سیمین شرفی

In the past, the war was mainly a "hard war" using military means, but now its form has changed to a more "soft war" type, which is basically diplomacy-based. Health professions have also recently entered this field, and nurses are using diplomacy because of their occupational nature, their various roles including advocacy. Given the proximity of the concept of advocacy to the nature of diplomacy and negotiation, we aimed to investigate the role of advocacy of nursing managers in nursing diplomacy.

This is a qualitative study with a conventional content analysis approach. Data were collected using in-depth unstructured interviews with 14 nurse managers at different levels through purposeful sampling.

After analyzing the data, three main categories of system advocacy (including subcategories: systematic thinking and holistic view, organizational affiliation), advocate for people (including subcategories: demonstrating the role of the nurse in service to people, the use of people-centered literature) and the use of advocacy in negotiation (including 3 subcategories: unifying positions with an emphasis on interests, finding common ground, focusing on the other sidechr('39')s concerns).

The findings of this study indicates that nursing managers are involved in diplomacy and relying on the advocacy role that is less paid attention in the clinic. They use it to achieve their organizational goals.

Quality of care in the health system is one of the most important issues and one of the most important indicators in organizational accreditation. Use of managerial principles, such as the division of labor among nurses, can affect the quality of care.

This was a randomized double-blind clinical trial which included 44 nurses and 59 patients in 4 CCU wards. The intervention included 3 sessions of 2-hour workshops and then implementing the two above-mentioned care methods for the patients. After the intervention and at the time of discharge, the quality of care provided was assessed from the patients' point of view by means of quality care patient scale. Data were analyzed by Mann-Whitney test.

The results showed after the intervention, the mean values for general quality of patient care in the primary group and case method group were (14.2 ± 1.9) and (11.2 ± 2.8) respectively. Also the quality of professional care in the primary group and case method group were (18.2 ± 2.2) and (3.5 ± 14.2) respectively. Mann-Whitney test in both aspects showed that the quality of general and professional care was significantly higher in the primary group than in the case-method group (p <0.05).

The results of this study indicated that the primary method can be used in some wards, and was more effective than the case-method. Therefore, paying more attention to nursing care management planning is recommended.

Delirium is a disorder in the ICU and sleep disorder can be a risk factor for it. Therefore, it is important to take non-pharmacological measures that are within the scope of the nurse's authority and that can promote sleep as a potential strategy to reduce delirium. The aim of this study was to determine the effect of using earplugs and eye mask during sleep on the delirium of patients in the intensive care unit.

This experimental study was conducted on 73 patients hospitalized in ICU that they were selected by available method for 6 months randomly then allocated in two groups of control (37 patients) and mirror therapy (36 patients). In the intervention group, earplugs and eye mask was used for 3 consecutive days at 22 to 6. Patients before and after intervention were evaluated using NeeCham Delirium scale, a valid and reliable instrument. Delirium score and its domains in different stages in two groups were compared by repeated masseur ANOVA.

The results showed that the use of earplugs and eye mask and time both had a significant effect on total score of delirium (p<0.05). In the process and behavior domain of the effect of time, group and interaction, there was a statistically significant difference (p<0.05). However, in the physiologic domain, the effect of group and total effect did not show a significant relationship (p>0.05).

Earplugs and eye mask as a non-pharmaceutical and independent nursing care can be a useful, inexpensive and affordable tool to prevent confusion or delirium. But the relationship between sleep, sound and light and delirium requires more research.

clinical education is the most fundamental part of nursing training, so appropriate evaluation methods should be used. Although various evaluation methods such as case based discussion and logbooks, each one has its own advantages and limitations, this study had designed aimed to comparison of the effect of clinical evaluation method with case based discussion and logbooks On satisfaction of nursing students.

This experimental study with two groups after the intervention was conducted in 2017. Participants were 58 nursing students of Mashhad nursing and midwifery school that draw on both the patient discussion and log books by random assignment. Students' satisfaction was measured by researcher- made questionnaire that its´ reliability and content validity was confirmed by Cronbach's alpha and using expert opinion, respectively. Data were analyzed using independent and paired T-tests and Mann-Whitney through SPSS.

The results showed that the mean and standard deviation of students' satisfaction of case based discussion group was 69/06 ± 22/7 (of 100) and logbook 67/8 ± 21/8 (of 100). Results of Independent T test showed no significant differences between the two groups in satisfaction score (p=0/757). Although students' satisfaction of case based discussion group in suitability field was statistical significant higher than the other group (p= 0/018).

Considering the students´ higher satisfaction of case based discussion method, it seems this method has somehow achieved the expectations of students compared to the logbook method. However, due to insignificant results, studies with a larger sample size and devoting more time to implement this method is necessary.

One of the most important problems of patients admitted to intensive care units (ICU) is their sleep quality. In these units, there are various visual and auditory discomfort factors that can negatively affect the outcome of the patient's treatment. The purpose of this study was to determine the effect of simultaneously using earplug and eye mask on the quality of sleep in hospitalized patients in the ICU. This study was performed on 73 patients who had been admitted to the ICU of Ghaem Hospital and Imam Reza Hospital in 2016 in Mashhad. Patients were randomly assigned to control (n = 37) and test (n = 36) groups. The test group used an earplug and an eye mask during their night's sleep. Patients' sleep quality was assessed by using Voran-Schneider-Halper's questionnaire. Data were analyzed using SPSS16 software. Independent t-test and Mann whitney U showed that before and after the intervention stage, no significant difference was observed between the test and control groups regarding the mean score of sleep quality. However, the results of Wilcoxon test showed a significant difference in the quality of sleep score in both groups before and after intervention (p <0.001). In this study, simultaneous use of earplug and eye mask was effective in improving the quality of sleep in patients admitted to the ICU. Therefore, this technique can be used as a simple, low-cost, and effective method in helping patients to prevent complications from sleep disorders.

Problem-Based Learning is a new approach in medical sciences and some theoretical and experimental studies have been done in this regards. The purpose of this research is to investigate the effectiveness of PBL in medical sciences.
This is a quasi-experimental study with pretest-posttest design by control group. statistical population included 40 undergraduate students at Shiraz University of Medical Sciences (college of Management and Information) in course of Human Resources Development that were selected as random sampling method and divided into two groups of (Control group=19, and Experimental group=21). A man-made questionnaire was used for evaluating academic performance, data were analyzed using descriptive statistics (Mean and standard deviation) and inferential statistics (ANCOVA) through SPSS .
result showed that problem solving learning is effective on student's academic performance(p since problem solving learning has a positive effect on student's performance, it is recommended medical sciences teachers try to use of this teaching approach and consider as priority in universities of medical sciences

for patient care, nurses are responsible for numerous tasks that sometimes some of these tasks away them from their primary mission, which is patient care. Therefore, the aim of this study is, evaluated time nurses for non-nursing tasks and text services in nursing shifts.
Material and This study is a descriptive-analytic study. Community nurses working in Imam Reza and Ghaem and Montaserieh hospital in Mashhad city. Questionnaire derived from the checklist Bradshaw & Harrison and reliable sources nursing. After assessing the validity and reliability of the questionnaire was used and results were analyzed using the software spss16.
The results showed that from the perspective of nurses, nurses spend more time answering phone calls and different things (3.60%) and in response to repeated questions about patients and their family appointment by specialists (7.56%). The Spearman correlation coefficient direct connection between the nurses on unnecessary tasks with age (p=0.01, r=0.22) and work experience (P>0.001, r=-0.39) there was a significant inverse relation.
The results indicate a lot of time nursing and non-nursing for written assignments, it is recommended Nursing managers with a better understanding of the scientific principles of business management and ability to apply these skills to more accurate monitoring and the use of management time, with regulatory reform and reduce some of the non-nursing tasks by designing a care plan correctly, to provide care targeted and enhance the quality of care and more satisfied patients.

Now, all efforts of mediapunditsin schools and clinical Environments are immobilized conditions that the students give to specialize, because the clinical training of medical students is the most important part of learning professional performances. Therefore, this study aimed to determine the viewpoints of nursing teachers with regard to the coordination of theoretical and clinical training.
Material and This study is descriptive. The research tools are Demographic questionnaire and "check compliance theory and practice" whose three parts. After confirming the validity and reliability by Cronbach's Alpha(0.08) the questionnaire was given to all of coaches Clinical Nursing and Midwifery Mashhad (29members) during the sampling period were taught in school. Data were analyzed using SPSS 16 software.
The average age of coaches 41/53±11/99, 82.8% (24 members) were married and 62.1% (n = 18) were male 89.7% (n = 26) had a master's degree and the others were PhD. The professors lessons Duration of training with the skill that most closely matches their lessons including public health (3/88± 1/47), Psychiatric Nursing (3/77 ± 1/15) and management (3/77±1/31) and lessons that are least adapted to particular sectors intensive care (2/14 ± 0/9) and emergency (2/26 ± 1/28) (P According to the results of this study, the duration of most of the workshops to become proficient enough in those lessons. Since now on nursing care and nursing education are traditional and basic needs students are not taught to them in the workplace, It seems that the modified curriculum or specialized nursing course is way to solve problems.

The nursing profession is mainly based on the quality of care. Different approaches to provide nursing care in nursing management can affect the quality of service. This study aimed to compare the effect of “Primary Nursing” and “Case Method” on patient's quality of physical care.
This study is quasi-experimental study that was performed in two Critical Care Units (CCU) of the Ghaem Hospital and two CCU of Imam Reza Hospital in Mashhad. 59 patients (33 patients in the “Primary Nursing” group and 26 patients in the “Case Method” group) were studied. Data was collected using “Quality of Patient Care” (QUALPAC). The content and face validity was confirmed by 10 members of the Faculty of Nursing and Midwifery in Mashhad University. Furthermore, the reliability was achieved by Cronbach's alpha. In this study, both “Primary Nursing” and “Case Method” approaches were implemented in CCU and their impacts on patients’ quality of care was evaluated. Data were analyzed using SPSS/16.
The mean of patient quality of physical care in “Primary Nursing” group (5.2 ± 44.4) was significantly higher than the one in the “Case Method” (6.5 ± 29.8) (P The patient quality of physical care in the division of labor "Primary Nursing" is higher than "Case Method". Therefore, the "Primary Nursing" is recommended.

Quality of patient care is enhanced by effective communication between nurses and patients. One of the most important management practices to improve the quality of nursing care is applying nursing care delivery systems by nurse managers; especially by head nurses effectively.
Aim: This study was done for comparing the effectiveness of primary nursing care and case method on quality of nursepatient interaction in CCU.
Methods and materials: This study was a quasi-experimental study that was done in four CCU in two teaching in Mashhad in 2014. Two units for case method (n=26 patients) and two units for primary nursing (n=33patients) randomly selected. In implementation, at first all of the nurses trained with two nursing care delivery systems by workshops. And then, in primary system allocated (3) patients to primary nurse who was responsible to their discharge. In other shifts sh/he supervised him/her associate nurse. Also, in case method, head nurse allocate (3) patients to nurses in the shift, only they were here. All of the policies established thatwere needed by head nurse mutually. Both of two nursing care delivery systems implemented for (2) months. Data were gathered by standardized questioner QUAL PAC) Quality of patient care) that its reliability was measured by α-Chronbach (0.89). Data were analyzed by SPSS16 and statistical tests such as Mann-Whitney, 2 and others were used. Applying descriptive statistics (mean and standard deviation) and inferential statistics (Pearson moment correlation coefficient and stepwise multiple regression analysis) data were analyzed by SPSS16.
findings showed that there is a significant difference between two group (case method and primary nursing) in quality of interaction between nurses- patients (p In order to effectiveness primary nursing care in promotion in quality of interaction between nurse- patients, it is suggests to nurse managers that they apply its model in CCU.