نشریه پرستاری و مامایی ارومیه
سال هجدهم شماره 10 (پیاپی 135، دی 1399)

Nurses are the largest group of health care providers and their decisions play a very important role in the clinical fate of patients. Due to the importance of nurseschr('39') decisions, this study was conducted to investigate the clinical decision-making ability of hemodialysis nurses in Urmia hospitals.

The present study is a descriptive cross-sectional study performed on 60 nurses working in hemodialysis wards of hospitals affiliated with the Urmia University Medical Sciences. The samples were selected by counting. Data were collected from the Demographic Information Questionnaire and the Lauri and Salantra Clinical Decision Questionnaire. Data were analyzed using SPSS-17 software and descriptive and inferential tests.

The average score of nurseschr('39') overall clinical decision-making was 8.62 ±93.53, of which 57.5% of nurses had intuitive decisions, 22.5% had analytical-intuitive decisions, and 20% had analytical decisions.

The research findings showed that with increasing age and clinical history, nurseschr('39') decision-making progresses towards analytical decision-making, while younger and less experienced nursechr('39')s benefit more from intuitive decision-making.

Achieving justice in the distribution of health services is one of the main goals of the health system. Therefore, the aim of this study was to determine equality in the distribution of health human resources (physicians) of Qazvin University of Medical Sciences before and after the health transformation plan based on Gini coefficient.

 In the present descriptive-analytical and applied study, the statistical population was general practitioners, specialists, and subspecialists of Qazvin University of Medical Sciences during the years 2012 to 2018. Demographic statistics of the cities were extracted from the statistical yearbooks of the Statistics Center of Iran and physicianschr('39') statistics from the Vice-Chancellor for Treatment and Health of Qazvin University of Medical Sciences and inequality was measured using Gini coefficient and Lorenz curve in Excel 2016 and Stata 16 software.

According to the results, the highest number of general practitioners in 2015, specialists and subspecialists in 2018 and the lowest number were in 2017, 2012 and 2016, respectively. Also, the Gini coefficient of general practitioners in the years 2012 to 2018 was in the range of 0.61 and 0.63 and for specialist physicians, the lowest Gini coefficient was observed in 2016 (0.57) and the highest was found in 2018 (0.60) and it was 0.52 for subspecialists from 2012 to 2018.

According to the Gini coefficient, inequality in the distribution of general practitioners in the province did not change after the health transformation plan, and among the specialist and subspecialty physicians, the Gini coefficient was in the range of inequality to high. The transformation plan was not successful in the equal distribution of manpower, so it is necessary to redistribute and implement distribution policies.

Execution of medication orders is one of the most common nursing activities and is considered as the most important duty of the nurse, a task that is associated with high risk and always requires care and observance of safety points by the nurse. To safely prescribe drugs in the clinic, the ability to calculate drugs is one of the basic skills needed by nurses. The aim of this study was to determine the effect of an integrated approach using drug dose calculation software and traditional methods on the rate of medication errors in the neonatal intensive care unit of Shahid Motahari Medical Center in Urmia in 2020

In this quasi-experimental study, 55 nurses working in the neonatal intensive care unit of Shahid Motahari Medical Center in Urmia in a group with pre-test and post-test design were included in the study. The sampling method was easy (available). First, a pre-test was performed on 55 subjects, then the intervention was held in the form of a workshop, and immediately after the intervention, three weeks later, and one month after the test a researcher-made questionnaire was utilized to evaluate the capability, level of knowledge, attitude, and practice regarding the prevention of drug errors. The validity and reliability of the instrument were determined by calculating the reliability coefficient of Spearman-Brown equal to 0.93. Data were analyzed using SPSS software version 26 and Wilcoxon, Friedman, and Kolmogorov-Smirnov tests.

The results of the study showed that the majority of participants were within the age group of 22 to 30 years, female, married, with a bachelorchr('39')s degree, the number of patients under care in each shift was 5 patients, mostly rotating shifts, 11 to 15 years of work experience, GPA 15 Up to 17 and were experimental diplomas. The results showed that after the intervention, there was a statistically significant difference in the mean score of knowledge, interest, and attitude in calculating the drug dose electronically and mentally. The mean score of attitude in the electronic method increased significantly compared to mental method (p <0.001). After the intervention, there was a significant difference between the electronic method and the traditional method in the error rate of nursing staff in the calculation of drug dose by routine and software methods (p=0.000). Also, there was a significant difference between electronic mathematical anxiety compared to the traditional and mental methods (p <0.001). The use of software helps create long-term learning and increases learning stability, accuracy, positive attitude and correct performance and empowerment in nurses.

The electronic method helps improve the positive attitude of employees and also it can improve the safety and quality of nursing services. The use of different types of information technologies can significantly reduce the rate of medical errors and improve the quality of services provided to patients by preventing medical errors and mistakes, and by evaluating errors and the care system.

The new coronavirus (SARS-CoV-2) originated in China and causes pneumonia and respiratory, gastrointestinal, and many other symptoms. The risk of adverse pregnancy outcomes increases in pregnant women infected with the respiratory virus. The purpose of this systematic review was to review maternal outcomes and neonatal status in infected mothers. Searches in PubMed, Elsevier, and Google Scholar were conducted to identify related articles from 2019 to 2020. The search terms "Corona Virus 2019", "Covid 19", and "Pregnancy" were used. All articles were reviewed and the extracted data were categorized. A search of PubMed, Google Scholar, Elsevier and other databases revealed 87, 7280, and 12 results, respectively. Finally, 20 articles were included in the study. The number of women in each article was 1 to 16 (total: 78). All women were in the third trimester of pregnancy except for 2 who were less than 28 weeks pregnant. The most common clinical symptoms were fever, cough, and sore throat. The most common maternal outcome was intrauterine distress, PROM, and preterm delivery. Most mothers give birth by cesarean section. The most common complications of preterm infants were fetal distress, low birth weight, and bacterial pneumonia. In this systematic review, there is some evidence that Covid 19 disease has negative consequences for both mother and fetus during pregnancy.

In the last two decades, accreditation has been used by health systems as an important tool to improve the quality, safety, and effectiveness of healthcare services. The aim of the present study was to investigate the impact of the accreditation program on the quality of hospital services from the perspective of nurses in Tehran, Iran.

This cross-sectional study was descriptive-analytical and it was conducted in 2018 among 365 nurses from 9 educational hospitals affiliated to Iran University of Medical Sciences. Data were collected using a 54-item questionnaire that included nine dimensions of quality results, leadership, commitment and support, strategic quality planning, quality management, staff training, reward, use of data, staff involvement, and benefits of accreditation. Statistical analysis was performed in two sections: descriptive statistics (frequency, percentage, mean, standard deviation) and analytical statistics (Pearson correlation coefficient test, multiple linear regression).

Among the dimensions of accreditation, the highest mean score and the lowest mean score were related to the "staff involvement in accreditation" dimension and "staff training" dimension, respectively. The results of analytical statistics showed that accreditation had a positive impact on the quality of hospital services. Also, three dimensions of leadership, commitment and support, reward and staff involvement in accreditation were significant predictors of the quality of these services (p<0/05).

The results of the present study showed that the implementation of accreditation program is a useful tool to improve the quality of hospital services. Management support is necessary in order to implement this program more effectively and it is vital to create an appropriate reward system to provide sufficient incentive for staff to participate in program implementation. Finally, the necessary training about the accreditation program should be provided to staff.

There is no self-management to control the pain of heart patients, and these patients perform self-management using their own resources after coronary artery bypass graft surgery. The aim of this study was to determine the effect of acceptance-based self-management training on pain intensity in patients undergoing coronary artery bypass graft surgery.

This study is a clinical trial that was performed on 60 patients who were candidates for coronary artery bypass graft surgery. The samples were randomly divided into control and intervention groups. All patients received pain management self-management training immediately after hospitalization and were re-evaluated on the day of discharge. Data collection tools included demographic characteristics and Data analysis was performed using paired and independent t-test using SPSS software at a significant level of p <0.05.

Independent group t-test showed that the difference in postoperative pain scores of patients undergoing coronary artery bypass graft surgery before the intervention between the control and intervention groups was not significant (t = -0.678 and p = 0.50). However, the scores of postoperative pain in patients undergoing coronary artery bypass graft surgery after the intervention were significantly different between the control and intervention groups (t = 2.28 and p = 0.02).

Psychological aspects of pain acceptance interventions as a complement to self-management training can accelerate the patientchr('39')s adaptation to new painful conditions and subsequent behavioral changes desired by medical staff.

Amniocentesis is the most common invasive procedure used to diagnose prenatal genetic disorders. Pregnant women who are candidates for amniocentesis are often afraid of this procedure because they predict it to be painful and describe the pain as a mental experience. Therefore, the present study was performed to determine the effect of acupressure of point H7 hand on amniocentesis pain in pregnant women.

This clinical trial study was performed in the sonography clinic in Birjand city on 60 pregnant women who were candidates for amniocentesis by available sampling method. Individuals were divided into two groups of intervention and control through drawing lots (even and odd days). In the intervention group, acupressure was performed at point H7 for 5 minutes in each hand (a total of 10 minutes) 30 minutes before amniocentesis and the control group did not receive any intervention. Data collection tools in the present study were demographic and pregnancy questionnaires and visual pain scale tools. Immediately after amniocentesis, pain intensity was measured in both groups. Data were analyzed using SPSS16 software and independent t-test and chi-square.

The results showed that in the control group immediately after amniocentesis the mean pain intensity was 6.95±1.82 and in the intervention group, the mean pain intensity was 4.43±1.33. The mean pain intensity immediately after amniocentesis was significantly lower in the acupressure group than in the control group (p <0.001).

The use of H7 hand acupressure was effective in reducing amniocentesis pain. Therefore, midwives can teach this method to pregnant mothers who are candidates for amniocentesis to reduce the pain.

Pregnancy is an important stage in a womanchr('39')s life that leads to significant physical, psychological, and social changes. Hence, strengthening pregnant mothers seems vital to cope with these changes. The present study is carried out to determine the effect of training on pregnant womanchr('39')s self - efficacy.

This study is semi-experimental with the control group. 123 pregnant women referring to the urban centers of comprehensive health services in Kashmar city were randomly assigned into two groups of control and intervention (64 intervention and 59 control). Intervention trainings were held in 8 sessions based on the results of the needs assessment checklist for the intervention group and common delivery preparation classes were held for the control group. Questionnaires were completed before and after the intervention by both intervention and control groups. The data collection tools consisted of the form of demographic characteristics and a researcher-made self-efficacy questionnaire. The validity and reliability of the tools were confirmed. The data analysis was conducted using SPSS version 16 using the Kolmogorov - Smirnov test, an independent t – test, and the covariance analysis test. A p-value less than 0.05 was considered statistically significant.

In this study, there was no statistically significant difference between the intervention and control groups in terms of self-efficacy score of pregnant women before the intervention (p-value >0.05). But after the intervention, a statistically significant difference was observed in the mean score of self-efficacy in the intervention group (p-value <0.05)

The study revealed that training based on motherchr('39')s needs can increase the score of self - efficacy in comparison to the routine training classes. Therefore, it is suggested to use this training approach in pregnancy preparation classes.