فهرست مطالب امیر امامی زیدی

As a pandemic disease, Covid-19 has no proven specific treatment. Predicting the patient's condition and preventive treatments are helpful in helping patients recover, so this study was conducted with the aim of investigating the effect of using the MEWS tool in predicting mortality due to covid-19 disease.

This study was conducted by searching Persian scientific databases such as SID, Magiran, Iran medex, with the keywords of mortality, modified early warning system, covid-19, prevention, corona virus and for studies published in in English, the keywords MEWS Score, Mortality, Predicting, covid19, corona virus, modify early warning score are used in Scopus, PubMed, Web of Science, Science Direct and finally Google Scholar. The year limit was not applied to search for articles. Exclusion criteria included review articles and articles without full text.

From the total of 45 searched articles, 15 articles were included in the study. The findings showed that the use of the MEWS tool during the admission of patients with covid-19 helps in predicting the patient's clinical condition and the course of his disease, as well as estimating the adopted treatment process and its effectiveness.

With the proper use and practical training of this tool to nurses and their proper follow-up, timely treatment and proper monitoring of clinical symptoms, the mortality caused by covid-19 can be predicted to a high extent.

 The development of postgraduate nursing education and its transformation needs to know the educational process, awareness of modern methods of its implementation, recognition of material resources and facilities, and awareness of the role and duties of human resources. This integrative review has been conducted with the aim to identify the challenges and strategies of Master of Science in nursing education in Iran.

 In this integrative review, an extensive search of databases such as Iranian Nursing Journals Index (nindex.ir), Iranian Journals Database (magiran), Scientific Information Database (SID), Iranian Research Institute for Information Science and Technology (IranDoc), the Islamic World Science Citation Database (ISC) and the Regional Information Center For Science and Technology (RICeST) was conducted from 1988 (the beginning of the first master's degree in nursing in Iran) to December 4, 2021, using Persian and English keywords related to the aim of the study.

 Altogether, 10 articles from 291 studies were selected. There are several challenges in postgraduate nursing education that nursing educators are looking for solutions to address them. Master nursing education in Iran is not based on goals and mission and graduates do not have a good quality of work. In Iranian universities, the role of the master of nursing in society is not clear and so far, no special review has been made in this regard. Finally, it seems that the master's degree program in nursing in Iran is being implemented without direction and considering the needs of society.

 Developing a coherent theoretical and practical training program in accordance with the needs of the community can be considered as the first step in reforming the program of master of science in nursing education in Iran.

Mortality rate due to intentional and unintentional poisoning is higher in vulnerable older adults than the general population. This study was performed to determine the prevalence of acute poisoning and factors associated with the incidence and severity of this condition in aged people.

A retrospective cross-sectional study was conducted using the medical records of all older adults (> 60 years old) admitted to Qaemshahr Razi Hospital, Mazandaran province due to acute intentional or unintentional poisoning during 2013-2020. Demographic characteristics, poisoning motive, occurrence and type of substance leading to poisoning, clinical signs, and treatment outcome were studied. Data were analyzed using STATA14.

There were 200 cases (mean age: 69.84±8.40 years) with poisoning, including 64.5% men. Unintentional poisonings were seen in 77.5% of the cases. Opium and its derivatives were the most common causes of poisoning. The most common toxins were opium and alcohol. Gastrointestinal poisoning was reported in majority of patients (76.5%). Only 0.5% were discharged after outpatient treatment. The mean duration of hospitalization was 2.2 days and this period was longer in patients poisoned due to concomitant use of several drugs or drug abuse. Intubation, ICU hospitalization, and emergency dialysis were required in 1.5%, 4.5%, and 1.5%, respectively. Death occurred in 0.5% of the patients during hospital stay. 

Unintentional poisoning accounts for a significant proportion of older age poisoning. Further studies are recommended to investigate indirect mortality rates, such as death due to complications after discharge, and socioeconomic burden of poisoning in aged people.

Spiritual Intelligence is one of the factors that can affect psychological well-being and control of anger. This study aims to determine the relationship between Spiritual Intelligence and anger among nurses in emergency units of hospitals affiliated to Kurdistan University of Medical Sciences.

This descriptive correlational study was performed in the emergency departments of hospitals affiliated to Kurdistan University of Medical Sciences in 2021. 250 nurses were selected based on the inclusion criteria of the census method. King Spiritual intelligence questionnaire and Aggressive questionnaire survey were used to collect the data. Data were analyzed by descriptive statistics and inferential statistical methods at a significant level p<0.001.

According to the findings of this study, the mean scores of Spiritual intelligence and
anger among participants in the study were 48/42 ± 14/45 and 38/17 ± 13/52, respectively and  were moderate. Pearson correlation test showed that there is a significant negative relationship between the Spiritual intelligence and the anger of the participants in the study (p<0.001) and Multiple regression test results showed that spiritual intelligence explains 21% of anger changes (p<0.001, F=4/77).

Considering the significant relationship between spiritual intelligence and anger one of the effective strategies in reducing anger can be shifting the attention of nurses towards spiritual intelligence and attempt to promote it.

Ventilator-associated pneumonia is a serious nosocomial infection that can increase the length of stay, prolong the use of mechanical ventilation, and increase the risk of death in patients in the critical care unit. The aim of this study was to evaluate the knowledge of Iranian critical care nurses toward the prevention of ventilator-associated pneumonia in a systematic review.

In this systematic review, an extensive search of databases, such as PubMed, Web of Science, Scopus, Iranmedex, Magiran, SID and Google Scholar search engine using Persian and English keywords related to the aim of the study, was conducted from the earliest to October 17, 2020.

In total, 8 articles from 1822 studies, with 887 nurses and a mean age of 31.80±5.87 years, and work experiences of 62.04±39.48 months in critical care units, were included in this study. In six studies, the level of knowledge of nurses was insufficient. The lowest and highest levels of knowledge were related to the dimensions of "suction through tracheal tube/tracheostomy and drainage of subglottic secretions" and "selection of the appropriate patient position", respectively. In two studies, a direct relationship was reported between nurses' level of knowledge and work experience. In one study, older age was directly related to the mean score of nurses' knowledges.

The knowledge of Iranian critical care nurses toward the prevention of ventilator-associated pneumonia was insufficient. Therefore, it is suggested that researchers implement appropriate interventions in nurses to improve their knowledge toward prevention of ventilator-associated pneumonia, in future studies.

Background and Some patients need to repeat certain tests. However, despite a peripheral vein catheter in the patients usually phlebotomy is done. This study examined the biochemical and hematological test results of the two methods of usual blood sampling and blood sampling through peripheral vein catheter.
A case-control study was carried out in 96 patients admitted to the intensive care unit in Sari Imam Khomeini Hospital, 2014. Each patient was considered as a control group. Blood samples were taken in the usual way (control) and peripheral venous catheter (case). To obtain a blood sample, peripheral venous catheters were washed by 2cc of normal saline. After 5 minutes, 0.5 CC blood was discarded and sampling was performed again. In all samples the levels of hemoglobin, hematocrit, sodium, potassium, BUN, Cr and FBS were investigated. Results were analyzed using Chi-square test, t-test, Wilcoxon, and Fisher’s exact test in SPSS V.18.
The patients were 56.2% male (n= 54). Mean age of the participants was 47.58±17.83 years. The results showed no significant difference in the values of hemoglobin (P=0.452), hematocrit (P=0.718), potassium (P=0.282), BUN (P=0.239), Cr (P=0.247) and FBS (P=0.074) between the two methods. But a significant difference was found between the values determined for sodium levels (P= 0.034).
Blood sampling through peripheral venous catheter while the patient is receiving liquid, is a reliable method for the analysis of hematocrit, hemoglobin, BUN and Cr.

Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection overall and the most common nosocomial infection among mechanically ventilated patients in the intensive care units (ICUs). It is associated with significant morbidity and mortality. Considering the importance of prevention of VAP in patients undergoing mechanical ventilation, the aim of this study was to evaluate the critical care nurses’ knowledge of evidence-based guidelines for prevention of VAP. In a descriptive cross-sectional study, a total of 120 critical care nurses who worked in the ICUs of in Amol and Sari city in 2013, were evaluated. A three part self-reported questionnaire including personal information, multiple choice questions for evaluation of the nurses’ knowledge regarding evidence-based guidelines for prevention of VAP and questions about the barriers of implementing evidence-based practices regarding prevention of VAP in their wards were used for data collection. The collected data were analyzed using descriptive statistics, Pearson correlation coefficient, independent t-test, ANOVA and multiple regression analysis (adjusted) using SPSS 20 software. The results of the present study have shown that among all of the participants, 14 (11.6%) were male and 106 (88.33%) were female, with mean±SD age of 32.45±6.11 and average work experience was 8.01±5.005 years. The lowest level of knowledge of nurses (0.5%) were about using endotracheal tubes with extra lumens for drainage of subglottic secretions and the highest level of their knowledge (92.5%) were about the appropriate position for reducing the incidence of VAP in patients undergoing mechanical ventilation. Regarding taking actions based on the evidence in the prevention of VAP, 57.5% of nurses stated that some of these actions are performed routinely in their workplace. Multivariate linear regression analysis revealed that with an increase of one year of work experience, nurse’s knowledge scores have been increased by 10%.Discussion & Considering the low level of nurses’ knowledge about evidence-based guideline in the prevention of VAP and its important role in this regard; allocation of resources and educational programs regarding evidence-based practice guideline for prevention of VAP and therefore changes of caring methods in patients undergoing mechanical ventilation, can have an important role in the prevention of VAP in these patients.

One of the jobs that involves shift work and is related to sleep disorders is the groups of doctors and nurses. Moreover، nursing is mixed with shift work and is related to sleep disorder and this issue can cause disruption in physical and psychological buses of the nurses. This can lead to problems for them. In work environment، sleep disorders can interrupt the task performance of nurses and also can impaired the quantity and quality of professional practice which is basically a response to the need of patients. The aim of this study was to evaluate sleep quality and its related factors among nurses، work in open heart intensive care units in Mazandaran providence in 2013. This cross-sectional study was conducted from January to February 2013 in four local hospitals in Mazandaran province. A total of 63 nurses who were working in open heart intensive care units were studied. Pittsburgh Sleep Quality Index (PSQI) for assessment of sleep quality was used. Also، demographic data and information on job status were collected. Independent t-test and Chi square test were applied for analysis. The results of this study showed that 84% of nurses had poor sleep quality (Global PSQI≥5). A significant relationship between sleep quality and the arerage night shift in month was seen (p=0. 04). The high percentage of nurses working in open heart ICU has poor sleep quality. An increased number of night shifts have a main role in this case. Considering that the poor sleep quality can adversely affect the quality of nursing care، therefore a proper planning to improve the sleep quality of nurses working in open heart intensive care units are necessary.

Hospital infection is undoubtedly the most important world's problem which is considered by health care centers. Lack of proper understanding of staff of infection controling ways and procedures play a decisive role in the increased transmission of infectious agents in hospital infections. If Nurses know the proper effective ways they would help to reduce hospital infections. The purpose of this study was to determine the nurse's practices in control of nosocomial infections. The sample of this cross sectional analytic study was 200 nurses working in medical surgical wards in educational hospitals of Uremia. Data were obtained by a checklist and observation. A descriptive and analytic statistics were used to analyze the data. Results showed that the mean age of nurses was 32.40±5.58. Majority of nurses (87.6%) was female. In the field of infection control related to nurses 70.6%, related to patients 65.1% and related to environment 73.5% had average performance. There is a significant difference between quality of performance and work experience (p=0.006) and between quality of performance and workshop (p=0.001). According to research findings based on limited performance and training needs, more attention is necessary to provide conditions to promote nurses, knowledge about infection control.

A chronic disease is a long term, debilitating with a noncurable pathology that may cause decrease in quality of life. The patients need a long term help for keeping their abilities and preventing of disabilities. Orem self care pattern can be used for creating a balance between human abilities and needs like proper diet. With regard to importance of nutrition in health promotion and quality of life in hem dialysis patients and lacking of related educational programs, the study was done to determine Orem’s nursing theory effects on nutritional program self-care on quality of life in haemodialysis patients referred in educational hospitals in Urmia-Iran. In a Design of quasi-experiments, 70 patients in dialysis wards in treatment group and a control group in educational hospitals in Urmia in 2009 were requested to fill in demographic questionnaire and the validated SF-36 QoL questionnaire before and after receiving dietary education. The SF-36 questionnaire was used، a short-form QoL scoring system consists of 36 questions that are compressed into eight multi-item scales covering all aspects of QoL. Ttest and ANOVA were used for data analysis. Self care education about nutrition had asign ificatant relationship with economic situation and educational status. (p=0. 05) But no significant relationship with age, gender and duration of hemodialysid was seen (p=0. 14) in study of proper nutrition education effects, no significant relationship with physical functioning، role-physical, vitality, emotional role, general health, general perception about health no significant relationship was found. Based on the results, self-care for nutrition dimension was effective on QOL in patients. However, non-significant meaningfulness before or after education in some items may be related to patients illiteracy or misunderstanding of education that were taught because of Poverty and difficulty.

Nursing is one of the stressful jobs and its employees have high ranking in visit the doctor because of psychological problems. On the other hand stress causes reduced level of serum zinc and complications related to its deficiency. So the aim of this study was to evaluate the effect of zinc supplement on ICU nurses under job stress in educational hospital، Sari-Iran in 2011. In this double-blind randomized clinical trial (RCT)، 90 female ICU nurses who completed Osipow job stress questionnaire and had job stress and had been qualified for study entry، randomly allocated in two equal intervention and control groups. At the beginning of the study، five milliliter blood was sampled from antecubital vein for measuring of serum Zinc. Intervention group received one capsule zinc sulfate 220 mg per 72 hours for four weeks and control group received one capsule placebo in the same way. Again at the end of the 4th week، job stress and serum Zinc level was measured in both groups and compared. In intervention group serum zinc level at the end of the study (88. 25±13. 2 mcg/dl) was significantly increased in comparison to before the study (56. 63±15. 8 mcg/dl) (p<0. 05). But in control group the difference between serum zinc level before (54. 72±15. 1 mcg/dl) and after the study (59. 35±14. 7 mcg/dl) was not significant. There was no significant change in overall value of job stress before (208. 39±31) and after the intervention (206. 65±29) in both study groups. In intervention group، in three dimensions of job stress (role overload، role ambiguity and responsibility) significant reduction was seen (p<0. 05) but in control group there was no significant change in any dimensions of job stress. Considering to the finding of the present study، to reduce some dimensions of job stress in ICU nurses، zinc supplement usage seems logical.

The safety of teenagers and young are the major factor in developing a community and they are also the major group at risk of behavioural problems. So, this study was performed to evaluate the prevalence of risky behaviours among different university students in Babol, located in Norther of Iran. This cross sectional study was carried out in a random sample of Babol university students including medical university, university of engineering and Azad University with roughly equal sampling ratio with respect to university and gender. The data was gathered by a designed questionnaire including demographic characteristics, physical involvement with others (violence), cigarette smoking, drug abuse, physical inactivity, overweight and obesity. In statistical analysis the Chi square test was used to determine the association of risky behaviours with demographic characteristics. The results revealed that in general the prevalence of physical involvement with others (violence) during a recent year was 33.3% current cigarette smoking 13.7%, overweight and obesity 25.6%, physical inactivity 15.3% and drug user during recent year 0.3%. In general, the prevalence of some risky behaviour was more in boys than girls (P<0.001), and it was more in single than married (P<0.001) and in residence of dormitory and rented houses than personal houses (P<0.001) and also in engineering and Azad university in contrast to medical university (P<0.001). For example, the prevalence of cigarette smoking was 25.7% in boys and 3.6% in girls (P<0.001). This study showed a rather high frequency of risky behaviours among students in Babol city in North of Iran.

Background and The monitoring of the patients’ hemodynamic status and vital signs is a routine practice in ÏÇÜ and the use of a low-cost and soothing method to maintain stable physiological parameters is necessary. This study aimed at investigating the effect of music on the vital signs and SpÔ2 of patients after open heart surgery. This study was a randomized clinical trial (RÇT) conducted on 60 patients hospitalized in the open heart surgery ÏÇÜ of Mazandaran Heart Çenter. Patients were randomly assigned into case and control groups. Ïn the case group, the patients listened to the music, which they selected before, through headphones for 30 minutes, while headphones without playing any music were used for patients in the control group. Vital signs and SpÔ2 of the patients were assessed before the intervention, immediately, 30 and 60 minutes after the intervention. The data were analyzed using Çhi-square; T-test and repeated measure statistical tests. Findings showed that music led to a significant decrease in the rate of heartbeat, systolic blood pressure, and mean arterial pressure and a significant increase in SpÔ2 rate (P<0.05) was also observed. But music had no significant effect on the respiratory rate and diastolic blood pressure (P>0.05).Çonclusion: Âs a non-pharmacologic, inexpensive, non-invasive method and without any side effects, music can improve the vital signs of the patients after open heart surgery.

Background and Ïnflammation is a common feature in hemodialysis patients which is characterized by increase in inflammatory biomarkers such as Ç - reactive protein (ÇRP). Ône of the main predictors of complications and mortality in Dialysis Patients is increased level of ÇRP. The aim of this study was to determine the effect of intravenous vitamin Ç on the level of ÇRP in hemodialysis patients. Ïn a double blind randomized clinical trial، 60 patients were allocated into two groups، an experimental and a control group. Ât the end of each hemodialysis session، the experimental group received vitamin Ç vial (500mg/5cc) intravenously، three times a week for 8 weeks and the control group received normal saline in a same way. The level of ÇRP was compared in each group before and after the intervention. Data were analyzed by Ïndependent T test، Paired T test and Çhi-square tests. Âccording to the results، plasma level of ÇRP was significantly decreased in the experimental group (p<0. 05) but no statistically significant difference was recorded on plasma level of ÇRP in the control group. Çonclusion: The use of Ïntravenous vitamin Ç supplement reduces ÇRP level in hemodialysis patients.