The effect of simulation-based education on nursing students� knowledge and performance of adult basic cardiopulmonary resuscitation: A randomized clinical trial

Background & Aim: Cardiopulmonary arrest as a life-threatening condition needs urgent interventions to protect individuals� life and prevent irreversible damages to vital organs. This study aimed to investigate the effect of simulation-based education on the knowledge and performance of nursing students of adult essential life support cardiopulmonary resuscitation (BLS-CPR). Methods & Materials: This study used a pretest-posttest study with a control group. It was conducted at Iran University of medical sciences, Tehran, Iran, in 2017. In this study, 49 nursing students at the sixth education semester were assigned using the simple random allocation into two groups of intervention (n=28) and control (n=21). Initially, the conventional BLS education was provided to the two groups of intervention and control using the conventional method. Next, the intervention group received a simulation-based education. The knowledge and performance of the students before, immediately after, and three months after the intervention was assessed using a modified knowledge assessment questionnaire and a modified performance evaluation checklist about BLS in adults. Results: The students� knowledge in the intervention group immediately after (p<0.001) and three months after the intervention (p<0.05) were significantly higher than the control group. The mean scores of performance immediately after (p<0.001) and three months after the intervention (p<0.001) were significantly higher than the control group. Conclusions: Simulation-based education increased the knowledge and performance of nursing students in the field of BLS-CPR. According to the results, integrating conventional training with simulation-based education can be effective in learning BLS among nursing students. © 2020, Tehran University of Medical Sciences. All rights reserved

Home healthcare in Iran: A hybrid concept analysis

Background: Healthcare is changing from a focus on acute care health issues to one of managing chronic conditions. This change has resulted in the development of home health-care systems as a way of managing chronic conditions outside the hospital. The aim of this study was to analyze the concept of home healthcare using a hybrid model. Materials and Methods: This hybrid concept analysis consisted of three phases: theoretical, fieldwork, and analytical. Science Direct, PubMed, ProQuest, and Scopus were searched with related terms in the theoretical phase. In the fieldwork phase, six professionals with experience in home healthcare were interviewed and after each interview, qualitative content analysis was conducted. During the final phase, descriptions and themes from the first two phases were combined. Results: In the theoretical phase, the definition of home healthcare included descriptions answering the Who, What, When, Where, and Why questions. In the fieldwork phase, the results were divided into three areas: 1-comprehensive care; 2-extent of services; and 3-outcomes. The final analysis phase of this study indicated that the home health-care concept is a comprehensive, professional, and holistic care system accompanied by medical services and professionals whose goals are to support an individual's health and provide care in their home. Healthcare provided in one's home was found to preserve a patient's dignity and reduce health-care costs. Conclusions: The definition of the home healthcare concept establishes a foundation for developing a comprehensive home health-care system. This concept analysis for home healthcare could be a guide for future studies. © 2021 Wolters Kluwer Medknow Publications. All rights reserved

The impact of social network-based nursing care training on oncology nurses� occupational stress and self-efficacy: Non-randomized clinical trial

Background & Aim: Inadequate clinical knowledge is one of the leading causes of stress and low occupational self-efficacy among nurses. Nursing training can enhance self-efficacy and reduce stress. Therefore, this study aimed to determine the effect of social network-based nursing care training, using mobile phones, occupational stress, and self-efficacy among oncology nurses. Methods & Materials: This non-randomized clinical trial study was conducted on 78 nurses working in oncology wards of two selected educational hospitals in Tehran in 2018. The nurses entered the study through available sampling. They were randomly assigned to two groups of control and intervention. Nursing care training in chemotherapy was provided to the nurses in the intervention group through a mobile phone social network for four weeks. On the other hand, the nurses in the control group were provided with the routine training pamphlets and brochures in the oncology ward. The nurses� stress level was examined using an expanded nursing stress scale and their occupational stress was measured using a job self-efficacy questionnaire once before the intervention and then one month after the intervention. The data analysis was then performed according to independent t-test, paired t-test, and chi-square using SPSS software version 16. Results: The two groups were homogeneous in terms of age, gender, work experience, and education. There was no significant difference in terms of occupational stress and self-efficacy between the two groups before the intervention (P<0.05). The changes in the occupational stress score were statistically significant (P<0.05) among the nurses in the intervention group. Moreover, the changes in the occupational self-efficacy score were statistically significant among nurses in the intervention group compared to the control group (P<0.05). Conclusion: Educational intervention through social networking can lead to a reduction of occupational stress and an increase in self-efficacy among oncology nurses. Reducing stress and increasing nurses� occupational self-efficacy will improve their performance at the bedside. This is an easy, inexpensive, and effective training method that can be used by health managers and educators to enhance employee�s performance. © 2021, Tehran University of Medical Sciences. All rights reserved

Comparison of Single and Combined Effects of Nature Sounds and Foot Sole Reflexology Massage on the Level of Consciousness in Traumatic Comatose Patients: A Randomized Controlled Clinical Trial

Consciousness disturbances are the most common posttraumatic complications. The purpose of this study was to compare the single and combined effects of nature sounds and foot sole reflexology massage on level of consciousness in traumatic comatose patients. This randomized controlled clinical trial was conducted in 2 teaching hospitals in an urban area of Iran. Samples were 120 traumatic comatose patients who were randomly assigned into control, nature sounds, foot reflexology massage, and nature sounds plus foot sole reflexology massage groups. Patients in all groups received routine care. Interventions were performed twice a day for 2 weeks, each time for 30 minutes. The patients' level of consciousness was assessed using the Glasgow Coma Scale before, 1 week, and 2 weeks after the intervention. The groups had no significant differences in the mean scores of the consciousness level before, 1 week after, and the last day of the intervention. Also, there was a significant difference in the number of patients who regained full consciousness (P =.001) in the intervention groups compared with the control group. Significant differences in the number of days of consciousness were reported in at least one of the groups compared with other groups (P =.001). This difference was significant in the control group compared with the foot reflexology massage group (P =.032), as well as the nature sounds plus foot sole reflexology massage group (P =.001). Single or combined interventions can increase the level of consciousness in comatose patients and reduce the duration of coma. © 2019 Wolters Kluwer Health, Inc

Factors affecting nursing error communication in intensive care units: A qualitative study

Background: Error communication includes both reporting errors to superiors and disclosing their consequences to patients and their families. It significantly contributes to error prevention and safety improvement. Yet, some errors in intensive care units are not communicated. Objectives: The aim of the present study was to explore factors affecting error communication in intensive care units. Design and participants: This qualitative study was conducted in 2019. Participants were 17 critical care nurses purposively recruited from the intensive care units of 2 public hospitals affiliated to Iran University of Medical Sciences, Tehran, Iran. Data were collected through in-depth semi-structured interviews and were analyzed through the conventional content analysis method proposed by Graneheim and Lundman. Ethical considerations: The Ethics Committee of Iran University of Medical Sciences, Tehran, Iran approved the study (code: IR.IUMS. REC.1397.792). Participants were informed about the study aim and methods and were ensured of data confidentiality. They were free to withdraw from the study at will. Written informed consent was obtained from all of them. Findings: Factors affecting error communication in intensive care units fell into four main categories, namely the culture of error communication (subcategories were error communication organizational atmosphere, clarity of processes and guidelines, managerial support for nurses, and learning organization), the consequences of errors for nurses and nursing (subcategories were fear over being stigmatized as incompetent, fear over punishment, and fear over negative judgments about nursing), the consequences of errors for patients (subcategories were monitoring the effects of errors on patients and predicting the effects of errors on patients), and ethical and professional characteristics (subcategories were ethical characteristics and inter-professional relationships). Discussion: The results of this study show many factors affect error communication, some facilitate and some prohibit it. Organizational factors such as the culture of error communication and the consequences of error communication for the nurse and the patient, as well as individual and professional characteristics, including ethical characteristics and interprofessional relationship, influence this process. Conclusion: Errors confront nurses with ethical challenges and make them assess error consequences and then, communicate or hide them based on the results of their assessments. Health authorities can promote nurses� error communication through creating a supportive environment for them, developing clear error communication processes and guidelines, and providing them with education about the principles of ethical practice. © The Author(s) 2020

The effects of music intervention on background pain and anxiety in burn patients: Randomized controlled clinical trial

This study aimed to investigate the effect of music on the background pain, anxiety, and relaxation levels in burn patients. In this pretest-posttest randomized controlled clinical trial, 100 hospitalized burn patients were selected through convenience sampling. Subjects randomly assigned to music and control groups. Data related to demographic and clinical characteristics, analgesics, and physiologic measures were collected by researcher-made tools. Visual analog scale was used to determine pain, anxiety, and relaxation levels before and after the intervention in 3 consecutive days. Patients' preferred music was offered once a day for 3 days. The control group only received routine care. Data were analyzed using SPSS-PC (V. 20.0). According to paired t-test, there were significant differences between mean scores of pain (P <.001), anxiety (P <.001), and relaxation (P <.001) levels before and after intervention in music group. Independent t-test indicated a significant difference between the mean scores of changes in pain, anxiety, and relaxation levels before and after intervention in music and control groups (P <.001). No differences were detected in the mean scores of physiologic measures between groups before and after music intervention. Music is an inexpensive, appropriate, and safe intervention for applying to burn patients with background pain and anxiety at rest. To produce more effective comfort for patients, it is necessary to compare different types and time lengths of music intervention to find the best approach. © 2015 by the American Burn Association

The challenges of using physical restraint in intensive care units in Iran: A qualitative study

Background: Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. Aim: This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. Methods: This qualitative study was conducted in 2018�2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Findings: Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Conclusion: Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues. © The Intensive Care Society 2019

Nurses� knowledge, beliefs and practices towards hand hygiene

Background & Aim: Nurses� hands are important channels of microorganisms transmission and hospital acquired infections. This study aimed to investigate knowledge, beliefs and practices of nurses regarding hand hygiene. Methods & Materials: This was a cross-sectional study conducted in 2012. All nurses (n=282) working in three hospitals of Lorestan University of Medical Sciences participated in the study. Data were gathered using a demographic form, social desirability questionnaire, and hand hygiene knowledge, belief and practice questionnaire. Data were analyzed through descriptive and statistical tests (Independent ttest, ANOVA, Pearson Coefficient) in the SPSS-PC (v.21.0). The level of significance was set at below 0.05. Results: The mean scores of nurses� hand hygiene knowledge, beliefs and practices were 4.6±2.00, 3.8±0.40, and 4.33±0.50, respectively. Nurses washed their hands after contact with patients more often in compare with prior to contact with patient. There was a statistically positive and significant correlation between nurses� practice in required situations and nurses� beliefs regarding hand hygiene. Conclusion: According to the results, nurses� knowledge regarding hand hygiene was low; and hand hygiene practice in required situations was undesirable. Many nurses had negative and false beliefs regarding hand hygiene. Based on these results, it is necessary to plan programs to increase nurses� knowledge, belief and practice regarding hand hygiene. © 2015, Tehran University of Medical Sciences (TUMS). All rights reserved

Gender specific variations in the description, intensity and location of Angina Pectoris: A cross-sectional study

Background: Some research suggests that men and women may experience Angina Pectoris (AP) differently. More research is needed to characterize AP symptoms by gender and to familiarize health care providers with them, to enable proper education, diagnostic evaluation and timely management. Objective: This study examines gender differences in the description, intensity and location of AP in patients with CHD. Design: A cross-sectional study was performed to compare AP patients according to gender. Settings: This study was performed on patients residing in Tehran, who were being treated in a hospital and were admitted to cardiac units. Participants: Five hundred patients with AP were selected. The participants were patients with AP who were diagnosed with CHD based on documented results from an angiography. Method: Outpatients who were admitted to the cardiac units were screened. Informed consent was obtained from all study participants, who then completed the Iranian version of the AP characteristics questionnaire. Results: Women were significantly more likely to feel pain in the left arm and hand, odds ratio 1.5 (95 CI = 1.0-2.1, P = 0.04), left scapula, odds ratio 2.3 (95 CI = 1.6-3.5, P < 0.001), and neck, odds ratio 2.8 (95 CI = 1.9-4.1, P < 0.0001), while controlling for demographic and clinical factors. Women were significantly more likely to choose the possible pain descriptors for describing their AP and reported significantly greater intensity than men for all the pain descriptors. Significantly higher scores for sensory, affective, total and NRS (Numeric Rating Scale) scores were observed in women (P < 0.001). Multiple linear regression analyses revealed that gender remained a statistically significant predictor of pain scores and NRS, while controlling for demographic and clinical factors. Conclusion: Women and men differ with respect to description, intensity and location of AP. Educating the general public and informing health care providers about gender variation in AP may help to decrease delays in seeking medical care. © 2010 Elsevier Ltd