مجله دانشکده پرستاری ارتش
سال دهم شماره 1 (پیاپی 19، بهار 1389)

We live in a world where disasters occur. In all of disasters, emergency healthcare professionals are needed. Nurses are the main health professionals in touch with the community. They must have exceptional knowledge of the people affected by disasters, and recognizes the physical and the psychosocial impact of disasters on well being of individuals, families and community. This requires expansion of their knowledge by providing standard education in disaster preparedness.

This is a review article. The information is based on searching in library and internet.

This paper is a review article based on data which is searched in the internet and laboratory studies and journals.

Disasters are a primary cause of morbidity and mortality. Whether the origin of the disaster is natural or attributable to human causes, the outcomes can be devastating. Community needs extraordinary efforts to cope with them. Nurses are in frontline during disasters and do important tasks such as taking care of the affected people, assessing their health conditions and any special needs and use the available resources to attend to these health needs. The World Health Organization (WHO) report 2006 acknowledges that nurses lack knowledge and skills in disaster and recommends that nurses to be involved in disaster preparedness and response by standard education. Under such critical circumstances nurses can be more effective when receive adequate training in preparedness and responding to disasters. Education about disaster must focus on triage, basic or advanced trauma care, scene management, basic tactical medical operations, and transport of patients. Current education has highlighted radiological, chemical, and biological, hazardous materials incidents. In today’s world, an absence of adequate medical supplies continues to be a real threat to disaster victims. Disaster nurses take care of these victims, even in the face of imminent demise. Nurses can play an important role in disaster, but they receive very little training. There is a Shortage in number of skilled nursing in disaster, too. Statistics indicate that the number of natural disasters continues to grow and because of current attacks and threats of terrorism in our society, educated nurses are in a unique position to participate in all aspects of disaster response, including triage, stabilization, definitive care, and evacuation. Disaster nurse is a brave, caring, courageous individual. Disaster Nursing will prepare any nurse to provide health care under a variety of disaster conditions. By their very nature, disasters are complex scenarios full of odd variables that often change in the blink of an eye. But disaster nurses, who combine effective leadership and organization skills with medical expertise, are as prepared as possible.

Improving the quality of health care is an important priority. However, research has shown that methods of altering clinician’s behavior or implementing organizational change are often ineffective.

This paper is a review article based on data which is searched in the internet and laboratory studies and journals.

Action research has been used successfully to facilitate change and improve service provision in industry, education and more recently in health care. In this paper action research methodology and why it could be successful in promoting change and quality of nursing services are outlined. Recently published studies using action research demonstrate that action research improves clinical care, teamwork, communication and administration. It also encourages practice teams to audit their work and identify their educational needs.

Action research should be a useful means of improving quality in health care and could be used more widely. Action research could be a useful method of transforming theory to practice.

The effective medical sorting of mass casualties (triage) and their subsequent treatment after a nuclear event have been considered extremely difficult or even impossible.1 In the case of a major exchange of strategic nuclear weapons (500-5, 000 MT), the triage of casualties using the remaining resources would certainly be futile and frustrating. Without transportation and tertiary medical-care facilities, the only benefit would be to identify persons who are capable of combat. Even the minimally injured casualty may receive little (if any) meaningful attention in such a situation. However, if a nuclear event occurs, it is more likely to take place on a limited scale rather than as a strategic weapons exchange.1 After a smaller-scale tactical detonation (0.1-2.0 kt) or a nuclear detonation by terrorists, hundreds or a few thousand casualties are more probable than millions2 or billions.3 Considerable medical resources may be intact and available for treating many of them. This chapter presents plans for the management of large numbers of casualties suffer- ing either radiation injury alone or conventional trauma combined with radiation injury.

This paper is a review article based on data which is searched in the internet and laboratory studies and journals.

The degree of injury of a radiation casualty can be categorized by the symptoms of exposure. Casualties can be rapidly sorted on the basis of unlikely, probable, or severe radiation symptoms. This rapid sorting of victims allows the conventional traumatic injuries to receive appropriate attention. Lymphocyte counts are the most necessary laboratory procedure in the first hours and days after exposure. Information from currently available physical dosimeters is of limited value and cannot be relied on entirely in making triage decisions. Triage is greatly complicated if the patient has suffered combined injuries. A shift in priority to the expectant category is likely for a radiation casualty who requires more than one surgical procedure or who has received a surface burn of more than 10%. In the first hours after radiation injury, the priority will be to treat the injuries that require immediate attention. Candidates for surgery must be carefully chosen. Only radiation victims who can be attended to within 36 hours and whose con-dition does not call for multiple procedures should go to surgery. Decontamination of surface radio nuclides is nearly always a second priority after the initial resuscitative support, and can be effectively done with lavage before surgery. Chelation therapy for internal radionuclide contamination can be safely accomplished with the experimental agent DTPA, but the effectiveness of this therapy with mass casualties remains uncertain.The use of antiemetics and antidiarrheals may contribute significantly to patient comfort. Unfortunately, in effective doses, the currently available agents have major side effects that impair the patient’s performance. The prevention of infection and the appropriate use of antibiotics are important in the first few weeks after exposure. Within the first 7-10 days, selective gut decontamination should be used before leukopenia and sepsis occur. Two to 3 weeks later, if infection is indicated by fever and leukopenia, parenteral antibiotics should be initiated. To help prevent infection with new organisms, environmental control measures should be instituted as soon as possible. Supportive therapy with blood components has been shown to be extremely effective in combating hemorrhage and anemia following combined injury. However, granulocyte transfusions and bone-marrow transplants as currently used appear to be of little help. A combination of simple supportive measures, including fluids, electrolytes, antibiotics, adequate nutrition, and platelet transfusions, can significantly reduce mortality, as shown by studies of animal re-search models.

Effective triage will permit the use of limited resources to improve the greatest number of radiation casualties. Survival after either radiation injury alone or combined injury can be greatly enhanced by the application of currently available treatments.

Breast cancer, along with cervical cancer, is one of the most commonly diagnosed cancers of pregnancy. Most would define gestational breast cancer as breast cancer that is diagnosed during pregnancy, lactation, and up to 12 months post-partum. The diagnostic and therapeutic implications in this Clinical setting is special. These women typically present with a more advanced-stage disease that carries an associated poorer prognosis. Physicians thus are challenged to balance aggressive maternal care with appropriate modifications that will ensure fetal protection.

This study is a review article and is based on many reputable sources about enuresis published in 2002-2010 Materials and methods This paper is a review article based on data which is searched in the internet and laboratory studies and journals.

Most women diagnosed with pregnancy-associated breast cancer will present with a painless mass in the breast. A milk-rejection sign has been described rarely in case reports when a nursing infant refuses a lactating breast that harbors occult carcinoma. Although 80% of these masses are benign, further evaluation is warranted. if findings persist more than 2 to 4 weeks. Evaluation begins with a thorough clinical examination, and a baseline breast examination is recommended at the first prenatal visit. Mammography in young no pregnant and no lactating women (<35years) often reveals dense breast parenchyma, contributing to the recommendation that mammography should not be employed for routine screening purposes in this patient population. As breast size and parenchyma ensity increase during pregnancy and lactation secondary to hyper estrogenic proliferative changes, the corresponding efficacy of mammography historically has been questioned. More recently, both the safety and efficacy of mammography during pregnancy have been supported, and mammographic sensitivity rates of 78% to 90% have been documented.

Control of microorganisms exist in wound area can promote wound healing, decrease the length of hospital stay. Cost effective and reduce pain level. Since ancient times, different antimicrobial agent used for treating and preventing of burn wound infection. Each of this has some advantages and disadvantages and side effects that limit the use of them. Silver is one of the materials that used for along time as an antimicrobial agent. Many researches demonstrated that nanocristalline silver products are more effective than the others to prevent infection and to improve wound healing.

This paper is a review article based on data which is searched in the internet and laboratory studies and journals.

Silver has antiseptic, antimicrobial, anti inflammatory properties, to treating and preventing infection. Nanocristalline silver utilizes nanotechnology to releas extremely small and highly reactive silver particles. The smaller the particles of silver the greater the wound surface area that will be can contact with silver. Thus increasing bioactivity of silver.

Nanocrystalline silver dressing can use as a safe And cost effective dressing which can promote healing in burn wounds.

Diabetes mellitus is the most important disease in the world. Investigations show that 50% of adults above 65 years old experiment Glucose Tolerance impairment and because of it’s terrible effects, diabetes is the most important cause of blindness. So controlling this disease and it’s effects are so important step in community health services.

This is a review article. The information is based on searching in library internet.

Diabetes mellitus is a kind of metabolic disorder which has a lot of serious effect. One of this serious effects is visual disorder, and we can divided this visual disorder to proliferative Retinopathy, Non proliferative Retinopathy, Cataract, eye muscle plegia, optic neuropathy and… Therefore it is so important to promote our knowledge about this disease, the methods of prevention, controlling these effects and for this reason health care members educate people about this disease.

Basis one safety clinical practical in nursing, is matching that with professional laws and standards of cares. The principle just measurement and adjustment that nurse, which actively for patient is documenting carefully. In exceptional deviation of these standards, could nurses coordinate to criminal, neglect and malpractice in nursing services. that lead to reduce quality of nursing cares. In other to we believe that nursing care that not record thus no occurs. Which the nurse documenting and how recording, could in legal places determinate the clinical competency for nursing. in this study, a new strategy effectiveness, nurses documentation committee, that help to solving problems for documenting nurses.

This study is a review article based on the information and data, which is published in the internet, journals and associated researches. Results and

A one extremely problems in present services in healthy and treatment units is awareness and believe in nurses for documenting that lead to quality of nursing cares. There for the nurses about patients is responsibility and must documentation is very good. Organization nurses documentation committee could promotion quality of cares. Continuing staffing development lead to promotion quality of documentation in nurses.