mohammad javadinejad

Background & aim: 

Thinking about death is a human cognitive activity which affects a dying patient and the individuals who take care of them, especially nurses. Considering the high mortality rate in ICUs, the present study aims to determine the views of the nurses of ICUs regarding patients’ quality of dying and death.

This descriptive-cross-sectional study was conducted in 2023 in hospitals affiliated with Tehran University of Medical Sciences. The research population consisted of 176 ICU nurses in hospitals affiliated with Tehran University of Medical Sciences, who were selected via a convenient sampling method. The data was collected using a demographic survey and the Quality of Dying and Death (QODD) Questionnaire —Version 3.2a by Cho et al. (2017).

In evaluating the quality of dying and death and its three components (patient’s experience at the end of life, end-of-life medical care, and quality of the moment of death experience), it can be stated that all of these components were lower than the mean scores. Therefore, from the nurses’ viewpoints, the quality of dying and death and its components are lower than mean scores. Regarding the demographic characteristics (gender and marital status), there was no significant difference in the quality of dying and death of terminally ill patients in ICUs of hospitals affiliated with Tehran University. In regards to nurses’ education and their received training in the field of quality of dying and death, a significant difference was observed (P<0.05).

Regarding nurses' understanding of the quality of dying and death in ICUs, planning can be done to help preserve the human dignity of dying patients and the peace of their families by creating supportive measures. Through this process, families can also be assured that by maintaining the patient's human dignity, their death can be more convenient, and can be a foundation for knowledge in this field.

Nursing grand rounds are one of the potential factors for providing up-to-date evidence to nurses and nursing students and their use at the patient's bedside. Identifying the visible and hidden angles of this experience can help to improve this approach.  Based on this, this study was exploring the experience of undergraduate nursing students from Grand Round.

This study is part of a qualitative study with an exploratory sequential interventional combined approach that was conducted with the help of conventional content analysis. For this purpose, 25 undergraduate nursing students of the 7th semester, who had internship experience in intensive care units in the Grand Round method, were purposefully included in the study. Then, with the help of semi-structured, in-depth, and face-to-face interviews with an average of 40 to 60 minutes, the experiences of these participants were extracted and after recording and implementation, they were analyzed with the help of Granheim and Lundman's approach.

The mean± SD age of these students was 21.3 ± 10.8 years. From a total of 25 interviews conducted with the participants, 423 primary codes were extracted. After merging the codes that had similar content and meaning, three main categories of internship purposefulness, withdrawal from island education and perceived challenges appeared with 9 subcategories.

Since the participants in the study claimed that with the help of this approach, education at the bedside is targeted and in fact, they are faced with a new approach in education, it is necessary to take steps to identify this approach and try to solve the challenge of this approach.

This review study was conducted with the aim of highlighting the importance of a preoperative preventive approach in the recovery of patients undergoing coronary artery bypass surgery.

With the increase in the number of patients who are candidated for heart surgery, improving the health status before the operation is of great importance to optimize the results after the operation. This review has been conducted with the aim of evaluating the evidence related to the pre-rehabilitation of patients undergoing coronary artery bypass surgery.

The present literature review was conducted by searching out library resources and databases, Scopus, Chochrane Library, Magiran, SID, PubMed, Up-to-date, OVID, CINAHL, and Web of Science with the keywords, coronary artery bypass surgery, pre-rehabilitation, cardiovascular disease and their Persian equivalents without time limit. From a total of 104 articles, 63 full texts articles entered the review stage, of which 17 articles entered the literature review.

The findings indicate the favorable effects of pre-rehabilitation on improving the quality of life and preventing complications in the early postoperative period. Pre-rehabilitation programs should adopt multifaceted approaches including nutrition, exercise, and anxiety reduction to improve patient resilience in the preoperative period. The pre-operative period is a critical opportunity to implement pre-rehabilitation interventions for vulnerable patients awaiting cardiac surgery.

Cardiac pre-rehabilitation includes a wide range of preventive interventions that can be taught by nurses to patients undergoing cardiac surgery. Pre-rehabilitation requires an interdisciplinary approach, because it suggests a change from the current model of health care and transformation from one-dimensional care to interdisciplinary care, which can be an effective tool for the medical and nursing system in timely identification of physical and mental disorders in initial preoperative assessment, preoperative education and management, as well as prevention of postoperative complications.

The present review study was conducted with the aim of exploring what nurses should know about interactions of diet containing vitamin K with warfarin. Background. Warfarin is one of the most widely used oral anticoagulants. Dietary interactions, mainly due to vitamin K, are a common concern when consuming warfarin. In the meantime, the nurse, as the first person in the care chain and the main person in charge of patient education, can play an important role in reducing these interactions, which is a challenge for patients.

The present review study was conducted through searching out library as well as databases such as PubMed, Cochrane Library, Web of Science, Scopus, Up-to-date, OVID, CINAHL, Magiran and SID using Persian keywords of warfarin, dietary interactions, vitamin k diet, patient and nurse education and their English equivalents in the period 1999 to 2021. Out of a total of 30 articles found, 8 articles were reviewed after screening the articles.

The findings of this study showed that the amount of vitamin K intake in the diet should be kept constant. This is 90 to 120 micrograms per day. Patients should be properly and continuously educated about vitamin K in various foods and supplements. In the meantime, the role of the nurse as one of the pillars of patient education is very important and fundamental.

Due to the role of the nurse in educating these patients, it is recommended that education about dietary interactions be used using authoritative sources. It is possible with methods such as preparing a clinical guide, making a video and designing an application, and including tables of vitamin K levels in foods.

This review study aims to investigate the impact of reducing Door-to-ECG (DTE) time on on morbidity and mortality of patients with chest pain referred to emergency department.

Chest pain is the second most common reason for referral to an emergency unit. According to American Heart Association, all patients with chest pain presenting to the emergency ward should be approached with an ECG within 10 minutes of entrance to the emergency department. This is considered as the first line of diagnostic tests for myocardial infarction.

In this narrative review study, several databases and search engines including SID, Pub Med, Google Scholar, Web of Science and Scopus were used to find the articles published between 2000 and 2018. The keywords used to search articles were “Door to ECG”, “chest pain”, “emergency unit” and “triage”. The articles selected for review were interventional or descriptive in terms of design, in Persian or English, with available full text. The criterion for selecting articles was the similarity of the their subject with the search keywords including Door to ECG (DTE) time and triage and their value in the early diagnosis and treatment of coronary disorders.

A total of 20 articles were found. After removing the articles that didn’t meet the inclusion criteria, 11 articles related to the subject of the study remained in review. The significant outcomes of timely triage, appropriate time to perform ECG, barriers to access and suggestions for faster treatment by the system especially the role of nurses, were investigated.

The reduction of triage time and Door to ECG (DTE) time as well as the role of the nurse in those cases are associated with a reduction in the morbidity and mortality of cardiac patients.