A comparison between the risk of needle stick injuries among nurses in emergency wards and nurses in other wards of hospitals

Background and Aim: Nursing work in emergency departments is tangled with unbearable hardship and high working pressure as well as an increased risk of occupational injuries. Needle stick injury is among such risks. Incidence of these injuries differs in different hospital wards. This study aimed to determine needle stick injury risks in emergency ward in comparison with other wards of Qazvin hospitals in 2010. Materials and Methods: This historical cohort study was done on nursing staff working in Qazvin hospitals. Statistical population included nursing staffs at Qazvin hospitals who were responsible for direct patient care. From among nurses working in the emergency wards, 52 were selected. Control group consisted of 258 nurses who had worked in other wards of the same hospitals. The research instrument was a self-administered questionnaire. To determine validity and reliability of the Instrument, content validity and test-retest were performed. The collected data was analyzed using Independent t test, Mann-Whitney, Chi-Square, Fisher Exact Test, and Logistic Regression through SPSS (version 16) at 0.05. Results: Risk of injury in emergency ward was three times more than other wards (p<0.01). The average numbers of beds in emergency wards and in other wards were 24.2±.6.7 and 18.1± 10.7 respectively. Nonetheless, number of nurses on different shifts in emergency wards, especially in the evening shift, was significantly lower (p<0.05). However, according to logistic regression analysis, the work in emergency ward was an independent risk factor for needle stick injuries (p<0.05). Conclusion: The risk of needle stick injuries among nurses in emergency wards is dramatically higher than other wards. It seems that more beds per nurse affects this increased risk. It is proposed that the number of nurses in emergency departments be increased, especially in the evening shift so that the risk of this serious injury may be reduced

The Effect of Music on Fatigue and Anxiety of Patients Undergoing Hemodialysis

Abstract Introduction: Chronic renal failure is largely asymptomatic complication, which requires dialysis as a time process to control it. On the other hand, due to the high prevalence and progressive maladaptive nature, its progress should be prevented. In addition to various physiological changes, it changes the mental, psychological, and social aspects of patients. Fatigue and anxiety are common nursing diagnoses of patients undergoing hemodialysis. Employment of music as a complementary therapy and an uncomplicated, low-cost, and pleasurable method can be a nursing practice to reduce such complications. The current study aimed at investigating the effect of listening to music on anxiety and fatigue in patients undergoing hemodialysis. Methods: The current clinical trial was conducted on 25 patients as a group randomly selected to participate in the study. Patients listened to music for 30 minutes three times per week, 12 sessions a month, during hemodialysis sessions. Data were collected using three questionnaires: a researcher-made demographic information questionnaire, Beck anxiety inventory (BAI), and fatigue severity scale (FSS). Data were collected by a researcher based on interviewing method. Data were expressed as means ± standard deviation (SD). Data were statistically analyzed with SPSS version 20. The paired t test was used to compare before and after intervention mean valuesbetween the groups. The level of significance was &lt; 0.05. Results: The mean anxiety score of the patients before intervention was 19.6%, indicating a moderate level of anxiety and the mean anxiety score was 14.48% after intervention. The mean fatigue score decreased from 36.8 to 31.2, and remained at moderate levels of fatigue. The reductions were significant (P &lt; 0.05).Conclusions: The results of the current study showed that the employment of music as a complementary therapy was effective on reducing the anxiety and fatigue ofpatients undergoing hemodialysis and utilizing it along with other therapeuticinterventions is recommended

Supra hepatic inferior vena cava and right atrial thrombosis following a traffic car crash

We present a case of nephrotic syndrome associated with right atrial and supra hepatic vein part of inferior vena caval thrombosis. This patient presenting with dyspena, lower extremity edema and back pain after a vehicle accident and blunt trauma to abdomen. Trauma should be considered not only as a thrombophilic pre-disposition, but to be ascertaining as a predisposing factor to IVC endothelium injury and thrombosis formation. Echocardiography revealed supra hepatic vein IVC thrombosis floating to right atrium .C-T scan with contrast also showed pulmonary artery emboli to left upper lobe. With open heart surgery right atrial and IVC clot were extracted and main and left and right pulmonary artery was evaluated for possible clot lodging. The patient had a uneventful postoperative recovery and thrombosis was not occurred with periodical follow-up examination

Quality of Life and Its Related Factors Among Elderly With Diabetes

Objectives: Diabetes is a common chronic disease in the elderly that affects their quality of lives. As &ldquo;quality&nbsp;of life&rdquo; is one of the most important factors and indicators of health, this study examined the &ldquo;quality&nbsp;of life&rdquo; in the diabetic elderly people. Methods & Materials: This descriptive-analytic study was conducted on diabetic elderly people living in&nbsp;Kerman, Iran, in 2013. A total of 120 patients were randomly selected with multistage sampling method.&nbsp;For data collection, the demographic and SF-36 questionnaires were used. Then, the obtained data&nbsp;were analyzed by SPSS version 18 by conducting t-test, correlation coefficient, and analysis of variance&nbsp;(ANOVA). Results:&nbsp;The results showed that the mean age of the subjects was 71.5 years. The total &ldquo;quality of life&rdquo;&nbsp;score of diabetic patients was 46.48. The elderly showed that the highest mean among the 8 dimensions&nbsp;of &ldquo;quality of life&rdquo; in physical health dimension belonged to general health (47.87), and with regard to&nbsp;mental health dimension, the highest score was in social function (49.78). The total score of physical&nbsp;dimension was 44.89, and the total score of mental dimension was 48.07. Furthermore, the results of&nbsp;t-test and 1-way ANOVA indicated that there were significant correlations between &ldquo;quality of life&rdquo; and&nbsp;variables of sex, educational level, complications of diabetes, income, age, duration of diabetes, and&nbsp;body mass index (P&le;0.05). Conclusion: In our society, no normative standard has been set for the &ldquo;quality of life.&rdquo; However, the mean&nbsp;value of 50 with standard deviation of 10 can be an acceptable and standard score for the &ldquo;quality of&nbsp;life&rdquo; among the elderly. The mean score of &ldquo;quality of life&rdquo; among diabetic elderly people in this study&nbsp;was 46.48 which was lower than our standard. Also, in studying the 8 dimensions of &ldquo;quality of life,&rdquo; the&nbsp;mean score of all dimensions was lower than 50. Prevalence of chronic diseases like diabetes among&nbsp;the older people could end in lowering the mean score of physical dimensions as compared to mental&nbsp;dimensions of &ldquo;quality of life.&rdquo; Something that was mentioned in the present study, too.The lower quality&nbsp;of life among women could be due to gender inequality in using health system. As a result, the women&nbsp;are more vulnerable to problems as well as mental and physical diseases which decreases their quality&nbsp;of lives. There was a significant relationship between the educational level of diabetic older people and&nbsp;their quality of lives. Those with higher educational level enjoyed a better quality of life. The effect of&nbsp;higher education on the &ldquo;quality of life&rdquo; could be due to the people&rsquo;sawareness of the importance of&nbsp;diet, exercise, proper medication, and control of risk factors of chronic diseases like diabetes. Furthermore,he higher education could increase quality of life through promotion of social class, increasing income,&nbsp;and self-esteem. Also, the people with higher education, armed with their health knowledge and&nbsp;using self-care methods provide the grounds for increasing their quality of lives.As regards the increasing&nbsp;rate of diabetic patients in ageing population and considering that chronic diseases affect and lower&nbsp;physical and mental aspects of &ldquo;quality of life&rdquo; in older people, and in line with improving the &ldquo;quality&nbsp;of life&rdquo; in these people, we suggest that policymakers and authorities pay proper attention to physical,&nbsp;mental, and social support of this group

Determination of Morphological and Microstructural Properties of Polyacrylonitrile/Single-Walled Carbon Nanotubes Composite Nanofibers

Pure polyacrylonitrile (PAN) nanofibers and functionalized-single walled carbon nanotube (FSWNT), reinforced by PAN nanofibers with variable FSWNT content (up to 1 wt%), were fabricated by electrospinning process. The chemical structure, morphology and microstructure of the electrospun nanofibers have been characterized using Fourier transform infrared (FTIR), scanning electron microscopy (SEM) and X-ray diffraction (XRD). SEM analysis of the nanofibers revealed that the deformation of the nanofibers increased with increasing FSWNT concentration. Very smooth surfaces of the composite electrospun nanofibers even for nanofibers with concentration of 1 wt% FSWNT have been successfully prepared because of the high stability dispersion of FSWNTs. Moreover, with increasing the concentration of FSWNT in the PAN solution from 0 to 1 wt%, the average nanofibers diameter increased from 405 ± 54 nm to 488 ± 50 nm. The recorded spectra from FTIR were close to PAN nanofibers with peaks at 2243 cm-1 (CN stretch), 2932 cm-1 (CH2 stretch), 1450 cm-1 (CH bend) and 1730 cm-1 (C=O stretch) wavenumbers. FTIR Spectroscopy and XRD studies showed that PAN/FSWNT nanofibers exhibited higher crystallinity compared to PAN nanofibers without FSWNT. The analysis of the microstructural properties of the composite nanofibers with 1wt% FSWNT revealed that they exhibit an enhanced crystallinity from 44% to 48%, and the crystallite size was decreased from 25.0 nm to 19.9 nm, as compared to pure PAN nanofibers. The results indicated that the embedded FSWNTs in the PAN nanofibers nucleated the growth of crystals

Device-associated infection rates and bacterial resistance in six academic teaching hospitals of Iran: Findings from the International Nocosomial Infection Control Consortium (INICC)

Summary: Device-associated health care-acquired infections (DA-HAIs) pose a threat to patient safety, particularly in the intensive care unit (ICU). However, few data regarding DA-HAI rates and their associated bacterial resistance in ICUs from Iran are available. A DA-HAI surveillance study was conducted in six adult and pediatric ICUs in academic teaching hospitals in Tehran using CDC/NHSN definitions. We collected prospective data regarding device use, DA-HAI rates, and lengths of stay from 2584 patients, 16,796 bed-days from one adult ICU, and bacterial profiles and bacterial resistance from six ICUs. Among the DA-HAIs, there were 5.84 central line-associated bloodstream infections (CLABs) per 1000 central line-days, 7.88 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator-days and 8.99 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. The device utilization ratios were 0.44 for central lines, 0.42 for mechanical ventilators and 1.0 for urinary catheters. The device utilization ratios of mechanical ventilators and urinary catheters were higher than those reported in the ICUs of the INICC and the CDC's NHSN reports, but central line use was lower. The DA-HAI rates in this study were higher than the CDC's NHSN report. However, compared with the INICC report, the VAP rate in our study was lower, while the CLAB rate was similar and the CAUTI rate was higher. Nearly 83% of the samples showed a mixed-type infection. The most frequent pathogens were Acinetobacter baumannii, Staphylococcus aureus and Pseudomonas aeruginosa, followed by Klebsiella pneumoniae and Enterococcus spp. In the S. aureus isolates, 100% were resistant to oxacillin. Overall resistances of A. baumannii and K. pneumonia to imipenem were 70.5% and 76.7%, respectively. A multiple drug resistance phenotype was detected in 68.15% of the isolates. The DA-HAI rates in Iran were shown to be higher than the CDC-NHSN rates and similar to the INICC rates. Resistance to oxacillin and imipenem was higher as well. Comparing device use, DA-HAI rates, and bacterial resistance for the primary isolated bacteria indicated a direct association between urinary catheter use and the rates of CAUTI. Keywords: Hospital infection, Iran, INICC, International Nosocomial Infection Consortium, Device-associated infection, Bacterial resistanc