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Background & Aim: High frequency of traumatic and non-traumatic brain injuries in one hand and improvement of the health care condition to restore patient&aposs life in the other hand has increased the frequency of comatose patients in ICU. These patients often experience physical, cognitive, behavior or sensory defects, and the sensory input reduction in intensive care units expose them to cognition disorders. It seems that using sensory stimulation programs may be effective in preventing from sensory deprivation and facilitating recovery process.

Methods & Materials: In this quasi-experimental study, 30 comatose patients who were hospitalized in ICU in Shariati and Sina hospitals were sought to be studied. The subjects were selected randomly using matching that was placed in case and control group. In the intervention group, patients received an auditory stimulation for 2 weeks, 6 days of a week, 2 times a day. The auditory stimulator was a recorded tape (5-10 minutes) of a familiar voice for 30 minutes. The Glasgow Coma Scale (GCS) was used for measuring the level of consciousness (LOC). LOC was measured before and after each intervention 4 times a day. The control group LOC was measured in a similar manner to the case group. At the same time, homodynamic symptoms (blood pressure, pulse rate, and mean arterial pressure) were measured. Non-parametric test was used for analyzing data. The data was analyzed through SPSS V.11.5 computer software.

Results: The findings indicated that there was a significant difference in LOC of the intervention group at the first day and after fourteen days of the intervention (P<0.001), but not in the control group (P=0.769). Although 2 groups were similar in LOC of the first day (P=0.605) but there were a significant difference between their LOC at the fourteenth day (P=0.001).

Conclusion: The results showed that the auditory stimulations with familiar voice were effective in increasing LOC in the comatose patients. It is suggested that nurses expose comatose patients with auditory stimulations using a recorded tape of familiar voice in ICU.

 

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Background & Aim: Extravasation is one of the complications of peripheral intravenous catheters. Doing standard nursing cares leads to more effective and safer treatment and care of extravasation and the reduction in the length of hospital stay for neonates. This study aimed to audit nursing cares related to the treatment of extravasation in neonatal intensive care units.

Methods & Materials: In this descriptive study (the audit), 200 nursing cares regarding neonatal extravasation were observed and assessed. Data gathering tool was a standard check list. The data collection method was the observation and recording of nursing cares related to neonatal extravasation in neonatal intensive care unit of selected hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2015. The data were analyzed using descriptive statistics on SPSS software v.21.

Results: The standard cares were performed by nurses in some cases, and in some standards, nurses showed poor performance. Among 25 common nursing cares of extravasation, 22 cares were far from standards. After third and fourth degree extravasation, none of required nursing cares were done properly.

Conclusion: Nursing cares of extravasation for neonates in NICU are far from standard cares. This could be attributed to the lack of nurses’ awareness of the importance of proper extravasation care and its consequences, failure in nurses’ education, lack of authorities’ supervision on cares, lack of facilities and equipments, and nursing shortage.

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Background & Aim: Mechanical ventilation is one of the most common treatments in neonatal intensive care unit and is however associated with many complications. One of the ways to reduce complications is providing nursing care according to standards. This study was conducted with the aim of determining the conformity of nursing care related to weaning neonates from mechanical ventilation to the standards in neonatal intensive care units.

Methods & Materials: In this descriptive study (the audit), 105 nursing cares related to weaning neonates from mechanical ventilation in neonatal intensive care units at the selected hospitals affiliated to Shahid Beheshti University of Medical Sciences were selected and observed by the event sampling method in 2015. Data were gathered through a demographic questionnaire for nurses and hospitalized newborns, a checklist of nursing care related to weaning from mechanical ventilation. The data were analyzed using descriptive statistics and Chi-square test at the significance level less than 0.05.

Results: Conformity rate of nursing care related to weaning neonates from mechanical ventilation to standards, was 68.3 percent, and compliance with the standards of care was 71.4 percent before weaning, 65.7 percent during weaning and 66.4 percent after weaning.

Conclusion: Nursing cares related to weaning neonates from mechanical ventilation are far from standards, and for its improvement, applying clinical guideline for neonatal nursing care and clinical supervision by managers for optimizing its implementation are suggested.

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Background & Aim: Decreased level of consciousness is one of the life-threatening complications associated with brain injuries. The aim of the study was to explore the effect of auditory and tactile stimulation by a family member on patients’ consciousness level.
Methods & Materials: This quasi-experimental study was conducted on 80 comatose patients with traumatic brain injury hospitalized in the intensive care units of Zahedan educational hospitals in 2019. Samples were selected by the convenience sampling methods and then randomly divided into experimental or control groups. Data collection tool included a demographic information questionnaire, and FOUR criteria for the level of awareness. For the experimental group, the intervention including auditory and tactile stimulation was performed by a family member for 10 minutes for seven consecutive days. The control group received routine interventions. To analyze the data, descriptive and inferential statistical tests (independent t-test, paired t-test, analysis of covariance, chi-square and repeated measures ANOVA) were used through the SPSS software version 21.
Results: The results indicated no significant differences in the level of consciousness between the two groups on the first and fourth days. Yet, independent t-test, analysis of covariance and repeated measures ANOVA showed that the intervention group had significantly a higher level of consciousness on the fifth, sixth and seventh days compared to the control group (P<0.001).
Conclusion: Findings showed that auditory and tactile stimulation by a family member is effective in increasing the level of consciousness in comatose patients with brain injury. So, this technique is recommended as an intervention in nursing care to increase the consciousness level in these patients.