طوبا حسینی عزیزی

Caring for COVID-19 patients was a new and challenging experience for nurses. Knowing the effect of psychological, emotional, and spiritual care on physiological responses, nurses provided holistic care.

This qualitative study was conducted with the conventional content analysis approach in one of the referral hospitals for COVID-19 in Iran. Data were collected using in-depth, semi-structured individual interviews. Data was analyzed using the Lundman and Granheim qualitative content analysis and the Lincoln and Goba criteria.

In all 17 nurses were interviewed. The mean age (SD) of participants was 34.41 ± 7.49 years. The findings indicated a "butterfly-like care" with four main categories [caring with all one's heart, resilience, self-sacrifice, and conscious presence in danger).

During the COVID-19 pandemic, nurses, being aware of all the health and social consequences and overcoming fear and doubt, volunteered to take care of patients and save lives, and despite understanding the risk of being infected, they lovingly surrounded the patients. Considering the central role of nurses in the treatment team, special attention should be given to the maintenance and strengthening of nurses in the planning of the development of healthcare systems in the face of the upcoming epidemics.

The role of the non-technical skills in reducing undesired errors is significant and
there are a few methods that improve the effectiveness of CPR's non-technical skills. The aim of this
study was to determine the effect of Seven-Stage Response Plan of cardiopulmonary resuscitation
(SSRP-CPR) on non- technical skills of nursing and anesthesiology students.

The current quasi-experimental study included forty-two undergraduate
nursing and anesthesiology students that divided in stratified sampling and random allocation into
the experimental (SSRP-CPR) and traditional groups. All participants completed a course of CPR
technical skills, and then participated in a 4-hour workshop. The trainings included routine

of CPR and Seven-Stage Response Plan in traditional and experimental groups, respectively. Data
were collected by using the Team Emergency Assessment Measure (TEAM) Tool and were
analyzed by SPSS 20.

The mean total scores of team's performance in SSRP-CPR group (35.08±9.63) were
significant and higher than the traditional group (23.46±5.68), (p<0.002). Furthermore, the mean
score of non- technical skills categories including leadership (p<o.oo1), teamwork (p<o.oo2) and
task management (p<o.o24) were significant and higher in SSRP-CPR group, than the traditional
group. In addition, the results showed that there was no significant difference between the two
groups in a number of subcategories of teamwork, including working together, team superiority and
team morale, respectively. (p<o.310, p<0.292 p<0.187).

The SSRP-CPR, as a teamwork and leadership model, can improve the non-technical
skills of resuscitation. Therefore, it’s suggested that the model of SSRP-CPR could be used to train
the non-technical skills of resuscitation in a simulation and real resuscitation environment in hospital
resuscitation teams.

The family is an integral part of the treatment process and patient safety in intensive care units. Despite evidence of positive effects of family participation in patient care، the family presence in intensive care unit is still under question. Therefore this study performs to investigate the effect of family’s supportive presence on the recovery of patients with brain injury in intensive care unit. This randomized clinical trial was conducted on 60 patients with brain injury hospitalized in the intensive care unit in Kamyab Mashhad hospital. Intervention was patient''s primary care by members of the family in the first 6 days of admission. «Apache II” used as recovery scale، and the data were analyzed by SPSS version 11. 5. Based on the results of the independent t test، there was no statistically significant difference between the two groups in the mean of» Apache II” on the first day (p=0. 838). But the mean of «Apache II” score of patients in the intervention group showed greater reductions in sixth day than the control group (p=0. 005). Statistically significant correlation was found between female family member and change in»Apache II” scores in the intervention group (p=0. 006). Family’s supportive presence in the intensive care unit will speed up the patient’s recovery process. Existing concerns among nurses، and revising their beliefs about this، can provide the context for using the benefit of the family presence.

Despite the proven positive impact s of family presence on the patients in the intensive care units (ICU)، family presence in the ICU was limited due to concerns about patient safety and increase of nosocomial infection. Correcting the ICU nurses’ attitudes can be supportive for the patient''s family and provide positive effects. So، this study aimed to investigate the impact of patient’s family presence on the attitudes of ICU nurses in this unit. This quasi- experimental study was conducted between March 2010 to July 2011 on 45 nurses working in neurology ICUs of Mashhad Shahid Kamyab Hospital. The questionnaire consisting of 14 questions and 3 subsets based on the Likert scale and was used to evaluate the attitudes of nurses about family presence in the ICU before and after the intervention. Intervention included the presence of patient’s family twice a day. The results were analyzed with Paired t-test and Friedman test. Paired t -test results indicated that there was no statistically significant difference between the attitudes of nurses before and after the intervention (p=0. 810). There was a significant difference between changes in the nurses’ attitude and place of work (p=0. 008). The Friedman test showed significant differences between changes of the average scores of each of the 14 questions after the study (p=0. 013). This study shows that nurses are aware of the benefits of patient’s families supportive presence in the ICU، but due to concerns about the quality of patient care، providing care in the presence of family and cultural barriers in families about understanding the nature of care، they do not show a positive attitude towards it.

Sensory deprivation is one of the complications threatening the comatose patients. Sensory stimulation is a treatment that awakes the brain's reticular activating system, which helps brain re-organization. This study aimed to investigate the impact of familiar sensory stimulation on level of Consciousness in patients with head injury in ICU. This clinical trial was conducted on 60 patients with head injury in ICUs of Mashhad Emdadi Hospital. Intervention was the presence of family members and provides sensory stimulation in first 6 days of admission. Patients consciousness checked on GCS score on the first day and sixth and findings was analyzed with the SPSS 11.5. According to the non-normal distribution of the GCS, the Mann-Whitney test was used. The results of this test showed that the GCS in first day were homogeneous in two groups (P=0/402). Increase of GCS on the sixth day in the intervention group was more statistically significant than the control group (P=0/002). Early sensory stimulation is increase consciences in patients with brain injury. Revising in visiting policy in intensive care unit can be appropriate to provide positive effects of family presence on patient.