بررسی میزان دانش و عملکرد پرستاران بخش اورژانس درباره تریاژ داخل بیمارستانی

Introduction: Determining patients’ treatment priority based on the severity of their condition, and choosing the best treatment for the highest possible number of patients in the shortest time is called triage. Although triage has only been used in Iranian hospitals since a few years ago, almost all hospital emergency services over the country currently have this unit. Nurses are responsible for triaging patients, but there is little data on their knowledge and quality of practice in this regard. Therefore, this study was aimed to assess the knowledge level and practice of emergency department (ED) nurses regarding hospital triage. Methods: This study is a prospective cross-sectional one, carried out with the aim of evaluating the knowledge level and practice of nurses regarding hospital triage. Simple random sampling was used to select ED nurses from teaching hospitals in Yazd province. Data were gathered using a questionnaire, validity and reliability of which had been confirmed before. The questionnaire comprised of 3 parts, 11 demographic questions, 15 questions evaluating knowledge, and 10 assessing practice. Data were analyzed using SPSS 16.0 and descriptive and inferential statistical tests.  Results: A total of 45 questionnaires were filled and gathered. 62.2% of cases were male with the mean age of 35.92 ± 5.74 years, and 37.8% were female with the mean age of 30.82 ± 7.37 years. Mean age of all participants was 34 ± 6.80 years. Mean work experience of the studied nurses was 10.07 ± 6.89 years and their mean work experience in ED was 5.31 ± 4.70 years. Evaluation of the second part, regarding their knowledge, revealed that 42.07% of the answers to the questions were correct and their mean score was 6.33 ± 1.96. In addition, their practice assessment showed that 50.44% of the answers given in this part were right and their mean score in this regard was 5 ± 1.47. In total, 45.33% of the answers given by the participants were correct regarding the scenarios. Mean overall score (sum of the scores obtained from knowledge and practice parts) for the participants was 11.33 ± 2.50. Statistical analysis found a significant correlation only between the working shift and the knowledge score (p = 0.003). Conclusion: It seems that the knowledge and experience of the nurses working in EDs of centers under supervision of Shahid Sadoughi University of Medical Sciences, Yazd, Iran, regarding triage, is below average. Consequently, it is suggested to hold special retraining courses in the field of triage for the staff in order to improve the quality of care. مقدمه: اولویت بندی بیماران برای ارایه خدمات بر اساس شدت آسیب و انجام بهترین اقدام درمانی برای بیشترین افراد در کمترین زمان را تریاژ می گویند. هرچند سابقه راه اندازی تریاژ بیمارستانی در ایران به چند سال اخیر بر می گردد ولی امروزه تقریبا تمام اورژانس های بیمارستانی در کشور دارای این واحد در ساختار خود هستند. مسوولیت انجام تریاژ بر عهده پرستاران گذاشته شده است ولی اطلاعات اندکی از میزان دانش و عملکرد ایشان درباره تریاژ در دسترس می باشد. لذا این مطالعه با هدف تعیین میزان آگاهی و عملکرد پرستاران بخش اورژانس درباره تریاژ بیمارستانی انجام گرفته است. روش کار: این مطالعه از نوع مقطعی آینده نگر می باشد که به منظور بررسی میزان دانش و عملکرد پرستاران در زمینه تریاز بیمارستانی صورت گرفت. نمونه گیری به روش تصادفی ساده و از پرستاران بخش اورژانس بیمارستانهای آموزشی استان یزد انتخاب گردید. جمع آوری داده ها با استفاده از پرسشنامه ای که روایی و پایایی آن قبلا مورد تایید قرار گرفته بود صورت گرفت. این پرسشنامه در سه قسمت مشتمل بر 11 سوال دموگرافیک، 15 سوال ارزیابی دانش و 10 سوال ارزیابی عملکرد بود. داده ها با استفاده از آزمون های آماری توصیفی و استنباطی و نرم افزار آماری SPSS 16.0 مورد تجزیه و تحلیل قرارگرفتند. يافته ها: در مجموع 45 پرسشنامه تکمیل و جمع آوری شد. 2/62 درصد نمونه ها مرد با میانگین سنی 74/5 ± 92/35 سال و 8/37 درصد زن با میانگین سنی 37/7 ± 82/30 سال بودند. میانگین سنی کلیه پرستاران مورد مطالعه نیز 80/6 ± 34 سال بود. میانگین سابقه کار پرستاران مورد مطالعه به طور کل 89/6 ± 07/10 سال و میانگین سابقه کاری ایشان در بخش اورژانس 70/4 ± 31/5 سال بود. بررسی نتایج بخش دوم پرسشنامه که مربوط به میزان دانش پرستاران بود نشان داد که 07/42 درصد پاسخ های داده شده به این بخش صحیح بوده و میانگین نمرات نمونه های مورد پژوهش 96/1 ± 33/6 بود. همچنین بررسی نتایج میزان عملکرد پرستاران نیز نشان داد که 44/50 درصد پاسخ های داده شده به این بخش صحیح بوده و میانگین نمرات کسب شده در این زمینه 47/1 ± 5 بود. در مجموع 33/45 درصد پاسخ های پرستاران شرکت کننده در پژوهش به آزمون مربوط به سناریو ها صحیح بود. میانگین نمره کل (مجموع بخش میزان دانش و عملکرد) شرکت کنندگان نیز معادل 50/2 ± 33/11 بدست آمد. آنالیز آماری تنها ارتباط معنی داری را بین شیفت کاری و نمره مربوط به میزان دانش پرستاران در زمینه تریاژ (003/0p =) نشان داد. نتيجه گيری: به نظر می آید میزان آشنایی و احاطه پرستاران شاغل در بخش های اورژانس مراکز تحت پوشش دانشگاه علوم پزشکی شهید صدوقی یزد در خصوص تریاژ در سطح کمتر از متوسط قرار دارد. در این راستا برگزاری دوره های باز آموزی مخصوص تریاژ برای پرسنل به منظور ارایه خدمات با کیفیت بالا پیشنهاد می شود

Requirements for nurse supervisor training: A qualitative content analysis

Background: Supervisors should have certain characteristics and adequate preparation for their roles. Yet, there are no well-educated experts knowing about the supervisor's role and responsibilities and how to train them. So, this research was conducted with the purpose of finding the factors affecting nursing supervisor training. Materials and Methods: This research is an inductive content analysis. Participants were 25 in number, consisting of nurses and supervisors in Shahid Sadoughi University hospitals. The participants were chosen by a purposive sampling method. Data collection was done by semi-structured interviews and reviewing documents. Data were analyzed using conventional content analysis. Results: Findings included two main themes: Firstly, establishment of a supervisory infrastructure that includes “making the appointments and retention of supervisors, clarifying the duties and authority of supervisor, developing supervisory culture, specializing supervision, and conducting practice-based training” and secondly, comprehensive supervisory competencies that include “acquiring scientific, managing, communicative, professional, ethical, pedagogical, and supporting adequacy.” Conclusions: Clinical supervisor has a major role in ensuring the quality of nursing care. This leads to improvements in patient care and nurses' personal and professional development. So, it is necessary that for effective supervision in nursing, first an infrastructure is provided for supervision and then the comprehensive competency of a supervisor is enhanced to apply effective supervision

Comparison of the Effect of Yakson Touch and Oral Glucose on the Severity of Phlebotomy Pain in Preterm Infants

Background: Infants are exposed to different painful procedures during hospitalization in the neonatal intensive care unit (NICU). Due to the harmful effects of pain on infants, NICUs require methods by the aid of which the pain in infants can be controlled. Yakson touch and oral glucose are among non-pharmacological methods for pain relief in infants. In this regard, the present study was conducted to compare the effect of Yakson touch and oral glucose on the severity of phlebotomy pain in preterm infants.Methods: In this randomized clinical trial, 99 preterm infants hospitalized in NICU were randomly allocated to three groups, including Yakson touch (n=33), oral glucose (n=33), and control (n=33). In the oral glucose group, 1 cc of 50% glucose was orally given to the infants 1 min before phlebotomy. In the Yakson touch group, touching was performed for 5 min, and then the phlebotomy was performed. The infants in the control group did not receive a specific treatment. Infant pain level was determined before and after the phlebotomy using video recording based on Neonatal Infant Pain Scale. The data were analyzed using the analytical statistical tests, including the analysis of variance, Chi-square, Wilcoxon, and Kruskal-Wallis, in SPSS software (version 20).Results: The mean scores of pain in the two experimental groups were significantly lower than that of the control group (P=0.001), but there was no significant difference between the two experimental groups (P>0.05).Conclusion: According to our findings, both two methods (i.e., Yakson touch and oral glucose) can reduce phlebotomy pain in preterm infants hospitalized in intensive care unit. It is recommended to use Yakson touch in case of lack of access to glucose

The Relationship between Disability and Quality of Life in Multiple Sclerosis Patients

Background: Disability is the most important determinants of disease course, treatment and rehabilitation outcomes and consequently the quality of life in patients with multiple sclerosis. The aim of the present study was to determine the relationship of disability and quality of life in multiple sclerosis patients. Methods: This cross-sectional study was performed on 325 patients referred to the physiotherapy unit of the Multiple Sclerosis Society of Iran (Tehran). Data collection tools were MSQOL-54 questionnaire for evaluating quality of life and Expanded Disability Status Scale (EDSS) for assessing the degree of disability. Data analysis was performed through SPSS16 and using t-test, chi-square test and linear regression. Results: Mean age of patients was 39.1± 10.4 years. Among 14 domains of quality of life, the highest score was related to pain (67.8 ± 25.7) and the least was related to role limitations due to physical problems (31 ± 17.1). Linear regression model showed significant negative effect of disability on both physical and mental health domains of quality of life (P <0.001). Conclusion: The present study showed the association between disability and factors such as age of disease onset and gender and quality of life in multiple sclerosis patients. Therefore supportive care to reduce disability and maintain patients’ functions at the highest possible level, particularly in women and patients with later age of disease onset, in order to improve the quality of life is recommended. Keywords: Disability, Quality of life, Multiple sclerosis, MSQOL-5

Correlation between medication errors with job satisfaction and fatigue of nurses

Background: Medication errors which can cause several medical malfunctions, have been in the spotlight recently. Job satisfaction and fatigue seems to be related to the increase of medication errors in nursing. Objective: This study aimed to determine the correlation between the amount and type of medication errors with job satisfaction and fatigue of nurses working in Shahid Sadoughi hospital in Yazd-Iran. Methods: This is a descriptive study by a cross-sectional and correlational approach conducted on all the nurses working in an educational hospital who have characteristics of samples. Participants were 170 nurses working in Shahid Sadooghi hospital in Yazd, Iran in 2012. The questionnaires of demographic characteristics, medication administration error and nurses' job satisfaction and fatigue by purposive sampling were used for gathering data. Validity and reliability were checked for internal consistency and stability. Data were analysed by SPSS version 17 using Pearson correlation coefficient and Independent-samples t-test. Results: The findings did not illustrate a significant relationship between job satisfaction and fatigue with medication errors. Among the demographic characteristics, age of nurses was significantly associated with the frequency of medication errors (p=0.037). However, others were not significantly correlated (p>0.05). Conclusion: In spite of the findings, based on no significant statistical relationship between job satisfaction and fatigue with the type and amount of medication errors in nursing, the effect of these variables on medication errors cannot be disregarded; thus further studies in this area are suggeste

Knowledge and Practice of Nurses Regarding Patients’ Triage in Emergency Department

Introduction: Determining patients’ treatment priority based on the severity of their condition, and choosing the best treatment for the highest possible number of patients in the shortest time is called triage. Although triage has only been used in Iranian hospitals since a few years ago, almost all hospital emergency services over the country currently have this unit. Nurses are responsible for triaging patients, but there is little data on their knowledge and quality of practice in this regard. Therefore, this study was aimed to assess the knowledge level and practice of emergency department (ED) nurses regarding hospital triage. Methods: This study is a prospective cross-sectional one, carried out with the aim of evaluating the knowledge level and practice of nurses regarding hospital triage. Simple random sampling was used to select ED nurses from teaching hospitals in Yazd province. Data were gathered using a questionnaire, validity and reliability of which had been confirmed before. The questionnaire comprised of 3 parts, 11 demographic questions, 15 questions evaluating knowledge, and 10 assessing practice. Data were analyzed using SPSS 16.0 and descriptive and inferential statistical tests.  Results: A total of 45 questionnaires were filled and gathered. 62.2% of cases were male with the mean age of 35.92 ± 5.74 years, and 37.8% were female with the mean age of 30.82 ± 7.37 years. Mean age of all participants was 34 ± 6.80 years. Mean work experience of the studied nurses was 10.07 ± 6.89 years and their mean work experience in ED was 5.31 ± 4.70 years. Evaluation of the second part, regarding their knowledge, revealed that 42.07% of the answers to the questions were correct and their mean score was 6.33 ± 1.96. In addition, their practice assessment showed that 50.44% of the answers given in this part were right and their mean score in this regard was 5 ± 1.47. In total, 45.33% of the answers given by the participants were correct regarding the scenarios. Mean overall score (sum of the scores obtained from knowledge and practice parts) for the participants was 11.33 ± 2.50. Statistical analysis found a significant correlation only between the working shift and the knowledge score (p = 0.003). Conclusion: It seems that the knowledge and experience of the nurses working in EDs of centers under supervision of Shahid Sadoughi University of Medical Sciences, Yazd, Iran, regarding triage, is below average. Consequently, it is suggested to hold special retraining courses in the field of triage for the staff in order to improve the quality of care