MATLAB software.

Results: The results showed that the system-designed schedule resulted in 57% reduction in the arrangement costs and 93% time saving for nursing managers in comparison with the expert-designed schedule during 6 months.

Conclusion: System-designed schedule had higher efficiency than the expert-designed one. It entailed higher efficiency of managers and higher job satisfaction of nurses. It also reduced problems of working with paper schedules. Nurses&apos preferences and hospital requirements could be taking into account, as well. Since we used the limited data gathered from two selected wards for writing the program, the program should be modified based on the data provided from other wards. Further studies are needed to design similar systems with more details in order that it can be available in various wards of hospitals.