نشریه پرستاری و مامایی ارومیه
سال دهم شماره 2 (پیاپی 37، خرداد و تیر 1391)

Medication errors are among the most common medical errors. Nursing students may commit these errors. Thus, the aim of this study is to determine the frequency and type of medication errors done by nursing students.

In this descriptive study, 54 senior (7th and 8th semesters) students of Urmia Nursing and Midwifery school were recruited by census. Data were gathered by a structured questionnaire and were analyzed through descriptive statistics.

The highest error was done in the medicine phase (87.3%). The most common error reported was giving the medication later or earlier than its prescribed time (20.7%) and the next one was to forget giving the prescribed medication to patients (14.7%). Antibiotics were the most common drugs on which the error was done.

The results of this study showed that the frequency of medication error done by nursing students is high. Therefore the universities have to include some effective strategies in their training programs in order to avoid medication errors and improve the patient's safety.

Communication skills are among the most important characteristics that a medical student requires. Since, communications skills have not been described for the medical students. The aim of this study is to assess the communication skills level among medical college students of Hamadan. This descriptive-analytical study was carried out on 400 college students of Hamadan University of medical sciences which were recruited with a stratified sampling method. A questionnaire was used for data collection which measured the feedback, listening, and verbal skills. Validity and reliability of questionnaire were approved. Data were analyzed with SPSS-13 software using coefficient correlation, T test and ANOVA. The subjects reported 18, 19 and 17.8% of receivable scores of verbal, listening, and feedback communication, respectively. Significant differences in average score of communication skills related to gender, marriage status, degree, and education level were seen (P<0.05).There was a significant correlation between verbal, listening, and feedback communication with each other at 0.01 levels. The results show that the communication skills among students in overall levels were evaluated at the adverse level. It seems that the communication skills are required as experimental method in the student's admission for the university.

Healthcare organizations in Iran are striving to improve patient safety and quality of care through implementation of safety systems and creating a culture of safety. The purpose of this study was to evaluate the rate of supporting a culture of patient safety at Urmia hospitals.

In this descriptive-analytical and cross- sectional study the Hospital Survey on Patient Safety Culture standard questionnaire was used to assess the culture of patient safety in Urmia that was prepared by The Agency for Healthcare Research and Quality. The survey questionnaire was distributed hospital-wide in 4 hospitals of Urmia city, to 500 health professionals including nurses, physicians, staffs of radiology ward, staffs of laboratory ward, supervisors/managers.

Overall Patient Safety Grade was rated as excellent or very good by 23% of respondents, acceptable by 52%, poor 20% and failing by 5%, respectively. 70% of respondents believed that the staff feels not free to question the decisions or actions of those with more authority. Areas of strength for most hospitals were teamwork within units, handoffs and transitions. Areas with potential for improvement for most hospitals were non-punitive response to error, frequency of events reported, staffing, and communication openness, management support for patient safety, feedback and communication about errors. By using regression model we determined some patients’ culture safety aspects that were important in overall grade.

Leadership is a critical element to the effectiveness of patient safety initiatives. Response to errors is an important determinant of safety culture in healthcare organizations. In order for healthcare organizations to create a culture of safety and improvement, they must eliminate fear of blame and create a climate of open communication and continuous learning.

Spinal cord injury (SCI) leads to sensorimotor deficits and neuropathic pain (NP). Cell therapy is a common method for treatment of SCI. The mechanism which has been explained for development of NP including: transplantation of stem cell leads to differentiation of these cells to astrocytes, and these cells secretes NGF which leads to axonal sprouting in dorsal horn neurons and this leads to NP. Since Schwann cells (SCs) are commonly used in cell therapy, we sought to investigate whether intraspinaly injection of these cells develop NP. 24 male Wistar rats were used. SCs were cultured, model of SCI was performed and rats were divided into the three groups including: a control group, an experiment group and a sham group. In control group only a laminectomy was performed, the experiment group received SCs intraspinaly. The sham group received serum in the same way. Locomotion was assessed using BBB test and NP was assessed by withdrawal threshold test. Significant improvement was observed in the BBB scores in experiment group (P<0.05) compared to sham and control group and there was a significant difference in withdrawal threshold means between sham and experiment groups (P< 0.05). The present study shows that intraspinaly transplantation of SCs can improve locomotor recovery and lead to NP, so it is required for development of methods for attenuation of NP in cell therapy studies in future.

Nowadays a lot of works are being carried out in family planning which is also increasing However, about 8 to 30 million of unwanted pregnancy happens annually because of not using the contraceptive methods continually. In this study, the maintaining use of the methods and effective factors in their interruption are investigated. This study is peripheral and descriptive. The Studied women were 15 to 49 years old that had stop their contraceptive methods.486 women were selected randomly. Data were collected by questionnaires that have been validated by content validation method and for determining the final result, Bakh test with coefficient of 91% has been used. After collecting data by SPSS software, they were analyzed by statistics tests such as variance analyzing and Kay and Caplan Mayer square tests. This study indicates the most common contraceptive method being used iscandom (41.7%), and the lowest common method been used is IUD(3/4%). the average time of using the contraceptive methods for Iud, Ocp, candom and DMPA are 12.3, 422.4, 814.79 and 14.610, respectively. The most important reason for stoping the use of ocp (changing the method 30 % (candom (husband’s resistance and fear of being not effective 22%) IUD (bleeding and spotting 48%) DMPA (changing the method 28%) In addition to the coherent and more scientific trainings, motivational counseling with cooperating of couples in the inception time and the first six months is suggested

Learning drugs and intravenous therapy are necessary for nursing students. This study was done with the aim of assessing the Drug and intravenous therapy basic clinical skills in nursing students at the end of third year. This is a descriptive-cross sectional study and the sample was 107 seventh semester nursing students of Babol University at the end of third year. Questionnaire was used as an instrument for evaluation, evaluating likert scale (never perform or seen=1, confident & independent=5). Questionnaires were completed in first day of internship course and collected on the same day. Analysis of data was done with spss-16 and descriptive statistic and non-parametric tests. Also, student self-esteem affected the answers that researchers couldn’t control it. 91.6 %(98) of samples were female and 84.1 %(90) of them had not academic clinical work experience. Student average score was 16.01 in past semesters. The mean score of students skill in intravenous solution preparation and its administration were 4.96±0.44, drug administration via bolus and mini-infusion pump were 4.87±0.29 and intramuscular injection 4.87±0.44 and were more than others. Lowest students skill were in dosage and drop calculation with 4.28±0.67 and intradermal injection with 4.32±1.13.There is a significant relation between academic clinical work experience and intravenous therapy skill (p=0.02). the result of this study identified the strengths and weaknesses of nursing students in the Drug and intravenous therapy basic clinical skills. In time detection of these points, educational improve support and more powerful nursing delivery to society.

Self- efficacy is the belief of a person on his ability in order to succeed in a particular situation. It is essential to increase self-efficacy motivation on hemodialysis patients and planning on it. Using nursing theories especially Orem theory could be effective in self-efficacy improvement. So this study has been done in 2011 in order to evaluate the effect of Orem self care model on self efficacy in hemodialysis patients. This research is a quasi experimental case control study. Data were collected through a questionnaire. Sixty patients were chosen according to none randomized method, and then equally divided into two groups as case and control groups (30 patients in each group). After pretest, the self care plan was done through three phases on case group as follows 1- Self care assessment 2- intervention in physical, psychological and social domain of self care 3- Controlling patients for 45 days, then the post test was carried out. The data were analyzed with SPSS software, Independent T, Chi-square and Mann-Whitney tests. Results showed that there was no significant difference between self care (P=0.77) and self- efficacy (p=0.95) mean scores. While in post test step there was a significant difference in self care between two groups (P=0.04). But there was no significant difference between two groups in self efficacy before and after the intervention (P=0.418). According to the dependency to caring in hemodialysis patients, knowing their self care needs according to the nursing theories and caring programs might help fit the patient's condition and promote self efficacy activities.

The necessity for providing appropriate services in hospitals during an earthquake is imperative that is needful comprehensive preparedness of hospitals. This study was performed to assess the preparedness of hospitals affiliated to the Urmia University of Medical Sciences against earthquake risk in 2011. This cross-sectional study was performed in all hospitals affiliated to Urmia University of Medical Sciences that located in province centers. Data were collected using checklist and the interview and observation existing documents. The data was Analyzed by SPSS 19 and using Fisher's exact and Spearman correlation coefficient tests. From 8 surveyed themes, the highest level of preparedness against earthquake risk was in management disaster plan and the least level of preparedness was in the planning efforts in the field of environmental health. Results showed that six hospitals were located in very poor level, three hospitals in poor level and one hospital in the middle level of preparedness against earthquakes risk. Overall average mean of hospital preparedness against earthquakes was 20.07 percent. Based upon Spearman correlation coefficient test, a statistically significant relationship was seen within the area of the planning essential equipment and supplies and planning to support vital services (r=0.824, p=0.003). Based upon the results, the overall level of preparedness rate of hospitals against earthquake risk was assessed in the poor level. It is recommended while developing short term educational programs in crisis management and continuing that implement, where possible retrofitting non-structural hospitals to be considered as a priority.

The success of nursing students depends on the understanding of complex concepts and applying them in their care, nursing process is a linear model that cant show the relationships between concepts. Concept map is a meta-cognition strategy that can enhance the learning process by showing the relationship between concepts. This study was conducted to compare the effectiveness of concept mapping and nursing process on self-regulated learning, self-efficacy and cognitive strategies of nursing students of Arak University of Medical Sciences. This was a pre-post quasi-experimental study with control group of 53 nursing students participating. They were divided randomly into two groups, control (nursing process, n=25) and experimental group (concept mapping, n=28). Motivated Strategies for Learning Questionnaire (MSLQ) was used to assess self-regulated learning, self-efficacy and cognitive strategies. Data were analyzed by SPSS-16 software using independent t test. There were not statistical differences of pretest scores and demographic characteristics between two groups. The increase in self-efficacy and cognitive strategies posttest mean scores in comparison to pretest was statistically significant in concept mapping group (P<0.05).Statistically significant treatment-control group differences were found in the mean scores for self-efficacy and cognitive strategies (P<0.05). No statistical significance was found in self-regulated learning. The use of concept mapping as a metacognitive intervention will increase the self-efficacy and cognitive strategies in nursing students.

Clinical education is the main part of nursing education and without it training efficient and competent nurses is far reaching. Any problem in clinical education may damage the efficiency of education program. The present study tries to investigate the stress factors in clinical education among nursing students in Nursing and Midwifery College in Khorram Abad. This cross-sectional study was conducted on 95 cases were selected and studied. The data were collected and analyzed. The results show that among the environmental and education factors, there are some stressful factors facing the emergency patients such as excessive number of the students in a single ward, the initial care giving in the presence of public, lack of adequate skill and making stress on the part of the instructor while doing his/her duty as well as students’ fear of being infected to infectious diseases. Since the stressful factors may affect clinical education negatively and have negative effects on the aims of clinical education, it is recommended to remove or reduce these factors.

This research was conducted to study the relationship between the coping skills and career exhaustion with psychological health of Urmia doctors. This descriptive-correlation study was conducted on 313 (83 specialists, 230 general doctors) physicians that were selected via proportionate stratified sampling method. Maslach burnout scale, Goldenberg mental health questionnaire and Lazarus and Folkman coping strategies were used to measure the variables. Career exhaustion is suitable predictor of mental health. There were significant negative relationships between confronting ways and psychological health. There was significant positive relationship between confronting ways and career exhaustion. There was significant negative relationship between career exhaustion and psychological health. There were no difference between male and female on coping skills and career exhaustion and psychological health. These finding highlight the importance of training coping skills and developing prevention programs for enhancing psychological health in relationship with coping skills and career exhaustion.

Sleep disturbance is a common complaint among patients with end-stage renal disease. The aim of this study is to determine the effect of acupressure on the quality of sleep in hemodialysis patients.

in this randomized double blind clinical trial, 108hemodialysis patientsof ‏ three hemodialysis units of Imam Reza, Shahid Hasheminejad and Emam Zaman hospitals of Mashhad city were assigned to three groups: acupressure, sham acupressure, and the control group via balanced randomized method. The subjects in the acupressure group were given a massage of the Shenmen (HT7) points on the wrists for three minutes on each point for three times a week, for up to four weeks during dialysis. The same technique was used for subjects in the sham acupressure group; however it was done 1-1.5 centimeter away from the main points. For control group, they were only given the usual medical care. Pittsburg Sleep Quality Index (PSQI) Questionnaire and the Sleep Log were used for gathering the data and for data analysis one way ANOVA, Kruskal-Wallis, paired t-test, Wilcoxon, and repeated measure ANOVA were used.

the global score of PSQI (p = 0.000) and subscale scores of the subjective sleep quality (p = 0.000), sleep latency (p = 0.000), sleep duration (p = 0.000), sleep sufficiency (p = 0.000), sleep disturbance (p=0.003), and daily performance (p = 0.000) were improved in acupressure group patients after intervention. In paired analysis of the groups (the acupressure group with the sham acupressure group and the control group in respect), a significant difference was found in the global score and all the subscale scores, but this difference was not significant in terms of sleep sufficiency and sleep medication. According to the results of the Sleep Log, an increase in sleep quality and a decrease in the number of sleepless periods during night were found for the acupressure group.

The study shows that acupressure has a positive effect on the sleep quality of patients undergoing dialysis, and it can be used as a noninvasive way to treat sleep disturbance in such patients.

Memory gives possibility to mental life of human including thoughts, perceptions, opinions, and in general, learning. Academic failure rely on the weakness of memory is an internal and durable supporting oneself influences on the learning strongly and negatively. The purpose of this research is the study of the effect of memory and motivation with gender and academic achievement in order to prevent students from falling. 89 of successful and unsuccessful of non-medical and medical students from both sexes were under investigation by measuring short-term and long-term memories and the achievement motive. Measuring instrument of this study were Short-term and long-term memories tests, AMT and mean average of the students. And finally the analysis of variance was used for analyzing data. There was no significant difference between Short-term and long-term memories in both sexes. Also between short-term and long-term memories of successful and unsuccessful students as well as medical and non-medical students no significant differences were observed. But in our study we found significant difference between achievement motivation in both successful and unsuccessful students. Finally in this study females showed significantly higher motivation than males. The results showed that success or failure of students in all courses and grades in both sexes is more related to the motivation than memory.

Many studies have demonstrated the role of psychological and behavioral risk factors in the etiology and pathogenesis of cardiovascular disorders. The present research aimed to examine the relationship between psychological factors D- type personality and forgiveness with hope level among individual suffering from coronary heart disease. 132 patients from three hospital of Urmia city and private offices were selected by available sampling method. The D-type Personality Scale (Denollet), Heartland Forgiveness Scale (HFS), and Snyder Hope Scale (HS) were used as analyzing tools. Data was analyzed using correlation and stepwise regression analysis method. The results showed that there was significant positive relationship between hope and forgiveness (r=/038,p<0/01). And there was significant negative relationship between type D personality and forgiveness(r=-0/22,p<0/01). Also there was significant negative relationship between type D personality and hope(r=-0/48,p<0/01). The regression analysis showed that forgiveness and type D personality were able to predict 31/1 percent of the variance of hope between patients with coronary heart disease. The result of this research emphasizes the need to recognize the role of forgiveness and type D personality in patients with coronary heart disease.

Arthritis of the lumbar spine is known as Disk Arthritis. The most common and most important sign of Disk Arthritis is back pain. Acupressure is among the methods of alternative medicine, its impact in reducing pain in various parts of the body and confirming invasive intervention does not account. Therefore, this study’s aim is to determine the effect of acupressure on the rate of low back pain in patients with disc arthritis that referred to selected clinics in Isfahan in 2010. This study is a clinical trial. Samples for this study included 40 patients with disc arthritis referred to clinics in Isfahan hospitals: Alzahra, Sadughi, Kashani and Shariati. Samples including 40 patients of spondylarthritis were selected by stratified. Intervention (Acupressure technique) was performed for twenty minutes by professional acupuncture. Measurements were taken before and after intervention and recorded the intensity of pain's Samples by visual analog scale and numerical rating scale. For analyzing the data descriptive and analytical statistical methods (paired-sample T-test) and computer software SPSS18 were used. The mean of pain after intervention (3.82) significantly decreased in comparison with before intervention (6.10). (p<0.001) By assessing the effects of acupressure as safe and effective intervention in reducing pain in patients in this study, this can be used a simple technique, cheap and executable in all health centers and even athome for patients to help them.

Clinical supervision is one of the core activities in professional care and it is the main path of support and professional development in nursing. Positive implications are considered for clinical supervision. Qualified supervisors lead to effective controlling and; therefore, it is necessary to identify characteristics of an effectiveness (or a good) supervisors. This qualitative research was conducted on 18 supervisors and nurses who were selected by purposive sampling method. Data collection was done using semi-structured interviews, observation and field notes and they were analyzed using arbitrary content analysis. Based on the findings, the characteristics of an effective supervisor are as follows: sufficient knowledge skills, appropriates behavior, considering all issues, proper management, patterns of work and performance, sense of responsibility and commitment, supportive, active listener, educator, incentives, note the real issues, positive thinker and as the central theme considering all the points that includes others. Based on the result an effective supervisor needs to have wide and broad spectrum characteristics and attributes that need to know for implement of effective clinical supervision. Also it helps managers for preparing suitable management and choosing of supervisor.

Acceptable communication performance is essential for safe, effective, and suitable care. Proper communication is essential for data collection, diagnosis, treatment and patient education. This study aimed to determine the communication function of nurses with patients in critical unit of educational and non educational hospitals in Urmia. This descriptive-analytical study was carried out with census sampling method with participation of 167 nurses working in Urmia city critical unit. Data were gathered using nurse communication function with patient questionnaire. The data were analyzed using descriptive statistical testes and spearman coefficient and independent T test. The average score of nurse communication with critical patients was 91.64 from 105, in other words, nurses working in critical unit of Urmia city evaluated their function about communication with patients in good level. A result of this study showed verbal communication of nurses working in non-educational hospitals was better than nurses working in educational hospitals, as respect, non verbal communication of nurses working in educational hospitals was better than nurses working in non educational hospitals and had a significant difference (p=0.012). Appropriate communication of nurses with patients in critical unit, reduce anxiety of patients and improves their treatment process. Although nurses evaluated themselves in a good level of relationship with patients of critical parts but it is important to improve nurses’ education about communication skills.