Cardiovascular Nursing Journal

Longitudinally investigation of the skills of cardiopulmonary resuscitation in nurse interns of Kashan University of Medical Sciences

Mohsen Adib-Hajbaghery

Abstract

Aim. This study was aimed to evaluate the changes in the cardiopulmonary resuscitation (CPR) skills of nursing students during a two year interval.

Background. CPR skills are of vital skills every healthcare worker should posses. Several studies are available on CPR skills of nursing students, however, changes in the students' skills have rarely been studied.

Method. This time series study was conducted on all graduating nursing students who were passing their internship period during 2011-2012. Data collection instrument had two parts including demographics form and a checklist for assessment of CPR skills (including closed chest compression, tracheal intubation, using of defibrillator and CPR management). Descriptive statistics were used for reporting the findings.

Findings. Seeking no help was the most frequent mistake made by the students in the domain of cardiac massage and artificial ventilation, both in the first and the third assessment. Only 41.67% and 32.61% of the students sought help in the first and the third assessment, respectively. Pressing the laryngoscope blade on the teeth was also the most common mistake in the domain of using the laryngoscope so that only 50% of the students performed this action correctly in all the three assessments. The most common error in the domain of defibrillation was ignoring repetition of the defibrillation in cases the patient’s cardiac rhythm did not returned to normal, so that only 52.08%, 28% and 21.74% of the students performed defibrillation correctly in all the three assessments, respectively.

Conclusion: Most of the students were evaluated as weak, especially in the CPR management domain. Retraining the CPR skills are suggested, especially when the students are near graduation.

Comparison of the effect of written, figurative and written-figurative training package of myocardial perfusion imaging on patients’ cooperation

Maryam Esmaeilinasab

Abstract

Aim.The aim of this study was to compare the effect of written, figurative and written-figurative training package of myocardial perfusion imaging (MPI) on patients’ cooperation in the nuclear medicine department of Rajaie Heart Hospital.

Background.Coronary artery disease (CAD) is one of the most common causes of deathall over the world and MPI is a well-known diagnostic method for CAD. However, not knowing about the procedure makes the patients anxious and reduces their cooperationand causes personnel of the department to experience fatigue and workload.

Method.A quasi-experimental design was used to conduct the study. One hundred patients, referred to the nuclear medicine department of Rajaie Heart Hospital, Tehran, Iran, were randomly assigned in four groups (25 in the control group, 25 in written training group, 25 in figurative training group, and 25 in combined training group). Two questionnaires were provided including demographics, and a researcher-made questionnaire for evaluation of patients’cooperation. Kruskal-Wallis test and Mann-Whitney U post hoc test were used for data analysis.

Findings.A statistically significant difference was seen between cooperation level of the control group and the other three groups. Figurative training package was the most effective training package.

Conclusion.Explaining the procedure to the patients before myocardial perfusion imaging is a significant action to improve their cooperation, leading to less time waste and better results.

Effect of resistance and endurance training protocols on functional capacity and quality of life in male patients after myocardial infarction

kamal Azizbeigi

Abstract

Aim.The aim of this study was to examine the effect of heart rehabilitation by resistance and endurance training on functional capacity and quality of life in male patients with myocardial infarction.

Background.Half of all people who have a heart attack will survive, but they might end up with a weakened heart and loss of functional capacity. It is necessary for nurses to gain essential knowledge to improve the patient’s quality of life and functional capacity.

Method. In this experimental study, 24 male patients with a history of myocardial infarction were recruited and randomly allocated to the endurance training group (n=8), resistance training group (n=8), and control group (n=8). Exercise training was implemented for 50-60 minutes at three sessions in weeks for eight weeks. Endurance training was implemented at 60-85% maximum heart rate on treadmill, while resistance training was implemented at 40-70% one repetition (RM) in three sets with leg press, calf elevation, and leg cruel exercises. Before and after intervention, functional capacity was assessed with modified Bruce test and quality of life was evaluated with SF-36 questionnaire for all groups under study.

Findings.The results showed that there was a statistically significant difference in functional capacity of resistance (P=0.002) and endurance (P=0.03) training group with control group. However, there was not significant difference in quality of life between endurance and resistance training groups.

Conclusion.Resistance and endurance training can improve functional capacity in male patients with a history of myocardial infarction. However, resistance training is more effective than endurance training in improving the functional capacity and quality of life.

The study of the domains of patient safety culture in Rajaie Cardiovascular, Medical and Research Center in 2012

Mahnaz Mayelafshar

Abstract

Aim. This study aimed to assess the domains of patient safety culture issues at Rajaie Cardiovascular, Medical and Research Center in 2012.

Background. Patient safety is a critical component of health care quality. As health care organizations continually strive to improve, there is a growing recognition of the importance of establishing a culture of safety.

Method. This descriptive analytical cross-sectional study was conducted in Rajaie Cardiovascular, Medical and Research Center. Multi-stage random sampling, proportionate to the number of the hospital staff., was used to recruit the participants. The sample consisted of the physicians, nurses, and laboratory personnel. The questionnaire “Hospital Survey on Patient Safety Culture” was used to collect the data.

Findings. The total mean score was 65%. The highest score was achieved by the paraclinical and diagnostic departments in the issue of team-work within organizational units (83%), and the lowest score belonged to the paraclinical and diagnostic departments in the issue of error occurrence (42%) and the intensive care units in the issue of staff affairs (42%).

Conclusion. Overall, the assessment of patient safety culture in a hospital can serve various purposes, not only can it evaluate the status of patient safety culture in that hospital and identify its strong and weak points, but also it can raise the awareness of the staff vis-à-vis this significant issue and thus improve it. Those aspects of patient safety culture that scored less than 60% need augmentations.

Effect of training cardiopulmonary cerebral resuscitation management on nurses’ knowledge

sima hashemy

Abstract

Aim. The aim of this study was to determine the effect of training cardiopulmonary cerebral resuscitation management on knowledge of nurses working in maternity wards of Ganjavian Hospital, Dezful, Iran, in 2013.

Background.Cardiaopulmonary cerebral arrest is one of the most dangerous situations that threats the life and requires immediate and appropriate action to survive and protect life and prevent irreparable/irrecoverable complications of the body vital organs.

Method.This is a quasi-experimental pretest-posttest study in which 40 nurses employed in maternal wards of Ganjavian Hospital in Dezful were recruited. The tool used in this study was a researcher-made questionnaire including 20 questions to determine the knowledge of nurses about cardiopulmonary cerebral resuscitation management. After the content validity and reliability of the questionnaire was confirmed, it was distributed among and completed by the participants, before and after intervention. Training workshop was conducted in the form of lecture and practical training on manikin, 8 hours per day for 2 days in both basic and advanced level. The data were analyzed using SPSS 17.

Findings. Maximum and minimum scores of pretest were 13 and 5, respectively, with a mean of 9.90 and standard deviation 7.9. Maximum and minimum scores of post-test were 15 and 8, respectively with a mean of 11.25 and standard deviation 1.6. There was a statistically significant difference between scores of nurses’ knowledge, before and after training (P<0.0001)

Conclusion.The findings provide strong evidence, supporting the important role of holding continuous in-service training courses of cardiopulmonary cerebral resuscitation to improve scientific qualification of the nurses. It is recommended to put more emphasis on resuscitation management process and standardization of the efforts of resuscitation team during emergency events.

The effect of supportive nursing program on depression, anxiety and stress of family members of patients during coronary artery bypass graft (CABG) surgery

Pegah Salahshoor

Abstract

Aim. This study was conducted to examine the effect of supportive nursing program on depression, anxiety and stress of family members of patients during coronary artery bypass graft surgery.

Background. patient’s family members experience high levels of depression, anxiety and stress during coronary artery bypass graft surgery. Informational and emotional support of family members during surgery may have significant effect on reducing their psychological distress and enabling them to better support of the patient.

Method. This semi-experimental study was conducted on 104 relatives of patients. They were recruited in the study with regard to the inclusion criteria and assigned to either experimental (n=52) or control (n=52) group. The experimental group received supportive nursing program including informational and emotional support. The control group only received routine interventions. Data were collected by demographic form and modified Depression Anxiety and Stress Scale (DASS). The data were analyzed by Chi-squire and T-test using SPSS software, version 21.

Findings. There were no statistically significant differences between control and intervention group regarding the mean scores of depression, anxiety and stress before surgery. After intervention (at the end of surgery) experimental group reported significantly lower levels of depression, anxiety and stress (P<0.0001).

Conclusion. According to the finding, supportive nursing program could reduce depression, anxiety and stress of family members of patients during coronary artery bypass graft surgery so, we suggest this program as an effective intervention to support family members during coronary artery bypass graft surgery.

Neonatal positioning during care in neonatal intensive care unit

Mona Alinejad-Naine

Abstract

Aim. This paper reviews various positions for neonates admitted to Neonatal Intensive Care Unit (NICU), describes benefits and disadvantages of each position and suggests a clinical guideline to improve development.

Background. It has been known that development of active muscle tone begins at 36 weeks gestation, when the baby achieves a postural state known as physiological flexion. Premature babies suffer from low muscle tone because they have missed out on some or all of the substantial stages of muscle tone development in the uterus. Without appropriate intervention these babies may experience head flattening and cranial molding. Without support, gravity causes preterm babies shoulders and hips flatten onto the bed, often called ‘frog leg position’ and ‘W arm position’. This can result in inappropriate or delayed development and mobility challenges including the inability to crawl, stand, walk and problem in fine motor skills such as hand-mouth co-ordination.

Method. In this literature review, papers published during the last 15 years, were searched out through search engines and data bases: Science Direct, Google Scholar, Ebsco, Pub Med, Ovid, Proquest based on which 16 papers about neonatal positioning during nursing care were selected. Also, three neonatal textbook were used.

Result. One of the earliest neurodevelopmental strategies in the NICU is therapeutic positioning. Positioning of premature infant is an essential neonatal nursing care. These positions are supine, prone, side-lying, and head up tilted position. Many studies have shown that a variety of outcomes can be affected by different body positioning of premature infants. Every position has its own advantages and disadvantages, so each infant should be individually assessed and positioned according to condition, preferences and behavioral cues. Position changes should be slow and steady, so that the infant doesn’t become distressed and dislodgement of invasive and monitoring equipment can be avoided. Whenever possible, an infant should be touched gently and talked to before changing their position.

Conclusion. It is necessary to ensure that preterm and sick neonates receive individualized positioning appropriate for their musculoskeletal development in order to minimize complications. Infants receiving developmentally supportive care have been demonstrated better medical outcomes including shorter duration of mechanical ventilation and supplemental oxygen support, earlier oral feeding, and shorter hospitalization.

Self-care education and improving quality of life in patients with hypertension: a review literature

Maryam Shahidi

Abstract

Aim.The aim of this paper is to review studies related to self-care education and quality of life improvement in patients with hypertension.

Background. Hypertension is one of the greatest health problems in the world and also, one of the major risk factors for cardiovascular disease. One of the main aims of health care is improving quality of life. Self-care education can improve the quality of life. Due to the need for recognizing trend of studies related to self-care education and quality of life in patients with hypertension, conducting literature review in this field is necessary.

Method. This article reviews the studies published during the recent 15 years regarding self-care education and quality of life in patients with hypertension that were searched out through scientific databases, including Science Direct, PubMed, Cochrane, Medline, SID, Scopus, CINAHL, OVID, Iran Doc, and Magiranby the keywords “self-care educational program”, “quality of life”, and “hypertensive patients” and their Persian equivalents.

Result. The literature review revealed that few studies have examined the effectiveness of training programs on the quality of life in patients with hypertension. Results showed that patients with hypertension have low quality of life. In some studies, different educational methods were used in an attempt to improve the clinical outcomes of patients and some of these self-care educational programs had positive effects on the quality of life.

Conclusion. The quality of life in patients with hypertension is low. Therefore, because of the importance of quality of life improvement and due to the limitations of the studies, it is essential to conduct further research to investigate the effect of self-care educational program on quality of life in patients with hypertension.