Cardiovascular Nursing Journal

The study of the quality of triage of the patients admitted to intensive care unit

Faezeh Ghaemipour

Abstract

Aim. The aim of this study was to determine the current quality of triage in intensive care units for patients admitted to hospital emergency departments in ShahidBeheshti University of Medical Sciences in 2012.

Background. Accurate and rapid patient triage in emergency departments is the key to a successful performance. The study and understanding of the current condition and evaluation of the educational needs of triage nurses are highly important.

Method. This study is a retrospective descriptive study in which the data were gathered via in a list of ESI triage forms. To determine the content validity of data collection tools was used. In this study, the reliability of the test listed under triage nurse was both between observers and reliability with Intraclass Correlation Coefficient (ICC) : 0.857 was specified.

Findings. In this study,23% of the case were undertriage and 11.7% were overtriage.The most of undertriage cases was level 3 based on Emergency Severity Index (ESI) system. There is a direct correlation between the mortality and hospitalization in the Intensive Care Unit (ICU) and undertriage.

Conclusion. There was no statistically significant difference between proper triage and undertriage cases in mean length of hospital stay, duration of hospitalization and emergency department waiting time for the first visit of the emergency physician.

Anthropometric indices in acute myocardial infarction patients and their relationship with some coronary heart disease risk factors

Abstract

Aim. The aim of this study was to investigate anthropometric indices in acute myocardial infarction patients and their relationship with some coronary heart disease risk factors.

Background. Several studies showed that not only the quantity, but also the distribution of the fat mass is important, because increased visceral fat tissue deposition is a risk factor for cardio-metabolic diseases.

Method. In this cross-sectional study with a descriptive correlational design, 140 patients with acute myocardial infarction were selected from cardiac care unit of Shariati and Rajaei hospital in Karaj, 2009. The sampling method was convenience. Demographic data and history of cardiovascular risk factors were collected through interview, and some medical information were reviewed from medical records, anthropometric indices were measured by balance scale and meter tape. Data were analyzed using SPSS software and using descriptive statistics, t-test, ANOVA and Pearson coefficient correlation.

Findings. Neck circumference of 46.6% of men was over 40cm and 33.3% of women more than 37cm. Also, 53.9% of men and 74.1% of women had a waist circumference above 95 cm. Waist-to-hip ratio of 66.4% of men over 0.95 and 66.7% of women over 0.90. Waist-to-height ratio of 61.9%% of men over 0.55 and 66.7% of women over 0.62. Also, 13.3% of males and 29.6% of women had a BMI above 30 kg/m².There were significant positive correlation between triglyceride levels with neck circumference (p=0.006), waist circumference (p<0.001), waist-to-height ratio (p<0.001) and BMI (p<0.001), between cholesterol with neck circumference (p=0.009), waist circumference (p=0.001), waist-to-height ratio (p=0.003) and BMI (p<0.001), between LDL with waist circumference (P=0.005), waist-to-height ratio (p=0.014) and between glucose with waist-to-height (p=0.038). HDL had negative correlation with Waist-to-hip ratio (p<0.001) and waist-to-height ratio (p=0.001).

Conclusion. More than half of myocardial infarction patients had central obesity. Central obesity is associated with cardiovascular risk factors. It Seems that lifestyle change and weight loss are to be considered during cardiac rehabilitation programs for myocardial infarction patients with overweight and obesity for reduces cardiovascular risk factors.

The relationship between religious coping styles and quality of life in patients with coronary artery disease

Yaser Saeid

Abstract

Aim. This study was conducted to evaluate the relationship between religious coping style and quality of life in patients with coronary artery disease.

Background.Nowadays, beliefs and religious coping are considered as a significant factor in the development of psychological comfort and personal adaptation in patients with chronic diseases.

Methods. This descriptive-correlational study was conducted on 100 inpatients and outpatients with coronary artery disease in two selected teaching hospitals in Qom. Convenience sampling method was used to select patients. Short form 36 health survey questionnaire (SF-36) and Pargament religious coping styles were used for data collection.

Results. The mean and standard deviation Scores for positive and negative religious coping style were respectively 23.36 (3.88) and 10.80 (3.91).Among patients, 54.2% had high scores on positive religious coping strategies and 40.6% had high scores on negative religious coping strategies.Regarding to quality of life ,there was statistically significant relationship between positive religious coping styles and physical pain (r=0.24, P<0.05) and inverse significant relationship between negative religious coping styles and social functioning and mental health (r=0.29, P<0.01).

Conclusion. Accordingly, teaching of coping skills focusing on strengthening religious coping styles in routine care of coronary artery patients may improve the quality of life and health status in these patients.

The comparison of eight weeks of combined and aerobic training on functional capacity, body composition and strength in post-coronary artery bypass graft cardiac patients

Abstract

Aim.The aim of this study was to compare the eight weeks of combined and aerobic training on body composition and strength in cardiac patient post- coronary artery bypass graft.

Background. Cardiac rehabilitation improves fitness and clinical status in cardiac patients after coronary artery bypass.

Methods. In this randomized clinical trial, 20 cardiac patients under CABG surgery in Tehran Heart Center were randomly divided into two groups, combined and aerobic training. The protocols of combined group included two movements of the upper limbs (Pectoralis Major and Deltoid muscles) and two movements of the lower limbs (quadriceps and Hamstring muscles) by 3 sets/10Rep and aerobic group with 60-85 minute exercises at 70-85% peak HR in three sessions per week for 8 weeks. Functional capacity (VO2peak), strength, body weight, BF percentage and WHR were assessed before and after the training protocol. The collected data were analyzed using the Independent and Paired t-tests.

Findings. There was an elevation of functional capacity following, combined (p<0.05) and aerobic (p=0.027) training with a significant further increase in the combined group (p=0.016). The strength increased significantly after combined training (p<0.05). The BF percentage with no significant difference between two groups, decreased significantly following the both training protocols (p<0.05).

Conclusion. Combined aerobic-resistance training and aerobic training to improve functional capacity in Post CABG cardiac disease.However, Combined aerobic and resistance training is more effective than aerobic training in improving the functional capacity (cardiovascular fitness) and strength.

The effect of muscle relaxation training on nurses' insomnia in Tehran Heart Center

Abstract

Aim. The aim of this study was to evaluate the effectiveness of Progressive Muscle Relaxation Technique (PMRT) on nurses' insomnia in Tehran Heart Center .

Background. Insomnia is a highly prevalent health complaint in adults in recent century, which make some nurses involved. Pharmacological and cognitive-behavioral therapies are effective for the treatment of insomnia however, the current treatments are associated with side effects and may reduce the level of accuracy.

Methods. This was a randomized, controlled clinical trial that involved all nurses of Tehran Heart Center using ISI questionnaire. Among nurses with diagnosis of insomnia,60 people were randomly assigned to experimental and control groups. The experimental group was taught PMRT and asked to do exercises before sleep, while the control group had no intervention.During a month, performing PMRT was reminded verbally or via short message service. After one month both experimental and control groups were re-evaluated by the ISI questionnaire.

Findings. As compared to the control group, the PMRT group had significantly lower post-treatment scores for insomnia severity (p < 0.001). The insomnia severity in the PMRT group was significantly lower than that in the control group.

Conclusion. This study showed that PMRT might be effective in reducing insomnia in shift-work nurses with insomnia. This treatment leads to clinically significant sleep improvement within 4 weeks. Follow-up studies are required to find whether these improvements last for a long period of time.

The study of coronary angiography results in patients referred to coronary angiography laboratory of Shahid Beheshti Hospital from November 2010 to April 2011

Abstract

Aim. This study was done to assess coronary artery angiography results in ACS patients referred to KashanShahidBeheshti hospital.

Background.Coronary artery disease is one of the most common diseases with the highest mortality rates in developed and developing countries.

Method. This is a cross-sectional study, which was conducted using existent data through convenience sampling of 435 patients. The data were gathered using patient's records using tools including questionnaires and checklist. Variables include age, sex, diagnosis, physician name, left ventricle ejection fraction, dominant side of perfusion of cardiac muscle, type of physician recommendation and involved vessels. Finally, data was statistically analyzed using SPSS software, 16.0.

Findings. The results of this study showed 56.1% of cases had mild (non-pathological) disorder and others (43.9%) had a severe stenosis in their coronary arteries. Also, 21% of cases had three vessel disease. Also, left anterior descending artery (LAD) was more stenoticthan the other arteries.

Conclusion.According to the results of this study and high frequencies of non pathologic cases, it is recommended that cheaper diagnostic methods such as accurate clinical examination get used for patient selection

Nursing care of congenital heart diseases in neonates

Mona Alinejad-Naeini

Abstract

Aim. This paper reviews staff nurses roles in diagnosing and stabilizing neonates with congenital heart disease.

Background. Nowadays, development in managing congenital heart defects has increased survival and quality of life among neonates suffering these defects. Many attempts has been made to detect neonatal congenital heart disease before or immediately after birth, but a large number of neonates with heart problems remain undiagnosed before developing severe signs and symptoms. Although mild forms of the disease may subside spontaneously, severe conditions needs prompt management.

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 by the keywords nursing care, congenital heart disease, neonatal, cardiac, and management.

Findings.Twenty three English papers about diagnosis and stabilization of neonatal congenital heart disease and a textbook were selected. The findings are presented within four domains: 1) physical examination, 2) symptoms of disease, 3) management in delivery room and neonatal stabilization, and 4) communication with the parents.

Conclusion. Nurses are the first health care members encounter neonates with congenital heart diseases. Early recognition and stabilization of congenital heart disease is the cornerstone of nursing care of neonates suffering this problem.

Visiting hours in Intensive Care Units: Is the time for change?

Abstract

Aim.The aim of this study is to review the visiting policies, strategies and potential challenges and their different dimensions in ICUs in different societies.

Background. Considering the special needs of patients and their families is one of the essential elements of care in the intensive care units (ICU).

Method.This is a comprehensive review of the studies on different policies about visiting patients in intensive care units, based on the scientific database.

Findings.The studies show that despite awareness of the role of family care, visiting hours and related policies in ICUs are still limited due to the medical team concerns. While existing research and evidence do not support these concerns. They show open visiting hours have more benefits for patients and families, however visiting hours in some societies are still restricted.

Conclusion. The integration of theory, practice and the use of research findings in improving the quality of care of critically ill patients and their families in intensive care units is an important part of care. In practice, it is necessary to change the beliefs and attitudes of nurses in intensive care units. Further studies on opening visiting hours in intensive care units and its effect on treatment process is one of the major issues.