نشریه پرستاری مراقبت ویژه
سال ششم شماره 3 (پیاپی 20، پاییز 1392)

Fatigue is one of the most common dialysis side effects and it has been among the main nursing diagnosis in hemodialysis patients and it can predict cardiovascular events and its mortality in hemodialysis patients as a bioalarm. Considering that decrease in Serum level of vitamin C is one of the main causes of fatigue in these patients، this study had been done with the aim of evaluating the effect of supplementation with intravenous vitamin C on fatigue in hemodialysis patients. In a randomized، parallel group، double-blind clinical trial، 177 patients with chronic renal failure who referred to hemodialysis units of Baqiatallah and Chamran hospital in Tehran were studied. They distributed in three groups of experimental، control and placebo in 2011. In addition to demographic questionnaire، multidimensional questionnaire (MFI) had also been used for determining fatigue before and after intervention. Then in experimental group an 2. 5cc injection contacting 250 mg vitamin C was injected three times every week، at the end of each dialysis session via the intravenous route، for 8 weeks. In the placebo group normal saline placebo had been injected with the same amount for the same time and there was no intervention in the control group. In order to analyze data statistically and compare them between groups، SPSS statistical software، and Chi square، T-test، Paired t-test and ANOVA were used. Complain of fatigue was observed in 81/6 % of patients and 30/7% of these patients suffered from severe fatigue before the intervention. The average loss of activity، physical fatigue and general fatigue had respectively higher mean in compare with the other five of fatigue dimensions. The mean of total scores of fatigue five dimensions was 65. 39±15. 92. After the end of intervention there was significant difference between findings of the three groups fatigue mean was decreased in experimental group to (52. 28±13. 82). Vitamin C supplementation can decrease fatigue significantly and it can be used as a simple، safe and inexpensive way.

evidence-based care instructions are one of the effective tools for appropriate decision-making and enhancing the quality of taking care of the patients with mental disorders. The aim of this study has been determined:” Designing and Accreditation of evidence-based nursing care instructions in psychiatric emergencies”

The study had been done with “developmental research” method with the evidence-based approach in Mental Units of Baqiyatallah hospital in 2014. Nursing care instructions had been designed according to Stetler model and with the evidence-based approach for patients who were exposed to the high risk of suicide & violence. For assessing content validity of the instructions with Delfi method، opinions of ten faculty members of Baqiyatallah، Tehran، Shahid Beheshti، Army and Sabzevar Universities had been considered in three stages. Applicability of the instructions had been assessed by focused group discussion method with 10 experienced experts of Mental Units.

In addition to reviewing nursing books، 100 articles from 2006-2013 had been studied، and with considering criteria of choosing evidences، 40 articles had been chosen as credible evidences. At the end، 7 evidenced -based nursing care instructions had been designed for the patients with psychiatric Emergencies.

With designing Evidence-based nursing care instructions in psychiatric emergencies، some needs of clinical nurses in confronting these patients were removed. So it is recommend performing such instructions and to design and perform care instructions in other units in the next studies.

Using IT for preventing unpleasant events due to medical errors، decrease of death and length of stay is attended more than before. The aim of this study was nurses’ understanding of IT acceptance according to IT acceptance model. It was a descriptive-analytic study. 47 nurses، working in ICU were chosen through available method from three chosen hospitals of Tehran in 2012. Data collection tool was a questionnaire based on IT acceptance model and planned behavior theory by considering reliance variable. Relationship between the main construct of the model with Spearman test and simple regression test had been used for predicting relationship between IT acceptance model constructs. Data were analyzed by SPSS16 software and descriptive and inferential statistical tests. there was significant relationship (P=0. 02) between nurses’ education level with their reliance on IT. There was strong correlation between reliance and understanding ease of use. There wasn’t any correlation between attitude constructs، behavioral control and subjective norms with nurses’ trend to use IT. Behavioral trend to use IT is remarkably influenced by understanding ease of use. educational planners and IT managers can promote ICU nurses trend to use technology by strengthening constructs of perceiving ease of use، subjective norms and reliance

ECG interpretation in clinical situation has developed fgrom simple determination of rate and rhythm toward the diagnosis of complex arrhythmias، ischemia and myocardial infarction. Having enough knowledge and skills in this field is one of the essential competences for nurses، especially in intensive care units، which can be influenced by education circumstance and also regarding this; the survey of new educational methods for obtaining deep and effective learning of Electrocardiography seems necessary. The aim of this study was to determinate the effect of educational software of dysrhythmia simulator on ECG interpretation''s knowledge among nurses who are working in intensive care units. This quasi-experimental study conducted with participation of 73 ICU and CCU nurses from two Seyedoshohada and Taleghani hospitals of Oroumiyeh that were randomly placed in two groups; intervention and control. Data were gathered by a researcher-made questionnaire، which verified their validity and reliability and was consisted of 15 theoretical questions and 25 dysrhythmia strips in the form of pretest-posttest design. The collected data were analyzed by SPSS statistical software and descriptive statistics (ver. 16). The mean and standard deviation of the nurses’ before and after scores، the group that used educational software of arrhythmia simulator method was 17. 21±2. 04 and 22. 15±3. 27 respectively، whereas it was 16. 77±4. 86 and 19. 13±5. 28 in the conference group، respectively. The Independent statistical T-test revealed a significant statistical difference between the post training scores in two groups (p=0/004). Also the comparison of average of scores in the form of intra- group with paired t-test revealed significant differences in before and after scores in every group (p<0/005). However، the mean difference between pre and post scores in the intervention group was higher. The use of educational software of dysrhythmia simulator causes more improvement of the knowledge of nurses in dysrhythmia interpretation field. According to the results of this study، the ease of using and availability of simulator software، and it''s application in wards can facilitate in-service training for staff، particularly nurses who are working in intensive care units and also enhance their knowledge and skills in the interpretation of electrocardiograms effectively.

one of the effective education evaluation methods in higher education is evaluating students in the area of knowledge and using specialized courses that one of these courses is pharmacology course. Nowadays، doing pharmaceutical orders is an important part of nursing cares. Awareness of the precautions concerning drugs and using them is counted as one of the increasing factors of nursing cares in drug therapy. The present study had been done with the aim of “determining the amount of pharmaceutical knowledge and pharmaceutical calculations skill in CCU among nursing students of Oroumiyeh and Khouy and comparing them”.

this cross-sectional study had been done on 120 nursing students of Orumiyeh and Khouy through census method in the academic year of 2013. Data collection tool was a questionnaire including three parts: demographic information، pharmacology knowledge and pharmaceutical calculations that had been analyzed after their collection through descriptive statistic and long linear (row effect) test by using SAS 92 software and chi 2 test in SPSS16 software.

findings showed that pharmaceutical knowledge in the area of nursing cares among nursing college students of Oroumieh; 43. 3% and Khouy students; 48. 3% was good and there was no significant difference. In the area of drug class، the amount of familiarity، Oroumieh nursing students; 76. 7% and Khoy students; 48. 3% was good andt there was significant difference (P=0. 0). About pharmaceutical calculations، Oroumieh students 48. 3% and Kouy students 16. 7% was good and there was significant difference (P<0. 001).

considering the results of the study، the pharmaceutical calculation power of all the nursing students is not in the appropriate level. So it is required to promote pharmaceutical knowledge and pharmaceutical calculations skills by the professors and teachers for decreasing risks and increasing patient’s safety and it needs exact planning in nursing students educational programs.

Few studies have assessed physical and emotional distressing symptoms in patients with chronic renal failure undergoing hemodialysis. The aim of this study was to investigate distressing symptoms and its relationship with the quality of life of the patients، suffering from chronic renal failure undergoing hemodialysis. In this cross sectional study، two hundred patients with chronic renal failure undergoing hemodialysis at four dialysis units in Karaj، in 2011 were interviewed and also their medical records were investigated. Sampling method was census sampling. The used instruments included; demographic data form، dialysis symptom index and World Health Organization quality of life (WHOQOL-BREF) questionnaire. Data were analyzed by SPSS software and using descriptive statistics، t-test، ANOVA and Pearson coefficient correlation. Findings showed that، the most common distressing symptoms was related to decreased interest in sex (87%)، difficulty of becoming sexually aroused (81%)، fatigue (68. 5%) and bone or joint pain (57%). 77% had mild and 20. 5% had moderate distressing symptoms severity. There were significant positive correlation between frequency score of distressing symptoms with age (p<0. 0001) and negative and significant correlation with physical health (p<0. 0001) social relationships (p<-0. 011)، mental health (p<0. 0001)، environmental health (p<0. 0001) and total score of quality of life (p<0. 0001). Distressing symptoms severity had significant positive correlation with age (p=-0. 006) and negative correlation with physical health (p<0. 0001) social relationships (p<0. 0001)، mental health (p<0. 0001)، environmental health (p<0. 0001) and total score of quality of life (p<0. 0001). Hemodialysis patients experience many distressing symptoms that negatively affect their quality of life. Teaching self-care behaviors in order to reduce and control distressing symptoms can help to improve the quality of life in hemodialysis patients.

Infants، who are hospitalized، may need transformation due to different reasons that may happen in or inter or intra-hospital form، but what should be attended in transferring an infant is stabilization of the infant’s situation before transformation and maintenance of the stabilization during transformation. So this study had been designed and performed with the aim of “determining inter-hospital situation”. in this cross-sectional study، which had been done in chosen hospitals of Tehran Medical Sciences University in 2013، totally 52 inter-hospital infants’ transformations had been assessed by using the least equipment standard checklist of transformation، transformation team features، and the questionnaire of the infants’ situation and the checklist of performing infant’s stabilization program. Data were analyzed by using SPSS 19 and descriptive statistic. most of the transformations had been done by one single person and by expert nurses، most of these people were in the age range of 20-29 years old (46. 6%) and female (72. 6%) and they had the experience of working in ICU (71%). Most of them did not pass the neonatal resuscitation courses، or it was more than six months from their last passed course (61. 2%). Most of the transformations had been done without monitoring blood oxygen (56. 6%). There wasn’t enough necessary equipment and drugs with the infant during transformation in most of the transformations (71. 8%). inter-hospital transformation situation is far from the international standard. Considering this situation، it is expected that authorities of nursing permanent education hold training and skill courses of infant’s transformation and highlight the part of emotional support in educational programs. Also paying attention to use special incubators and having necessary equipment and drugs for transformation is essential.

one of the main contents of management and decisions in emergency triage is triage. Considering the importance of learning triage especially among medical emergencies staff and contradictions about the amount of education method effect and that some of these methods have some merits regarding the effect of learning، easiness، speed and cost، this study had been done with the aim of “studying the effect of triage educational film through START style on awareness and performance of medical emergencies staff”. in and intervention study، 72 of medical emergencies staff of north of Khouzestan، who were selected randomly in 2013 were tested، before education، immediately after and 15 days after education (by a triage 45 minutes educational film and after 15 minutes asking and answering) by a researcher-made questionnaire، which included three parts of questions (demographic، awareness and performance)، then results were analyzed by SPSS18 software and descriptive test and paired t-test. the average of awareness and performance were respectively increased from 39% to 84f. 6% and from 29. 31 to 75. 57 and also there was significant statistical relationship (P<0. 001). Also there was significant statistical difference between the average of awareness and performance immediately after and 15 days after education (P<0. 001).