امین سهیلی

Prompt response times in the prehospital setting are crucial for improving patient outcomes, with longer delays demonstrably linked to poorer prognoses. Therefore, this study aimed to investigate ambulance response times and their contributing factors within the prehospital system in Khoy, Iran, in 2023.

A descriptive study with a retrospective chart review design was conducted on 53450 medical and trauma cases in both urban and rural areas of the Khoy prehospital system from March 21, 2023, to March 19, 2024. Data were collected using a standardized data extraction checklist developed by Dadashzadeh et al. (2016). SPSS statistical software version 25 (IBM Corp., Armonk, NY, USA) was used for data analysis. Descriptive statistics were calculated, and inferential tests were conducted, including independent-samples t-tests, one-way analysis of variance (ANOVA), and Sheffe's post hoc test.

During the one-year study period, the Khoy prehospital system received 53,450 calls. Of these calls,, 70.3% were non-traumatic, 25% were traumatic, and 4.7% pertained to women's health issues. There were differences in ambulance response times between urban and rural settings. Urban missions had an average response time of 11.3 minutes, while rural missions averaged 12.7 minutes. The factors influencing response times were categorized into three main areas: (a) characteristics of dispatch staff, (b) characteristics of operational staff, and (c) characteristics of the incident.

Our analysis revealed that urban ambulance response times in the Khoy prehospital system exceeded the recommended standard, while rural missions were less the acceptable range. It is recommended to plan and take necessary action in order to modify the processes, policies and policies of the intra-city traffic coordination along with presenting the results of the research in the city traffic coordination council in order to access medical services on time and in the right place in emergency situations.

The communication skills of nursing managers play a crucial role in influencing nurses’ job satisfaction and anxiety levels. Therefore, it is of the utmost importance to thoroughly investigate and understand the extent and nature of the relationship between nursing managers' communication skills and nurses' job satisfaction and anxiety. This study aimed to examine the communication skills of nursing managers and their associations with nurses' job satisfaction and anxiety.

This descriptive correlational study was conducted on 200 nurses at the Academic Medical Centers of Urmia University of Medical Sciences in 2023. Participants were selected using a proportional stratified random sampling. The inclusion criteria were willingness to participate in the study, a minimum of six months of clinical work experience, and no history of psychiatric disorders. Data were collected using a 4-part questionnaire, which included (a) demographic characteristics, (b) nursing managers' communication skills scale, (c) the Minnesota Satisfaction Questionnaire, and (d) the Spielberger State-Trait Anxiety Inventory. The collected data were analyzed using the IBM SPSS software V.22.0.

The nurses’ job satisfaction score was average (M = 52.30, SD = 6.09). Participants exhibited scores below the average level for personality anxiety (M = 38.1, SD = 5.41), situational anxiety (M = 38.43, SD = 7.02), and total anxiety (M = 76.53, SD = 10). Similarly, the mean scores for nursing managers' nonverbal communication skills (M = 42.06, SD = 6.56), verbal communication skills (M = 37.24, SD = 4.08), and total communication skills (M = 125.37, SD = 11.96) indicated an average level of proficiency. The Pearson correlation test revealed a statistically significant relationship between nursing managers' communication skills and nurses' job satisfaction (r = 0.001, P < 0.638) and anxiety (r = 0.001, P < 0.532).

The higher the nursing managers' communication skills, the greater the nurses' job satisfaction and the lower their anxiety levels. Therefore, healthcare system officials should emphasize empowering nursing managers in terms of communication skills and consider these skills as one of the most crucial criteria for the employment, appointment, and evaluation of nursing managers.

Gaining an in-depth understanding of the cultural beliefs and behaviors of patients, their relatives, and healthcare professionals (HCPs) in the emergency department (ED) can have a significant impact on patients' and their relatives' ED experiences, expectations, satisfaction, and outcomes. This study aims to explain and describe what it is like to wait in an Iranian ED by focusing on its ongoing cultural features.

Based on Spradley’s (1980) developmental research sequence, a focused ethnographic approach was conducted at the ED of Imam Reza University Hospital in Tabriz, Iran. Purposive sampling was used to identify eligible participants from patients, their relatives, and the healthcare professionals in this ED. Data collection involved participant observation, ethnographic interviews, and examination of related documents and artifacts, which continued until data saturation was achieved.

The study identified six cultural patterns as follows: (1) patients and their relatives experience uncertainty due to a lack of information; (2) relatives feel obliged to insist on their presence; (3) the presence of relatives is perceived as having both constructive and destructive aspects; (4) a lack of empathy undermines reciprocity in the healthcare system; (5) healthcare approaches are mostly one-dimensional; and (6) self-organized HCPs dynamically address the disorganization in the ED.

The findings of this study can provide a foundation for designing effective strategies to promote technical and interpersonal dimensions of quality in ED care. These strategies should be closely aligned with patients' and their relatives' needs, expectations, and preferences.

Misuse of opioids addiction, as a global issue, has widespread consequences for the physical, psychological, social, and spiritual health of individuals, families, and communities.This qualitative study was designed and conducted to better explain the challenges of addiction from the lived experiences of women with addicted spouse and to gain a deep understanding of their problems.

In this research, the hermeneutic phenomenology approach was used as a qualitative method to understand and interpret the meanings of the life experiences of women with addicted husbands. 12 wives of addicted men who visited the psychiatric clinic in Khoy were selected through purposive sampling and participated in the study until data saturation was reached. Data were collected using in-depth semi-structured individual interviews. All interviews were recorded, transcribed, and analyzed using the constant comparative method and Graneheim & Lundman's approach.

The analysis of the extracted interviews revealed four main concepts and fifteen sub-concepts, the main themes of which were "Deficiencies in maintaining health and hygiene functions," "Psychosocial disorders," "Communication impairments, spiritual distress," and "Impaired resilience and ineffective coping."

The findings of the study indicate that wives of men addicted to Misuse of opioids experience a wide range of physical, psychological, social, and spiritual stresses in different dimensions of life.

The approach of reciprocity and mutuality in the patient/family and healthcare professional relationship is of great importance in achieving patient- and family-centered care in emergency departments (EDs). This study aimed to explore and describe the current status of reciprocity between patient/family and healthcare professionals in an Iranian ED with a particular focus on cultural features.

A focused ethnographic approach was used in the ED of a tertiary academic medical center in the northwest of Iran from April 2018 to February 2019. A total of 54 participants including patients, family members, healthcare professionals, and other stakeholders were selected by applying the purposive sampling technique. Data were collected using three methods of participant observation, ethnographic interviews, and examination of related documents and artifacts until data saturation was achieved.

The overarching cultural pattern of “lack of reciprocity in providing and receiving emergency care” emerged within which there were two main themes: (a) responsibility avoidance (includes three sub-themes of evasion of liability; a sense of superiority; and slacking off at work) and (b) self-seeking (includes three sub-themes of me first, others later; emotional expressiveness; and destructive convergence).

Lack of reciprocal interaction between patient/family and healthcare professionals is one of the main cultural barriers in providing and receiving optimal care in EDs. Findings indicate the need to change the extent, nature, and approach of interactions in the EDs by focusing on divergent behaviors and evasion of liability which leads to the establishment of mutual trust and rapport.

Evidence-based practice, as a new paradigm for healthcare practice and medical education, has become a core competence for the new century healthcare professionals and thereby, it is now possible for healthcare professionals to easily retrieve, critically appraise, and apply evidence from primary and secondary quantitative research. However, despite the increasing growth of qualitative research in the field of healthcare and the importance of the use of evidence from qualitative research in clinical decision-making and practice, the retrieval, appraisal, and application of qualitative evidence have been neglected in the principles of evidence-based practice. This editorial briefly introduces the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework as an alternative to the PICO (Population/Problem, Intervention/Exposure, Comparison/Control, Outcome) framework for systematic retrieval of qualitative evidence.

In the Iranian Healthcare System, emergency departments (EDs) face many challenges such as limitations of the physical environment and overcrowding, meanwhile, unnecessary presence of relatives at their patientschr('39') bedside goes beyond EDs challenges and has made the situation worse. Therefore, the aim of this study was to explore, gain an understanding of, and describe the cultural beliefs and behaviors in an Iranian ED.

A focused ethnographic approach based on Spradley’s (1980) developmental research sequence was conducted at the ED of Imam Reza University Hospital in Tabriz, Iran. Purposive sampling was used to identify eligible participants from patients, their relatives, and the healthcare professionals of this ED. Participant observation, ethnographic interviews, and examination of related documents and artifacts were used for data collection and continued until data saturation achieved.

The overarching cultural pattern of “perceived constructive/destructive duality of relativeschr('39') presence” emerged within which there were two main themes as follows: constructive presence (includes two sub-themes of compensation and support) and destructive presence (includes two sub-themes of dissuasion and workplace violence).

Our findings provide valuable insight into the perceived duality of relativeschr('39') presence which strenuously affect not only the patients and their relatives but also the healthcare professionals, healthcare system, and healthcare quality. Conspiciously, most of the time, the relatives played the role of “12th man” in our healthcare system. However, their violent and aggressive behaviors against healthcare professionals were the most destructive aspect of their presence.

The nursing master degree programs should prepare graduate nurses to integrate advanced theoretical, research-based, and clinical knowledge into clinical nursing practice. Since comparing the nursing master degree programs in different universities is of key importance in identifying their strengths and weaknesses and utilizing successful strategies and experiences, this study aimed to compare Iranian neonatal nursing curriculum with the neonatal nursing curriculum of the McMaster University of Canada. This descriptive comparative study was conducted in 2018 using the Beredy model in four steps of description, interpretation, proximity, and comparison. The comparative elements included the philosophy, mission, vision, value, goals and objectives, Graduates' roles, entry requirements, duration and courses, executive strategies, teaching and evaluation methods, and accreditation. The values and goals of both master programs were based on the beliefs and values of the community and their mission was clear. In the Iranian program, the role of neonatal nurses included the supportive, educational, research, and management while the Canadian program did not mention the future roles of their neonatal nurses. Also, the McMaster University provided more comprehensive and more relevant admission requirements and postgraduate courses for the neonatal nursing program than the similar Iranian program. The results showed that the Iranian neonatal nursing program, compared to the Canadian one in McMaster University, has mainly focused on research and has had executive failures in organizing robust entry requirements for student admission, enriching the students’ competencies in specialized neonatal nursing skills, and providing and securing a better position for the graduates in the clinical settings. Therefore, we should address these deficiencies in the Iranian neonatal nursing program to improve our curriculum and achieve better outcomes and high-quality care in the field of nursing practice.

Paederus is a genus of small beetles of the family Staphylinidae (rove beetles), widely distributed around Northern Iran and known as Dracula in this region. It releases a potent vesicant and notorious toxin called pederin which results in mitosis blockage by inhibiting protein and DNA synthesis and causes a self-limiting form of acute irritant contact dermatitis known as Paederus dermatitis. Since there isn't any specific antidote to neutralize the toxin and its effects, the treatment is largely conservative, focusing on relieving symptoms. It seems the best method to prevent these complications is to avoid contact with the beetles in the first place and in case of contact, the affected area should be immediately washed with soap and water and/or alcohol-based rub-in cleanser to remove the irritant. Unfortunately, the lack of proper notification by healthcare officials and providers to the local inhabitants and the coincidence of high rates of traveling to this region with the peak season of Paederus activity leads to a larger population to be exposed to this insect and subsequently a high incidence of the disease. On the other hand, there are no precise statistics available for the incidence rate of Paederus dermatitis, characteristics of affected patients, and distribution patterns of insects due to a lack of a comprehensive system for recording and reporting the cases of this disease.

Virtual social networks have become an unrivaled means in the field of information and communication technology and are one of the effective factors plays an important role in the academic achievement of students in today's modern world. Accordingly, this study aimed to determine nursing student's perspective toward the role of virtual social networks on their academic achievement.
This study was a descriptive survey conducted on 356 nursing students in Tabriz University of Medical Sciences in 2017. The participants were recruited using stratified random sampling. A researcher-made questionnaire was used for collecting data. Descriptive statistics were applied to the data by SPSS ver. 13 Software.
while the majority of the participants expressed that virtual social networks have had a constructive and positive role in both "inquiry" and "assignment writing" domains, they disclosed that virtual social networks were destructive in the two other "grade promotion" and "concentration" domains of academic achievement. Also, from the student's perspective, virtual social networks have had a neutral impact on the "academic motivation".
It is a necessary requirement for officials of nursing education and other stakeholders to adopt preplanned measures in line with guiding the students to make the most of the positive points of virtual social networks and to prevent potential pitfalls and malicious consequences that their misuse could bring with them.

or similar products. However, unfortunately, there are no analgesics or similar products in prehospital emergency services in most provinces of our country and only Ketorolac, which is only effective in management of mild to moderate pain, is available for pain management quite limitedly and in just a handful of regions.
Obviously, the most important outcome of lack of analgesics for managing acute pain in urban and intercity prehospital emergency services, which are the first line in medical emergencies, accidents and disasters, is infliction of suffering, illness, distress and destructive psychophysiological responses of pain on patients from the occurrence of the accident to hospital arrival, and depriving them from their right for reducing and controlling pain, which is incompatible with patient's rights charter in our country and will lead to patients being dissatisfaction with and distrusting prehospital emergency service. In addition, daily exposure to patients suffering from uncontrolled acute pain and incapability to relieve their pain despite having the necessary clinical competency causes a high level of moral distress to prehospital care providers and has negative effects on their morale and performance.
A comparison of the existing pain management proceedings in prehospital emergency service of developed countries with Iran indicates a lack of standardized scientific approach in the field of prehospital pain management in our country, which results in the current unfavorable condition. Though strong evidence exist regarding the necessity of early treatment of pain, which is not only ethically correct, but is also of primary importance in controlling both its metabolic repercussions and improvement of patient outcomes, and despite the extensive use of analgesics in developed countries' advanced prehospital care, unfortunately, misconceptions like fear of possible adverse events tied to analgesic use, possibility of masking clinical findings (signs and symptoms of illness) following pain relief, probable abuse of analgesic medications specially opioids, and etc. have prevented consideration of analgesics for common use in our prehospital emergency service, to date.
Working in prehospital emergency service and providing service in real accident scenes and observing the present problems in this field made the authors address this neglected issue by explaining the status quo and weighing up the opportunities and threats ahead. We hope that the officials of Iran Disaster and Emergency Management Center (DEMC), Ministry of Health and others involved pay special attention to this matter and take effective steps towards removing organizational and legal obstacles that lie in the way of using analgesics in our prehospital emergency service by taking proper actions such as development, ratification, review and dissemination of evidence-based clinical practice guidelines and off-line protocols for prehospital pain management and training highly competent advanced prehospital providers (paramedics).

Epistaxis is defined as acute hemorrhage from the nostril, nasal cavity, or nasopharynx. It is a frequent Emergency Department (ED) complaint and often causes significant anxiety in patients and clinicians. Accordingly, this study aimed to compare the administration of topical Phenylephrine with topical Tranexamic Acid (TXA) in management of epistaxis.
This double-blind, randomized clinical trial was conducted on 120 patients with epistaxis referred to Imam-Khomeini University in Urmia, Iran. Patients who met the inclusion criteria, were randomly allocated into two intervention and control groups. Sixty patients in the intervention group received one pledget soaked with TXA for 10 minutes in each nasal cavity. Sixty patients in the control group received Phenylephrine 0.5% with the same way. The cessation of bleeding in ED were evaluated by 10 minutes after the administration of the above-mentioned drugs.
Nasal hemorrhage was stopped in 17 out of 60 patients of control group received Phenylephrine (28.3%) while in the intervention group received TXA, 40 out of 60 patients (66.7%) experienced the cessation of their nosebleed that the difference was clinically and statistically significant (P According to study results, topical application of injectable form of TXA (500mg/5mL) can be used as an ideal drug in management of epistaxis in prehospital and hospital settings and subsequently leads to a reduction of extra costs and length of stay in the EDs.

Addiction is such a widespread problem that requires a comprehensive action conducted by a range of researchers and specialists in different fields. Unfortunately, this phenomenon is sometimes accompanied with a record of quitting, but it is seen that addicts turn into addiction. Identifying its factors can help to prevent this problem. Since a detailed study about the onset of addiction based on cultural and economic factors in Urmia, was not carried out, the present study was performed.

A number of 400 addicts referred to addiction treatment centers in Urmia, were included in a descriptive-analylical study carried out using a demographic and researcher made questionnaire, by multistage cluster sampling metod, 46% of them had at least one record of quitting and the rest were referred for the first time. Scientific validity of the questionnaire was confirmed by using apparent validity and the content validity of the questionnaire was confirmed by experts and the members of the scientific board and its reliability was confirmed by a test of internal compatibility.

The study showed that encouragement of friends, spending time with them and not being accepted by them after quitting drugs, were the most important causes of tendency to re-addiction in the subjects referred to addiction treatment centers in Urmia. A significant relationship between their tendency and the level of literacy and cigarette smoking of their father has been observed, but other demographic factors does not have significant effect on this issue (p>0.05).

On the basis of the results of this study, taking legal measures to increase awareness in this regard, reducing the factors enticing the youth to drug addiction and re-addiction and establishing and enhancing the role of advice giving centers, can be useful in reducing these problems.

Failure in acquiring necessary skills is one of the main issues of nursing graduates in clinical education and employing supervision in clinical education can improve the clinical skills. Accordingly, this study was designed to investigate the effect of clinical supervision on nursing students’ clinical skills.
The present study was a quasi-experimental design with pre and post design, in which 32 nursing students of Urmia University of Medical Sciences in 1394 who were enrolled in the study were randomly assigned to two groups of test and control. The 6-week training course for the experimental group was performed based on the clinical monitoring process and for the control group according to the conventional method. The clinical skills assessment checklist was used to collect the data.
Clinical skills of students in the test group was significantly higher than students in the control group in terms of: (1) recognition and administration of medication; (2) education to patients and their companions; (3) team working; (4) considering the safety issues; (5) prevention of infection; and (6) use of the nursing process (p Applying supervision in clinical education compared to conventional methods leads to further enhancement in clinical skills of nursing students. Therefore, educational officials of nursing would benefit from taking this method in nursing education, particularly in “clinical courses”.

The aggression and interpersonal problems in nurses can adversely influence the quality of care in the health care system, especially in Emergency Departments (EDs) that the nurses’ level of occupational stress is higher than others. Therefore, this study aimed to investigate if the ED nurse's level of aggression and interpersonal problems can be predicted based on their occupational stress.
This descriptive-correlational study was conducted on 134 nurses in EDs of both Rasool Akram university hospital and Hasheminejad university hospital in Tehran, Iran. The participants were selected by complete enumeration. The Inventory of Interpersonal Problems (IIP), occupational stress scale and Aggression Questionnaire (AQ) were used for collecting the data. Descriptive and inferential statistics were applied to the data.
It was found that the nurse's occupational stress significantly predicted their aggressive tendencies (R2=.051, F=7.14, p The results showed that the tendency to aggression in ED nurses can be predicted based on their occupational stress. Therefore, the healthcare systems’ officials would benefit from taking proper actions in this area.

Nursing Education in doctoral degree has many positive impacts for both the nursing profession and healthcare systems. However, due to the development of nursing education and the dynamic nature of community needs in terms of healthcare system, it is faced with challenges. Accordingly, this study aimed to determine the content and executive challenges of nursing doctoral curriculum based on Delphi technique.
This Delphi study was conducted in 3 rounds on 29 nursing doctoral students and 17 nursing faculty members in Tabriz University of Medical Sciences, Iran. Qualitative content analysis was applied to the data to summarize data, extract statements and identify main themes to develop the primary questionnaire in the first two rounds. In the third round, Data were quantified using descriptive statistics and data analysis was performed using the IBM SPSS software (version 24; SPSS, Chicago, IL).
The findings of present study were classified in four categories: (1) education; (2) research; (3) clinical; (4) administrative. The responsiveness of nursing doctoral curriculum to the needs of community, healthcare systems, nursing profession and even faculties/students themselves were considered as the biggest challenge. Moving away from the clinical environment and failure to improve the clinical competencies of nursing doctoral graduates were the other serious challenge of the nursing doctoral curriculum.
Major revision and reform of nursing doctoral curriculum were needed to fulfill the challenge of its responsiveness. Evidently, the officials of Iran board of nursing would benefit from taking into account the clinical issues and problems of current healthcare system, considering the underlying pitfalls of nursing doctoral programs and qualitative and quantitative evaluation of different levels of nursing education, particularly doctoral degree as the "prestigious pillar of profession".

Self-care is a basic concept in nursing care and has desirable outcomes in maintenance and promotion of human health. Orem's model focuses emphatically on self-care and leads patients to participate and collaborate in their caring process. This study aimed to investigate several studies conducted on Orem's self-care model through integrated review method and determine its applicablity in Iranian healthcare system.
Material & In an integrated review, all Iranian papers published during current 5 years (2011-2016) in both Persian and English language were searched using the related keywords of Orem's self care model in Elsevier, Web of Sciences, Scopus, PubMed, ProQuest, CINAHL, Google Scholar, Ovid, Magiran, SID, IranMedex, IranDoc databases. The quality of the articles was evaluated using CONSORT 2010 Statement. Finally, data were extracted, classified, summarized and, analyzed from 24 included articles in this study (Out of overall 28384 articles).
Out of 24 included articles, 17 artciles were published in Persian language and 7 articles were in English. All of the articles were original interventional studies (one experimental, 11 quasi-experimental, 11 clinical trial and one field trial). In all the papers, the researchers were used pretest and post-test design. Also, 3 main domains were derived from the literature review including: “type of intervention”, “intervention outcome” and “study population”.
Given that still many problems remain in patient care and post-discharge self-care and according to the positive and optimistic view of Orem’s self-care model about patients’ participation in self-care and about nurses’s prominent role in healthcare provision in both partly and wholly compensatory systems which is consistent with the contemporary values of of Iranian society; it seems that the scrutiny of this model’s implications is needel. Evidently, the nursing officials and stakeholders would benefit from the preparation of local clinical guidelines and promotion of nurses’ awareness about Orem’s self-care model that leads to the “translation of theoretical knowledge in practice”.

Appropriateness and Nature of clinical decisions and medical interventions in trauma management is one of the most important concepts in prehospital trauma care systems. Therefore, this study aimed to determine the nature of prehospital medical interventions delivered to traumatic patients in Tabriz.
In this descriptive study, the records of all traumatic patients activated EMS and led to a prehospital mission, investigated in 2014. A six-part checklist consisted of patients’ characteristics, mechanism of injury, type of trauma, level of consciousness, medical interventions, physician consult and coordination with the hospital were used for collecting data. Descriptive and inferential statistics were applied to the data by SPSS v.13 software.
A total of 5614 out of 37002 registered missions during a year were related to trauma injuries. Traffic accidents (72.9%) were the most common cause of trauma and blunt trauma (85.6%) were the most common type of trauma among injured patients. Although 92/46%of traumas were related to head and neck trauma and multiple trauma, the cervical collar has been merely used for 11.5 percent of them. Also, 93% of the trauma missions led to the transfer of patients to the hospital while in 99.43% of them, no coordination was done between prehospital emergency medical services and hospitals’ A&E departments.
According to study results, despite the high percentage of trauma to the head and neck and multiple trauma, the cervical collar and long back board has been merely used for a few traumatic patients which is unacceptable and indicates the necessity of organizing prehospital trauma care courses and workshops for emergency medical technicians. Also, regarding the lack of coordination between prehospital and hospital facilities, it seems that a much more robust and organized structure is required in Iranian healthcare system.

Poor sleep quality and loneliness in the elderly are associated with many physical and mental disorders, lead to increased demand of healthcare services. The living environment also affects these issues. Accordingly, this study aimed to determine the association between loneliness and sleep quality in older adults with a focus on their living environment in Tabriz.
This descriptive-correlational study was conducted on 400 older adults residing in families or nursing homes in Tabriz, Iran. The participants were selected using a multi-stage random sampling method. The Pittsburgh Sleep Quality Index (PSQI) and loneliness scale were used in collecting data. Descriptive and inferential statistics were applied to the data as well.
The loneliness score in older adults living in families is significantly lower than nursing homes residents, and the level of sleep quality in older adults living in families is significantly higher that elderly residents in nursing homes in Tabriz as well (p According to the Iranian sociocultural context, it is necessary to educate the families to reconsider their decision about transferring the elderly to nursing homes. In addition, it is recommended that schedule programs are carefully considered to enhance the quality of environment and welfare facilities of nursing homes, and resemble the nursing home settings to the family environment as much as possible, Also, It is necessary to encourage relatives and significant others to have regular communication with their older adults in nursing homes.

One of the most important concepts in pre-hospital trauma patients is a rapid response and transfer in order to provide high quality care and reduce injuries and deaths in the emergency situation. Several time indicators affect the process of dispatching ambulances. This study aims to investigate the pre-hospital dispatching time intervals in Tabriz.
In this descriptive study¡ the records of all trauma patients¡ which activated Emergency Medical Services (EMS) and led to an emergency dispatch¡ studied in 2014 in Tabriz. A four-part checklist consisted of patient characteristics¡ patient condition¡ scene status and dispatching time intervals used for collecting data. Descriptive and inferential statistics were applied to the data by SPSS v.16 software.
A total of 5614 out of 37002 registered missions during a year were related to trauma injuries. The majority of patients (75.88%) were male. Their mean age was 35.54 ± 17.71. 94.5% of patients had stable level of consciousness and no patient had died during their transfer in the ambulance. The average time of activation¡ response¡ spent at the scene and transfer to hospital were 2.38¡ 10.07¡ 8.11 and 9.13 minutes¡ respectively. Traffic accidents (72.9%) were the most common cause of trauma and blunt trauma (85.6%) were the most common type of trauma among injured patients. The mean of total dispatching time (from call to delivery of patients to the hospital) was 30.16 minutes. There is a significant relationship between the activation time in the various levels of consciousness and mechanism of injury. Also¡ there is a significant relationship between the mean of total dispatching time¡ level of consciousness¡ type of trauma¡ and the mechanism of injury.
The results indicated that traffic accidents were the leading cause of trauma in Tabriz. Overall dispatching time indicators were better in comparison to other studies and emergency personnel were quick in patients with low GCS and penetrating trauma. Ambulances activation time seems to be higher that requires more planning and modifications to take proper actions in this area.

Admission to the hospital and waiting for the invasive procedures like coronary angiography is an extraordinary source of anxiety that causes detrimental behavioral and cognitive effects. This study aimed to determine the effect of pre-operative supportive care plan on physiological indicators of patients undergoing coronary angiography in Urmia Seyed-Alshohada university hospital.
In this experimental study with pretest-posttest design, 124 patients undergoing coronary angiography in Urmia Seyed-Alshohada university hospital who met the inclusion criteria were randomly allocated into two groups as control and experimental. The control group received conventional routine care but the experiment group received interventions based on nursing care plan before angiography in addition to the normal cares. The patients’ anxiety score was measured through Amsterdam Preoperative Anxiety and Information Scale (APAIS), their blood pressure measured by a Richter mercury sphygmomanometer and a Litman stethoscope and their heart rate measured by a digital pulse oximetry (Bitmos-Sat 805 Model). The collected data was analyzed by SPSS v.13 software using descriptive and inferential statistics (independent t-test and Mann-Whitney U test).
The results showed that the physiological indicators (anxiety scores, heart rate and blood pressure of patients undergoing coronary angiography) in the experimental group was significantly less than the control group (P It seems that supportive care plan before coronary angiography has considerable clinical advantages and reduces the level of anxiety in patients undergoing coronary angiography significantly. Therefore, it is recommended to apply the holistic nursing developed supportive care plan presented in this study as a key to reduce the level of anxiety in patients undergoing coronary angiography.

To make a development in nursing education, it’s necessary to evaluate the processes of the clinical education and become informed about modern executive models. In this regard, Competency Based Education Model (CBEM) is a new educational model that aims to reach desired clinical role. This study aims to determine the effect of implementing competency-based education model on nursing students’ clinical performance in Coronary Care Unit (CCU). In this quasi-experimental study with post-test design 34 senior nursing students, who met the inclusion criteria, were selected through census and divided into two groups as control and experimental. The control group received conventional education and the experiment group received competency based education for their CCU course. The students’ clinical performance score was measured through 3 researcher-made data collecting instrument (clinical performance assessment checklist, self-report questionnaire and multiple choice test). The collected data was analyzed by SPSS (16) software using descriptive and inferential statistics (Chi-square, independent t-test and Mann-Whitney U test). The results indicated that clinical performance of students in the experimental group was significantly higher than students in the control group both in terms of specific clinical performance (P<0.001) and generic clinical performance (P=0.001). Competency-based education model more than the conventional model improved the students’ generic and specific clinical performance. Therefore, it is recommended that nursing educational officials improve the efficiency and the effectiveness of clinical courses by taking advantages of this educational model and modifying the nursing curriculum based on modern educational strategies.

Communication skills are the cornerstone of the entire adequate clinical measures and have an important role in health sector. Therefore, educating communication skills to the students improve the efficiency of the education system. In this regard, Competency-Based Education Model (CBEM) is a new educational model that aims to reach desired clinical role. This study aims to determine the effect of implementing competency-based education model on nursing students’ communication skills in Urmia Medical Sciences University. In this quasi-experimental study with post-test design; 34 senior nursing students, who met the inclusion criteria, were selected through census and divided into two groups as control and experimental. The control group received traditional education and the experiment group received competency-based education for their coronary care unit course. The students’ communication skills score were measured through a researcher-made data collecting instrument (self-report questionnaire with likert rating scale). The collected data was analyzed by SPSS (19) software using descriptive and inferential statistics (Kolmogorov-Smirnov, Chi square and independent t-test). The results indicate that communication skills of students in the experimental group was significantly higher than students in the control group (P=0.007). CBEM better than the conventional model improves the students’ communication skills. Therefore, it is suggested to improve the efficiency and the effectiveness of clinical courses by taking advantage of this educational.

The ability of Decision-Making is one of the fundamental features of nursing professional practice, and it influences quality of care more than any other factor. It can be acquired by proper education & clinical experiences. Meanwhile, a lot of nursing graduates can’t demonstrate their Decision-Making skills. This study aimed to determine nursing students’ Decision-Making ability in Urmia School of Nursing and Midwifery. This cross-sectional study was conducted on 220 nursing students in Urmia Medical Sciences University in 2014. Data collecting instrument was a questionnaire (“Analysis of Decision-Making in Nursing”) with 2 parts: demographic characteristics (3 items) and different aspects of Decision-Making in nursing (81 items that classified in 10 scope and rated according to semantic differentiate scale (1 to 7). After entering the data to the SPSS (19) software, data analysis was performed by using descriptive and inferential statistics, as needed. 103 of participants were female (46.8%) and 198 were single (90%). The mean and standard deviation of the age of the subjects was 21.24 ± 1.83. 61.4% of the participants had the moderate Decision-Making ability, and 38.6% of them had high Decision-Making ability. The participants’ clinical decision-making ability in “Creativity” aspects was better than other aspects. The results showed that the Decision-making ability in nursing students was moderate. Therefore, to take the effective steps and to expand the Decision-Making ability in nursing students, it is highly recommended to include relative courses in nursing curriculum.

Incidence of medical emergencies in the dental office is not uncommon and is challenging for the dentist and the patient. Cardiopulmonary arrest is one of the most important medical emergencies and CPR is a vital component and the first step in responding to it, Therefore, having knowledge in this field is essential for dental students. This study aimed to determine the Level of Knowledge and Attitude in Dentistry students about Principles of CPR. This cross sectional study was conducted on 60 dentistry clinic students in Urmia University of Medical Sciences. Data collecting instrument was a researcher-made questionnaire with 56 items in 4 parts: Demographic, knowledge of basic CPR, knowledge of advanced CPR, and attitudes about CPR. After entering the collected data to the SPSS (19) program, data analysis was performed by using descriptive-analytical statistics. The results indicated that from 60 participants in the study, 38/3% were male and 94/2% were single, and the mean age was 23/84. Level of knowledge about principles of basic and advanced CPR was very poor. 95% of the participants did not have any theoretical and practical training during their education in this regard. Also, none of the samples had the background of observation or participation of CPR. The findings confirm that level of knowledge of clinic students of dentistry in the field of CPR is not appropriate. Therefore, effective steps must be taken to enhance the level of knowledge and attitude of dentistry students. It is suggested to organize workshops or to submit protocols about CPR and especially to corporate specific theoretical and practical CPR courses in the pre-clinic or clinic curriculum in the dentistry schools.