فهرست مطالب فاطمه کلروزی

Timely assessment of health status and the adoption of preventive measures, especially among the military, reduce health injuries and minimize complications. Accordingly, the present study was conducted to determine the general health status of military forces in different countries of the world.

In this review study, articles published between (2005-2020) were reviewed. In order to obtain relevant scientific documentation, the references were searched in credible databases. Persian and English databases, including Academic Database of Academic Jihad (SID)), Magiran Database, Iranian Medical Science Database (IranMedex), PubMed, Google Scholar, Scopus, ProQuest, Ovid, Science Direct and Elsevier were searched. The selected keywords used in the search strategies, after examination in MeSH, were “General health”, “mental health” and “Military force”, finally 48 articles were included.

Studies have shown that the state of general health, especially mental health in soldiers and military forces has been considered. In most studies, this group general health was low and had more health problems (mental and physical) than the general population. Discussion and

Since military forces are at risk of losing their health according to their job position and duties, therefore, obtaining information on physical and mental health is very important for them, and this requires educational interventions, counseling and workshops. 

Military medicine students must be capable of functioning in highpressure war and crisis situations. To attain this objective, employing effective training methods is essential to ensure their learning is enduring.

The purpose of the present study was to compare peer and instructor education on the clinical dressing and perceived stress scores amongst nursing students of Aja University of Medical Sciences.

This was a quantitative study using a quasi-experimental approach and a pre-posttest with two groups. The study involved 54 first-semester nursing students who received four months of training at the Clinical Skills Center of Aja University of Medical Sciences in the second half of 2020. Data collection tools comprised a personal information form, a researcher-developed dressing skill assessment checklist, and the Cohen Perceived Stress Questionnaire. The students completed the perceived stress questionnaire before and after the intervention, and their clinical dressing skills were evaluated within four weeks post-training.

In this study, a statistically significant difference was found between the two groups regarding the mean clinical skill score after peer intervention (P<0.001), with the Peer education group showing better performance. Moreover, there was no statistically significant difference between the two groups in terms of perceived mean stress before and after the intervention (P= 0.35).

Peer education did not effectively reduce students’ perceived stress, but it did enhance nursing students’ clinical performance in dressing skills. Utilizing highersemester students to instruct lower-semester students is advised.

The coronavirus like other viruses has mutated genetically and created several variants that spread easily and cause more severe symptoms and mortality rates among people in society, especially in vulnerable groups. In this article, the studies conducted on the effects of covid-19 on pregnant women, as a vulnerable group, were reviewed.

In this review, articles published from 2019 to 2022 were examined. In order to obtain related scientific documents, an electronic search in English databases EMBASE, Cochrane Library, UP to Date, and PubMed using the keywords of Covid-19, Pregnancy, SARS-CoV-2 variants, medicinal considerations, and vaccination was performed and 78 articles were extracted. These Articles were available in full text. Materials published in the form of editorial letters or unavailable full text of a study were excluded from the study.

According to the conditions of the pregnancy, the symptoms of the disease, and different peaks and variants, drug and non-drug treatment methods are used to manage covid-19. Since some treatment methods are still being discussed in the management of Covid-19 in pregnancy, preventive measures such as vaccination are very important Discussion and

pregnant women are one of the vulnerable groups in the covid-19 pandemic with regard to their condition. Further studies are very important in order to treat this vulnerable group. It is recommended that the results of the studies be used according to the treatment and care conditions of each society for maintaining the health of pregnant women.

Today, Percutaneous Coronary Intervention is widely used in cardiac patients. The procedure is to open the arteries using a balloon and stent insertion and is associated with complications such as hematoma, bleeding and severe pain. The aim of this study was to compare the efficacy of two methods of cold compress and local anesthetic on pain after angiography by systematic review of previous studies.

In this review study, articles published between (2020-2000) were reviewed. In order to obtain relevant scientific documentation, electronic search in both Persian and English using Keywords (Angiography, Heart Disease, Pain, Cold Application, Local Anesthetics) in Academic Database of Academic Jihad (SID) ), Magiran Database, Iranian Medical Science Database (IranMedex), PubMed, Science Direct, Ovid, ProQuest and Google, and 20 articles The study was adapted to the effect of using two methods of cold compression and local anesthesia on the severity of pain after angiography, 12 articles due to lack of access to the full text, and being out of the defined time frame (2000 -2020) were removed from the study and the remaining eight studies were reviewed.

Studies have shown that a variety of methods, including pharmacological (topical anesthetics) and non-pharmacological (cold compresses), are used to reduce pain in patients undergoing angiography. The results all studies showed that cold compress were significantly effective in reducing pain after angiography and were more effective in reducing pain than local anesthetics.

According to the results of studies and the effectiveness of non-pharmacological methods in reducing pain after angiography, this method can be used to provide relief and pain relief after angiography

 Coronavirus disease 2019 (COVID-19) pandemic has caused a great deal of conflict and tension between couples and their families. Meanwhile, less attention has been paid to potential tensions and conflicts in families exposed to high stress, such as military families. Therefore, this study was conducted to investigate the effect of cognitive-behavioral therapy on changing the conflict resolution styles in military personnel and their spouses during the COVID-19 pandemic.

 In this quasi-experimental study, 66 military personnel and their spouses were included. They were then assigned to the case (n=32) and the control (n=34) groups using block randomization method. Data were collected by using a demographic information form and Rahim Organizational Conflict Inventory-II. The later form was completed before, immediately after, and one month after the intervention. Cognitive-behavioral therapy was presented to the case group during 9 sessions. Each session lasted 90 minutes. The Control group underwent no intervention. Independent t-test, Chi-square, and Fisher's exact test were used to analyze the data by SPPSS software (version 22).

 The results showed that the use of non-constructive conflict resolution style was significantly reduced in the case group compared to the control group (P<0.001) after the implementation of cognitive-behavioral therapy. In addition, it was found that the use of constructive conflict resolution style increased significantly in the case group compared to the control group (P<0.001).

 Our findings suggested that cognitive-behavioral therapy reduced the use of non-constructive conflict resolution style but increased the use of constructive conflict resolution style among military personnel and their spouses.

Introduction:

Patient safety is an important health strategy. Therefore, it is important for nurses to safely inject principles. The purpose of this article is to provide a comprehensive overview of the researches done on the status of nurses’ performance regarding safe injection in Iran.

Materials & Methods:

This is a comprehensive review study. In order to find relevant studies, a search was conducted through Academic Jihad Scientific Database, Iranian Medical Science Database, English databases including Google Scholar, Medline, Scopus, Elsevier, PubMed, Science Direct Nurses ‘Performance and Safe Injection and Nurses’ Performance and Safety Injection were used without time limits.

Results:

Of the 56 papers obtained after a thorough review, 12 articles were selected. By studying these articles, it was found that unsafe injection methods, including preparation of contaminated medicines, contaminated needle contact, reuse of contaminated needles and syringes, improper disposal of sharp and window waste as an effective factor in transmitting diseases. Blood-borne diseases (hepatitis B, hepatitis C and AIDS) have been introduced. In most articles, the most dangerous unsafe injection that puts nurses at risk is contact with the infected needle head.

Discussion and Conclusion:

Overall, the results showed that there is no accurate and reliable information about the performance of nurses in safe injections in Iranian hospitals. Although most injections are in a relatively safe and safe range, they are expected to be fully complied with WHO guidelines that regard compliance with more than 90% of these standards. It is therefore recommended to consider supportive measures such as improving injection methods, modifying the work plan, planning training programs for the use of personal protective equipment and providing sufficient safety equipment for nurses.

Pain management and promotion of pulmonary function are the most important goals in caring for patients undergone heart surgery and should be a priority in the care program.

The present study aimedto compare the effect of massage and hot towels on pain and pulmonary function in patients undergoing open-heart surgery.

The study population of this clinical trial study consists of all patients undergoing open-heart surgery in the intensive care unit of selected Aja hospitals of Shiraz in the second half of 2020. Ninety patients were selected by purposive sampling method and randomly assigned to three groups of heat therapy, massage therapy and control. For heat therapy group a 42 degree- heated towel was used, and for the massage therapy group, stroke massage was applied on the patient’s back in the second to fourth days after the operation. Visual pain scale and motivational spirometry results were used to collect data from the demographic information questionnaire. Data were analyzed using SPSS 21. The significance level was considered less than 0.05.

In this study, the means of pain intensity and pulmonary function before the intervention were not significantly different in the three groups (P>0.05). But on the third and fourth days, it changed in the massage (P<0.001) and heat (P<0.001) groups. Massage therapy was more effective in reducing pain intensity.

The use of back massage by hands and hot-towels affect muscular pain and pulmonary function of patients undergoing CABG. Besides, itreduces pain and improves pulmonary function in patients. However, the present study found the effectiveness of hand massage Therefore, it is recommended that nurses caring for open-heart surgery patients use these two methods specifically hand massage.

Adherence to preventive behaviors of people in a community affects the health of the people of that community. Performing these behaviors and determining their predictors in soldiers is very important because of the situation and conditions in which they are placed.

This study aimed to determine the relationship between health literacy and the preventive behaviors of soldiers.

This is a descriptive-analytical cross-sectional study and the research community consisted of soldiers during the necessity service period of the Armed Forces barracks in the Northwest of the country in the first half of 2020. Three hundred qualified soldiers were enrolled in the census. To collect data, questionnaires of soldiers’ demographic information, health literacy of the Iranian adult population, and a researcher-made questionnaire on preventive behaviors were used. Data were analyzed using SPSS software version 23 using Pearson correlation confidence.

The percentage of the sing subjects was 84.3%, 38.8% had undergraduate education, and 80% were non-native with a mean age of 22.16±3.24 years. The level of health literacy of soldiers (62.08±12.93) was not enough and the level of preventive behaviors (12.69±5.66) was low. Based on the results, the relationship between health literacy and preventive behaviors (r = 0.163, P=0.006) was significant and direct. The relationship between marital status (P=0.046) and hospitality history (P=0.049) with health literacy was significant and the health literacy of married soldiers with a history of hospitalization was higher.

Given the importance of health literacy in predicting health behaviors and its direct and significant relationship with preventive behaviors, it is recommended to assess the health literacy for all soldiers at the beginning of the military service and consider training programs for its promotion in low-level cases.

Caring for patients treated with mechanical ventilation is of particular importance because of its complications. The occurrence of various diseases, including pneumonia and its resulting mortality, is affected by inadequate and improper implementation of principled and safe instructions by the care team, especially nurses.

This study aimed to evaluate the implementation of airway care safety guidelines for patients under mechanical ventilation.

This descriptive study was performed in 2020 in the intensive care units (ICUs) of selected Military hospitals in Tehran. The study population included all nurses working in these wards. The performance of 90 nurses working in these wards was observed four times. A total of 270 observations of nurses’ performance in patients’ airway care were recorded in a researcher-made observation checklist. Data were analyzed using SPSS software version 25 and descriptive and inferential statistical tests such as independent t-test, ANOVA, and Pearson correlation coefficient. The significance level was considered less than 0.05.

In total, 61.1% were male, 54.4% were married, 92.2% were bachelor, and 7.2% had a formal contract with a mean age of 33.36±8.44 years. The total amount of care in the first time was 35.08±7.59, in the second time was 35.12±7.30, and in the third time was 35.61±7.05. Safe airway care of patients had a significant relationship with the variables of gender, marital status, work experience, type of employment, shift and work history of patient safety, intensive care, and mechanical ventilation.

In this study, it was found that the status of implementation of airway safety instructions by nurses for patients under mechanical ventilation is at an unfavorable level. Further monitoring of nurses’ performance, practical and quality training on how to care for patients’ airways, and strict implementation of safety instructions are strongly recommended.

Safe injection as a part of the quality and safe care, is one of the common methods of prescribing drugs. If safety standards are not observed, recipients and service providers may face many risks..

The present study aims to compare the effect of training through a workshop and training through an online learning content on the knowledge, attitude and practice of emergency ward nurses in selected AJA hospitals regarding safe injections.

This quasi-experimental study was performed on 46 nurses in the emergency ward of selected hospitals in Aja, Tehran in 2019-2020. Eligible participants were randomly divided into two training groups through the workshop and virtual training. The effect of training on nurses’ knowledge, attitude, and practice about safe injection before, after, and one month after the intervention was investigated. Awareness, Knowledge and attitude questionnaires and observational performance checklists were used for this purpose. Data were analyzed through descriptive and inferential tests in SPSS 23 and the significance level was considered less than 0.05.

There was no significant difference between the knowledge and attitude of the two groups before and after the intervention (P>0.05). Furthermore, there was no significant difference between the performance of the two groups before the intervention (P>0.05), but after the intervention, the performance score in the workshop training group was significantly lower than that of the other group (P<0.05). There was no significant difference between the performances of the two groups one month after the intervention (P>0.05).

The results of present study showed that the nurses who participated in the training group had a higher performance than the those trained by online learning educational content. Therefore, this method can be used to improve the performance of nurses and ultimately improve the quality of their performance in providing care services.

Pulmonary complications as one of the most common, important and costly complications after surgery play an important role in the incidence of disability and mortality of patients. The purpose of this Article is to review studies on the effects of the use of incentive spirometry in reducing pulmonary complications after surgery.

This systematic review by searching the keywords of pulmonary complications, spirometry, incentive spirometry and surgery in valid Persian databases Google Scholar, SID, IranDoc, Iran Medex and Magiran and searching English articles in the reputable English databases Web of Sciences, PubMed, ProQuest, Google Scholar, Science Direct and Scopus from 1997 to 2020 and A total of 844 articles were found. 14 articles were extracted from them. Inclusion criteria included originality, writing in Persian and English, and consistency with the purpose of the study, and exclusion criteria included not having access to the full version of the article.

In total, 6 articles confirmed the positive effects of incentive spirometry in reducing pulmonary complications, but 8 articles did not provide evidence of these positive effects.
Discussion and

Based on the results, it cannot be said with certainty that the use of this method can be effective in reducing pulmonary complications after surgery. Further studies under specific conditions are needed to achieve the goal and find common ground on the benefits of incentive spirometry.

Communication is the process by which information is transmitted from person to person through symptoms, symptoms and behavior. Communication skills have long been recognized as an important part of medical and nursing care. Regarding the fact that effective communication forms the basis for the quality of care services, there have always been many debates. In this article, the strategies used in related articles in promoting nursing communication skills are discussed.

In this review article, published articles were reviewed between years (2009-2017). At this stage, the researcher reviewed the literature on referring to valid databases such as Medline, Science Direct, ProQuest Google, and IranMedex. Nurses, communication skills and their combination were searched for keyword search, communication keys, nurses and communication skills.

Several studies have shown that nurses are not well-informed in communicating with patients and patient entourage and other staff in the treatment, which causes a lot of problems in the treatment process. Therefore, the recommended patterns and strategies in these articles can be effective in solving this problem.

Discussion and Conclusion:

Communication skills are one of the basic principles of nursing profession. Therefore, by reviewing and summarizing the nurses’ problems in the field of communication skills, planning and proper training in this field can enhance communication skills of nurses.

Pain is a common and unpleasant complication reported by patients undergoing angioplasty following arterial sheath removal. Pain is one of the most common complications of arterial sheath removal in patients undergoing coronary artery angioplasty, which has been reported to be very unpleasant.

This study aimed to determine the effect of cold compress on pain intensity due to arterial sheath removal in patients undergoing coronary angioplasty.

The present study is a semi-experimental study consisting of 60 patients undergoing coronary artery angioplasty hospitalized in selected hospitals of Aja in the second half of 2019. The research samples were selected by convenient method and randomly divided into cold compressions (n= 30) and control (n= 30) groups. Demographic and Visual Analog Scales were used for data collection. The intervention  was done using a 2 × 2 × 4 cm ice pack placed in a latex glove with a sterile gauze cover and used for 5 minutes before the the removal of sheath and there was no intervention in the control group. Data were collected in three stages before, during and after the intervention and analyzed with SPSS 23.

Mean scores of pain intensity were not significantly different between the two groups before the intervention, while in comparing these two variables during the intervention, a statistically significant difference was observed between (P<0.001).

The results showed that cold compress can be effective in reducing the pain intensity to arterial sheath removal in patients under coronary angioplasty, so it is recommended that one of nursing interventions be used in this regard.

Anxiety is one of the common symptoms and complications in patients with chronic obstructive pulmonary disease that increases readmission and decreases the quality of life in these patients.

This study aimed to determine the effect of controlled breathing exercises on Anxiety and Arterial Oxygen Saturation in chronic obstructive pulmonary disease in the intensive care unit.

This study is a quasi-experimental study with statistical population consisting  of all patients with chronic obstructive pulmonary disease hospitalized in selected hospitals of Aja in the first half of 2019. The samples were divided into two intervention and control groups. For data collection, Demographic information, Beck Anxiety Inventory and Pulse Oximeter were used. The intervention group received controlled breathing exercises for four days. Data were analyzed using SPSS 23.

Mean scores of total anxiety and arterial oxygen saturation were not significantly different between the intervention and control groups before the intervention, but there was a significant difference between  both groups after the intervention, using independent samples t-test (P<0.001).

The results showed that controlled breathing exercises can  can reduce anxiety and improve arterial oxygen saturation level in patients with chronic obstructive pulmonary disease, Thus, it is recommended that they be used by nurses as a nursing intervention.

Today, anxiety disorder in cancer patients, especially breast cancer, has become increasingly important due to its high prevalence in women and its psychological impact as one of the most sensitive and most difficult duties of health care workers. Today, efforts to reduce centralized anxiety Has been. Anxiety control in patients with cancer can be positive if properly and effectively, and encouraging the patient to pursue treatment by hoping for the treatment of the disease will lead to active participation in therapeutic programs. Therefore, the present study aims to Determination of the effect of multimedia education program on the anxiety of patients with breast cancer.

The present study was a review study conducted in Persian databases of Iran medex, sid and English databases, Pubmed, Web of Science, Scopus, Science direct, and Google Scholar in 2019. The key words were Multimedia, Education, Anxiety, Breast Cancer. The timeframe was between 2004 and 2019. The criteria for entering the study were 1- Original research 2. The full text of the article is available 3. The language of the articles is Persian or English. Case studies, short articles, studies, letters to the head and systematic and review articles were deleted.

11 articles were selected for inclusion in the study. The results showed that age, education, occupation, income, family dimension, and gender were important predictors of anxiety evaluation. In some studies, interventions based on the multimedia education program have increased the self-efficacy of the individuals. Also, behavioral control and perceived risk from the disease show the positive effect of the multimedia education program on the anxiety of the patients.

The effect of information transfer on the basis of multimedia education program has been shown to improve the anxiety of patients with breast cancer. Often people who received multimedia information have shown a more significant decline in their anxiety than other groups.

Patients-with cancer in chemotherapy wards, face high degree of mental tensions such as anxiety in disease. These patients require effective training methods to manage anxiety. Multi-media education is one of the most useful and flexible educational strategies.

Thus, the present study aimed to investigate the impact of multimedia education program on the level of anxiety in patients admitted to chemotherapy wards.

The present study is quasi-experimental and was performed on 30 patients with definite diagnosis of cancer referring to selected AJA hospitals in Tehran. Sampling was done randomly. The researcher gave educational CDs to the intervention group and no intervention was performed in the control group. The Spielberg’s Anxiety Inventory contained 20 multiple choice questions. Finally, the data were analyzed using SPSS software 16.

The results showed that there was no significant difference between the mean anxiety scores before and after the test group (before: M= 43.96±6.05, after: M= 43.40±5.95) and the control group (before: M= 45.13±10.06, after: M= 47.53±10.32) (P> 0.05).
Discussion and

The results of the present study showed no significant difference between the mean anxiety scores before and after the test group, but it is recommended to perform further comprehensive studies.

Communication skills and social compatibility have long been recognized as an important part of medical and nursing care. Nursing, due to its feature, requires high social compatibility, specially nurses in psychiatric ward whose main responsibilities are to create a relationship based on trust and motivation in patients to participate in the treatment process. In the Fellner Social Competence Model, various components and dimensions of social adequacy are identified and, accordingly, the necessary training is provided for the development of social skills.

The present study aimed to investigate the effectiveness of Social Competence training based on Felner Model on Communication Skills and Social Adjustment of nurses in the psychiatric ward.

This study was a quasi-experimental study. Sixty selected nurses in the psychiatric ward of the AJA hospitals (in 2018) were included in the study and equally divided into the experimental and control hospitals. The experimental group was trained in a two-month 10 sessions, each 60 minutes based on Felner Social Competence Model and Barton Communication Skills questionnaire and Bell Social Adjustment questionnaire were used for data collection. Then, data were analyzed based on descriptive and inferential statistics using SPSS 25.

The result of independent and dependent t tests showed that Social Competence training based on Felner Model significantly improved the mean scores of Communication Skills and Social Adjustment after the intervention (P<0.05). A precise examination of the sub-components of communication skills showed that in all of the sub-components, the scores increased after the intervention but this increase was only significant for the sub-component of listening skills (P=0.01).
Discussion and

Felner Social Competence training is an effective way to improve the Communication Skills and the Social Adjustment of nurses in psychiatric ward. Thus, experts and health professionals can use Felner Social Competence training as an effective way to improve the Communication Skills and the Social Adjustment of their nurses in the psychiatric ward.

External body aspiration - one of the medical emergencies in children -is one of the most important causes of mortality in the five years old children. The most important factors for the referral of children with foreign body aspiration are coughing, confusion, shortness of breath and less often with a history of sudden choking. The purpose of this article is to familiarize with the aspiration of foreign bodies in children and how to manage and treat them.

This article is a review which is conducted based on library studies and search via Internet databases of MEDLINE, PubMed, SID and Magiran, over the years 2005 to 2015 by aspiration, children and foreign body keywords

The most common aspirated material in Asian parts of the bony parts, but in European countries, were organic materials, including peanuts (children’s toys, coins, or even teeth may aspirate. Aspiration of the foreign body is based on high clinical suspicion and Take a biography and conduct a thorough physical examination. Normal breast gradient does not reject this distinction. In cases where this diagnosis was suspected, but the chest was normal, complementary imaging methods should be used. However, bronchoscopy is the best way to diagnose and treat this disorder, but in many cases fibrobuccory bronchoscopy can also be used in this direction. There are several methods for aspiration, the most important of which is the drainage of the inner tube, repeated injections of 5-10 ml of distilled or serum, the use of a large amount of liquids, and so on.

In spite of timely diagnostic and therapeutic measures, foreign body aspiration is still associated with high morbidity and mortality, but more attention is paid to biographies and clinical symptoms, and considering the possibility of absence of radiological findings and more diagnostic measures, It is possible to prevent the mistake or disregard of the correct diagnosis and tried to protect the lives of these patients. One of the most important causes of awareness is aspiration, because parent’s awareness can be helpful in reducing aspiration.

Receiving safe care, based on the knowledge of the day and based on the superiority of the patient's benefits, is one of the fundamental rights of patients in the health system of all countries, including Iran. The purpose of this article is to provide a comprehensive overview of all research on the safety of pediatrics intensive care units throughout Iran. Using the documentation, reports and articles published in this context, the authors review the safety status of the pediatrics safety in intensive care units in Iran.
This study is a comprehensive overview study. In order to find relevant studies, a search was conducted through Persian language databases including Magiran, SID, and IranMedex; and also the English language databases, including Google Scholar, Medline, Scopus, Elsevier, PubMed, and ScienceDirect, using the Persian keywords "Pediatric Intensive Care Units and patient safety" without any time limitations.
Of the 61 papers obtained after a thorough review, 35 articles were selected. Regarding the research goal, ten articles were directly related to safety in the PICU section and were published in English and Farsi in domestic and foreign journals, and access to full text or summary of the article was provided in this study.
There are no accurate statistics on the safety of PICU sections in Iran. It seems that lack of awareness among nurses about safe delivery, high workload, inadequate safety culture in departments, and inappropriate policies in providing patients with safety are among the most important factors affecting children's inadequate child safety.

Patients as one of the most vulnerable social groups from the aspect of physical, psychological, social and economic, have formal and legal rights that in all societies try to follow it. In this paper, is tried to review the history of patient’s rights charter and then the results of several studies on the situation of patients’ rights in health centers has been reported.

This paper is a review article that based on collecting data by searching the key words: “Patients’ rights” “Hospitalized” in the library, theses and online databases: SID, Google Scholar & Magi ran among 2008 -2016 has been done.

Effective factors on patients' rights are classified in three groups: organizational factors, factors related to personnel (doctors, nurses) and factors related to service recipients (patients, clients). In addition, factors such as age, education level, place of residence (urban / rural), duration of hospitalization, can have an impact on patients' rights. Also marked, this charter as well as among health care personnel and patients is unknown or if know, have still not implemented properly.

Discussion and Conclusion:

Patients' rights are not in good condition. Therefore, it is suggested, the authorities focused on programs to educate and increase public awareness in base of patient rights.

Foot injuries and wounds are one of the most important complications of diabetes, which accounts for a large share of the cost, time and manpower of health systems. Nurses as the most important member of the health care team can play a vital role in preventing, diagnosing and educating the patient. In this article, we have tried to explain the role of nurses and their education in improving the level of health literacy and self-care of diabetics in order to prevent and reduce the complications of diabetic foot.

This article has been reviewed through a search of databases such as SID, PubMed, Google Scholar, and library resources published over the last 10 years.

Various studies show that over 15% of diabetic patients develop diabetic foot ulcers during their life, that one of the most important complications of that is foot amputation. Treatment for diabetic foot is very difficult, but prevention is much more beneficial and economically more economical. Studies have shown that nurses with timely diagnosis, training on their complications for predisposed individuals, regular diabetic footprints, proper foot cover, and rapid treatment of foot problems can play an important role in the prevention and treatment of diabetic foot.

Discussion and Conclusion:

The results of this study indicate that nurses play the most important role in the prevention, care and treatment of diabetic foot. Therefore, it is suggested that nurses, by participating in training classes and in-service training workshops, try to update their knowledge in this field so that they can pass on their knowledge about ways to prevent diabetes with the best quality.

In the event of health crisis, optimum performance crisis team personnel, are necessary and expected, and the key to success in managing the large number of victims with limited resources is triage; therefore triage training of crisis team nurses is very important.
The purpose of this study was to determine the effect of triage education by pre-advance organizer model on knowledge of crisis team nurses at AJA selected hospitals.
In this quasi-experimental study, during year 2015, two hospitals affiliated to the army, based on the centrality of the crisis, were considered as the study population and assigned to intervention and control groups, 50 nurses from the two hospitals were selected, based on available sampling. Educational content triage in crisis by the pre-advance organizer model in two sessions for an hour and a half was held for the experimental group while the control group did not receive any intervention. For both groups, pretest and post test tools, demographic questionnaire, and knowledge questionnaire were used. Finally data were analyzed by using descriptive analytic statistics using the SPSS version 22 software.
The results showed that the mean knowledge of nurses before the intervention in the experimental group was 8.66±1.65 and in the control group was 7.57±1.19, respectively (p=0/264) , and after the intervention, in the experimental group it increased to 15.66 ±1.02 and in the control group to 8.3±0.92; the independent T-test showed a difference between the two groups, which was statistically meaningful (PDiscussion and Considering the positive results, the use of pre-advance organizing model to promote awareness of crisis team nurses, and subject triage crisis training for faculty of nursing and retraining workshops are recommended.

Performance improvement in organizations requires a good model for the performance evaluation, because of realization goals in the absence of a comprehensive model for assessing and reviewing plans is not possible and organizations cannot regardless of the results of operations, effective management of their programs don’t apply. Among the models that are currently in clinical audit and clinical governance model can be cited. This article aims to identify the impact of the clinical audit and its relationship to quality of care and improve clinical effectiveness in nursing.
Material& This study is a review article based on data collected from regular search internet resources in pubmed and google and SID Sites , library studies and scientific articles have been published between 2000 and 2012 have been used.
The findings suggest that the clinical audit is an cyclical process, which is performed in several steps to improve the quality of services focuses on a different area and in addition to, the clinical audit can be a tool to measure and evaluate the quality of care, can be used as a training tool to develop new ideas about care and learning experiences are also discussed.
Due to this topic, the clinical audit process impressive effect on quality of clinical services, it seems that this process can help to improve the services provided by nurses in clinical environment.

According to the statistics, hemodialysis is a widely used medical practice for patients with kidney problems. This method involves frequent intravenous cannulation, which is associated with an intense pain insofar, as it is expressed intolerable by one fifth of patients undergoing hemodialysis.
This study aimed to investigating the effect of shiatsu massage as a non-pharmacological and non-aggressive method on venipuncture pain in patients undergoing hemodialysis.
This randomized clinical trial was conducted with participation of 72 patients undergoing hemodialysis, visiting the hemodialysis wards of AJA hospitals in Tehran in 2015. Patients were first divided into intervention and control groups using random number table. On the first visit, demographic information of both groups were collected using demographic inventory and their pain was measured with pain assessment scale. On the second visit, 20-minute shiatsu massage of the point LI-4 was given to the intervention group before intravenous cannulation, and the amount of pain at the insertion site was measured again with the same scale. The collected data was analyzed with descriptive and inferential tests using SPSS 19.
There were no significant differences between the two groups in background variables using chi-squared, Fisher’s exact and independent t-tests. The mean pain scores at the insertion site were 5.91 ± 0.8 versus 5.75 ± 0.64 in the intervention and control groups, respectively. This between-group difference was not statistically significant (P = 0.87). The mean post-intervention pain score was significantly lower in the intervention group than the control group (3.69 ± 1.16 versus 5.61 ± 0.76) (P = 0.001).
Discussion and The research findings suggested that the use of shiatsu massage of the point LI-4 (between the thumb and the index finger of patient with arteriovenous fistula) can decrease the pain at the site of insertion. Therefore, nurses are recommended to use this technique to ease the pain at the insertion site in patients undergoing hemodialysis.