ABSTRACT
PURPOSE: The aim of this study was to explain the experiences of Iranian nursing students regarding their clinical learning environment (CLE). METHODS: Twenty-one nursing students participated in this qualitative study. Data were collected using semistructured interviews and analyzed using conventional content analysis. RESULTS: Analysis of interviews identified six categories: educational confusion, absence of evaluation procedures, limited educational opportunities, inappropriate interactions with nursing staff, bullying culture, and discrimination. Systematic and consistent methods were not used in clinical education and evaluation of nursing students. In addition, there were inadequate interactions between nursing students and health-care staff, and most students experienced discrimination and bullying in clinical settings. CONCLUSION: Findings showed that the CLE of Iranian nursing students may be inadequate for high-level learning and safe and effective teaching. Addressing these challenges will require academic and practice partnerships to examine the systems affecting the CLE, and areas to be addressed are described in the six themes identified.
Subject(s)
Humans , Bullying , Discrimination, Psychological , Education , Education, Nursing , Iran , Learning , Nursing Staff , Nursing , Qualitative Research , Students, NursingABSTRACT
Nurses and other members of health care team provide mental patients with health services through interprofessional collaboration which is a main strategy to improve health services. Nevertheless, many difficulties are evidently influencing interprofessional collaboration in Iranian context. This paper presented the results of a study aimed to explore the context. A qualitative study was conducted using in-depth interviews to collect data from 20 health professionals and 4 clients or their family members who were selected purposefully from the health centers affiliated with Isfahan University of Medical Sciences. Themes were identified using latent qualitative content analysis. Trustworthiness of the study was supported considering auditability, neutrality, consistency and transferability. The study lasted from 2010 to 2011. Some important challenges were identified as protecting professional territory, medical oriented approach and teamwork deficits. They were all under a main theme emphasizing professionals' divergent views. It could shed insight into underlying causes of collaboration gaps among nurses and other health professionals. The three introduced themes implied difficulties mainly related to "divergences" among health professionals. Moreover, the difficulties revealed the need for training chiefly to improve their convergent shared views and approaches. Therefore, it is worthwhile to suggest interprofessional education for nurses and other professionals with special attention to improving interpersonal skills as well as mental health need-based services.
ABSTRACT
Weaning decision for the patients on a mechanical ventilation [MV] device is often made based on personal judgments and experiences, which results in longer MV length of stay and higher costs. Therefore, the present study aimed to the effect of application of Burn's wean assessment program on MV length of stay among the patients hospitalized in intensive care units [ICUs]. This is a clinical trial in which 50 patients connected to mechanical ventilators for more than 48 h were selected through convenient sampling and were randomly divided into two groups of 25 subjects. Burn's wean assessment program was employed in study group, while weaning was assessed by a physician in control group. The findings were analyzed by descriptive [frequency distribution, mean and SD] and inferential [independent t test, Chi square, Fisher's exact test, and Mann Whitney] statistical tests. The findings showed that length of MV was 134.2 [20.5] h which was significantly less than the control [P = 0.03]. The results showed that application of Burn's wean assessment by the nurses to assess patients' readiness for weaning from the ventilator is a safe method in day time and shortens the length of MV in ICUs compared to the routine methods.
ABSTRACT
Fractures of femur are among the most important causes of mortality in musculoskeletal injuries. Owning to lack of adequate research to compare various techniques of fracture stabilization, there has not yet been an agreement over a protocol to utilize a specific type of splint for femoral fracture immobilization. This study was thus conducted to compare the effects of simple and traction splints on pain intensityimmediately after and at the 1[st], 6[th], and 12[th]h after splinting among patients with femur fracture in the centers affiliated to Isfahan University of Medical Sciences [Isfahan, Iran]. This quasi experimental study was performed on 32 patients with femur fractures. Prehospital emergency ambulances were divided into two groups of simple and traction splints using a table of random numbers. Continuous convenient sampling was employed in each group to use either a simple or a traction splint for the patients with femur fractures. Pain intensity of the patients was then measured by a visual analogue scale [VAS] immediately, 1 h, 6 h, and 12 h after splinting. The effects of the two techniques were finally compared. After splinting, pain intensity decreased significantly in both groups [P = 0.0001 in both groups]. The reductions were significantly more in the traction splint group at the 1[st], 6[th] [P = 0.0001], and 12[th]h after splinting [P = 0.02] compared with the simple splint group. There was no significant difference in pain intensity immediately after splintingbetween the two groups [P = 0.441]. The significant difference in pain reduction between the simple and traction splint groups at the 1[st], 6[th], and 12[th]h after splinting emphasizes the superiority of traction splints.