نشریه پرستاری مراقبت ویژه
سال دوم شماره 3 (پیاپی 4، پاییز 1388)

According to ambiguous status of quality of dialysis in Abadan, this study was performed to evaluate the dialysis adequacy in Abadan hemodialysis center in 2007.

In this cross-sectional study, all ESRD patients who have referred to Abadan hemodialysis center in 2007 and had more than 3 months of dialysis history were evaluated. Data was collected by a questionnaire. Then kt/v and URR indices were calculated for hemodalysis adequacy and PCR for nutritional status. Data analyzed by SPSS 13 software.

The mean of kt/v was 0.9± 0.21 with the minimum of0.2 and the maximum of 1.27. The mean of URR was 53±10% with the minimum of 14 and the maximum of 70%. In addition, the mean of PCR was 0.79±0.18 with the minimum of 0.35 and the maximum of 1.26. kt/v and URR had no significant relation with age, sex, hemodialysis session per week and filter type. There was no significant relation between kt/v and PCR by pearson correlation coefficient.

According to hemodialysis inadequacy in 97.8% of patients, further evaluation is necessary to determine the causes. Also, according to the importance of correct measurement of dialysis urea level for assessing adequacy, using the new method of this article by other centers is recommended.

Non-compliance of cardiac patients is one of the most challenges in controlling the cardiac diseases and readmission in cardiac care units. This study was accomplished to explore the compliance concept and effective factors on occurring non-compliance in readmitted patients with congestive heart failure (CHF).

Using qualitative research, 42 CHF patients with readmission during 6 months (November 2007 until April 2008) were interviewed in two educational hospitals of Tehran University of Medical Sciences. The data were analyzed based on content analysis method.

Doing any unscientific action for establishing "well feeling" is the meaning of compliance in patients; whereby the patients applied it as a strategic variable for resolving their main concern "running about providing comfort in daily living". Primary codes revealed three themes of "preventive factors related to the patient and his/her family", "preventive factors related to medicament and medical team" and "preventive factors related to socioeconomic problems as effective factors on occurring incompliance" which were the main causes of non-compliance in CHF patients.

By applying qualitative research, the compliance meaning and the non-compliance predisposing factors extracts more completely. Exploring the meaning of compliance and effective factors on non-compliance in patients should be considered before discharging to prevent hospital readmissions.

Vulnerability assessment of the hospital against crises has three areas; structural, non-structural and organizational & management. The aim of this study was to evaluate the management and organizational vulnerability of a selected hospital in the face of crisis.

This cross-sectional observational study was conducted in 2008 in a military hospital in Tehran. Data was collected by a self-constructed questionnaire using 5-scale Likert system. Data was analyzed by the SPSS 16 software using different statistical methods.

The maximum and minimum level of structural vulnerability was seen in general surgery ward (76.5%) and emergency department (52.22%), respectively. The maximum and minimum of non-structural vulnerability existed in internal and operation room wards (73.5%) and children ward (36.44%), respectively. In management and organizational factors, intensive care unit had the highest vulnerability (80.27%) and the operating room and internal wards the lowest (69.06%).

According to high vulnerability of the hospitals against crisis, it is necessarily required for senior managers to prepare plans improving the ability of the organization against crisis.

During recent years, in most developed countries there have been many attempts to increase the application rate of entonox inhalation using education and other interfering methods. In this study, the effect of entonox and pure oxygen inhalation on pain intensity of delivery was compared.

In this interventional study, 60 women with term pregnancy in Fatemeh Zahra Hospital of Najafabad were selected based on purposive method and were randomly divided into 2 equal case and control groups. The case group inhaled entonox and control group only inhaled pure oxygen. Mcgill pain questionnaire was used to measure the intensity of the labor pain. Both groups were compared for labor pain and method of delivery. Statistical analysis was performed using chi-square and p<0.05 was considered as significant.

The mean of labor pain intensity was decreased significantly after using entonox compared with the control group (p<0.001). Also, fewer patients in the case group required cesarean section compared with the control group; but the difference was not significant (p=0.52).

Nearly 5 million people in the United States have CHF, with more than 1.5 million new cases diagnosed each year. The readmission rate within 3-6 months after discharge in these patients is 10-50%. This study conducted to determine the personal factors contributing to readmission of patients with congestive heart failure that admitted in heart internal wards of Shahid Beheshti University of Medical Sciences Hospitals in 2008.

This study is correlation descriptive and 110 male and female patients with congestive heart failure selected with quota purposive sampling method and were divided into two groups based on their admission background in last 6 months to study. Data was collected by a questionnaire from the patients and referring to their folders and was analyzed by statistical tests and SPSS 15 software.

61.8% of patients were readmitted to the hospital during the last 6 months to study and age, literacy level and incoming level affected the readmission rate of patients. The relation of age was direct and literacy level and incoming level had indirect relation with readmission.

Some individual characteristics which are amenable to change, dramatically increases the risk for multiple hospital readmission in patients with CHF.

Serving multiform of drugs, specially those used in milligram, milliecivalan or concentration/percent, mostly by nurses could be a source of calculation error. This study performed to investigate nurse's calculation error related to drugs mostly used in ICU.

In this descriptive study, 36 randomly selected ICU nurses of Mazandaran university of medical science's hospitals completed a questionnaire included demographic and 5 questions about the three main drugs used in critical conditions. The answers evaluated to three levels (low, moderate and good).

Most ICU nurses (55/5%) drug calculation ability was moderate. There were no significant difference between male and female nurses in drug calculation ability.

Nurse's drug calculation ability in non milli- or microgram unit drugs is low or moderate and they do lots of mistakes. So, it is suggested that all of ICU nurses should learn about drug calculation and attend in some related educational classes.