نشریه پرستاری مراقبت ویژه
سال چهاردهم شماره 2 (پیاپی 50، تابستان 1400)

In recent years, the role of liaison nurse in Intensive Care Units (ICUs) has been considered to develop inter-professional collaboration along with continued advanced care during the transfer of critically ill patients from ICUs to general wards. In this regard, a systematic review study was conducted to investigate the effectiveness of the role of the nurse liaison of ICUs on improving the outcomes of patients.

This systematic review study was conducted in 2020 by searching international scientific databases that had full coverage of nursing texts including Scopus, Pub Med, CINAHL, Science Direct, Google Scholar as well as internal scientific databases including SID and Magiran. Searching was performed by the keywords "Nurse" "Intensive Care Unit" and "Patient Outcomes" between 2005 and November 2020. The articles were critically evaluated using the Jadad tool and out of a total of 335 initially retrieved articles, 13 selected articles entered the final review stage.

The findings of 13 final articles showed that liaison nurses in ICUs have a positive effect on patient outcomes including: increasing satisfaction, reducing relocation anxiety, reducing the duration of hospitalization and readmission, reducing the incidence of side effects, and accelerating the recovery of patients. This is while they had no effect on improving the level of consciousness, laboratory parameters and some hemodynamic indicators.

Although the evidence of the present review shows a positive effect of this role on the outcomes of patients, but in some studies, these effects have not been statistically significant. To confirm the effectiveness of the role of nurse liaison in ICUs, studies with different quantitative and qualitative research approaches and larger sample sizes and different research environments are needed.

Despite the negative opinions of intensive care unit staff about the presence of the family next to the patient, many studies have shown that family-centered care can be effective in meeting this need as well as the comfort and physiological parameters of patients. The purpose of this study was to determine the effect of family-centered care on physiological parameters of patients of brain injury patients admitted to intensive care unit in selected hospitals in Isfahan, in 2020.

This study was a quasi-experimental study. A total of 30 brain injury patients referred to selected hospitals in Isfahan in 2020 were included in the study by available sampling and were assigned to two groups of 15 intervention and control by random assignment of permutation. In the intervention group, the patientschr('39') first-degree families were present at the patientchr('39')s bedside for 3 days and twice a day at 10:00 AM and 3:00 PM and performed a family-centered care program. The control group received routine ward care. Physiological parameters were recorded and measured 15 minutes before, during and after care.

The findings showed that the mean of physiological parameters such as heart rate, systolic blood pressure, and arterial blood oxygen saturation in the intervention group was significant difference than the control group (P< 0.05). However, there was no significant difference in physiological parameters such as diastolic blood pressure of the intervention group (P >0.05).

The results of this study showed that family-centered care on the patientchr('39')s bedside causes significant changes physiological parameters that cause relaxation in the patient and balance in the patientchr('39')s physiological parameters. Therefore, it should be possible for the closest family member to be present at the patientchr('39')s bedside at the appropriate time with adequate training in family-centered care.

weaning of ventilator-dependent patients has always been associated with serious and risky challenges. There are some measurable categories that predict the consequences of weaning. Due to the multiplicity of these categories, the researchers decided to conduct a study to identify the most important category in the patientchr('39')s readiness for and consequences of weaning from the ventilator.

In this cross-sectional study, 96 ventilator-dependent patients were included randomly. Patient`s respiratory criteria and physiological parameters were measured in three time intervals. Patients were divided in two, successful and unsuccessful of weaning. By following each of the respiratory and physiological criteria and using regression test statistics and plotting the rock curve, we plotted the power of each of the above criteria in predicting the weaning consequences.

The odds ratio (OR) for failure in weaning increases with increasing RSBI at all three times. Also the results showed that the criteria of RSBI in the time of before the take out of the endotracheal tube with a sensitivity of 73% and a specificity of 88% and a surface below the curve of 0.82 in comparison with other criterions has the greatest effect on predicting failure in weaning.

Among the clinical criteria available to assess the probability of failure in the weaning, RSBI in compare to other criteria has a better sensitivity and specificity.

Mental workload of nurses increases their fatigue, and result in adverse consequences for patients. The aim of this study was to determine the relationship between nurseschr('39') mental workload and the quality of care services in the intensive care unit (ICU).

This descriptive-correlation study was conducted in 2019 in Zanjan. In this study, NASA-TLX tool with a score of zero to 100 was used to assess the mental workload of nurses and mental workload of 38 ICU nurses was assessed 138 times. Also, the quality of cares was observed in 300 patients using a researcher-made checklist.   

the mean mental workload of nurses was 81.53±0.987. The average score of care quality out of 100 scores was 70.28±11.06. Among the mean scores of care dimensions, the emergency measures was lower than other dimensions and poor performance level. But in other cases, patient care scores were above 50, indicating good or excellent quality of care. There was no statistically significant relationship between nurseschr('39') mental workload and their quality of care.

According to the results of this study, mental workload of ICU nurses was high. The quality of nursing care seems to be poorly related to the nurses’ mental workload. Therefore, it is recommended to investigate the reasons for the diminution the quality of care with qualitative studies.

Early referral after stroke and the use of modern intravenous therapies and blood pressure control accelerates the improvement of post-stroke symptoms. Therefore, this study was performed to investigate the relationship between the time interval between the onset of stroke symptoms and referral to the emergency department with demographic characteristics of patients with cerebrovascular accidents referred to the emergency department of Imam Khomeini Hospital in Urmia in the first half of 2018.

This descriptive-analytical study was performed on 296 patients referred to Imam Khomeini Hospital in Urmia in the first half of 2018 by census method. Data were collected using a demographic questionnaire.

In this study, the mean age of patients was 68.87±14.75 years, of which 153 (51.7%) were male and 143 (48.3%) were female. The mean time from the onset of symptoms to the emergency room was 36.21 ± 4.04 hours, the mean time required to reach the emergency room was 35.98± 2.48 minutes and the mean distance to the time of arrival to the emergency room was 41.11± 3.95 km, 291 patients (98.3%) had ischemic stroke and 5 patients (1.7%) had hemorrhagic stroke. Dimensions, level of education of the patient and his companions and the mode of transmission had a significant relationship with the delay in visiting the hospital emergency department.

The results of our study, like other studies, showed that the time to go to the hospital to treat patients after a stroke has a high average, and factors such as long distance from the treatment center, how patients are transferred, level of education that can indicate insufficient knowledge in clinical signs of stroke were involved in this affair.

Wound management of trauma patients is one of the most important and common measures in the emergency department. Following trauma, hemodynamic and metabolic changes occur in the body that are sometimes very complex and lead to many complications and deaths, even with great care. The aim of this study was to investigate the risk factors for managed wounds in trauma patients referred to the emergency department of Imam Khomeini Hospital in Urmia.

This descriptive-analytical study was performed on all trauma patients referred to the emergency department of Imam Khomeini Hospital in Urmia from October 1, 2017 to March 20, 2017 by census. Data were collected using a checklist that includes demographic characteristics, underlying diseases, wound characteristics and wound management of patients in terms of complications and recovery in the sixth month according to the Vancouver Oscar criteria.

Of 350 patients studied, 86 (24.6%) were female and 264 (75.4%) were male and the mean age of patients was 37.3±11.1 years. The most common complications were infection (9%) and inflammation around the wound (5%). Smoking (P<0.05), diabetes (P = 0.03) and wound infection (P = 0.03) were associated with infection, Antibiotic prophylaxis (P=0.02) and keeping the wound clean were also associated with a reduced incidence of infection (P=0.01). The mean degree of wound was 6.4 ± 2.3 at the beginning of admission for patients and 3.1±1.6 after 6 months; Statistical evaluation showed that there was a significant decrease in the degree of wounds after 6 months (P=0.001).

Diabetes and smoking are common risk factors for infection and reduced wound healing.