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Showing 30 results for Intensive Care Unit
Anolin Aslan, Maryam Esmaeili, Volume 7, Issue 2 (9-2018)
Abstract
Abstract
Aim. The purpose of this study was to review the patient– and family-centered care studies in coronary artery bypass graft surgery.
Background. Nowadays, the length of hospital stay after cardiac surgery is reduced, and the most of the patients recover at home with their families without usual nursing and medical care. It is necessary to provide the care based on the same needs.
Methods. This is a comprehensive review of literature published between 1990-2018 about patient- and family-centered care interventions and patient/family important outcomes in adult ICUs that was conducted through searching out databases and search engines Medline, Ovid, Science Direct, PubMed and Google scholar, including English and Persian papers. In total, 73 English papers and 46 Persian papers were found, out of which 25 papers were included in this review.
Findings. Engaging families in patient care can profoundly influence clinical decision making and patient outcomes. Yet in many hospitals and health care systems, outdated visiting policies separate families and other loved ones during hospital stays.
Conclusion. Patient– and family-centered care is associated with better clinical outcomes. The clinical benefits that have been identified through a family partnership approach in these settings include decreased mortality, increased satisfaction, improved adherence to treatment regimens, and decreased readmission rates. Although high-quality interventional studies are needed to further evaluate the effectiveness of patient- and family-centered care in coronary artery bypass surgery, it is obvious this movement in healthcare is making a huge impact on family satisfaction and patient outcomes.
Payam Abbasi, Hamid Peyrovi, Seyed Habibollah Kavari, Hamid Haghani, Volume 8, Issue 1 (3-2019)
Abstract
Abstract
Aim. This study was conducted to evaluate the readiness of intensive care units of hospitals affiliated to Iran University of Medical Sciences for the implementation of family-centered care in 2017.
Background. Patients in the intensive care unit often are not able to participate in therapeutic decisions, therefore, involving families in decision-making process, implementation and treatment processes, and meeting the their needs improves treatment outcomes and increases patient and family satisfaction. Family-centered care is one of the means of providing care that recognizes and respects the vital role of the family.
Method. This was a descriptive cross-sectional study in which all of the intensive care units in the hospitals of Iran University of Medical Sciences were studied in terms of their preparedness for family-centered care. Proportionate stratified sampling method was used to recruit nurses, and the physicians were recruited based on convenience sampling. In order to investigate the structure and facilities, through a census of all specialized departments of hospitals affiliated to Iran University of Medical Sciences, a checklist was filled out. Data were analyzed in SPSS software version 22 using descriptive and inferential statistics.
Findings. According to the results, 60.9% of nurses were opposed to implementing family-centered care and have a negative attitude, and 57.3% of physicians agreed to implement family-centered care. There was a statistically significant difference between the attitudes of nurses and doctors (p≤0.0001). Also, the overall scores obtained from hospitals affiliated to Iran University of Medical Sciences showed that the facilities and hospital structure were poor for implementing family-centered care.
Conclusion. Differences in the attitudes of nurses and physicians about family-based care showed the need for clarifying the concept of family-centered care. The implementation of family-centered care requires structural changes and extensive equipment in accordance with the standards.
Anolin Aslan, Maryam Esmaeili, Volume 9, Issue 1 (3-2020)
Abstract
Abstract
Aim. This study aimed to examine the effects of preoperative preparation of patients and family caregivers on outcomes after coronary artery bypass graft surgery (CABG).
Background. Preoperative preparation can improve patients’ experience of surgery and hospitalization. However, there is limited data about how preoperative preparation affects postoperative outcomes following CABG.
Method. This non-randomized clinical trial was conducted on ninety pairs of patient/ caregiver in the time period from July to November 2018. The participants were purposively selected and non-randomly allocated to either control or experimental group. The intervention was performed one day after admission and the day before CABG in the form of an educational video, an intensive care unit tour, and an educational booklet. In both groups, on the third day after surgery, patients' delirium was assessed in the ICU and family caregivers were asked to complete a family satisfaction questionnaire. Patients and their family caregivers in both groups completed a hospital anxiety and depression questionnaire (HADS) on the first and seventh days after surgery and before discharge. Data were analyzed in SPSS version 16.0 using descriptive and inferential statistics.
Findings. After intervention, the mean score of patients’ anxiety and depression in the intervention group was significantly less than the control group (P=0.03). After intervention, the mean score of anxiety and depression among family caregivers in the control and experimental groups were not significantly different (P=0.11). Family caregivers’ satisfaction of experimental group was significantly higher than the control group in both healthcare providers’ performance dimension (P=0.01) and comfort dimension (P=0.027). Moreover, the groups did not significantly differ from each other regarding delirium incidence (P=0.6) and length of stay in the intensive care unit (P=0.21).
Conclusion. Considering that the preparation of the patient and family caregiver on the day before CABG can reduce patients' anxiety and depression and increase the satisfaction of the family caregiver, it is recommended to use this intervention for patients and family caregivers before CABG.
Nasibeh Barani, Fatemeh Bahramnezhad, Khatereh Seylani, Farshad Sharifi, Alun C. Jackson, Behzad Ahsan, Volume 9, Issue 1 (3-2020)
Abstract
Abstract
Aim. This review study aimed to investigate the role of thirst in the development of delirium in patients admitted to intensive care units.
Background. Delirium is a common clinical syndrome in patients admitted to intensive care units, affecting approximately one-third of these patients. Delirium is a multidimensional phenomenon. One of the most important and controversial factors in the occurrence of delirium is the phenomenon of thirst.
Method. This study was conducted by searching out Persian and English databases of Magiran, SID, Web of Science, Science Direct, PubMed, Scopus, without publication year consideration and using the keywords "thirst", "dehydration", "hyperosmolarity" and "delirium". Of 55 articles retrieved, 17 articles were reviewed by the research team among, and finally, after complying with the inclusion criteria and evaluating the quality of articles, 6 articles were included in the study.
Findings. The findings of the present study showed that tolerating the thirst for more than 24 hours is a risk factor for delirium. The role of fluid deficiency in the pathogenesis of delirium is not fully understood, but factors such as tissue hypoperfusion (especially in the brain and kidneys), increased concentrations of drugs or their metabolites in reduced intravascular volumes, and decreased renal function in excretion and/or drug metabolism are possible causes for development of delirium.
Conclusion. There is a lack of studies in this area and due to the importance of delirium and thirst in patients in the intensive care units or the elderly patients, more studies should be conducted in this area. All these factors calls for more attention and studies in this area.
Mona Alinejad-Naeini, Farshad Heidari-Beni, Volume 9, Issue 1 (3-2020)
Abstract
Abstract
Aim. This review study explores cardiovascular changes in preterm neonates during the transition from intrauterine to extrauterine life, respective challenges, and nursing care during this period.
Background. The transition from intrauterine to extrauterine life requires well-regulated and complex biochemical, physiological, and anatomical changes to ensure the survival of the neonate. Compared with term neonate, transition for a preterm neonate occurs over a longer period of time. Careful assessment and timely intervention by health care providers is pivotal to help the preterm neonate adapt to extrauterine life.
Method. This review study was conducted through systematic and focused searching out for literature published between 2000 and 2020 in database/ search engines Google Scholar, Web of Science, PubMed, Scopus by the selected keywords Transition, Extrauterine life, Preterm neonate, Nursing care and their Persian equivalents.
Findings. Twenty six English articles and two books about neonate related to the topics of transition to neonatal extrauterine life, challenges and respective nursing care were found. Findings were organized into five thematic category: immature myocardium, blood circulation, patent ductus arteriosus (PDA), hypotension and hemodynamic instability.
Conclusion. Comprehensive hemodynamic monitoring and skillful clinical evaluation, and wise judgment are recommended for better management of complex transition phenomena in preterm neonates. Management protocols should be developed for transition period in preterm neonates.
Soheila Salmanian, Sheida Jabalameli, Maryam Moghimian, Fariba Arjmandi, Volume 10, Issue 1 (3-2021)
Abstract
Abstract
Aim. This study was conducted to examine the effect of mentalization-based therapy and emotion-regulated therapy based on the Gross process model on psychological well-being and quality of work-life of nurses in intensive care units.
Background. Improving nurses' well-being and satisfaction with their quality of work-life improves the nurse-patient relationship and hospitals' performance from an organizational point of view. It is necessary to provide psychological therapeutic interventions to this crucial group of health care providers.
Method. This study was an experimental study (pre-test post-test with control group) in which 45 nurses working in intensive care units of selected Tehran hospitals, Iran, were selected by the convenience sampling method, and assigned to two intervention groups and one control group (15 nurses in each group). Reef's short-term psychological well-being and Walton's 32-item quality of work-life were used to measure dependent variables of the study. Then, mentalization-based therapy group received intervention in 8 sessions of 90 minutes as one session per week; and the treatment group based on emotion regulated therapy based on the Gross process model received the intervention in 8 sessions of 90 minutes, one session per week based on the protocol. No intervention was implemented for the control group. Data were analyzed using descriptive and inferential statistics in SPSS software.
Findings. Before the intervention, there were the highest scores for quality of work-life in the control group. At the end of the study and after the intervention, the scores of quality of work-life increased in all three groups, and no statistical significant difference was found between the groups. Before the intervention, the highest scores for psychological well-being was observed in the mentalization-based therapy group. (85.86±6.56), and after the intervention, although the psychological well-being scores of both interventions groups were higher than that of control group, but this diferrence was not statistically significant.
Conclusion. Based on the findings of this study, it seems that training sessions of mentalization-based therapy and emotion-regulated therapy based on the Gross process model improve the quality of work-life in nurses working in intensive care units, but the improvement was not statistically significant.
Sara Lotfian, Fatemeh Kermani, Dr Pardis Moradnejad, Haleh Dadgostar, Maryam Talebi, Volume 10, Issue 1 (3-2021)
Abstract
Abstract
Aim. This study was conducted to compare the prevalence of neck pain and disability among nurses in intensive care and general wards.
Background. Nursing is known as one of the ten occupations that are associated with musculoskeletal complications. In has been reported that neck and shoulder disorder are more common among nurses with high physical workload than those with low physical workload. So far, few studies have been performed on neck problems in nurses working at intensive care unit.
Method. In this cross-sectional descriptive-comparative study, 40 nurses from intensive care units and 40 nurses from general wards of Rasool Akram hospital, Tehran, Iran, were selected by convenience sampling method. Data collection in both groups was done through completing a checklist of demographic characteristics, Neck Disability Index (NDI) and Neck Pain and Disability Scale (NDPS) questionnaires by participants. The data was analyzed in SPSS version 22 using descriptive and inferential statistics.
Findings. The prevalence of neck pain and disability (measured by NDI and NPDS) in all nurses was 77.5 percent and 60 percent, respectively; 90 percent and 70 percent in nurses working at the intensive care units, and 65 percent and 50 percent in nurses working at general wards. The difference in scores measured by NDI was statistically significant between nurses working at the intensive care units and those working at general wards (P=0.014).
Conclusion. The prevalence of neck pain was significantly high in nurses, which could be due to their high workload that requires appropriate preventive measures and reduction of their physical workload.
Mohsen Ziyaeifard, Roghaye Mohammad-Taghi, Rasoul Azarfarin, Reza Abbaszadeh, Mehdi Heidari, Volume 11, Issue 1 (3-2022)
Abstract
Abstract
Aim. This study aimed to compare the effect of Adaptive Support Ventilation (ASV) and Synchronized Intermittent Mandatory Ventilation-Pressure Support (SIMV-PS) modes on consequence of weaning off patients from mechanical ventilator after coronary artery bypass surgery
Background. The ventilation mode used for respiratory support in patients after coronary artery bypass graft surgery is very important. In addition to avoiding pressure on patient's sternotomy incision, the ventilation mode should also provide the possibility of rapid weaning of patient to avoid complications caused by long-term ventilation.
Method. In a semi-experimental study, 26 patients were ventilated with ASV as the experimental group and 26 patients were ventilated with SIMV-PS mode as the control group after coronary artery bypass graft surgery in Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. Mechanical ventilation time and endotracheal tube removal time, hemodynamic variables, and arterial blood gas analysis were compared between the two groups. Data were analyzed using an independent t-test, repeated measures ANOVA and chi-square.
Findings. Out of 52 patients, 36 (69.2 percent) were male and 16 (30.8 percent) were female. The mean time for the endotracheal tube removal was 89.42±33.83 minutes in the experimental group and 101.53±44.91 minutes in control group, which did not have a statistically significant difference (p=0.843). The mean duration of mechanical ventilation of patients in the experimental group was 483.84±158.153 minutes and in the control group, it was 541.92±257.81 minutes, which were not statistically different (p=0.332).
Conclusion. The use of ASV mode for mechanical ventilation after coronary artery bypass graft did not affect reducing the duration of mechanical ventilation and the time of endotracheal tube removal compared to SIMV-PS mode. Therefore, the use of ASV mode for respiratory support of patients undergoing coronary artery bypass surgery should be considered according to the patient's condition and the nurses' expertise.
Parisa Bozorgzad, Maryam Ehsani, Mohammadreza Zarei, Volume 11, Issue 1 (3-2022)
Abstract
Abstract
Aim. This paper aims to investigate barriers and opportunities of the virtual visiting in intensive care unit during Covid-19 pandemic.
Background. Face-to-face visits of hospitalized patients in intensive care units reduce separation anxiety and stress caused by hospitalization, as well as increase the feeling of comfort and safety in patients. In addition, it is the key to patient/family-centered care. However, the Covid-19 pandemic and its related restrictions ruled out the possibility of using the family's potential and providing patient/family-centered care. Virtual visiting has been proposed as a solution to remove the family's distance from the patient.
Method. This review was conducted by searching out databases, Web of Science, Scopus, PubMed, Magiran, SID and Cochrane with the keywords, Covid-19, Video calls, Family-patient center care, Intensive care unit, and Virtual visiting without time limitation. The inclusion criteria were the publication of the article in Persian or English language and the availability of the full text of the articles. In total, 45 articles were found, most of which focused on virtual appointments and virtual patient visits by physicians. After removing irrelevant papers, and the cases without full text, 29 articles were evaluated in terms of quality. Finally, 10 articles were evaluated in terms of subject, and the purpose related to the present study.
Findings. During Covid-91 pandemic, virtual visits were done in intensive care units in most medical centers using cell phones and tablets through social networks facilities. In all cases, families and health care providers were satisfied with this communication method, but they considered it was not a suitable substitute for face-to-face meetings. They believed that this method combined with face-to-face meetings would be more effective. Lack of regular and systematic planning, ambiguities in the duties of health care providers in the field of holding virtual visiting, lack of access to the internet at a suitable speed, and the complexity of working with smartphones for some families, were barriers of this method.
Conclusion. Virtual visiting provides a form of presence for families who are far away from their patients. Via this method, not only one but also all the family members can visit the patient. Although this method did not affect the stress and anxiety of the family and patients, but it was able to create a positive experience for them during hospitalization in intensive care units. Moreover, by involving the family in treatment process and informing them opens the ways to reach the patient/family-centered care in intensive care units.
Samaneh Nik-Chehreh, Mona Alinejad Naeini, Volume 12, Issue 1 (3-2023)
Abstract
Abstract
Aim. The purpose of this review article is to introduce the phenomenon of patent ductus arteriosus (PDA) to health care providers of the neonatal intensive care unit, particularly nurses working in the neonatal intensive care unit.
Background. The patent ductus arteriosus is among the developmental diseases of the heart. The ductus arteriosus is the pathway that connects the left pulmonary artery to the descending aorta during fetal life. This duct closes in neonates within a few minutes to a few days after birth. Familiarity with this phenomenon may help health care providers in taking care of babies experiencing this condition. The transition from intrauterine to extrauterine life requires coordinated and complex biochemical, physiological, and anatomical changes that takes an extended period of time in premature infants and those with congenital conditions. Rapid and timely assessment and intervention by the health care team can help at this vital stage of life.
Method. This literature review was conducted through a systematic and targeted search of articles and texts published from 2008 to 2024 in PubMed/, Web of Science, Google Scholar, and Scopus using the keywords Patent ductus arteriosus, Infant, Nursing care, Treatment, and their Persian equivalents.
Findings. Twelve articles and one book were found and the findings were organized as definition and pathophysiology of patent ductus arteriosus, diagnoses. treatment options, and nursing care.
Conclusion. The transition of the fetus from the womb to extrauterine life is one of the dynamic and vital adaptations in the life of neonates, especially premature neonates. With comprehensive monitoring and skillful clinical assessment, patent ductus arteriosus in neonates can be better managed.
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