ABSTRACT
Background: The unplanned departure of endotracheal tube is one of the main complications for endotracheal intubation. In addition to endotracheal extubation, its movement can also lead to damage to the oral cavity. Stabilizing endotracheal tube is the most important factor that can prevent unplanned departure of endotracheal tube as well as its movement. The current study was done with the aim of determining and comparing the effect of stabilizing endotracheal tube by a holder with routine method on quality of airway care in patients hospitalized in ICU
Methods: This study was a quasi-experimental trial with a control group which was done on 100 patients having endotracheal tube attached to mechanical ventilation by a holder. The samples were selected randomly from patients hospitalized in ICU in Hazrat Rasoul Akram hospital. The samples were then divided into control group and test group. The endotracheal tube was stabilized by a holder in test group and by a routine method [gauze] in control group. The quality of managing airway was studied through 3 frequency indices: endotracheal tube extubation, frequency of linear movement of endotracheal tube, damage to oral mucosa. For the first two indices a self-designed tool was used and a modified version of Oral Assessment guide was used for the oral trauma assessment. The data were analyzed using descriptive statistics, chi-square test and independent t-test by SPSS version 17
Results: The findings showed no significant statistical difference in frequency index of endotracheal extubation. Linear movement of endotracheal tube was lower in test group compared to control group. There was no significant difference regarding oral trauma in both groups. A difference was observed in both groups in comparing scores before and after using two methods in "lips" and "Gingiva"
Conclusion: According to the results of this study, it was indicated that using ETT holder for stabilizing endotracheal tube compared to routine method only has preference in movement of endotracheal tube on quality of airway management. While applying methods of stabilizing endotracheal tube, it should be noted that not only type of stabilizing, but also other nursing cares from patients in ICU can affect quality of airway management. Therefore, it is recommended to do further studies on other factors influencing airway management
ABSTRACT
Hospitals and healthcare centers, like any other organizations, have some common norms and beliefs called as organizational culture. Organizational culture plays a key role in organization's and staffs' performances. Nurses' perspectives on the organizational culture affect the way they play their role in. This study aimed to investigate the role of organizational culture from perspectives of nurses working in selected hospitals at Tehran University of Medical Sciences. In this cross-sectional study, 230 nurses working in different wards of selected hospitals of Tehran University of Medical Sciences were recruited to the study. Data were collected using a demographic characteristics checklist as well as the nurse and organizational culture questionnaire extracted from the Robbins criteria. Data were analyzed using descriptive statistical indexes, independent t-test, Pearson correlation coefficient and regression in the SPSS v.17. Results showed that the existing organizational culture in the selected hospitals was in a moderately good level from nurses' perspectives. From the scores obtained for various dimensions of the organizational culture, the highest and lowest scores were for control [44.2%] and conflict tolerance [31.8%], respectively. The level of the organizational culture from the nurses' perspectives might lead them to decrease the quality of their performance. Optimizing the organizational culture can improve nurses' performance and motivate them to increase their quality of work
Subject(s)
Humans , Nurses , Organizational Culture , Cross-Sectional StudiesABSTRACT
Education is of the basic rights of the patients, and also, a main recognized role of the nurses. Education is an accrediting criterion of the organizations which provide health services. However, the results of the studies indicate that no effective patient education in different societies has been delivered, and this has had negative individual, family, and social consequences. Due to its interactional and cultural nature, patient education sounds to be vital and necessary to be investigated in specific societies and cultures. This study aims at identifying obstac les which leads to the lack of effective patient education. The qualitative research approach [grounded theory] was used in this study and open-ended interviews and field observations were used to gather the data. Eighteen nurses, 4 cardiovascular specialists, 9 patients with cardiovascular disease and 4 family members were interviewed at two educational hospitals in Tehran. Interviews were taped, transcribed and analyzed using constant comparative analysis. More than 800 first level code, 26 categories, and three main variables were extracted as barriers to the effective patient education which are listed as follow: ineffective management, inappropriate organizational culture, and cultural obstructs. Each of these categories includes specific sub categories with specific features, functions, and conditions. Organizational culture played an important and central role in patient education. Although intervening main factors such as those extracted in this study, namely management, organizational culture, and cultural factors are also considered as patient education barriers in different societies, their nature and functions of each of three factors are totally different in societies. Therefore, precise identification and definition of their situation in planning and improving patient education seems to be very necessary