Aim. The aim of this study was to determine sharp instruments injuries in intensive and general wards of Rasoule-Akram hospital in Tehran in 2010.

Background. Sharp instruments can cause transmission of blood-borne pathogens such as Human Immune Deficiency Virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV). Annually, there are 66000 HBV, 16000 HCV, and thousands of HIV cases as a results of contact with sharp instruments among health care personnel around the world. Nurses are almost involved in all sharp instrument injuries.

Method. This descriptive-analytical study was conducted on 76 nurses of medical-surgical wards and 44 nurses of intensive care units. Data were collected by using Virginia University Questionnaire (Prevention Information Network) for assessing sharp instrument injuries. The data was analyzed by SPSS software.

Findings. The finding showed that most injuries occur in patient's room and the lowest in the treatment room.  Also, 55.8% of all patients have done no action after injury, %35 of them is followed by wards and 9.2% of them are not followed by wards.

Conclusion.  According to high frequency of sharp instrument injuries, it is necessary to provide health care personnel with educational programs. Appropriate education may have significant effect in decreasing injuries among health care personnel.

Abstract

Aim. The aim of this study was to evaluate cardiac intensive care nurses’ performance in usingintravenous Streptokinase for acute myocardial infarction patients.

Background. Acute myocardial infarction is a common disease. Use of thrombolytic drug includingStreptokinase reduce mortality rate in these patients. Nurses have an important role in injectingthis drug.

Method. This descriptive study was conducted on 68 nurses who work in cardiac emergency room andcoronary care unit. Data were collected by observation check list of nurses’ performance. The data wereanalyzed by descriptive statistic and Chi-square.

Findings. The findings showed that the manner of presenting nursing care in pre- Streptokinase infusionstage was moderate in 52.9% of observations, but during the injection in 55.4% of observations and afterinjection, in 45.6% of observations was poor.

Conclusion. The care of patients was moderate and poor, therefore it is recommended to paymore attention to education of nurses about using intravenous Streptokinase for acute myocardial

Abstract

Aim. This study was conducted with the aim of evaluating mental health status in critical care nurses working in Coronary Care Unit (CCU), Intensive Care Unit (ICU), Emergency Department (ED) and dialysis ward in teaching hospitals of Tehran, Iran.

Background: Nursing is known as a difficult profession which needs an endless patience and tolerance with patients and their families. Furthermore, nurses must update theirs knowledge in all nursing-related topics, but it seems that it is so hard for nurses to update knowledge and at the same time, do their professional tasks such as meeting patients and family needs which occupy nearly all their time. This could run them at risk mentally and physically. Besides, it is much more possible for critical care nurses to be affected because of aggravated work-related stresses.

Method: This is a cross- sectional descriptive study. The sample included 375 critical care nurses with at least one year of nursing experience and six months of working in critical care wards. The convenience sampling method was used. Three valid and reliable questionnaires were used in this

study: "Chalder Fatigue Questionnaire", "Hamilton Anxiety Rating Scale", and "Pittsburgh Sleep Quality Index". Questionnaires were filled by study participants and the data were analyzed by SPSS.

Findings: The findings revealed that %73 of nurses experienced mild levels of anxiety, and %16.5 of them reported mild to moderate levels of anxiety. The remaining had either moderate to severe or severe levels of anxiety. Regarding sleep quality, %89.2 of the samples had bad sleep quality. In terms of fatigue, all participants reported moderate to severe fatig.

Conclusion: Critical care nurses in teaching hospitals of Tehran do not have satisfying mental health status. Most of them are suffering from bad sleep quality, moderate to severe fatigue, and mild or mild to moderate anxiety.

Abstract

Aim. This study assessed the knowledge of nurses about arterial blood gases interpretation in intensive care units of selected hospitals in Tehran.

Background. Measurement of arterial blood gases are widely used in intensive care units. The knowledge and mastery in interpretation of arterial blood gases is an essential skill for critical care nurses.

Method. This descriptive-analytical study was conducted on 117 nurses working in intensive care units at selected military hospitals in Tehran in 2013. Data were collected using a questionnaire consisted of 45 questions about personal and professional information, also in the domain of blood gases interpretation based on Bloom's classification of knowledge (judgment and evaluation phase). Data are analyzed by SPSS and descriptive and inferential statistics were presented.

Findings. Knowledge of intensive care unit (ICU) nurses was moderate to poor in arterial blood gas interpretation. A statistically significant difference was seen between the knowledge of the subjects in terms of some variables. Conclusion. Given the importance of arterial blood gases interpretation in ICUs, it is necessary to pay attention to in-service and continuing education programs for nurses.

Aim. This study aimed to evaluate the effect of preoperative cardiac surgery nursing care education on anx-iety, quality of sleep, fasting time and cardiac medication usage in cardiac surgery patients.

Background. Cardiac surgery is one of the most important therapeutic approaches in patients with heart diseases. According to previous studies it is necessary to reduce the anxiety level and improve the quality of sleep the night before surgery, fasting according to standard protocols and continuing usage of cardiac medications.

Method. This study was a quasi-experimental trial in which patients were studied in two groups (before-training group and after-training group). One hundred cardiac surgery patients were selected based on in-clusion criteria as before-training group and evaluated in terms of anxiety level, quality of sleep, fasting time and cardiac medication usage in the night before surgery. Sampling lasted for 42 days. Then, all of the surgical nurses were trained individually for a week, and given pamphlets. Their educational content in-cluded the latest fasting protocols, non-pharmacological methods of reducing anxiety and improving quality of sleep and emphasizing on the importance of cardiac medication usage in the night before surgery. Then, another 100 patients were evaluated as the after-training group. Sampling from this group lasted for 38 days. The tools included demographic sheet and Spielberger anxiety questionnaire. Data were analyzed with SPSS software.

Findings. The findings of this study showed a statistically significant difference in anxiety level between before-training group and after-training group (P<0.0001). Also, there was a significant statistical differ-ence in quality of sleep between two groups (P=0.004). But, there was not a statistically significant differ-ence in fasting hours and cardiac medication usage between two groups.

Conclusion. According to the findings, educating preoperative cardiac surgery nursing care decreased anxi-ety level and improved quality of sleep in after-training group. But this intervention neither decreased fast-ing hours nor increased continuing cardiac medication usage in after-training group.

Aim. This study was conducted to evaluate the effect of aromatherapy on ICU nurses' stress.

Background. Nursing, due to its high sensitivity, is known as one of the most stressful professions. ICU nurses experience more stress than other nurses. This stress can reduce the quality of patient care and results in nurses' feelings of inadequacy and depression. Aromatherapy, as a method of complementary medicine may reduce anxiety and warring.

Method: This was a quasi-experimental study in which 70 nurses, working in intensive care unit, were divided into experimental and control groups. Nurses' stress were measured before intervention, then intervention (inhalation of Lavendula using tags for 4 consecutive shifts, each shift for 20 minutes) was was applied for the experimental group (control group received no intervention). At the end of intervention in experimental group, the stress was again measured in both groups. Data were analyzed using the Chi-square and t-test in the SPSS, version 20.

Findings. After intervention, the mean of stress in experimental group (20.57±4.20) was not statistically different when compared with control group (22.43±5/24). But, in the experimental group, the mean of stress score after intervention (20.57±4.20) was significantly lower than the mean of stress score before intervention (22.32±4.61) (P=0/001). Comparing the groups, the changes in mean stress score before and after the intervention was statistically significant (P=0.001).

Conclusion: The findings of this study showed that the Lavender essence can reduce stress in ICU nurses. It is recommended that the aroma of lavender be applied to reduce stress in ICU nurses.

Aim. The aim of this study was to determine the effect of patient education and  nurse-led  telephone follow-up (telenursing) on adherence to treatment in patients with acute coronary syndrome admitted to cardiac care units hospitals affiliated to Alborz University of  Medical Sciences.

Background. Increasing adherence to treatment is essential in patients with acute coronary syndrome to reduce readmissions and improve the recovery, but only patient education does not guarantee the adherence to treatment and it is necessary to follow-up patients after discharge.

Method. This randomized clinical trial study was conducted on patients with acute coronary syndrome admitted to the selected hospitals of Karaj, Iran, in 2014. In this study, 90 patients were selected purposively and randomly allocated  in  three groups of education (n=30), education/ telephone follow-up (n=30), and control (n=30). Data collection instrument was questionnaire. Data were gathered at baseline and 12 weeks after the intervention. Patients in educational groups  (education, and education/ telephone follow-up groups) were trained before discharge using educational pamphlets. Telephone follow-up were implemented for education/ telephone follow-up group for 3 months; twice a week in the first six weeks and weekly in the second six weeks. The data was analyzed by descriptive and inferential statistics in SPSS version16.

Results. After intervention, there was a statistically significant difference between the groups in terms of adherence to treatment (P=0.001). Participants in the education/ telephone follow-up group and education group experienced more improvement in adherence to treatment than the control group.

Conclusion. Both patient education and education/ telephone follow-up have effect on improvement of adherence to treatment, but education/ telephone follow-up results in more improvement in adherence in comparison to education. It is recommended to implement education/ telephone follow-up for patients with acute coronary syndrome.

Aim. The aim of this study was to evaluate the ethical sensitivity and its relationship with demographic characteristics in critical care nurses of Shahid Rajaee Heart Center in Tehran.

Background. Nurses are the largest group of service providers in the health care system, and must be aware of and sensitive to ethical issues related to their profession. Ethical sensitivity is the basis of ethics in nursing enabling nurses to take care of their patients effectively and ethically.

Method. In this descriptive-analytical study, 181 nurses working in the intensive care units of Shahid Rajaee Heart Center hospital were randomly selected. Data were collected through demographic questionnaire and standard questionnaire of the nurses’ moral sensitivity. Moral sensitivity has six aspects: respecting the patient independence, awareness of how to communicate with patients, professional knowledge, experiencing the ethical problems, using moral concepts in decision-making ethics, integrity and benevolence. The data were analyzed based on SPSS version 19, using descriptive and inferential statistics.

Findings. The mean score of nurses’ ethical sensitivity was 70.85±7.73 with the highest scores in the domain knowledge of how to communicate with patients and the lowest score was related to the domain the level of professional knowledge. Among the demographic variables, there was a statistically significant correlation of age, average weekly work hours, and years of working with ethically sensitive nurses; with the increase of age and experience, the moral sensitivity was also increased, while the ethical sensitivity decreased as a result of the increase of average weekly work hours.

Conclusion. Considering that moral sensitivity in this study was moderate, it is recommended that nurse managers standardize the weekly working hours of the nurses in intensive care units in order to increase the ethical sensitivity in nurses.

Abstract

Aim.The aim of this study was to compare the effect of education through lecture and multimedia methods on knowledge, attitude, and performance of cardiac care nurses about temporary pacemaker care.

Background.Cardiac dysrhythmias are among the most common cardiovascular disorders. Temporary pacemaker insertion is a treatment or prevention method for cardiac dysrhythmia. Nurses are the main group to provide the care for patients with temporary pacemaker, so it is necessary to educate them in an effective and efficient way.

Method.This was an experimental study conducted in 2015 on 52 cardiac care nurses working in ShaheedRajaei cardiovascular center. All 52 nurses were randomly divided in 2 groups of education through lecture and multimedia. The level of nurses' knowledge, attitude and performance was evaluated before and three weeks after education and the effect of education was examined using Mann-Whitney and Wilcoxon Signed Ranks Test through SPSS version 22.

Findings.Before intervention, the median and interquartile range of knowledge levels for lecture and mul-timedia groups were 12.5 (10-14) and 11 (9-12), respectively, and after that, they increased to 17 (15- 19) and 17 (13- 19). The median and interquartile range of performance levels for lecture and multimedia groups changed from 29 (26- 30) and 30 (26- 31) to 34 (32- 35) and 34 (32- 35), respectively. The knowledge and performance levels increased in both methods. But there was no statistically significant difference between these two methods. Before intervention, the median and interquartile range of attitude levels for lecture and multimedia groups were 62.5 (60-64) and 64 (63-66) and after that, they changed to 64 (60-64) and 63 (61-64), showing that intervention has no effect on attitude level in any of these two groups.

Conclusion.There is no difference between the effectiveness of education through two methods of lecture and multimedia software on cardiac care nurses' knowledge, attitude and performance. In the other words, multimedia software method is as effective as lecture method. Education using multimedia software can be considered as a proper method for increasing demand in staff education. Proper infrastructure and optimal training programs are prerequisites to effectiveness of education through multimedia software method.

Abstract

Aim. This study aimed to examine the effect of education by video self-assessment on nurses’ knowledge and performance about cardiopulmonary resuscitation (CPR).

Background.Cardiopulmonary arrest is one of the main medical emergencies and one of the major causes of death around the world. Cardiopulmonary resuscitation is the critical components of basic life support in response tocardiopulmonary arrest. The success ofcardiopulmonary resuscitationrequiresproficiencyandperformance of resuscitation group.

Method. This was a clinical trial study conducted on 80 nurses that were randomly divided into experimental and control group. Participants in control group received traditional training and experimental group experienced video self-assessment after traditional training. Knowledge on CPR was evaluated with a valid questionnaire including multiple choice questions. Psycho-motor skills were measured through a visual checklist observing CPR performance of the participants on a manikin. Outcome variables were measured three times (before, immediately after, and two months after training). Data were analyzed by the SPSS through repeated measures analysis.

Findings. Comparing the mean score of knowledge between the groups at before, immediately after, and 2 months after training did not show any statistical significant difference. Immediately, and two months after intervention, the mean score of performance of the experimental group was significantly higher than that of control group.

Conclusion.Education by Video self-assessment is an effective method to improve nurses’ performance in CPR.

Abstarct

Aim.The aim of this study was to determine nurses’ knowledge, attitude, and performance in cardiopulmonary resuscitation (CPR) based on PRECEDE model.

Background. Despite development of CPR team in Iran’s hospitals, performance in the field of CPR is not satisfactory.

Method. In this cross-sectional descriptive analytical study, all staff nurses (n= 97) working at ateaching hospital (9 Day) in Torbat-e-Heiydariyeh, Iran, were studied.The data collection tools included a reliable and valid researcher-made questionnaire to collect demographic data and a questionnaire which developed based on PRECEDE model.Data were analyzed in SPSS version 20 using ANOVA, linear regression and Pearson correlation coefficient.

Findings. The mean age of the nurses was 29.45±7.45 years.The average score for PRECEDE model constructs were 79.17±18.68 (knowledge), 95.48±6.64 (attitude), 62.6±19.52 (enabling factors), 67.61±20.12 (reinforcing factors), and 72.37± 9.71 (performance).Also enabling factors were the most important predictor of nurses’ performance (B=0.773, p<0/0001).A statistically significant relationship was observed of nurses’ performance with gender (p=0.007) and experience of CPR (p=0.027). There was a positive significant correlation of enabling factors with reinforcing factors (p=0.007, r=0.274) and behavior (p=0.000, r=0.773).

Conclusions. Constructs of knowledge, attitude, and performance were in desirable level and constructs of reinforcing and enabling factors were in moderate level. It is recommended to implement interventions and programs while considering enabling and reinforcing factors for promoting the performance of nurses in CPR.

Abstract

Aim. The aim of this study was to examine the effect of Benson relaxation technique on anxiety of critical care nurses.

Background. Anxiety is one of  the important factors affecting nursing profession and the quality of care. Some complementary interventions such as Benson relaxation techniques may affects anxiety.

Method. This was an experimental study (pretest-posttest with control group design) in which 63 critical care nurses of Shahid Rajaie Cardiovascular, Medical and Research Center, Tehran in 2015. Stratified samples were selected based on ward and randomly allocated to to experimental and control group. Benson relaxation technique was implemented by experimental group for 20 minutes, twice a day, with at least six hours interval, and for a two weeks period. Data were collected through demographic questionnaire and Spielberger questionnaire. Data were analyzed in SPSS version 21 using Chi-square test, t-test, Fisher's exact test and repeated measures ANOVA.

Findings. In experimental group, the mean and standard deviation of anxiety, before the intervention and  one and two weeks after intervention were 42.19±4.85, 43.67±7.55 and 42.12±6.12, respectively. A week after the intervention, the two groups had significant difference in terms of anxiety. The mean score of anxiety in the control group was more than nurses in the intervention group (P=0.011). Also, following application of Benson relaxation, anxiety intensity decreased in the intervention group as compared to baseline. In the control group, the mean score of anxiety increased overtime.

Conclusion. Implementation of Benson relaxation can reduce the anxiety of critical care nurses. This method is proposed as part of the nurses' anxiety reduction programs by managers and officials in medical centers.