مجله مراقبت پرستاری و مامایی ابن سینا
سال بیست و دوم شماره 2 (پیاپی 45، تابستان 1393)

Microbial contaminations occurred in “Intensive Care Unit” (ICU) is the substantial cause of infection transmission within hospitals. The infectious organisms can be transmitted mainly through contact with the surface of instruments. Indicating the contaminated sources is the primary step during the infection control program. This study aimed to evaluate the risk of cross infection in hospital ICU. The study was performed during ten subsequent weeks in two distinct phases consisting of “Before” and “After” the cleaning program. Assessment of the cleaning efficacy was based on the ACC analysis، Gram staining، Cathalaze، Coagulaze، MSA and DNase approaches. Final results were reported as “Clean” and “Dirty”. The Mc Nemmar nonparametric analysis was used through the SPSS software version18. Visual assessment of instrument surfaces revealed 86% contamination. Using the SA and ACC indicators illustrated the contamination levels of 76. 5% and 12. 7%، respectively. The maximum levels of contamination according to visual، SA and ACC approaches were belonged to door handles (100%)، floor and patient bed and chairs (85%)، and desk belonged to patient bed and waiting chair (22. 5%)، respectively. The rate of contamination after the cleaning program was decreased for telephone set using the visual method (p<0. 021). The rate of contamination after the cleaning program also was decreased for patient bedsides using the ACC method (p<0. 021). The risk of infection transmission can be afforded via the source identification and establishing a cleaning and disinfection program. Preparing the integrated instruction and guideline regarding to the cleaning، disinfection and continues monitoring would be efficient to reduce the risk of cross infections.

Consideration of patient autonomy is an essential element in individualized and patient-centered care. Since outcomes of respect for patient autonomy، as one of the four key principles of ethical practice and health-related، is required for autonomy support and it is not clear this study was performed to explore outcomes of respect for patient autonomy in hospital.

This study was conducted with qualitative research approach and conventional content analysis method in 2013. With the use of purposeful sampling 13 patients، 7 nurses and 1 doctor were interviewed over a 10-month period in Tabriz and Hamadan teaching hospitals of Iran. The data were obtained by interviews with participants. The data were analyzed using qualitative content analysis method and using MAXQDA10 software.

out of 21 contributors included in study، we concluded 494 primary code، 13sub categories and four themes that indicated nature and dimensions of patients’ perception from consequences of respect for patient’s autonomy. These themes included: 1. Mental and physical comfort 2. Reduce dependence 3. Adherence 4. Trust.

Resultsof this study showed outcomes of respect for patient autonomy. These results can help the treatment team until motivate to respect for patient autonomy.

Premature rupture of membranes preterm (PPROM) is the term used when the pregnancy is less than 37 completed weeks of gestation. The purpose of this study was to compare of maternal & Neonatal complications in women between outpatients & Inpatients with PPROM. This study was a cohort study، All the mothers diagnosed and admitted because of PPROM with 24- 34 weeks gestational age in Fatemieh hospital since march 2012 to march 2013 were divided into two groups given that they remained in the hospital until delivery (discharged by physician order، n=50)، or had been discharge with patient consent، n=39. All parameters were compared between the two groups. Data processing and statistical analysis were performed using SPSS/21. The mean of neonatal birth weights، Apgar score، gestational age at delivery and interval between PPROM until time of delivery in home care group were significantly less than hospital care group. The mean of maternal age، number of pregnancies، neonatal death and the incidence of chorioamnionitis in the home care group were significantly more than hospital care group. according to the results of our study due to the our country’s cultural background and not returning back for their medical follow-up by mothers that have been discharged with personal consent، it is better that Patients be hospitalized in the hospital until delivery or discharge by the physician order and explain home care common and important problems Individually for each patient.

job satisfaction، especially among nurses is a crucial challenge in health care organizations. The aim of this study is to determine the effect of nursing process on job satisfaction of employed nurses in Intensive Care Units. This was a semi-empirical study. The statistical population of this research includes 47 employed nurses in Intensive Care Units of Gonabad hospitals in 1392. And these people have been chosen by census methods. In order to assess job satisfaction، we use Manokian questionnaire which was based on job satisfaction questionnaire of Moherman-Cooke-Moherman and for registering and implying nursing process we use check lists of registration process of Hasson and Arnetz. Then nurses were thought about practical use of nursing process and before and after two month using this nursing process، job satisfaction rate and the rate of implying nursing process again were checked. Data analysis was done by SPSS 20 program and using descriptive (average and standard deviation and…) and analytic census (T-paired tests). this study showed that there is a significant difference between internal satisfaction and total satisfaction scores of nurses before and after applying nursing process (p<0. 001). However، the external satisfaction scores of the nurses after and before the intervention were not significantly different (p<0. 136). The results of this study show that not also implying nursing process in clinical situation is possible، but also using nursing process can improve nurses’ job satisfaction.

Today، nursing education، basing on programs that emphasize the role of nursing instructors and special attention on students. This was a quasi- experimental study. The population of the study consisted of all nursing students in their last year of their field training who were being trained in their dialysis unit (n =114) and were divided into two experimental and control groups. The experimental group was trained by the instructor. Data collection tool consisted of the researcher made checklist of 23 questions. The data were analyzed by the software SPSS using descriptive statistics (frequency and percentage) and chi-square، Wilcoxon and independent t tests and Pearson and Spearman correlation coefficients. The results showed that there is a statistically significant difference between mean score of experimental and control group as well as performance level of both groups (p<0. 001). Also، the Independent t-test shows that there is a significant differences between the performance score and gender (p=0. 008) and performance scores and students’ mean (p=<0. 001) in both groups. Providing clinical training in intensive care units، such as dialysis with the presence of the trainer will increase the quality of education and thereby enhance awareness and improve nursing students'' performance.

The training is a one of important duties pediatric nurse and can empower parents to proper management the child''s tonsillectomy pain. This study with the aim of determines the effect of parents training on pain controlling in pediatric tonsillectomy in children admitted to Hamadan hospitals in 2013 was performed. In this randomized clinical trial study، 68 children 6 to 12 years admitted for tonsillectomy with a parent selected and randomly divided to control and case groups. For case group individual training، booklet and after discharge telephone follow-up were performed. Data collecting tools were the check list of self- reporting of pain and home dairy. Data were analyzed by SPSS 16 software، descriptive statistics and repeated measures ANOVA، independent t test and Chi-square test. In Three days after discharge، there was statistically significant differences between mean pain intensity scores (p=0. 006)، pain after swallowing (p=0. 008) and the sedative effect of analgesics (p=0. 04) in the experimental and control groups. Differences in pain intensity scores on the first day (p=0. 004) and second (p=0. 04)، pain after swallowing on the first day (p=0. 02) and second (p=0. 006) and the sedative effects of analgesic on the second day (p=0. 01) after discharge were significant. Pain intensity and pain after swallowing particular in the first two days after discharge lower and sedative effect of analgesic was higher in case group’s children. Therefore، training before tonsillectomy، with increases of knowledge and the skills of parents to manage pediatric pain at home was effective.

Multiple sclerosis (MS) is the most common debilitating diseases of the central nervous system that is a chronic and prolonged and human quality of life is affected. Continuous care in this disease is remarkable. This study with aim of the effects of continuous care، on the quality of life patients with MS was performed. this study is randomized clinical trial. The Participants were 72 patients with multiple sclerosis referred to Farshchian Hospital and Multiple Sclerosis Society of hamadan that were divided into two groups، intervention and control groups. The quality of life patients before and after the performance of continuous care model assessed by MSQoL-54 standard questionnaire. For the analysis of data from Chi-square test، paired t، and independent t-tests and repeated measures and SPSS 16 statistical software was used. Results of the repeated measures ANOVA to compare the quality of life patients in the intervention group، before one month and two months after continuous care model showed that the mean scores quality of life at the different stages measured، ha significant differences with each other (P<0. 01). But in the control group، before one month and two months after continuous care model had not a significant difference. The results of repeated measures ANOVA to compare the quality of life in both intervention and control groups at each three times showed that، There is a significant difference in quality of life (P<0. 01). According to no exact treatment of chronic diseases، applying of effective care models such as continuous care model to improve the quality of life of these patients is effective.

The most important factors in the prevention of nosocomial infections are considering the infection control standards with short term and continuing education for nurses. This study was conducted to determine the effect of education on impediments of adherence of intensive care nurses from infection control standards.

A randomized clinical trial was carried out with two group design pre and post-test control group including 30 nurses of intensive care units of hospitals of Hamadan University of Medical Sciences by theoretical and clionical lectures، focus group discussion and practical workshops in the intensive care units. The research tool was a researcher asking the nurses about impediments of adherence to infection control standards by measuring with a scale from 0 to 9. The r eliability and validity of the questionnaire was determined by expert panels، the test - retest (r = 0. 82) and Cronbach Alpha (0. 79). The questionnaires were completed by nurses in both the test and control groups before and after education. Statistical analysis was done by Friedman، Kruskal-Wallis and Man-Witni test.

There were not significant different among participants in two groups (p<0. 05). The mean scores of nurses'' perceptions about adherence impediments in test and control groups at baseline were not statistically significant. But 14 and 30 days after education، the mean increased in nurses'' perception about adherence impediments in test group (p<0. 05).

The education about infection control standards had a positive impact on nurses’ perception about adherence impediments. So the training of infection control standards is recommended short term and continiously.