Iranian Journal Of Medical - Surgical Nursing
Volume:12 Issue: 1, Feb 2023

Context: 

One of the common procedures in the neonatal intensive care unit (NICU) is the insertion of a venous catheter, and one of the most important and serious complications is extravasation, which is a leading cause of death in hospitalized infants. Based on the researcher’s experience in the NICU and the necessity of extravasation injury management in infants, this review study focused on extravasation injury management in infants.

The literature was searched in ProQuest, Scopus, and PubMed databases using the terms “extravasation” OR “vascular leakage” OR “Peripheral Infiltration” AND “Neonatal” OR “Newborn” OR “Infants” OR “NICU.” The search procedure was performed in the title, abstract, and full text of articles published in English from 2000 to 2022.

In the initial search, 3414 articles were extracted. After removing the duplicates and searching the titles and abstracts of the articles, 132 related articles were found, and their full texts were studied. Finally, 20 articles entered the final analysis stage. Nine case report studies, five case series studies, three clinical trials, and three retrospective review studies were found. The results showed that various treatment methods are available, including elevating limbs, pain relief, hot and cold compresses, flush-out technique with saline, dressings (hydrocolloid, hydrogel, and hydrocellular foam), medications (2% nitroglycerin ointment and subcutaneous administration of hyaluronidase and phentolamine), and new methods such as amniotic membranes, omega-3-rich fish skin (Kerecis), active leptospermum honey (ALH), PRP, and surgical removal.

Despite many medical advances, there is still no specific approach to managing extravasation in infants. The ideal approach to extravasation injuries is still to prevent them initially. The best next step is to minimize the damage using antidotes or hyaluronidase. Using saline to remove the solution and physically minimize damage can be useful. Thus, more studies are needed to address extravasation management in infants.

Traumatic brain injury (TBI) is an acquired brain tissue injury with different severities that leads to a change in the patient’s level of consciousness.

The present study aimed to compare the impact of foot reflexology massage and familiar sensory stimulation on the level of consciousness of trauma patients admitted to the intensive care units (ICUs) of Khatam Al-Anbia Hospital in Zahedan in 2021.

This quasi-experimental study was conducted with a pretest-posttest design on 135 trauma patients with an altered level of consciousness admitted to the ICUs of Khatam Al-Anbia Hospital in Zahedan in 2021. The participants were selected using convenience sampling from the patients who met the inclusion criteria and were randomly assigned to 3 groups: Foot reflexology massage, familiar sensory stimulation, and control groups (each with 45 patients). The foot reflexology massage group received reflex massage on both feet for 30 minutes, the familiar sensory stimulation group received familiar sensory stimulation for 45 minutes, and the control group received ICU routine care. The interventions were carried out for 1 week in 2 morning and evening shifts. The patient’s consciousness level was measured and recorded using the Glasgow Coma Scale (GCS) 5 minutes before and 30 minutes after the intervention. The data were analyzed using SPSS version 22, as well as using analysis of variance (ANOVA), paired samples t-test, independent samples t-test, and analysis of covariance (ANCOVA) at a significance level of 0.05 (P < 0.05).

The data showed that the average consciousness score for the patients in both foot reflexology massage and familiar sensory stimulation groups increased significantly after the intervention compared to the control group (P = 0.001), but the 2 interventions were not significantly different in improving the level of consciousness of the patients.

Foot reflexology massage and familiar sensory stimulation were both equally effective in increasing the level of consciousness of trauma patients with an altered level of consciousness, and none of them was superior to the other. Thus, nurses can use these 2 complementary medicine methods to speed up the improvement of consciousness of patients with TBI.

One of the reasons for the lack of success and desired treatment results in diabetic patients is their lack of participation in treatment. Diabetes self-care education is a key factor in the prevention and treatment of diabetes, which is effective in improving the patient’s quality of life (QoL) and cost reduction.

This study aimed to determine the effect of the flipped learning method on the self-care of patients with type-2 diabetes referred to the Diabetes Clinic of Bu-Ali Hospital in Zahedan.

A semi-experimental study was conducted on 114 diabetic patients. The participants were randomly divided into intervention and control groups, and a pre-test was administered. The self-care of diabetes index (SCODI), 40 items, was completed before and after the intervention by the research samples. The flipped learning program was conducted as an intervention in five sessions for patients in the interventiongroup, anda post-testwasadministeredtwomonthsafter the completion of the educational intervention. The obtained data were analyzed by SPSS 26. The significance level was considered less than 0.05.

Two months after the flipped learning intervention, the findings showed more positive changes in the flipped learning method in increasing the patients’ self-care in the intervention group (P > 0.001). The mean score of self-care and its variations mean was significantly higher in the intervention group in the post-test than in the control group (P = 0.001).

Implementing flipped learning positively affects increasing self-care in diabetic patients. It seems that the implementation of such programs can play an effective role in the treatment and prevention of type-2 diabetes complications.

Urinary tract infections (UTIs) are common in patients with traumatic brain injury (TBI) due to their inability to take care of themselves. Thus, families have a main role in caring for these patients.

This study sought to examine the effects of home-based education on the incidence of UTIs and bedsores in patients with TBI discharged from the hospital.

This quasi-experimental study was conducted on 50 patients with TBI admitted to Khatam Al-Anbia Hospital in Zahedan in 2022 and their caregivers. The participants were selected through convenience sampling among those meeting our inclusion criteria and randomly divided into the intervention and control groups. Caregivers in the intervention group received face-to-face home-based training on the second and fifth days after discharge (i.e., two 45-minute sessions). The participants in the intervention group also received educational pamphlets and videos in the patient’s living environment. The participants in the control group received routine care. After four weeks, urine samples from the patients in the two groups were cultured, and the growth of organisms and the number of colonies were determined. If the number of colonies was 105 per mL or more, the test was considered positive, confirming the presence of UTI. The data were analyzed by SPSS 21 software using appropriate statistical tests at a significance level of less than 0.05 (P < 0.05).

The results showed that 28% and 64% of the patients in the intervention and control groups were positive for UTIs, respectively. The result of the Chi-square test indicated a statistically significant difference between the two groups in terms of the incidence of UTIs (P = 0.01).

Home-based education for traumatic brain injury patients and their caregivers can be effective in reducing the incidence of UTIs after discharge from the hospital and should be incorporated into nursing care programs at the time of the patient’s discharge.

Success in cancer treatment requires accepting treatmentsandthe patient’s compliance with them. Oneof the factors affecting treatment adherence in women is to be supported, especially by their husbands, during different stages of treatment.

This study aimed to examine the effect of couple training on treatment adherence of breast cancer patients undergoing chemotherapy.

This quasi-experimental study was conducted on 80 breast cancer patients admitted to the chemotherapy rooms of Khatam Al-Anbia and Ali-Ibne Abitaleb hospitals affiliated with Zahedan University of Medical Sciences and their husbands in 2022. The participants were selected using convenience sampling and randomly assigned to intervention and control groups. First, the pretest was administered to the participants in both groups. The patients in the intervention group and their husbands attended a couple-training program for three consecutive chemotherapy sessions, each lasting 40 to 60 minutes. However, the control group participants received routine training in the chemotherapy departments. Six weeks after the last intervention session, the Medication Adherence in Chronic Diseases Scale was administered to both groups. The collected data were analyzed with SPSS software (version 27) and using the paired samples t -test, independent samples t-test, chi-square test, and analysis of covariance (ANCOVA). The significance level in this study was considered less than 0.05 (P < 0.05).

The mean treatment adherence score of the patients in the intervention and control groups changed from 162.60 ± 22.79 and 164.97 ± 12.95 to 175.15 ± 10.64 and 166.95 ± 9.67, respectively. The independent samples t-test showed that the mean treatment adherence score was significantly higher in the intervention group than in the control group after the couple training intervention (P < 0.001). The ANCOVA also indicated that the mean treatment adherence scores of breast cancer patients in the two groups showed a statistically significant difference after the couple-training intervention (P < 0.001).

Given the positive effect of couple training on patients’ treatment adherence, it is necessary to carry out educational interventions with the presence of spouses in training and care programs to encourage patients to pursue and adhere to treatment and emphasize their role in the continuation of treatment and adherence to it.

One of the conservative treatment methods for patients with end-stage renal failure is hemodialysis. Although hemodialysis contributes to patients’ lives, it has adverse emotional and psychological effects, including sleep problems, fatigue, and depression.

The present study aimed to examine the effect of sleep hygiene education on sleep quality, depression, and fatigue among hemodialysis patients admitted to hospitals affiliated with Zahedan University of Medical Sciences in 2021.

This quasi-experimental study was conducted on 80 hemodialysis patients in Khatam Al-Anbia and Ali Ibne Abi Talib hospitals affiliated with Zahedan University of Medical Sciences in 2021. The participants were selected through convenience sampling and randomly assigned to intervention and control groups using permuted block randomization. The data were collected using a demographic information form, Pittsburgh sleep quality index (PSQI), Multidimensional Fatigue Inventory (MFI), and Beck Depression Inventory-II (BDI-II). The patients in the control group received routine care, and the patients in the intervention group attended a sleep hygiene education program in three consecutive face-to-face dialysis sessions using educational pamphlets for 40 to 60 minutes, depending on the patient’s tolerance. Two months after the training program, the quality of sleep, fatigue, and depression were measured for patients in both groups. The patients’ data were analyzed with SPSS software (version 25) using the paired samples t-test, independent samples t-test, chi-square test, and analysis of covariance (ANCOVA) at a significant level of 0.05 (P < 0.05).

The mean scores of sleep quality for the patients in the intervention and control groups changed from 12.05 ± 2.18 to 10.85 ± 2.00 and from 10.28 ± 1.85 to 10.45 ± 1.85, respectively, and the paired samples t-test showed significant differences in both groups before and after the intervention, but the sleep quality scores increased for the patients in the intervention group (P = 0.001). Moreover, the mean fatigue scores for the patients in the intervention and control groups changed from 57.98 ± 13.48 to 52.25 ± 13.23 and from 48.88 ± 8.97 to 52.20 ± 8.80, respectively. The paired samples t-test showed significant differences in both groups before and after the intervention, but fatigue scores increased for the control group (P = 0.001). The data also indicated that the mean depression scores for the patients in the intervention and control groups changed from 24.20 ± 6.26 to 22.28 ± 5.26 and from 25.18 ± 7.70 to 25.68 ± 7.54, respectively. The independent samples t-test showed significant differences in both groups before and after the intervention (P = 0.001). By controlling the pre-test effect, the analysis of covariance (ANCOVA) revealed significant differences in the mean scores of sleep quality (P = 0.001), fatigue (P = 0.001), and depression (P = 0.001) in hemodialysis patients in both intervention and control groups after two months.

The study’s findings indicated that sleep hygiene education significantly improves sleep quality, depression, and fatigue in hemodialysis patients. Given that sleep hygiene education is a simple and easy-to-use method, sleep hygiene training courses need to be organized and held for dialysis patients.