Evidence Based Care
Volume:4 Issue: 4, 2014

Eye examination for screening of Retinopathy of Prematurity (ROP)، as a painful procedure، causes physiological changes in premature infants. Multisensory stimulation is a non-pharmacological analgesic method which affects physiological measures during painful procedures.

To determine the effect of multisensory stimulation on oxygen saturation in premature infants during eye examinations

In this single-blind randomized clinical trial، 80 premature infants in Khatamolanbya hospital of Mashhad in 2014 were randomly divided into two groups of “control” and “multisensory stimulation”. In the intervention group، multisensory stimulation was administered 15 minutes before the start of the examination and the control group received standard care. Arterial oxygen saturation of each infant was recorded at 30-second intervals before، during، and after eye examination in a researcher-built checklist and a physiological characteristics form. Data were analyzed by independent t-test، Mann-Whitney، and repeated measures ANOVA using SPSS version 11. 5.

The mean gestational age of multisensory stimulation group was 30. 4±7. 1 and the control group was 30. 6 ± 8. 1 weeks. Based on the analysis of variance with repeated measures، arterial blood oxygen saturation was significantly different in both groups during the evaluation (p<0. 001); which was 92. 6±3. 5 in the intervention group and 90. 1±2. 0 in the control group during eyes examinations. Changes in oxygen saturation during the examination was significant in the two groups (p<0. 001).

Multisensory stimulation program causes smaller reduction in oxygen saturation. Multisensory stimulation can be used as a way to reduce physiological changes during eye examination.

Successful nasogastric intubation is defined as “correct placement of the tube with minimum number of attempts” which is an important issue in nasogastric intubation. Due to controversies in the use of cold tubes in nasogastric tube insertion، need for research in this area seems necessary.

To compare the effect of using cold versus regular-temperature nasogastric tubes on successful nasogastric tube insertion.

In this two-group trial، 65 patients who were admitted to toxicology emergency department of Imam Reza hospital، Mashhad، were divided into two groups of control and intervention by random allocation. In the intervention group، nasogastric intubation was carried out with tubes that had been stored in a refrigerator at 2-8 °C، while in the control group room-temperature tubes at 22-28 °C were applied based on the standard procedure. Data were analyzed using chi-square and t-student tests in SPSS version 11. 5.

The mean age of the participants was 28. 5±9. 8، with 65. 6% men in control group and 51. 5% women in the intervention group. Among the participants، in 84. 4% of the control group and 100% of the intervention group subjects، nasogastric tube was inserted with only one attempt (p<0. 01); however، the frequency of correct intubation was not statistically significant between the two groups (P = 0. 30).

Refrigerating the tubes reduces the number of attempts in nasogastric intubation. Therefore، it is an effective way to enhance the success of nasogastric intubation and it is suggested that in order to decrease complications، increase patients’ comfort، and save nurses time، nasogastric tubes refrigerated before the procedure.

the aim of this study was to compare Celox powder and conventional bandage on time to hemostasis in the vascular access site in hemodialysis patients.

This one-group، before-after، clinical-trial was conducted on 30 dialysis patients who had been selected by purposive sampling and underwent hemodialysis through arteriovenous fistula in Imam Reza and Montaserieh hospitals of Mashhad and Modarres hospital of Kashmar in 2013- 2014. The arteriovenous fistula puncture sites were treated with Celox powder dressing in three intermittent weeks. Time to hemostasis in each puncture site was calculated. Data were analyzed by repeated measures، Bonferroni correction، Friedman tests using SPSS version 11. 5.

The mean age of patients was 54. 2 ±14. 3، and most of them (53. 3 percent) were male. Time to hemostasis in the vascular access sites of patients was 9. 8±1. 9 minutes. There was a significant difference in the hemostasis time between using 1 gram Celox powder and conventional dressing، (p<0/001). There was also a significant difference in time to hemostasis between utilizing 0. 5 gram Celox powder and conventional dressing (p<0/001).

Using Celox powder reduces time to hemostasis in vascular access site in hemodialysis patient. Therefore، its use in patients with delayed vascular access site hemostasis is recommended.

Pain is of stressful and unpleasant procedures after daily dressing of burn wound، so that if the burn pain is not alleviated properly، it can cause harmful effects other than discomfort. There is evidence that cathodal stimulation of somatosensory cortex can be effective in relieving acute pain.

The main purpose of this study was to determine the effect of Direct Transcranial Current Stimulation on the intensity of burn dressing pain.

To conduct this randomized two-group clinical trial، 60 eligible patients who had been hospitalized in burn department of Imam Reza (AS) hospital of Mashhad were enrolled through the convenience sampling and randomly divided into the control (n=30) and intervention (n=30) groups by stratification method. Patients in the intervention group received cathodal stimulation of somatosensory cortex for 20 minutes with one mA current intensity before dressing; while thetDCS device was turned off after 30 seconds of stimulation in the control group. The standard visual analog scale of pain was performed immediately before intervention، as well as before and after wound dressing.

In the intervention group، 76. 7% (n=23) of cases were male while in control group 46. 7% (n=14) of patients were female. Mann-Whitney test showed no significant difference between the intervention (1. 7±2. 0) and control (1. 0±0. 9) groups in terms of pain intensity before intervention (P=0. 46). Independent t-test showed that pain intensity in the intervention group (6. 4±1. 9) versus control (7. 9±1. 5) was significantly different after burn dressing (P<0. 001).

Applying tDCS can be an effective intervention for decreasing pain associated with burn dressing.

The sudden nature of confrontation with brain death complicates organ donation request and makes the understanding difficult for the family. Understanding the experience of these families with inductive approach provides a better understanding of their problems and explains the approaches to help families in this difficult and complex situation.

To discover mental concerns and challenges in brain-dead patients’ families while confronted with organ donation request

This qualitative study was conducted with content analysis approach. Data were collected using 24 unstructured، in-depth interviews and 14 supplementary interviews with 14 brain-death patient''s families consented to organ donation، as well as 12 families who refused organ donation. Individuals were enrolled in the study using the information obtained from center of organ transplantation of Mashhad University of Medical Science from July 2009 to October 2011. Data analysis was carried out simultaneously as they were collected using content analysis with the conventional approach.

Analysis of the data resulted in 680 codes، 12 categories، and 3 themes. The themes included doubt، fear، and hope، which the “Triangle of decision making purgatorial” was extracted as central theme.

Facing brain death and organ donation request is a complicated process that its acceptance is difficult and decision-making is full of challenges. Therefore، it seems that it is essential to support the family and pay attention to their mental challenges when requesting for organ donation.

Despite the implementation of nursing measures in disinfecting the ​​vascular access site for hemodialysis، this area is responsible for 23 to 73 percent of bacteremias occurring in these patients. Participation of the patients in washing this area may be helpful. this study was conducted to determine and compare the effect of washing vascular access site for hemodialysis with betadine scrub and soap by patient on the frequency and time of appearance of the inflammation and infection. The study was conducted on 62 volunteers in hemodialysis center of Mashhad city. Patients were randomly divided into two groups، betadine and soap. Before starting dialysis، the vascular access site was washed with either betadine by the betadine group or soap by the soap group. Assessments for inflammation in the vascular access site were performed using the inflammation-scale of «Association of intravenous injection» and the infections were monitored by culturing the secretions of the area over one month. Data were collected using a measure of inflammation by the “Association of intravenous injection”. Results were analyzed by chi-square and independent T tests، and survival was analyzed using SPSS version 11. 5. before the intervention، the two groups were similar regarding variables such as age، sex، blood sugar، vascular access، and marital status. The incidence of inflammation was 96. 7% in soap group and 53. 1% in betadine group during one month (p < 0. 001). The onset of inflammation in the betadine group (4. 8±2. 3 sessions) was longer than the soap group (4. 5±3. 2sessions)، but this was not significant (p= 0. 060). Participation of the patients in washing the vascular access site especially with Betadine solution، in addition to the usual disinfection by nurses can reduce the incidence of inflammation. Further study into the delaying effect washing on the onset of inflammation is required.

Pulmonary rehabilitation is an important part of treatment in patients with COPD (Chronic Obstructive Pulmonary Disease) with the goal of achieving and maintaining maximum functional independence since this disease causes symptoms including fatigue، and consequently decrease in daily living activity.

To determine the effect of home-based pulmonary rehabilitation on daily living activity among patients with COPD.

This quasi-experimental pretest-posttest study was conducted on 40 patients with COPD who had been admitted to Masih Daneshvari hospital of Tehran in 1389 and were selected with randomized blocking method in two intervention and control groups. For each participant in the intervention group، 3 one-hour، personal، face to face sessions with the content of theoretical teaching and practical training (training exercises including walking، lip bud breathing and practicing it) was carried out and was continued at home for 7 weeks after discharge. The research instrument was standard demographic Barthel Index. Data were analyzed by SPSS version 11. 5 using descriptive and inferential statistics (t-test، chi-square test، and ANOVA).

The mean age of the participants was 63. 5±11. 5 and 58. 3%were male. Average score of daily living activities before the intervention was 87. 2± 7. 5 and 80. 5± 16. 1 in controls (p=0. 12). After the intervention، the intervention group had a mean score of daily living activities of 95. 5± 4. 5 and the control group had 80. 8±11 (P<0. 001).

The home-based pulmonary rehabilitation program can be an effective step to improve daily living activities in patients with COPD، maximize their independence، and reduce complications in these patients.

Inflammation in the vascular access site results in infection، which is the second leading cause of death in hemodialysis patients. However، there is no specific protocol available for sterilization before vascular access in such patients. to determine the effect of the combination of alcohol and Betadine on the severity of inflammation in the vascular access site in hemodialysis patients In this Randomized Controlled Trial in July 2014، 68 patients undergoing hemodialysis and hospitalized in Imam Reza and Montasereye hospitals of Mashhad، were randomly assigned in two groups of control and combination of alcohol and Betadine group for one month. In the intervention group، vascular access site was disinfected with Betadine solution and alcohol in 2:1 ratio by the researcher before starting dialysis. The common method of the ward، which was povidone iodine alone، was used to disinfect the vascular access site in control group. The vascular access site of the patients was evaluated by the Iranian Nurses Association''s inflammatory criteria during 12 sessions. Data were analyzed by SPSS version 11. 5 using Mann-Whitney and chi-square tests. The mean of age in the intervention group was 46. 8±16. 6، and in control group was 54. 4±1. 6. Mean severity of inflammation in the intervention group (0. 2±0. 2) was lower than that in control group (1. 1±0. 4) (p<0/05). The combination of alcohol and Betadine as a disinfectant is effective in reducing the inflammation and consequently the infection in the vascular access site in hemodialysis patients، and nurses can use this antiseptic for vascular access.