Effects of Acupressure on Pain and Vital Signs of Patients After Small Abdominal Surgeries: A Clinical Trial

Background: Several studies have investigated the effect of acupressure on pain and vital signs however the results are inconsistent. Either no study has been conducted on the effect of acupressure on vital signs of post-surgical patients, or it is not available. Objectives: The present study was conducted to assess the effects of P6 acupressure on pain and vital signs of patients following small abdominal surgeries. Patients and Methods: A double-blind randomized controlled trial has been conducted during the first three months in 2012 on patients after small abdominal surgeries in Al-Zahra hospital of Isfahan. Patients who were candidates for small abdominal surgeries and met the inclusion criteria were entered the study and were randomly allocated to the intervention and placebo groups (40 patients in each group). In the intervention group, acupressure was applied to P6 acupoint on both hands. An acuband without a push button was also placed around the patients’ wrist in the placebo (control) group. Acubands were worn for seven hours. Pain and vital signs were assessed prior starting acupressure and once every hour in the first seven hours after regaining consciousness. Data analysis has been conducted with SPSS version 11.5. T test was applied to compare the severity of pain and the mean of vital signs in the two groups. Results: The mean score of pain severity was higher in P6 group at the first and fourth hours following surgery but this score was lower in this group at other times. However, the differences between the mean of pain severity of the two groups were not statistically significant. In total, no significant differences were observed between the vital signs parameters in the two groups at seven hours. Conclusions: This study showed that P6 acupressure had no statistically significant effect on post-operative pain, and vital signs of patients who underwent small abdominal surgeries. Further investigations with larger sampling are suggested

Epidemiology of Patients With Multiple Trauma and the Quality of Their Prehospital Respiration Management in Kashan, Iran: Six Months Assessment

Background: Respiration management is an important and critical issue in prehospital transportation phase of multiple trauma patients. However, the quality of this important care has not been assessed in Iran Emergency Medical Services’ (EMS). Objectives: This study was conducted to investigate the quality of prehospital respiration management in patients with multiple trauma, referred to the Shahid Beheshti Trauma Center, Kashan, Iran. Patients and Methods: This cross-sectional study was conducted in the first six months of 2013. All the 400 patients with multiple trauma, transferred by EMS to the Shahid Beheshti Medical Center, were recruited. The study instrument was a checklist, which was completed through observation. Descriptive statistics were presented. Results: Out of all included individuals, 301 were males (75.2%) and 99 were females (24.8%). The most common mechanism of trauma was traffic accident (87.25%). Furthermore, 71.7% of the patients were injured in head and neck and chest areas. The quality of consciousness monitoring and airway management was desirable in 95% of the cases. However, the quality of monitoring patients’ respiration was only desirable in 42% of the cases. Only 18.6% of the patients received oxygen therapy during prehospital transportation. Conclusions: The quality of monitoring patients’ respiration and oxygen therapy was undesirable in most patients with multiple trauma. Therefore, the EMS workers should be retrained to apply proper respiration management in patients with multiple trauma

Quality of Care for Patients With Traction in Shahid Beheshti Hospital in 2012

Background: With increasing incidence of traumatic fractures, the use of orthopedic intervention such as traction has increased. Inappropriate traction care may cause substantial morbidity and delay the patient rehabilitation. Objectives: This study was conducted to evaluate the quality of care for patients with traction in the orthopedic unit of Kashan's Shahid Beheshti Hospital, Kashan, Iran. Patients and Methods: An observational study was conducted on patients with traumatic fractures of hip and femur bones who were admitted to Kashan's Shahid Beheshti Hospital during the first 6 months of 2012, and for whom skeletal or skin traction was performed. Data was collected using a checklist including questions about personal characteristics and 23 items related to care for patients with tractions. These items were in three domains including caring while establishing traction, recording care and patient’s education. Descriptive statistics were calculated and independent sample t test and Pearson correlation coefficient was used to analyze the data. Results: A total of 100 patients were examined, among them 66% were male. The mean age of patients was 51.16 ± 23.28 years. In total, 47% of the patients were treated via Skin traction and 53% by skeletal traction. Overall, mean score of quality of care was 10.20 ± 2.64. Quality of establishing traction was good in 55% of patients, but the quality of care was poor in the domains of recording care (88%) and patient education (96%). Total mean of quality of care was significantly different between male and female patients (P < 0.02). Conclusions: The quality of care of patients with traction was not optimal. Therefore it is necessary to improve measures in this area

Faculty Members Quality of Work Life in Kashan University of Medical Sciences in 2012

Background: Quality of work life (QWL) is one of the most important factors for motivating humans and improving work. As one of the main assets for a university, faculty members should have a good QWL. However, few studies have been done concerning the QWL in faculty members and there are differing results from these previous reports. Objectives: This study aimed to investigate the faculty members’ QWL in the Kashan University of Medical Sciences. Materials and Methods: This cross-sectional study was conducted on 65 faculty members of the Kashan University of Medical Sciences during 2012. Faculty members were randomly selected from a list that was prepared through the Kashan University of Medical Sciences website. The data-gathering instruments consisted of two parts. The first part consisted of questions concerning demographic information, while the second part was the Walton’s quality of work life questionnaire. For statistical analyses, t-tests and one-way analyses of variance were used. Results: The subjects consisted of 64.6% men, 33.8% were in the medical college, 43.1% lived in a personal house, and 43.1% were instructors. The results of the study showed that faculty members’ overall QWL was 72.98 ± 9.62. No significant differences were observed between the subjects' mean QWL with regard to place of work, scientific ranking, and living location. Conclusions: QWL has an important impact on attracting and retaining employees, thus, it is necessary to pay greater attention to the faculty members’ QWL

Nurses' Evaluation of Their Use and Mastery in Health Assessment Skills: Selected Iran's Hospitals

Background: Health assessment skills are of the most important skills which nurses require. The more precise assessment, the better results would be obtained and the quality of patient care would be improved. However, in Iran, few studies have investigated nurses’ assessment skills. Objectives: This study was aimed to assess nurses' evaluation of the learned skills of health assessment and their use. Materials and Methods: This cross-sectional study was conducted on 200 nurses in Isfahan province hospitals. Data was collected by a questionnaire including demographic data and 120 health assessment skills. Nurses scored their frequency of using and proficiency in skills. Statistical analysis was conducted by ANOVA, Tukey test and independent sample T-tests. Results: The highest level of using and proficiency in skills was related to taking history. Nurses received 87.25% of score in this field. The lowest level of application was in assessment of the urogenital system so that nurses received 16.37% of score in this area. Also the lowest proficiency was in assessment of the nervous system and nurses received 34.58% of score in this area. Conclusions: The level of nurses' proficiency in the health assessment skills was not satisfactory. Modifying the curriculum and cooperating of nurse managers and nursing schools can help to improve the situation

The Quality of Pre-hospital Circulatory Management in Patients With Multiple Trauma Referred to the Trauma Center of Shahid Beheshti Hospital in Kashan, Iran, in the First Six Months of 2013

Background: Circulatory management is a critical issue in pre-hospital transportation phase of multiple trauma patients. However, the quality of this important care did not receive enough attention. Objectives: The aim of this study was to investigate the quality of pre-hospital circulatory management in patients with multiple trauma. Patients and Methods: This was a cross-sectional study conducted in 2013. The study population consisted of all patients with multiple trauma who had been transferred by emergency medical services (EMS) to the central trauma department in Kashan Shahid Beheshti medical center, Kashan, Iran. We recruited a convenience sample of 400 patients with multiple trauma. Data were collected using the circulatory assessment questionnaire and controlling hemorrhage (CAQCH) that were designed by the researchers and were described by using frequency tabulations, central tendency measures, and variability indices. The chi-square test was used to analyze the data. Results: The study sample consisted of 263 males (75.2%); 57.75% had lower levels of education and 28.75% were workers. The most common mechanism of trauma was traffic accident (85.4%). We found that the quality of circulatory management was unfavorable in 61% of the cases. A significant relationship was observed between the quality of circulatory management and type of trauma and staff’s employment status. Conclusions: The quality of pre-hospital circulatory management provided to patients with multiple trauma was unfavorable. Therefore, establishment of in-service training programs on circulatory management is recommended