Abstract
Aim. This review study was conducted to explain the causes of prehospital delay in Iranian people experiencing myocardial infarction.
Background. While rapid diagnosis and treatment of myocardial infarction reduces mortality, improves heart function and most importantly, improves the patient's prognosis, studies show that some people experiencing the symptoms of myocardial infarction return to medical centers with delay.
Method. In this review study, SID database was used to search out articles published from 2001 to 2019. The keywords “acute myocardial infarction” and prehospital delay” was uysed to searching out the articles. Articles with accessible full text were reviewed in this study.
Findings. The review of articles related to the factors of prehospital delay in Iranian people experiencing  acute myocardial infarction included expecting spontaneous recovery, attributing the disease to non-cardiovascular causes, unawareness of the symptoms of cardiovascular disease, not paying attention to the symptoms of the disease and taking medication arbitrarily, having an underlying disease such as diabetes, low level of pain in the onset, sex, old age, low education, low income, place of residence, insignificance of pain, being alone at the time of acute myocardial infarction, onset of symptoms from midnight to early morning, negative history of heart disease, and the gradual onset of symptoms.
Conclusion. The results of this review showed that the most important factors in prehospital delay of Iranian people experiencing myocardial infarction individual factors and misunderstanding of the disease. Health care team should work to improve public awareness of the signs and symptoms of cardiovascular disease.
 

Abstract
Aim. The aim of this study was to review the effect of music as a non-invasive, non-pharmacological, inexpensive method with no side effects, on people with heart disease
Background. Heart disease is a common disease with considerable annual mortality. This review study investigates studies to bring a comprehensive view about the effect of music therapy on recovery of people with heart disease.
Method. This study was a narrative review in which studies in Persian and English language were searched out in databases/ search engines Magiran, SID, IranMedex, Pubmed, Scopus, and Google Scholar using the keywords music therapy, heart failure, acute coronary syndrome, hypertension, hypertension, heart surgery and open heart surgery. Inclusion criteria included articles being published in Persian or English language that examined the effect of music on recovery of people with heart disease. There was no time limit for articles under review. Exclusion criteria included articles that their full text were not accessible.
Findings. Out of 24 articles, the most of them (10 articles) examined the effect of music on hypertensive patients and on vital signs in heart patients (8 articles). The results showed that the effect of music on the recovery of heart patients included increasing the percentage of oxyhemoglobin saturation, relieving pain, reducing anxiety and depression, improving sleep quality and reducing fatigue. The music had no effect on mean arterial pressure and respiration. There were conflicting results regarding the effect of music on blood pressure and heart rate.
Conclusion. Considering the easy and cost-free application of this method, it is recommended that the health care team and especially nurses use this non-invasive method in the care of people with heart disease.

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.

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.

Abstract
Aim. The aim of this study was to determine the attitudes of intensive care unit nurses towards communicating with unconscious or conscious intubated patients unable to speak.
Background. Communication is one of the most important tools in patient care and is more important in intensive care units because many patients are unable to communicate verbally due to illness or treatment.
Methods. This descriptive cross-sectional study was conducted on 174 nurses working in intensive care units. They were selected by convenience sampling method. Data were collected by a researcher-made questionnaire through self-report. This questionnaire had two sections of views on communication with unconscious or conscious intubated patients unable to talk and factors related to non-communication with these patients which was completed either in paper or electronic form. The data were analyzed in SPSS version 26 using descriptive statistics and Pearson correlation.
Findings. The results showed that the majority of the studied units (94.3 percent) had a positive attitude towards communicating with patients with speech disabilities admitted to intensive care units. It was also found that large number of patients, nurse's reluctance to work in intensive care units, loading of unprofessional tasks, psychological fatigue, and no mastery in communicative skills are more associated with communicating with this group of patients.
Conclusion. According to the positive attitude of nurses towards communicating with unconscious or conscious intubated patients unable to speak, this positive attitude can be used to improve nurses' communication performance. In addition, it is necessary to improve the quality and quantity of communication with patients with speech problems through management measures to control some factors related to communicating with patients with speech impediments.

Abstract
Aim. This study examines the relationship of COVID-19 infection with demographic characteristics of the staff at Rajaie Cardiovascular Institute during the first six months of the epidemic.
Background. The COVID-19 virus was first identified in December 2019 in China and then rapidly spread to other countries. One of the challenges that arose during the COVID-19 pandemic was human resource management. This led managers to prioritize protecting and managing employee health and safety.
Method. This descriptive-analytical study was conducted on the staff of the Rajaei Cardiovascular Institute who were infected with COVID-19 between February and September 22, 2020. Demographic characteristics and clinical variables of the patients were collected using clinical records, interviews with the infected individuals, and phone calls. Data analysis was performed using SPSS software version 22.
Findings. Over six months, 448 individuals with a mean age of 38.86 years contracted COVID-19. Among them, 280 individuals (62.5 percent) were female. A total of 155 employees (67.1 percent) developed symptoms of the disease within one to five days after contact with an infected person. Additionally, 206 employees (48.4 percent) used all three protective measures—masks, gloves, and social distancing. Contact with an infected individual was observed as the most common method of disease transmission. The most common symptoms among the infected were myalgia, weakness, and fever, with only 3.5 percent requiring hospitalization.
Conclusion. Most patients, despite following health and personal protection guidelines, contracted COVID-19. Therefore, it seems that in addition to adhering to health guidelines,  vaccination is also an important necessity to prevent the spread of COVID-19. Other factors, such as changes in virus strains and people's failure in following health protocols, also contribute to the spread of the disease.

Abstract
Aim. This study aimed to examine the effect of implementing a risk management program on pharmaceutical calculation skills of nurses in cardiac care units.
Background. Patient safety and the early detection of medication errors are indicators of the quality of care. Risk management, through a systems-based approach, is an important strategy for preventing medication errors and harm to patients.
Method. This was a semi-experimental study. The study population was staff nurses working in the cardiac care units of Milad Hospital in Isfahan. Sixty nurses working in cardiac care units were selected based on inclusion criteria using a convenience sampling method, and they were randomly assigned to experimental and control groups. The intervention group participated in a risk management program delivered in eight 2-hour sessions, two sessions per week. The control group received the hospital training program. Data collection instruments included demographic form and nurses’ pharmaceutical calculation skills questionnaire, which were completed at the beginning and two weeks after the study. Data were analyzed in SPSS 21.
Findings. Before the study, there were no statistical significant differences between the two groups in pharmaceutical calculation skills, interest, ability, need for training, ease of pharmaceutical calculation skills, and medication errors. The mean score of the pharmaceutical calculation skills was in the “good” level. After the study, in the intervention group the nurses’ pharmaceutical calculation skills, ease of calculations, and ability increased significantly (p≤0.0001), whereas there was no significant change in the control group. After the study, the difference in pharmaceutical calculation skills between the intervention and control groups was significant (p≤0.0001).
Conclusion. Implementation of the risk management program significantly enhances nurses’ pharmaceutical calculation skills and is suggested as a strategy for promoting safe medication administration by nurses and achieving high-quality nursing care.
 

Abstract
Aim. This systematic review aimed to investigate the role of nurses in using artificial intelligence to monitor medication use and therapeutic behaviors in patients with cardiovascular disease.
Background. With the increasing complexity of cardiac care and cardiac patient medication regimens, the use of artificial intelligence as a clinical decision support tool, especially in the nursing profession, has become increasingly important. This technology can play an effective role in monitoring cardiac medication use, reducing medication errors, and improving patient treatment behaviors.
Method. This study was conducted as a systematic review. Electronic databases including CINAHL, Medline, Google Scholar, Web of Science, Scopus, and SID were searched for relevant articles published between 2020 and 2025. Studies meeting predefined inclusion and exclusion criteria were selected, and their quality was assessed using the Joanna Briggs Institute appraisal tools. A total of 17 articles were included in the final analysis.
Findings. The results suggest that AI-based systems, including machine learning algorithms, neural networks, and risk prediction models, can help improve cardiac safety, monitor vital signs, and increase patient compliance with prescribed treatments. However, challenges were identified, such as nurses' resistance to technology, ethical concerns, threats to professional identity, lack of infrastructure, and issues related to data security and privacy.
Conclusion. Artificial intelligence demonstrates substantial potential to enhance nursing care quality, patient safety, and medication monitoring. Nevertheless, successful integration requires a human-centered approach, targeted education for nurses, organizational support, and preservation of clinical judgment.