جستجوی مقالات مرتبط با کلیدواژه « CCU » در نشریات گروه « پزشکی »

Colors and their effect on the human mind and body have been investigated in various ways, and patients admitted to the intensive care unit experience a lot of stress due to environmental factors and special treatment conditions. This study was conducted with the aim of comparing the effect of blue and green light with normal light on the vital signs and anxiety levels of patients admitted to the Coronary care unit (CCU)..

This clinical trial was conducted on 75 patients admitted to the CCU department of Imam Khomeini Hospital in Esfarayen North Khorasan in 2021-2022. Patients were randomly assigned to three groups of blue, green, and white light, and vital signs were measured every half hour, and patients' anxiety was measured twice (at the beginning and end of the study) using the Spielberger questionnaire. Data analysis was performed using repeated measures ANCOVA.

The variables of pulse, breathing rate, blood pressure, temperature, and anxiety levels were not observed significant difference between the subjects of the intervention groups and the control group (p>0.05). In the intervention group with blue light, blood oxygen saturation level on the first and second day and the second and third showed a significant difference (p<0.05).

There was no difference between the effect of blue, green light and white light on the level of anxiety, breathing, blood pressure, temperature, and pulse rate; But blue light had an effect on blood oxygen saturation level. It is suggested to study more in this field.

Hospitalization in the cardiac care unit (CCU) is a stressful event that can adversely affect the patient's recovery process. Another factor that may be affected by stress is hemodynamic indices. The aim of this study was to determine the effect of stress on hemodynamic indices in patients admitted to the CCU.

The present study is a descriptive correlational study in which the research population consisted of patients admitted to the CCU of Imam Khomeini Hospital in Tehran in the second half of 1400. 210 patients were selected by Convenience Sampling and based on inclusion criteria. Patients' demographic questionnaires and DASS-21 were used to collect data. Data were analyzed using SPSS 16 software.

The mean age of patients was 53.85 ±13.89 years. 65.3% of patients were male, 91.3% were married and 48% had undergraduate education. The mean stress of patients was 22.81 ±9.57 in the moderate range. 14.76% had normal stress, 27.61% had mild stress, 39.04% had moderate stress, 13.80% had severe stress and 4.79% had very severe stress. Correlation between patients' stress with hemodynamic indicators such as systolic blood pressure (P <0.001, r = 0.726), mean arterial pressure (P <0.001, r = 0.435), heart rate (P <0.001, 311) R = 0) and respiratory rate (P = 0.002, r = 0.255) were significant, so that with increasing stress, all these indicators increased.

The stress level of patients admitted to CCU was moderate, but according to the effects on the recovery process and hemodynamic indicators should be managed, it is recommended that nurses working in CCU in their examination to psychological complications and consequently it should pay attention to hemodynamic indicators.

Every year, many patients in different wards of the hospital die due to human error. One of the important aims in the field of human errors related to clinical care is to identify and prevent the occurrence of harmful effects caused by such errors. One of the preventive approaches in order to prevent human errors is to recognize and analyze them. The purpose of this study is to investigate all clinical care processes in the coronary care unit, identify human errors and prioritize the tasks and errors in this section.

Methods and Materials:

 This descriptive-analytical study was performed cross-sectional in three stages. In the first stage, human errors were identified and evaluated using the SHERPA approach and the frequency of each human error in the CCU was determined. In the second stage, the criteria and factors affecting the occurrence of human error in the CCU were determined by Delphi method. Finally, in the third stage, with the Analytic hierarchy process, the criteria and tasks that had the highest frequency of errors were prioritized. SPSS.24 and Expert choice.11 are two software that used to analyze data in this study.

Among the 116 identified errors with SHERPA, the highest percentages of errors identified from the total errors were related to the functional error (68.1%) and lowest percentages related to selective errors (2.58%) respectively. The results of different Delphi rounds showed that the factor of skill, experience, equipment, work time and workload are the most important factors which affecting the occurrence of human errors in the CCU. By pair comparison of this factors, we founded that experience and skill of nurses, with a weight of 0.278 and 0.272, have the most important and factor of equipment with a weight of 0.087, had the lowest important among the five effective factors for incidence of human error in the CCU. The task of extracting airway discharge with a weight of 0.125 was the most preferred among 16 tasks, in other words task of extracting airway discharge was the most risk of error in functional error. Factor of experience and skill as the most important factor in the occurrence of functional error. In the error type of recovery, the task of identifying drug information (time, date, dose and dosage form, etc.) with a weight of 0.054 was the highest rank in this type of error. The factor of experience and loading with weights of 0.018 and 0.01 were the most important, respectively in this type.

In the coronary care unit, functional and revisions errors in the vital tasks such as cardiopulmonary resuscitation, dose adjustment, and proper drug injection were the most common. Therefore, design and implementation of control measures such as periodic training on how to do the job properly, preparation of checklists with a focus on human behavior in different job processes recommended to eliminate or reduce the amount of identified errors in the hospitalchr('39')s CCU.

Nowadays, medication errors as the most common medical error are among the most important health and safety issues for patient safety. The aim of this study was Assessing and Management of Clinical Risk in medication Process of CCU in Mashhad teaching hospitals by HFMEA Method.

The present study is a combination (qualitative – quantitative, cross sectional -descriptive) method. Data was collected through direct observation, review of documents, FGD technique by Non-probabilistic sampling based on purpose and by HFMEA standard work-sheet to risk analysis, decision tree analysis, identifying the root causes of failure states and suggestion of Improvement measures. In this study Fuzzy AHP (Analytical hierarchy process) Technique for selecting Priority Process, the Eindhoven model (ECM) was used and the Idea Generation Method was used to suggestion Improvement measures. Finally, data was analyzed using Excel software by descriptive statistics.

A total of 50 failure states in the 5-step medication process were identified, so that failure states were identified as unacceptable risk.so that from the total root causes of erorrs were categorized based on the ECM model, 62.7% of latent errors and 37.3% of obvious errors and Improving measures were suggested., if these strategies are implemented, in the re-evaluated Controlled Risk The ratio of unacceptable risks will decrease from 56.9% to 21.6%.

The essential medication process due to Medicinal errors in some cases instead of treatment may increased costs, injury and prolonged hospital stay. The HFMEA Method with preventive approach and the focusing of systems rather than individual errors, in order to identify and resolve increases the agreement on process and organizational weakness and can play an Effectiveness role in eliminate the root causes of errors, especially in the sensitive and complex of the CCU ward.

Complaints of sleep disorders are common in ischemic heart patients, even after taking sleeping drugs. Evaluation of the causes of sleep disorders and modifying these factors that lead to the progression of patients' treatment is very important. Therefore, this study aimed at investigating sleep disorders and their effective factors in cardiac ischemic patients admitted to the cardiac care unit (CCU) with the use of sleeping drugs. This descriptive analytical study was conducted on 250 patients in the CCU ward of Kashan Shahid Beheshti Hospital, during 2017-2018, using the random sampling method. Data were collected by a specific questionnaire with 0.90 validity and 0.76 reliability. In total, 80.4% of the patients reported a degree of sleep disorders. The most common problems were observed subsequently in the onset and duration of sleep, sleep disorders due to environmental factors, daily dysfunction, sleep disorder due to heart disease, and respiratory problems during sleep. Among the environmental factors, there was a significant relationship between sleep disorders and lack of a comfortable bed condition (OR=20.42), continuous illumination of the lights (OR=19.05), feeling of hot or cold (OR=15.44), feeling of the unpleasant odor (OR=13.60), and high levels of noise in the ward (OR=12.22). According to the results of this study, paying more attention to these patients, comprehensive review of them, and the establishment of a care plan for the improvement of sleep conditions are necessary in hospitalized patients.

Big volume of patient’s medical data is one of the medical error reasons in coronary care unit (CCU). The purpose of this study was the designing a system that can monitored the patient’s vital sign continuously and when there are abnormal, producing alarms and proposed appropriate medical interventions according to the patient’s conditions in CCU.
This was application-development study that done in cross-sectional method in Shahid Rajai hospital at Tehran in 2015. 15 physicians and 15 nurses of CCU were considered as non-random purposively sampling. MEAN.js technology and MIMIC II Physionet’s database were used for system designing.
Normal and abnormal ranges of Vital signs were assessed according to the environmental and population conditions in this study. Variety of therapeutic interventions due to the patients’ vital signs changing was identified with their priorities. The results showed that the clinical decision support system (CDSS) had accuracy (94/68 %), sensitivity (82/60 %) and specificity (100 %) in proposing of proper interventions and had (92/92 %) accuracy, (80 %) sensitivity and (100 %) specificity in producing of timely alarms.
There are several factors that impact on determining of normal and abnormal ranges of vital signs and interventions priorities. The results showed that CDSS can help professionals in appropriate medical interventions selecting in unanticipated conditions at clinical care processes. At clinical point, this system can improve the understanding of vital signs, patient health conditions and decision-making process that can help in reducing of medical errors.

The attitude of hospital workers toward safety culture in working domain has a direct effect on safe quality of care services to patients. Therefore, the purpose of this survey was studying the safety attitudes of the nurses of CCU in the educational and non-educational hospitals of Ahvaz and comparing them to each other.The cross-sectional study was performed for 75 volunteer nurses of CCU. The data was collected through a modified Safety Attitude Questionnaire (SAQ) relating to the CCU wards. Reliability and validity of the questionnaire obtained from other studies. The data on six safety dimensions include teamwork climate, job satisfaction perception of management, safety climate, working condition, and stress recognition were scaled and scored for positive and negative questions separately using a 5-point Likert scale. Statistical analyses of the means were conducted using SPSS 16 Anova and pearson correlation at a significance level of P< 0.05.the results showed that the scores average of safety attitude in the 6 parts, i.e., teamwork climate, job satisfaction, perception of management, safety climate, working condition, and stress recognition was 68.37, 55.26, 52.11, 48.46, 57.04, and 57.09 for the nurses of the educational hospitals, and 75.41, 65.14, 59.59, 54.32,57.63, and 68.73, for the nurses of the non-educational hospitals, respectively. The results also showed the significant difference in teamwork climate between the two kinds of hospitals (sig=0.026). In addition, an interstitial difference was recognized in the management understanding of the two kinds of hospitals (sig=0.059). In recognition of stress, difference between the two types of hospitals was also completely significant (sig= 0.0001). Managing and trying to increase mutual understanding, and also paying attention and planning to improve effective factors of nurse's job satisfaction, especially for the female nurses in educational hospitals, can be very effective in their safety attitude and safety culture improvement in working climate.

Background and Different types of dysrhythmia occur with different degrees after heart attack. Involved patients need specific care and should be admitted in coronary care unit (CCU). Visit is one of the basic needs of patients and their families during admission period but visits are limited in CCU. This research evaluated the effect of planned visits on occurrence of heart dysrhythmias in patients on CCU. In a quasi-experimental study, 60 patients with acute myocardial infarction (in Hamedan, Iran) were selected through convenience sampling in 2011. They were randomly assigned to either case group or control group. The case group was asked to name family members and significant others who they were more comfortable with and were interested in their visits. Individuals in the list were provided with appropriate training on visiting etiquette. In control group visits were done without any special training. Data was collected through a questionnaire and cardiac monitoring. Dysrhythmias were recorded in a check list before, during and after visits. Data was then analyzed in SPSS V.18. No significant difference was found in occurrence of sinus tachycardia, premature atrial contractions and premature ventricular contractions before, during and after the visits (P>0.05). But significant differences were seen in the incidence of dysrhythmias in control group before, during and after the visits (P<0.05). Planned visits positively influenced the occurrence of dysthymias and reduced the incidence of some types of dysrhythmia such as tachycardia, premature atrial contractions and premature ventricular contraction.

Sleep is a basic need for recovery and survival of cardiac patients who are admitted to intensive care. Sleep disorder in them may cause physiological changes during sleep and negative effects on the health of patients. This study aimed to evaluate sleep disturbances in patients with acute coronary syndrome in cardiac care unit by using specific questionnaire.
In a descriptive study of 220 patients with acute coronary syndrome admitted to the cardiac care unit of Imam Ali Hospital in Kermanshah in 1391 were selected through random allocation sampling. Data collection tool in this study was a two-part questionnaire containing 25 questions that the its validity and reliability had been confirmed. Data by using SPSS v.20 software and descriptive were analyzed.
In total 81% of patients reported some degree of sleep disruption. In 50/9% of patient poor sleep disorders 39/5% moderate sleep disturbance and 0/5% of cases severe sleep disturbance was observed and no abnormalities were observed in 9% of cases. Of the six dimensions of questioner greatest problem were observed in the disturbance of onset and maintenance of sleep (16/4 ± 5/5.(
Discussion & Given to the high prevalence sleep disturbances in patients with CAD in the this study, Complete and comprehensive Evaluation of the patient and develop a care plan and nursing interventions is essential to improve the patient's sleep.

Myocardial infarction (MI) is the most common causes of mortality in the world. Due to multiple complications and limiting physical activity and disability, myocardial infarction can cause varying degrees of depression in patients. This study was performed to determine the effect of patients early mobilization program on the depression of patients with MI hospitalized in CCU. This study was a clinical trial that was performed on 38 patients with myocardial infarction in the cardiac care unit of Babol Shahid Beheshti hospital. Samples were selected using purposive sampling and are randomly allocated into experimental and control groups. The test group got out of bed based on a specific program within 12-18 hours after admission. The control group got out of bed based on routine care program within 48 hours after admission. Patient's depression was measured by Hospital Depression Scale (HADS) within 18-12 hours of admission (pre-intervention) and 72 hours after admission (post-intervention). The mean level of depression after the intervention (day three) was in the test group 3.2 and in the control group 8.2. Mann-Whitney test results showed that there was a significant difference (P<0.001) between the level of depression post intervention in two group. Results of the study showed that early mobilization was effective to reduce patients depression, therefore the use of this approach is suggested in the treatment and care program of patients with acute myocardial infarction

Patient education has a fundamental role in control and improvement of diseases. T his study aimed to investigate the impact of implementing the Six Sigma model on the quantity and effectiveness of patient education in the CCU of Vali-asr Hospital in Birjand. In this quasi-experimental study, 56 patients who were admitted in CCU during 1.5 months were taken as the control group and taught by the conventional method. Awareness and attitude were measured at the time of admission in, and discharge from, the ward, and the quantity of patient education was measured at the time of discharge. T hen, Six Sigma model was applied for nurses in group discussions and interviews, and nurses tried to educate patients based on the solutions obtained in the discussions. All patients (n=47) who were admitted in the hospital during the coming 1.5 months were taken as the case group and evaluated by the same methods and tools. Data were collected using a researcher-made questionnaire whose validity and reliability were confirmed. Data were analyzed in SPSS (version 18) using independent t-test and paired t-test. Results revealed that quantity of patient education increased significantly more in the case than the control group (P<0.001). The overall awareness score mean and its areas, and attitude score of patients in the case group increased significantly on the day of discharge vis-à-vis admission (P<0.001).However, no significant difference occurred in the control group. Results show a significant increase in the quantity and quality of education to patients after the implementation of the Six Sigma model. Thus, patient education can be promoted by recognizing the existing processes, their roots and defects, and by modifying the processes.

Understanding and meeting physiological and social needs of the family members of the patients hospitalized in ICU is very important for the nurses. This study has been done with the aim of “investigating and comparing psychosocial needs of the family members of the patients hospitalized in ICU and CCU”. This descriptive - analytical comparison study was done on 100 first-degree family members of the patients hospitalized in ICU or CCU of Khatam-ol- Anbiya hospital in Zahedan in 2011. Data were collected by the questionnaire of surveying psychosocial needs of the patients hospitalized in ICUs and they were analyzed by using SPSS 18 software، parametric t-tests and Fisher’s exact test. there was significant statistical difference between two groups in some items such as; need to meeting and changing in its times، nurses accepted the family members، talking to them about their feelings، understanding about ICU and participating in patient’s treatment (P<0. 05). considering the significance of these items into two groups، it seems that creating more opportunities for meeting and also giving more information to the family members about patients’ treatment process help to improve the psychosocial needs and reduce Psychological reactions caused by the patients’ family members in ICU

It is predicted that 23. 4 million people will be died of acute coronary syndrome up to 2030. Health education based on the awareness of risk factors of cardiovascular diseases and changing of patients'' attitude of patients are among important factors affecting the prognosis of these diseases. This study was conducted to determine the changes of awareness and attitudes of patients with acute coronary syndrome toward their disease during their hospitalization in CCU. In this descriptive study، 60 patients admitted to the CCU of Vali-Asr Hospital of Birjand were included using census method. Patients'' awareness and attitude were measured at the times of admission and discharge using a researcher-made questionnaire. Validity and reliability of the questionnaire was assessed using content validity and Cronbach''s alpha test respectively. The quantitative data was analyzed using descriptive statistics and t test was used for comparison of the means of the dates of admission and discharge. The findings of this study indicated that the rate of patients'' awareness at the discharge time was not significantly increased compared to the corresponding value of the admission time. The patients'' attitude toward the intensity of the perceived risk for recurrent morbidity was equals to or greater than the intermediate level. The average time of patients'' education during their hospitalization by nurses was 3. 83 ± 2. 87 minutes. According to the results of this study، more and extensive training courses for patients are warranted to improve the level of their awareness and attitude toward the disease of acute coronary syndrome.

hospitalization in CCU is always along with stress for the patients. As stress in healthy people can cause increase in heartbeat, cardiac output and blood pressure also in heart patients it can effect on physiologic factors and increase in death rate in these patients. According to the effect of emotional ties and increase of relationship with the relatives on decrease of these patients’ stress, this study had been done with the aim of determining the effect of planned meetings on physiologic indicators of the patients with ACS. This is a semi-experimental study that had been done on 72 ACS patients in CCU. Samples had been chosen with base on target method sampling and had been studied randomly in two intervention and control groups in two CCUs separately. Meeting plan in intervention group was as scheduled and included three times meeting in the second and third day of hospitalization with the presence of one to three relatives that the patient had requested and in control group it was in the form of one time meeting per day and with the presence of some open meetings. Patients’ Blood pressure, heartbeat, breathing and heart dysrhythmias were recorded every two hours in day and night and also before, after and during meeting. The results show significant decrease in physiologic indicators in the third day of hospitalization in compare with the first day in intervention group in contrast with control group, also the above variables in intervention group during meeting and after meeting were significantly less than control group. (P<0.05) Results of this study indicate that supportive effect of planed meeting on the patients is more than limited meeting and because of this it causes decrease of physiologic indicators and consequently it helps treatment quality improvement of the patients with ACS in CCU.

Introduction & Visiting is one of the basic needs of patients and their families while they are in coronary care units (CCUs). As the healthcare system moves toward a consumer-driven paradigm, talking about visiting hours has become a controversial and interesting topic. The aim of this research was to determine the effects of programmed visiting on physiological indexes in CCU patients. In this quasi-experimental study, 60 patients with acute myocardial infarction were selected through convenience sampling and randomly divided into two groups. Patients in the case group were asked to name those who are more comfortable with and love to be present at the visiting time. Visitors were trained for proper visiting. Data was collected by a questionnaire and Cardiac Monitoring. Physiological indexes (systolic and diastolic blood pressure, mean arterial pressure, heart rate, respiratory rate and oxygen saturation) were assessed 10 minutes before and during visiting, as well as 10 and 30 minutes after visiting. Data was analysed by SPSS software 18. In the case group, the mean scores of physiological indexes (systolic and diastolic blood pressure, mean arterial pressure, heart rate, respiratory rate and oxygen saturation) 10 minutes before visiting, during visiting and 10 and 30 minutes after visiting were not statistically significant (p>0.05). But the differences were statistically meaningful in the control group (p<0.05). According to this study, presence offamily members and friends in CCU wards based on programmed visiting does not make any significant difference in physiological indexes of the patients, so there is not any reason for restricting visiting patients in CCU.

Patients with ischemic heart disease in acute stage experienced great anxiety and in compared with patients had less anxiety were affected 5 times more to ischemia, re-infarction, tachycardia, arrhythmias and ventricular fibrillation.&nbsp; Excessive anxiety delays recovery and increases the probability of their death in the first month. Numerous studies have shown that heart disease affect the person&#039;s spirituality and suggested that interventions based spirituality may reduce anxiety. Thus, with regard to results of the research findings, vast library search, expert&#039;s opinion, one spirituality care program developed and considered its impact on anxiety of ischemic heart patients hospitalized in CCU.

Methods and Materials: 

This was a randomized clinical trial. Sixty-four ischemic patients in CCU randomly divided into test and control groups. Spiritual care program included supportive presence, support from patient&rsquo;s rituals, and using supportive systems for 3 days and Anxiety Questionnaire completed before and after the intervention for the both groups. Data analysis done through software SPSS and chi-square, independent-t and paired t-tests.

Mean score of Anxiety had no significant difference before intervention between two groups (P = 0.91); whereas paired t-test showed there was a significant difference in the test group before and after the intervention (P=0.001), also mean score of anxiety had a significant difference between test and control groups after the intervention (P=0.03).

With regard to results of present study spirituality care program could reduce anxiety of ischemic heart patients hospitalized in CCU, so nurses could apply spirituality care program to decrease the anxiety of patients.