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Clinical Care and Skills - Volume:5 Issue: 4, Autumn 2024

Journal of Clinical Care and Skills
Volume:5 Issue: 4, Autumn 2024

  • تاریخ انتشار: 1403/07/10
  • تعداد عناوین: 8
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  • J. Begjani, N. Bagheri Moheb*, Sh. Haghani, H. Babaei Pages 173-179
    Aims

    Insufficient nursing qualifications are among the factors contributing to clinical errors in care units. Additionally, frequent false alarms diminish nurses' trust in alarm systems and delay response times, potentially leading to alarm fatigue over time. This study aimed to investigate the association between alarm fatigue and clinical competence among neonatal intensive care unit (NICU) nurses.

    Instruments & Methods

    This descriptive correlational study included 140 NICU nurses from Kermanshah, Iran, during 2023-2024, selected using a census sampling method. Data collection tools comprised a demographic questionnaire, the "Nurse Competence Scale," and the "Alarm Fatigue Questionnaire." Statistical analysis was conducted using SPSS version 16, employing both descriptive and inferential methods, with a significance level set at p<0.05.

    Findings

    The mean alarm fatigue score was 21.61±7.45, indicating a level above average. Most participants (75%) demonstrated very good clinical qualifications. The average clinical competence score was 174.76±26.74, also rated at a very good level. A significant relationship was observed between alarm fatigue and clinical competence in the teaching-coaching subscale (p=0.019). However, no significant association was found overall.

    Conclusion

    As alarm fatigue increases, clinical competence specifically within the teaching-coaching subscale declines. However, no significant correlation is observed between overall clinical competence (excluding the teaching-coaching subscale) and alarm fatigue, nor between alarm fatigue and the individual subscales of clinical competence.

    Keywords: Nurses, Alert Fatigue, Health Personnel, Clinical Competence, Intensive Care Units, Neonate
  • L. Mostafavi, A. Bagheri Fard, Z. Rahami* Pages 181-187
    Aims

    Considering the important role of sexual dysfunction and decreased sexual function of patients with diabetes, the purpose of this study was to investigate the effect of soft gelatin capsules of ginseng as an herbal medicine on sexual function in patients with diabetes.

    Materials & Methods

    In this double-blind controlled clinical trial with a control group, 80 patients with diabetes (type 1 and 2) were selected using the convenience sampling method, and randomly allocated to two groups of control and intervention groups (each 40 people). The effect of 100 to 200 mg of ginseng soft gelatin capsules (daily for 8 weeks) on the sexual function of men and women with diabetes in the intervention group and a similar placebo in the control group were studied. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were used for gathering data before and at the end of 8 weeks of intervention. Data were analyzed using SPSS 16 software.

    Findings

    At the beginning of the study, the mean score of the IIEF index in the control and intervention groups was 28.08±5.93 and 30.73±8.15, respectively without significant change (p=0.199). Eight weeks after the intervention, the IIEF index significantly improved in the group receiving ginseng 44.95±7.64 as compared to the control group 27.81±6.02 (p<0.001). At the baseline, the mean score of the FSFI index in the control and intervention groups were 47.36±5.93 and 46.06±5.47, respectively (p=0.525). At the end of the study, the FSFI index significantly improved in the group receiving ginseng 66.17±5.63 as compared to the control group 47.21±8.41 (p<0.001).

    Conclusion

    The consumption of ginseng for 8 weeks had a significant effect on the improvement of the sexual function of male and female diabetic patients.

    Keywords: Ginseng, Sexual Activity, Diabetes
  • Z. Shabanikordsholi, M. Safari*, S. Parvizi, P. Shabanikordsholi Pages 197-205
    Background & Objective

    Skin-to-skin contact between mother and newborn is an important care in maternal and newborn health and promoting breastfeeding. This study aimed to determine the barriers of implementing the SCC guideline at birth from the perspective of midwives working in hospitals in Yasuj.Iran.

    Materials and Methods

    A descriptive-cross-sectional study was conducted with the participation of 88 midwives working in two hospitals of Yasuj 2024. Data were collected through interviews with a questionnaire consisting of two sections of demographic characteristics and questions related to seven areas of barriers to implementing the SCC guideline. Its validity was measured with the Content Validity Index. Data analyzed with descriptive statistics including frequency tables, central and dispersion indices and using SPSS version 16 software.

    Findings

    The age of the midwives was at least 25 and at most 59 years with a mean of 35.91 ± 8.482 and the work experience in the maternity hospital was at least 1 and at most 26 years with a mean of 6.672 ± 6.86. From the perspective of 48 people (54.5%), SCC in the hospital was not performed according to the guidelines. The frequency of midwives' knowledge barriers was 4 (4.5%), human resource barriers was 35 (39.8%), environmental barriers was 4 (4.5%), content barriers of the guideline was 2 (2.3%), maternal and newborn safety barriers were 15 (17%), cultural barriers were 5 (5.7%), and managerial and supervisory barriers were 17 (19.3%).

    Conclusion

    The main barriers were human resource, managerial and supervisory, maternal and newborn safety respectively.

    Keywords: Skin-To-Skin Contact, Midwives' Perspectives, Barriers
  • M. Yeganeh, H. Ahmadi, F. Salmani*, Sh. Goli Pages 207-213

    Bachground:

     Drug interactions include chemical reactions that often occur between two or more drugs or even when a drug is taken with food, drink, or a supplement. Therefore, the aim of this current review is the determine potential drug interactions in the intensive care unit, and the role of nurses in their preventions.

    Methods

    This is a single-article review. Our available sources include all studies conducted on drug interactions in elderly care units between 2012 and 2024 that are included in this study. The databases searched include: CINAHL, Scopus, PubMed, Cochrane Data Base of Systematic Reviews, Wiley, Science Direct, Iran Medex, Scientific Information Database (SID), and Google Scholar. The Persian-English keywords searched were: "drug interactions", "potential drug interactions", “Adverse events",“ intensive care units ",“ critically units ", “Risk of drug coexistence”,” Drug accident”, “adult “and “elderly”.

    Results

    The findings of this study showed that by searching for relevant keywords in the initial stage, 34 studies were found. 17 articles were excluded for reasons such as lack of relevance to the topic and unavailability of the full text of the article. Finally, 12 valid articles were confirmed, of which 6 were Persian articles and 6 were in English.

    Conclusion

    The study results showed that drug interactions have a direct relationship with low Apgar scores, age, long-term stays in the department, and the number of doctors. The drugs that were identified as the most interfering in the department, based on both Persian and English articles, are phenytoin, phenobarbital, and fentanyl.

    Keywords: : Drug Interaction, Prevalence, Potential Drug Interactions, Intensive Care Units
  • Maryam Seyed-Nezhad, Omid Yousefianzadeh, Mohammadsaeed Mirzaee, Mohammad Moradi-Joo* Pages 215-224
    Introduction

    In the ever-evolving healthcare landscape, nurses are at the forefront of patient care. Nurses’ procedural skills are the lifeblood of quality care. Artificial Intelligence (AI) is a useful game changer that can change how we approach nursing practice. This scoping review of reviews was conducted with the aim of determining the potential of AI in improving nurses’ clinical, educational, decision-making, informational, and research skills.

    Methods

    Eight electronic databases (PubMed, Scopus, Web of Science, Embase, CINAHL, ProQuest, Microsoft Academic, and OpenGrey) were searched to find all studies (peer-reviewed and grey literature) published up to September 2024 using the keywords AI, nursing skills, and related terms. The Google Scholar search engine was used to find relevant sources and complete the search coverage. Data collected from included studies on each role that AI could play in nurses' skills were analyzed using narrative methods.

    Results

    finally, thirty review studies were included. Accordingly, AI has a beneficial effect on six main themes (education, decision, clinical practice, research, information, and psychiatric nursing) and thirty-three subthemes.

    Conclusion

    The results of our study showed that AI plays a fundamental role in improving the clinical, educational, decision-making, informational, and research skills of nurses. The integration of AI technologies not only fosters better patient outcomes but also equips nurses with the tools necessary for continuous professional development and efficiency. Future research should continue to explore specific applications and address any barriers to implementation to fully realize the benefits AI can bring to the nursing profession.

    Keywords: Artificial Intelligence, Nurse, Skills, Education, Decision, Clinical Practice
  • Comparison of the combined effect of Benson relaxation and foot bath on sleep quality and anxiety in patients with acute coronary syndrome
    H. Arianpour, M. Hosseini*, A. Afrasiabifar, J.M. Malekzadeh Pages 1001-1025
    Background

    This research was conducted with the aim of comparing the combined effect of Benson relaxation and warm foot bath on sleep quality and anxiety in patients with acute coronary syndrome.

    Materials and methods

    This study is a controlled clinical trial that was conducted during the winter of 2017 and the spring of 2018 on 64 patients with acute coronary syndrome who were hospitalized in the CCU department of Shahid Rajaei Gachsaran Hospital. The patients were randomly assigned to four Relaxation group (16 people), warm foot bath (16 people), combination of both (16 people) and control group (16 people) were divided. The collected data were analyzed using SPSS software and Chi-square statistical tests, variance analysis of data based on repetition and Friedman test.

    Findings

    The results showed that the amount of anxiety decreased significantly with the passage of time during the intervention in the groups of Benson relaxation, foot bath and their combination, but in the control group, the observed difference was not significant. . Also, at the end of the intervention, there was no statistically significant difference between the intervention groups of Benson relaxation, foot bath and their combination, while all 3 groups had a significant difference with the control group.

    Conclusion

    Benson relaxation and warm foot bath separately or in combination improve sleep quality and reduce anxiety in these patients, so using each of them separately can be suggested as part of the treatment.

    Keywords: Benson's Relaxation, Warm Foot Bath, Sleep Quality, Anxiety, Acute Coronary Syndrome
  • Does carbon dioxide intraperitoneal insufflation pressure affect coagulation status and laboratory liver function test after laparoscopic cholecystectomy? A clinical trial
    Mohammadbagher Jahantab, Amir Mohsenpour, Shirvan Salaminia*, Saadat Mehrabi Sisakht, Narges Roustaei, Jan Mohammad Malekzadeh, Mohammadjavad Yavari Barhaghtalab Pages 1001-1010
    Aims

    The present study was conducted with the aim of investigating the effect of CO2 intraperitoneal insufflation pressure levels in laparoscopic cholecystectomy on the patient's coagulation status and liver function.

    Materials and Methods

    This clinical trial was consisted of 150 patients who were candidates for laparoscopic cholecystectomy and referred to Shahid Beheshti and Shahid Jalil Hospitals affiliated with Yasuj University of Medical Sciences. The main objectives of this study were the determination of the effect of CO2 intra-abdominal pressure change on the patient's coagulation status and liver function tests after laparoscopic cholecystectomy, determination and intra-group comparison of coagulation factors and liver function in patients with CO2 pressure of about 12 to 15 mmHg and 16 to 20 mmHg.

    Results

    In the group of more than 15, there was no significant difference before and after the intervention according to INR, T.Bili, and D.Bili, but PT, PTT, ALT, and AST variables after the intervention were significantly higher than before the intervention, and BT and ALP after the intervention were significantly lower than before the intervention.

    Conclusion

    the main takeaway lesson of this study is that CO2 pressure of more than 15 mmHg could be used safely in laparoscopic cholecystectomy surgeries, because, this method can prevent bleeding complications after the operation more successfully.

    Keywords: CO2 Peritoneal Insufflation Pressure, Coagulation Status, Liver Function Test, Laparoscopic Cholecystectomy
  • Comparison of the Antibacterial Activity of Hydroalcoholic Extracts of cydonia oblonga and Hypericum perforatum with Clindamycin against standard strain and clinical isolates of Biofilm Formation of Staphylococcus Aureus
    N. Gholami, A. Sharifi*, A. Khosravani, M. Zoladl, S.S. Khoramrooz, K. Sharifi Pages 1001-1013

    Background and subject :

    The ability of Staphylococcus aureus for biofilm formation caused increase bacterial viability in the host environment and antibiotic resistance. The aim of this study was to comparison of the antibacterial activity of hydroalcoholic extracts of Cydonia oblonga,Hypericum perforatum with Clindamycin and synergistic effect of them against standard strain and clinical isolates  of Biofilm formation with simultaneous genes presentation of Staphylococcus Aureus.

    Materials and Methods

    In this descriptive and analytical study, 148 clinical strains were collected. Phenotypic analysis was performed by concord plate agar method and genotypic checking by PCR genes was performed simultaneously. MIC, were obtained by microbroth dilution method. Data were analyzed by SPSS software version 21 and descriptive.

    Results

    MIC of cydonia oblonga extract, Hypericum perforatum extract; Simultaneous use of them on different concentration and Concomitant use of them and clindamycin antibiotics in standard strains of Staphylococcus aureus were 3125,375,1500,12500 and 2.5 respectively. MBC of cydonia oblonga extract, Hypericum perforatum extract; Simultaneous use of them on different concentration and Concomitant use of them and clindamycin antibiotics in standard strains of Staphylococcus aureus were 6250, 1500,1500,12500 and 10 respectively.

    Conclusion

     MIC and MBC of cydonia oblonga extract more precious than Hypericum perforatum extract and simultaneous of them and zone of inhibition diameter of Hypericum perforatum and hydroalcoholic extract of Cydonia oblonga extract and the antibiotic clindamycin was higher than this index in the case of hydroalcoholic extract.

    Keywords: Staphylococcus Aureus, Biofilm Gene, Cydonia Oblonga, Hypericum Perforatum