Showing 22 results for Intensive Care Unit
Fatemeh Behesht Aeen, Mitra Zolfaghari, Ahmad Ali Asadi Noghabi, Abbas Mehran,
Volume 19, Issue 3 (12-2013)
Abstract
Background & Aim: The ventilator associated pneumonia is a common problem in critical care units. It is associated with increased mortality, cost and length of stay. Nurses have great role in preventing the ventilator associated pneumonia. The aim of this study was to assess nurses' performance in prevention of ventilator associated pneumonia .
Methods & Materials: In this descriptive study, 110 nurses working in selected hospitals affiliated to Tehran University of Medical Sciences were selected using convenience sampling method. A 32-item observational checklist was provided based on the ventilator associated pneumonia prevention guideline. The nurses' performance was observed three times. Data were analyzed using descriptive statistics in the SPSS-16 .
Results: This study showed that the mean score of the nurses' prevention was 46.8±5.79. Most of the nurses (66.4%) had poor performance and 36.6% had relatively good performance. There were no nurses with favorable performance in the prevention of ventilator associated pneumonia. The highest score was in contact precaution (72±9.67) and the lowest score was in mouth hygiene (18.78 ± 17.4) .
Conclusion: The majority of nurses had poor performance in prevention of ventilator associated pneumonia. More attention should be paid for planning appropriate training programs for nurses and giving adequate facilities to improve health care quality .
Leila Valizadeh, Rahele Janani, Alehe Seyedrasooli, Abdollah Janat Dust, Mohammad Asghari Jafarabadi,
Volume 19, Issue 4 (3-2014)
Abstract
Background & Aim: Premature infants are the most admitted group to NICUs. Stabilization of cardio pulmonary parameters is a main goal in NICUs. Mechanical ventilation and endothracheal suctioning are the most common and effective procedures to stabilize cardio pulmonary parameters. The aim of present study was to compare the effects of two endothracheal suctioning methods (open and closed) on physiological stability in premature infants under mechanical ventilation .
Methods & Materials: In this clinical trial, 90 preterm infants (GA: 27-34 weeks) hospitalized in the NICUs of Alzahra and Taleghani hospitals were selected and randomly assigned to two groups. In one group, infants were suctioned using open suctioning method and in the other group, infants were suctioned using closed suctioning method. The physiologic parameters (O2 sat, HR, mean BP variation) and stability (recovery time of HR, BP) were compared between the groups. Data were analyzed using descriptive and inferential statistical methods such as x2, independent t-test and mixed model in the SPSS-21 .
Results: There was significant statistical difference between the two groups on mean BP (P=0.016). Recovery time of the BP and HR was shorter in the closed suctioning group. Physiologic stability was better in the closed suctioning group (P<0.05) .
Conclusion: Variation of the mean BP and recovery time was more in the open suctioning group compared with the closed suctioning group. Considering better physiologic effects of closed suctioning, it is recommended to assess the combined effect of closed suctioning with weight on physiologic parameters of premature infants .
Soroor Sohrabi, Zahra Ahmadi, Ziba Mosayebi, Hamid Haghani,
Volume 20, Issue 2 (8-2014)
Abstract
Background & Aim: Several studies have indicated that hospitalizing infants causes disruption on mother-infant attachment. The aim of this study was to assess the effect of infant massage by mothers on maternal attachment behavior in infants hospitalized in the neonatal care units .
Methods & Materials: In this clinical trial, 42 mothers and their neonates were recruited and randomly allocated to the intervention and control groups. Mothers in the intervention group received training by means of educational movies about practical exercises on how to massage the infants. The trained mothers used massage techniques on their infants for five days. The process lasted 15 minutes. The attachment of the mothers on their infants was assessed before and on the day 5 after the massage. Data were collected using the scale of mother-to-infant attachment. Data were analyzed using the Chi-squared test, Fisher’s exact test and the t-test in the SPSS-19 .
Results: There were no differences between the two groups in terms of demographic variables and the mean of maternal attachment at baseline (P>0.05). Five days after the massage, there were statistically significant differences between the two groups in the mean maternal attachment (P<0.001) .
Conclusion: According to the role of massage in attachment behavior, this traditional care is recommended to be used in neonatal units .
Mohammad Ali Aslani, Nasrin Hanifi, Fazlollah Ahmadi, Ramazan Fallah,
Volume 20, Issue 2 (8-2014)
Abstract
Background & Aim: The major problem with mechanically ventilated patients receiving enteral nutrition hospitalized in the intensive care units is delayed gastric emptying. Acupressure can increase gastric motility. This study aimed to determine the effect of acupressure on the amount of gastric emptying in mechanically ventilated patients hospitalized in the intensive care units .
Methods & Materials: In this clinical trial, 78 mechanically ventilated patients were recruited using convenience sampling method and were randomly divided into two control and experimental groups. Acupressure was applied on the Neiguan point for four days in the experimental group. The control group patients received no intervention. Gastric residual volume was measured in the admission time and before the gavages. The mean gastric residual volume of the admission time and the 1-4 days after the admission were compared in the two groups. Data were analyzed using the independent t-test, Chi-squared test, covariance analysis and repeated measured tests in the SPSS-16.
Results: The results revealed that there were no differences between the two groups in the admission time and the first day (P>0.05). There were statistically significant differences between the two groups in the admission time and 2-4 days after the admission (P<0.05). The difference of mean scores of gastric residual volume were significantly different between the two groups during the four days of post intervention constantly (Repeated measured ANOVA P=0.011) .
Conclusion: The acupressure increased the gastric emptying in mechanically ventilated patients hospitalized in the intensive care units. Since the acupressure wristband was an easy to use, non-expensive, available procedure, it can be used to improve gastric emptying and prevent delayed gastric emptying complications .
Elahe Dashti, Maryam Rassouli, Leila Khanali Mojen, Asma Puorhoseingholi, Azam Shirinabady Farahani, Fatemeh Sarvi,
Volume 21, Issue 3 (12-2015)
Abstract
Background & Aim: Preterm infants are at increased risk for readmission after discharge from the neonatal intensive care unit. Some factors and characteristics of preterm infants have an effect on their readmissions. This study aimed to determine neonatal factors related to preterm infants’ readmissions to the neonatal intensive care unit.
Methods & Materials: This correlational study was conducted on a sample of preterm infants admitted to the neonatal intensive care unit at three teaching hospitals of Shahid Beheshti University of Medical Sciences in 2013. Samples were studied using a questionnaire on possible factors and characteristics related to readmission including sex, gestational age, birth weight, multiple birth and length of stay in the neonatal intensive care unit after discharge. The infants were also followed for readmission thirty days after discharge. The data were initially analyzed by univariate analysis and then by the logistic regression model.
Results: The results of univariate analysis revealed that the infants readmitted at the time of follow up were significantly more premature and had lower birth weight and a longer initial hospital stay in the neonatal intensive care units (P<0.001). In the logistic regression model, only gestational age and birth weight had a significant statistical association with infants’ readmission (R: 0.805, P=0.001 and odds ratio: 0.998, P=0.001 respectively).
Conclusion: Infants’ gestational age and birth weight were associated with hospital readmission within thirty days after discharge, so that the infants with lower gestational age and birth weight were more likely to be hospitalized again after discharge.
Gholamhossein Falahinia, Maryam Razeh, Mahnaz Khatiban, Mahbobeh Rashidi, Alireza Soltanian,
Volume 21, Issue 4 (3-2016)
Abstract
Background & Aim: Poor oral care for the ventilated patients in intensive care units (ICU) can result in the accumulation of pathogens and respiratory infections. In this regard, in addition to the chemical methods, a mechanical method has been recommended to be added. However, concerning its effect on pneumonia, different findings have been reported. Therefore, this study was conducted to compare the effects of chlorhexidine solution with or without toothbrushing on the development of ventilator-associated pneumonia among patients in ICUs.
Methods & Materials: This was a single-blind, randomized controlled clinical trial conducted in two selected hospitals of Ahvaz city in 2014. A convenience sample of 68 ventilated patients was randomly allocated to the toothbrush group (34 patients) or the gauze swab group (34 patients) using R software. Both groups received 0.2% Chlorhexidine solution. The intervention was performed in both groups for 3 minutes twice a day for five days. At the end of the fifth day, the development of pneumonia was assessed using the Clinical Pulmonary Infection Score (CPIS). Data were analyzed by Chi-square and t-independent test through SPSS v.16.
Results: The two groups were similar for age, sex, cause of admission, level of consciousness, medication and tobacco use. The majority of patients (58.8%) were diagnosed with pneumonia (Group A: 55.9% and Group B: 61.8%). The Chi-square test showed no significant difference between the two groups for the development of pneumonia (P>0.05).
Conclusion: The use of Chlorhexidine solution with toothbrushing compared to using Chlorhexidine with swab could not reduce the development of pneumonia. However, due to its importance, further research is needed in this regard.
Sima Sabaghi, Manighe Nourian, Minoo Fallahi, Malihe Nasiri,
Volume 21, Issue 4 (3-2016)
Abstract
Background & Aim: Although mechanical ventilation is a life-saving intervention for many infants with respiratory distress syndrome, it carries potential complications. One of these complications is prolonged duration of mechanical ventilation. More than 15 days of mechanical ventilation is associated with increased risk of cerebral palsy and attention deficit hyperactivity disorder among extremely low birth weight infants. The current study aimed to determine the relationships between the length of mechanical ventilation and its related factors in neonates with respiratory distress syndrome.
Methods & Materials: In this analytical study, a convenience sample of 60 premature infants of 33 weeks’ gestation or less with respiratory distress syndrome was recruited from three hospitals (Mahdieh, Mofid, and Imam Hossein) affiliated to Shahid Beheshti University of Medical Sciences in 2014-2015. Then, factors related to the length of mechanical ventilation such as sex, type of birth, birth weight, gestational age, Apgar score at the first minute, Apgar score at the fifth minute were assessed. The data were analyzed using descriptive statistics, Pearson correlation, independent t-test, and multiple regression analysis on SPSS software v.20.
Results: The mean gestational age was 30.62±1.8 weeks and the mean weight of infants was 1510.33±390.940 grams. The mean length of mechanical ventilation was 3.58±2.97 days. There were not any correlations between sex, type of birth and the length of mechanical ventilation (P>0.05). Gestational age and weight were significantly correlated to the length of mechanical ventilation (P<0.001). But in adjusted analysis using multiple regression, only gestational age remained a significant factor related to the length of mechanical ventilation (P<0.05).
Conclusion: The results of the current study revealed that among the studied factors, only gestational age was a factor affecting the length of mechanical ventilation.
Zahra Saifollahi, Fariba Bolourchifard, Fariba Borhani, Mahnaz Ilkhani, Sara Jumbarsang,
Volume 22, Issue 1 (5-2016)
Abstract
Background & Aim: Pressure ulcers are a common complication in patients hospitalized in intensive care units. This complication continues to be a major problem in all health care systems and reflects the quality of nursing care in hospitals. The aim of this study was to evaluate the correlation between nurses’ knowledge and quality of nursing care for prevention of pressure ulcers in intensive care units.
Methods & Materials: This was a descriptive correlational study on a purposive sample of 92 nurses employed in intensive care units of four hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2014. Data were collected through a questionnaire containing demographic and occupational information, the Pieper’s nursing knowledge questionnaire, and a checklist to assess the quality of nursing care for prevention of pressure ulcers. Descriptive and inferential statistics (independent t-test and Pearson’s correlation) were used to analyze data on SPSS software v. 21. The level of significance was considered at P≤0.05.
Results: The study results showed that the average score of nurses’ knowledge of pressure ulcers prevention was a total of 75.7±6.9. The quality of nursing care in more than half of cases (54.3%) was relatively favorable. There was no significant correlation between nurses’ knowledge and the quality of nursing care for pressure ulcers (P=0.86, r=0.01).
Conclusion: In addition to inadequate knowledge of pressure ulcers prevention, the nurses did not fully implement what they knew in clinical practices. Therefore, a more accurate evaluation is recommended in this regard.
Mina Salimi, Anahita Masoumpoor, Azam Shirinabadi Farahani, Nezhat Shakeri, Fatemeh Alaee Karharoudy, Hossein Shiri,
Volume 22, Issue 2 (7-2016)
Abstract
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.
Zohreh Sadat, Nasrin Salehi, Mohammad Reza Afazel, Mohammad Sadegh Aboutalebi, Mansur Dianati,
Volume 23, Issue 2 (7-2017)
Abstract
Background & Aim: The role of caffeine as a cerebral stimulant for improving respiratory indicators in the
mechanically ventilated patients is unclear. The purpose of this study was to evaluate the effect of coffee consumption on respiratory indicators
among the mechanically ventilated patients in the Intensive Care Unit (ICU).
Methods & Materials: A double blind, randomized clinical trial (IRCT2013122915972N1) was performed on 80 patients who were selected by convenience sampling and randomly allocated into two groups (intervention and control). For the intervention group was administered 3.5 grams of espresso coffee powder dissolved in 80 cc water, then 20 cc water through gavage about an hour after breakfast. The control group received 100 cc distilled water. Respiratory parameters were recorded and compared in the two groups 2 minutes before the intervention and 30 minutes and 60 minutes after the intervention. Chi-square test,
t-test and the repeated measures analysis of variance were used to analyze the data.
Results: There was no difference between the two groups in the baseline variables. After the intervention, the spontaneous respiratory rate, tidal volume, the minute ventilation rate and arterial O2 saturation increased in the intervention group compared to the control group, but the increase was statistically significant only for the spontaneous respiratory rate and tidal volume.
Conclusion: Espresso coffee consumption through gastric tube in the mechanically ventilated patients increases the spontaneous respiratory rate and tidal volume but does not significantly affect other respiratory indicators.
Seyedeh Rabeeh Ghavami, Leili Borimnejad, Naiemeh Seyedfatemi, Hamid Haghani,
Volume 23, Issue 3 (10-2017)
Abstract
Background & Aim: Infant hospitalization in the intensive care unit is stressful for parents so that it affects their parental role. Nurses, due to their special situation, can play an important role in reducing parental stress. This study aimed to determine the effect of parental role training by a nurse on stress in the parents of hospitalized newborns in a neonatal intensive care unit.
Methods & Materials: A quasi-experimental study (IRCT201605131788N17) was conducted on 72 parents (36 couples in the intervention group, 36 couples in the control group) of hospitalized newborns in the neonatal intensive care unit of Ali-Asghar hospital in 2016. The intervention group received the parental role training based on their needs. Their stress level was compared with the control group using the Parental Stress Scale. Data were analyzed by descriptive statistics, chi-square test, paired t-test, independent t-test and Fisher's exact test using the SPSS software v.16.
Results: Before the education, there was no significant difference in the stress level between the two groups (P>0.05). After the education program, the stress level in the intervention group fell on the tenth day compared to the control group (P<0.001).
Conclusion: Training parents based on their educational needs reduces their stress. By reducing stress and improving the role of parents, it can be assured that the newborn is provided with the quality care at the time of admission.
Sedigeh Salimi, Vahid Pakpour, Hossein Feizollahzadeh, Azad Rahmani,
Volume 23, Issue 3 (10-2017)
Abstract
Background & Aim: Exposure to high stress in the work environment among the intensive care unit nurses results in leaving the profession and their unwillingness to continue their activities. This is one of the major challenges in the nursing profession and has a great effect on the effectiveness of health systems. Despite the importance of resilience, there is few studies on the intensive care unit nurses’ resilience. The aim of this study was to determine resilience and its association with the intensive care unit nurses’ intention to leave their profession.
Methods & Materials: This is a cross-sectional, descriptive analytical study on 400 nurses working in the intensive care units of teaching hospitals affiliated to Tabriz University of Medical Sciences in 2016. Data were collected through a modified form of Anticipated Turnover Scale designed by liou and a summarized form of Connor-Davidson’s resilience scale". Descriptive and inferential statistics (Mann-Whitney, and Kruskal-Wallis) were used for data analysis through SPSS version 13.
Results: The mean rank for intention to leave and resilience was 2.83 (IQR: 0.67) and 25.50 (IQR: 8) respectively. Also, there was a negative, significant correlation between resilience and intention to leave (P<0.001, R=-0.173).
Conclusion: Considering the rate of intention to leave the profession, more attention is needed to the factors affecting the intention to leave. In addition, due to the significant relationship between resilience and intention to leave, incorporating resilience-promoting strategies into nursing curriculum is recommended.
Maryam Jabbarpour, Fatemeh Abdoli, Majid Kazemi,
Volume 24, Issue 2 (7-2018)
Abstract
Background & Aim: Anxiety is one of the most common psychiatric disorders in the family of patients with traumatic brain injury. This study aimed to determine the effect of providing information about the patient’s condition on the anxiety level of the family members of hospitalized patients with traumatic brain injury.
Methods & Materials: This quasi-experimental study was conducted on 90 family members of traumatic brain injury patients admitted to Shahid Bahonar hospital in Kerman in 2016. The participants were selected by the consecutive sampling method and were assigned to intervention and control groups. In the intervention, the participants were informed by the nurse about changes in the patient’s condition during the first three days of admission to intensive care unit. During this period, the control received routine care. Data collection tool was the Spielberger anxiety inventory. Independent and paired t-test were used to compare the mean scores of anxiety using the SPSS software version 16.
Results: There was no statistically significant difference in the mean scores of overt, covert and general anxiety between the two groups before the intervention (P>0.05). However, after the intervention in the experimental group, the mean scores of overt anxiety (45.51±7.26), covert anxiety (45.42±6.51) and general anxiety (90.93±12.72) decreased (P<0.05) compared to the mean scores of overt anxiety (49.22±9.42), covert anxiety (49.02±9.15) and general anxiety (98.24±17.67) in the control group.
Conclusion: Providing planned information on changes in the condition of hospitalized patients with traumatic brain injury can reduce the anxiety of family members of these patients.
Clinical trial registry: IRCT20180206038642N2
Ali Hasanshahian, Ali Ravari, Tayebeh Mirzaei,
Volume 24, Issue 4 (1-2019)
Abstract
Background & Aim: Active participation of families can be an influencing factor on delirium in patients hospitalized in the ICU. The present study was conducted to investigate the effect of scheduled visits on delirium intensity in elderly patients hospitalized in the ICU.
Methods & Materials: This clinical trial was conducted on 70 elderly patients hospitalized in the ICU of Ali ibn Abi Talib hospital in Rafsanjan from November 1, 2017 to March 1, 2018. In the intervention group, patients were visited in two out-of-schedule sessions for three days in the morning and night. The control group received routine visits for 3-5 minutes. To assess delirium, the Neecham questionnaire with a scoring scale of 19-30 was used. The data were analyzed using the SPSS software version18.
Results: There was no statistically significant difference between the two groups in terms of age, sex and educational level. Before the intervention and one day after the intervention, no significant difference was observed in delirium score between the two groups. However, on the second day in the intervention group, the median and interquartile range for delirium were 27(3) and in the control group were 25(2) (P<0.0001). On the third day after the intervention, differences between delirium score in the intervention and control groups were 27(3) and 25(3), respectively (P<0.0001).
Conclusion: Scheduled visits can be considered an effective non-pharmacological method for preventing delirium in elderly patients hospitalized in the ICU.
Clinical trial registry: IRCT20150519022320N7
Tayebe Sedghi, Mahnaz Ghaljeh,
Volume 26, Issue 4 (1-2021)
Abstract
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.
Sara Sharafieh, Shiva Khaleghparast, Fatemeh Ghani Dehkordi, Saeideh Mazloomzadeh,
Volume 27, Issue 3 (10-2021)
Abstract
Background & Aim: Clinical decision-making is an essential part of the nursing profession. The nursing profession is based on ethical principles. Due to their commitment to patients, morally courageous nurses ignore occupational risks threatening their own lives. The aim of this study was to investigate the relationship between moral courage of nurses and their participation in clinical decision-making.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2019. The study population was nurses working in the CCU and ICU of Shahid Rajaie Cardiovascular Medical and Research Center. The sample size was 195 people. The data was collected using the Sekerka’s Moral Courage Scale, and the Participation in Decision Activities Questionnaire (PDAQ). Data was analyzed using descriptive statistics, independent t-test and Pearson correlation coefficient through the SPSS software version 19.
Results: The mean scores of moral courage and PDAQ in nurses were 90.38 ± 11.48 and 117.24±39.42, respectively. A positive correlation was found between moral courage and participation in clinical decision-makings (r=0.397, P<0.001).
Conclusion: The results showed that moral courage has pride of place in the nursing profession that can encourage nurses to actively participate in clinical decision making. Therefore, professional ethics courses are suggested to be organized to improve decision-making and clinical ethical performance of nursing students and nurses.
Nahid Dehghan Nayeri, Maryam Kesheh Farahani, Fatemeh Hajibabaee, Mahmood Sheikh Fathollahi, Mojtaba Senmar,
Volume 27, Issue 3 (10-2021)
Abstract
Background & Aim: Patient safety in general and medication errors in particular are the important indicators of hospital care quality. Risk management is an important and fundamental approach to preventing events caused by medication errors. The aim of this study was to determine the effect of risk management program on the rate of medication errors among intensive care unit nurses.
Methods & Materials: The present study was a non-randomized pre-test, post-test study with a control group, conducted in 2020 in two hospitals in Tehran. The hospitals were randomly assigned to either an experimental group or a control group. According to the inclusion and exclusion criteria, 150 nurses (75 nurses in each group) were selected by the convenience sampling method. For the experimental group, a risk management program was implemented. Data collection tools included the nurses’ demographic questionnaire, the 14-item Wakefield medication error self-reporting questionnaire, and the nurses’ medication quality checklist. Data was collected before and after the intervention and analyzed by the SPSS software version 16 using descriptive and inferential statistics.
Results: The results of independent t-test showed no statistically significant difference between two groups in demographic information and the rate of medication errors before the study (P>0.05). After the intervention, difference in the rate of medication errors was statistically significant between the two groups (P<0.005), indicating a decrease in medication errors in the nurses of the experimental group compared to the control group. The results also showed that the rate of medication error observed in nurses was significantly higher than the error reported by them (P<0.001).
Conclusion: The results showed that the implementation of risk management program was effective in reducing nurses’ medication errors. Implementing a risk management program is recommended to nurses as a way to promote safe medication and achieve safe and desirable nursing care.
Mohammad Reza Shaker , Marzieh Momennasab, Fereshteh Dehghanrad, Roya Dokoohaki, Reza Dakhesh, Azita Jaberi,
Volume 28, Issue 1 (4-2022)
Abstract
Background & Aim: Physiological and psychological needs of intensive care unit (ICU) patients are not met due to lack of effective communication. To facilitate communication, nurses can use augmentative and alternative communication strategies (AACs). The aim of this study was to determine the effect of using these strategies on the quality of nurses’ communication with patients with endotracheal intubation in the cardiac surgery intensive care units.
Methods & Materials: In this quasi-experimental intervention study with before-after design, 70 patients (35 at each stage) who were unable to communicate verbally after heart surgery due to intubation were recruited by the convenience sampling method, and also 10 nurses in the cardiac surgery ICU were randomly selected. In the pre-intervention stage, nurses communicated with patients using conventional methods, and after training in the post-intervention stage, using AACs. Data were analyzed using descriptive and inferential statistics through the SPSS software version 22.
Results: The lowest content of communication in the pre- and post-intervention stages was related to emotions, the frequency of which was higher in the post-intervention stage compared to the pre-intervention stage. The most commonly used methods in the post-intervention phase were the communication board and head gesture. In both stages, communication was mostly initiated by the patient. In the post-intervention stage, the number of times the nurse started the communication increased (P<0.05). In the post-intervention phase, patients’ and nurses’ satisfaction with communication increased (P=0.0001).
Conclusion: Training nurses about AACs and using them for the ICU patients increase the success of communication and patients’ and nurses’ satisfaction with communication. Therefore, the use of these strategies in these wards is recommended to nurses and nursing managers.
Venus Boochani, Batool Pouraboli, Marzieh Hasanpour, Hadi Ranjbar,
Volume 28, Issue 4 (1-2023)
Abstract
Background & Aim: Mothers with premature babies are more likely to experience anxiety than mothers with full-term babies. The separation of the mother from the baby disrupts physical contact with the baby, which is the most important component affecting attachment. The aim of this study was to determine the effect of a group positive thinking program on anxiety and attachment in mothers with premature infants admitted to the neonatal intensive care unit.
Methods & Materials: This study is a randomized clinical trial conducted in Kermanshah in 2020. A total of 72 mothers with premature infants admitted to the neonatal intensive care unit of Imam Reza and Mohammad Kermanshahi hospitals were randomly assigned into two groups of control and intervention. The Spielberger State Trait Anxiety Inventory and Postpartum Attachment Scale were used to collect the data. The collected data were analyzed using the SPSS software version 16 using statistical tests (ANOVA and Chi-Square).
Results: There was no significant difference in the state anxiety levels before (p =0.791) and after the intervention (p =0.373) between the control and intervention groups. Likewise, no statistically significant difference was observed in the latent anxiety levels before (p =0.831) and after the intervention (p =0.093) between the two groups but comparing the amount of changes showed a significant difference (p =0.025). Regarding attachment, none of the attachment subscales had a statistically significant difference between the two groups before the intervention (p>0.05). After the intervention, a significant difference was observed in the scores of the subscales “lack of hostility" and "satisfaction with the interaction" (p<0.05).
Conclusion: According to the findings of the study, the group positive thinking training is recommended to the nurses and managers of neonatal intensive care units as a complementary program, along with the routine care for mothers of premature infants.
Clinical trial registry: IRCT20210108049965N1
Fateme Ebrahimi, Ezzat Jafarjalal, Tahereh Najafi Ghezeljeh, Shima Haghani,
Volume 29, Issue 1 (4-2023)
Abstract
Background & Aim: Attempting to improve the quality is an important issue in the nursing service and care system. The COVID-19 pandemic has created great challenges for healthcare systems, especially for the intensive care units, which can affect the quality of nursing care provided to these patients. The aim of this study was to determine the quality of nursing care in nurses working in the intensive care unit of COVID-19.
Methods & Materials: In this descriptive-cross-sectional conducted in 2021-22, 142 nurses from Valiasr, Amir Kabir, Amir al-Momenin and Khansari hospitals affiliated to Arak University of Medical Sciences were selected by the census method. The Martins’ nursing care quality questionnaire (including 25 items in 7 domains) was completed by the participants. The SPSS software version 16 and independent t-tests, analysis of variance and the Pearson's correlation coefficient were used for the data analysis.
Results: The result showed that the mean score of the nursing care quality was 83.83±7.74, which was considered favorable due to being higher than the median score of the tool (62.5). Among the individual characteristics of nurses, the nursing care quality had a statistically significant relationship with the type of employment (P=0.003), age, work experience and work experience in the intensive care unit (P<0.001).
Conclusion: Considering the significant relationship of the nursing care quality with the type of employment, age and work experience, it is recommended that health managers take an effective step in formulating the necessary policies to improve the quality of nursing care by taking into account the experience of skilled nurses in intensive care units.
