ABSTRACT
Introduction: There is controversy regarding the effects of insulin and metformin usage in postoperative hyperglycemia after coronary artery bypass graft surgery. The purpose of this study is to compare the effect of insulin and metformin on blood acidity, bicarbonate, potassium and magnesium in nondiabetic patients undergoing coronary artery bypass graft surgery
Materials and Methods: In a clinical trial, 56 nondiabetic patients who underwent coronary artery bypass graft surgery in the Kowsar Hospital in Semnan and suffered post-operative hyperglycemia, randomly received insulin and metformin. Levels of blood glucose, acidity, bicarbonate, potassium and magnesium were measured and recorded for both groups before and after surgery. Data was analyzed [significant level 0.05] using Chi-square, Mann-Whitney and Friedman tests
Results: At the time of admission of patients in the ICU, means of arterial blood acidity, bicarbonate, potassium and magnesium were 7.37+/-0.07, 21.8+/-2.5 mEq/l, 4.3+/-0.5 mmol/l, and +/- 2.1+/-0.3 mg/dl respectively in the insulin group and in the metformin group these values were 7.40+/-0.05, 22.2+/-2.8 mEq/l, 4.1+/-0.5 mmol/l, and 2.1+/-0.4 mg/dl respectively. There was no significant difference between the means of potassium, magnesium and bicarbonate in the two groups at different times [P>0.05]. However, there was a significant difference between the mean values of arterial blood acidity 72 hours after admission in ICU in the two groups of insulin [7.41+/-0.03] and metformin [7.39+/-0.04] [P=0.047]. However mean PH of the blood remained normal
Conclusion: In nondiabetic patients who have hyperglycemia following coronary artery bypass graft surgery, the use of metformin and insulin does not affect bicarbonate, potassium and magnesium of blood. However, overtime the use of metformin may gradually increases the pH of the blood. Therefore, it is recommended that metformin should be used in patients with blood pH control
ABSTRACT
Introduction: Retraining programs for nurses are usually run as workshops and group discussions causing challenges as limitations on the number of participants, long lasting duration and high costs. Since most of these programs are taught by instructors working outside of clinical setting, it is necessary to use a method to train large groups of nurses in a short time. The purpose of this study was to determine the effects of lecture-based training delivered by the peer nurse on the EKG interpretation knowledge of critical care nurses
Methods: In this experimental study, two out of seven intensive care units of Semnan University of Medical Sciences were randomly selected as the experimental and control groups with 11 nurses each. Data collection on nurses' knowledge about electrocardiogram [ECG] interpretation in the experimental and control groups was done through a questionnaire containing 25 questions. Then, one of the nurses in the experimental group who obtained an acceptable score was selected and was considered as a lecturer in the same group after receiving additional training on interpreting ECG. She taught ECG interpretation principles to nurses in one session. After one week, nurses' knowledge on ECG interpretation in two groups was measured. Data were analyzed using descriptive and inferential statistics
Results: Significant difference was observed in the total scores and areas of ECG interpretation between pre and post test in the experimental group [P< 0.01]. A significant difference was also found in the mean of changes of mean scores in total scores and areas of ECG interpretation in the same group [P< 0.01]
Conclusion: Lecture-based training delivered by a colleague can be considered as a cost effective and efficient method for ECG interpretation education; therefore, it is suggested that health care managers concentrate on empowering their personnel and invite them to teach in retraining programs