جستجوی مقالات مرتبط با کلیدواژه "بخش های مراقبت های ویژه" در نشریات گروه "پزشکی"

Nurses are exposed to depression, anxiety and stress due to direct contact with Covid-19 patients, which leads to a decrease in life satisfaction among nurses. The purpose of this study is to compare life satisfaction, depression, anxiety, stress and demographic characteristics of nurses in intensive and non-intensive care units during the Covid-19 pandemic.

The present study is descriptive-comparative. The research population includes all the nurses working in the hospitals of Zanjan province, Iran between the fourth and sixth wave of Covid-19 in 2021-2022. In this study, census sampling was used and 1355 nurses participated in this study. Demographic questionnaire, "Satisfaction with Life Scale" and "Depression Anxiety Stress Scale-21" were used to collect data. The validity of the instruments in this study were limited to previous researches and reliability by internal consistency method by calculating Cronbach's alpha coefficient. The collected data were analyzed in SPSS. 24.

The average life satisfaction of nurses in intensive and non-intensive care units is 21.35±7.48 and 20.44±7.66 respectively, the average depression in special and non-special wards is 11.85±4.55 and 11.54±4.48 respectively, anxiety was 11.30±4.10 and 11.00± 4.11 respectively, and stress was 13.69±4.72 and 13.05± 4.63 respectively. There was a significant correlation between life satisfaction and stress in intensive and non-intensive care units (P<0.05). But there was no significant correlation between depression and anxiety in intensive and non-intensive care units (P>0.05).

Nurses working in different wards of the hospital during the Covid-19 pandemic have different degrees of depression, anxiety and tension. It is suggested that in order to increase life satisfaction and improve the mental health of nurses working in hospitals, planning and necessary support measures should be done by nurse managers.

Nursing is a care profession and nurses, due to their professional nature, need moral courage to provide safe and professional care to clients. On the other hand, one of the needs of nursing education is to improve the professional ethics skills of nurses in order to provide nursing care based on professional standards and ultimately to ensure proper clinical care. Therefore, this study was conducted to investigate the relationship between clinical competence and moral courage of nurses working in the intensive care units' hospitals of Tehran University of Medical Sciences at 2020.

This multicenter Cross-sectional Study was conducted on 350 nurses working in the intensive care units' hospitals of Tehran hospitals who were selected by quota method. The data collection tools of the study included demographic questionnaire, clinical competency questionnaire of intensive care unit nurses and moral courage questionnaire of Sekerka et al.

The mean scores of total moral courage and clinical competence in intensive care unit nurses were 74.24±12.22 and 155.10±23.37, respectively. There is a strong and significant direct relationship between moral courage and clinical competence of nurses (r=0.81 and p=0.001). Clinical competence in nurses with more work experience, older, working in the morning and day shifts and with formal and contract employment status was significantly higher than other nurses (p<0.001). Also, moral courage in male nurses, married, with more work experience, older, working in the morning and day shifts and with formal and contract employment status was significantly higher than other nurses (p<0.001).

According to the results of the present study, moral courage increases with increasing the clinical competence of nurses. Therefore, it requires the attention of as many officials as possible in this regard.

Antibiotic resistance of pathogens responsible for nosocomial infections, has been a growing concern for healthcare system in recent decades. The aim of the current study was to identify the strains responsible for nosocomial infections and determine their frequency rates and antimicrobial resistance profiles in the patients admitted to intensive care units of Hazrat-e Rasool General Hospital in Tehran.

In this cross-sectional study we collected 936 blood, urine and sputum samples from the patients who had been admitted to the intensive care units of Hazrat-e Rasool General Hospital in Tehran between March 2020 and March 2021. Determination of strains and frequency rates of pathogens were carried out using multiple specific differential cultures. Then, we detected antibiotic resistance profile of each pathogen by using disc diffusion method.

Acinetobacter (22.5%), Klebsiella pneumoniae (18.7%), Pseudomonas aeruginosa (13.6%), Candida albicans (11.2%) and Escherichia coli (7.2%) were the most common pathogens involved in nosocomial infections in this study. Acinetobacter isolates showed the highest sensitivity to clostin (100%) and cefotaxime (97.2%), respectively, and the highest resistant rate to ampicillin sulbactam (38.9%).

The results of the present study showed that in addition to the diversity of different pathogens in causing nosocomial infections in intensive care units, antibiotic resistance of these pathogens which is on the rise should be regarded important. Results of the current study and other similar periodic studies can provide valuable information for monitoring and management of emerging drug resistant infections.

One of the critical unit in each hospital is intensive care unit (ICU). The United States’ Environmental Protection Agency (EPA) recommends to control the noise level of this unit in order to not exceed 45 decibels (dBA) during the day and 35 dBA at night. In this study, our goal was to evaluate the noise level at adult and neonatal ICUs at some Sanandaj’s hospitals, Iran.

This cross-sectional study was conducted from May 4th to June 4th 2012 in adult and neonatal intensive care units at three major hospitals in Sanandaj (Besat, Tohid and Tamin-Ejtemaei). In order to assess the noise level properly, measurements obtained during the days and nights. At a given day, a unit was selected randomly and measurement of sound levels obtained successively within two-hour periods. The noise levels were measured in decibels using a sound level meter (SLM). This process took four weeks to be completed (one week per unit). In the end of study, the total of 336 records of noise levels were obtained. Descriptive analysis as well as fitting a mixed effect models were used to interpret collected observations. All statistical analysis performed using R developed by R core team.

The preliminary analysis of observations showed that mean level of noise varied from 65 to 71 dBA among ICUs under study. Noise levels during the day were slightly higher than that of were observed during the night. Descriptive analysis of observations showed no major differences between the noise levels over the time and between the days/nights. Fitting a mixed-effects model showed significant differences of the noise levels between ICUs (P< 0.001).

We found the noise levels were always above the EPA thresholds at all three hospitals both during the day and night. It is recommended to train hospital officials and staffs for keeping noise levels to an acceptable level.

Scoring systems have been developed to predict outcomes in the critical patients and to facilitate the decision making and resource allocation for management of such patients.

The aim of this study was to compare Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) in predicting hospital mortality of intensive care unit patients.

This cross-sectional study was conducted on 88 patients admitted to the intensive care unit because of trauma or surgery in Shahid Rajaee hospital، Qazvin 2008. During the first 24 hours of admission، the results of clinical examination and biochemical assays and demographic information were collected to complete each of the scoring systems. Observed mortality and predicted mortality were recorded and compared. Detection value of scoring systems was assessed by Receiver Operating Characteristic (ROC) curves and data were analyzed using logistic regression analysis and Chi-Square test.

M ean age of patients was 44. 25 ± 23. 09 years (2 to 86 years). Observed mortality in ICU was 32. 5% and predicted mortalities were 23. 63±24. 2% and 19. 88±15. 1% according to SAPS II and APACHE II، respectively. There was positive significant correlation between SAPS II and APACHE II scoring systems and between these two scoring systems and observed mortality. There was also positive significant correlation between SAPS II and APACHE II values and GCS score. Area under the ROC curve (AUC) of APACHE II was greater than SAPS II for predicting observed mortality (0. 823 vs. 0. 790).

With regards to the results، both APACHE II and SAPS II scoring systems can be used to predict mortality of intensive care unit patients، but not to help in definite decision-making.

Up to now there is no study evaluating correlation between serum magnesium and morbidity or mortality in patients admitted in intensive care unit. The aim of this study is to determine the prevalence of hypomagnesemia in critically ill patients and to evaluate its association with organ dysfunction, hospitalization period and mortality. We conducted a retrospective trial including 100 patients aged 16 years and above admitted to the medico-surgical intensive care unit over 2 years. Firstly, total serum magnesium was determined and then its correlation with ventilator need, duration of mechanical ventilation, hospitalization period, and demographic characteristics were evaluated. At the time of admission, 51% and 49% of the patients showed hypomagnesia and normomagnesia, respectively. Significant difference was observed in mortality rate, hospitalization period, or hospitalization in intensive care unit between the two groups (P<0.05, each). Hypocalcemia, hypokalemia, and hyponatremia were frequently observed in hypomagnesemic patients. The patients with hypomagnesemia in intensive care unit demonstrated higher Acute Physiology And Chronic Health Evaluation II (APACHE-2(and Sequential Organ Failure Assessment (SOFA) scores at time of admission (P<0.01), a higher maximum SOFA score during hospitalization in intensive care unit, higher requirement to ventilator, and longer duration to mechanical ventilation than the other patients. The ROC curve of SOFA score in the hypomanesemia generated significant results compared to APACHE-2. An increase of 5 units in the APACHE-2 or SOFA measured during admission increased relative probability of hypomagnesemia by 0.12 and 0.16, respectively. Hypomagnesemia during hospitalization in intensive care unit was associated with a poor prognosis. Monitoring of serum magnesium may have prognostic and therapeutic implications.